|
HC ICD REMV REPL EX SINGLE LEAD
|
Facility
|
IP
|
$94,891.00
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
906820215
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$18,978.20 |
| Max. Negotiated Rate |
$85,401.90 |
| Rate for Payer: Adventist Health Commercial |
$18,978.20
|
| Rate for Payer: Cash Price |
$52,190.05
|
| Rate for Payer: Central Health Plan Commercial |
$75,912.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,956.40
|
| Rate for Payer: EPIC Health Plan Senior |
$37,956.40
|
| Rate for Payer: Galaxy Health WC |
$80,657.35
|
| Rate for Payer: Global Benefits Group Commercial |
$56,934.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$85,401.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63,292.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36,153.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58,737.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,978.20
|
| Rate for Payer: Multiplan Commercial |
$71,168.25
|
| Rate for Payer: Networks By Design Commercial |
$61,679.15
|
| Rate for Payer: Prime Health Services Commercial |
$80,657.35
|
|
|
HC ICD REMV REPL EX SINGLE LEAD
|
Facility
|
IP
|
$80,657.00
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
906811422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$16,131.40 |
| Max. Negotiated Rate |
$72,591.30 |
| Rate for Payer: Adventist Health Commercial |
$16,131.40
|
| Rate for Payer: Cash Price |
$44,361.35
|
| Rate for Payer: Central Health Plan Commercial |
$64,525.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,262.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32,262.80
|
| Rate for Payer: Galaxy Health WC |
$68,558.45
|
| Rate for Payer: Global Benefits Group Commercial |
$48,394.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$72,591.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53,798.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30,730.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49,926.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,131.40
|
| Rate for Payer: Multiplan Commercial |
$60,492.75
|
| Rate for Payer: Networks By Design Commercial |
$52,427.05
|
| Rate for Payer: Prime Health Services Commercial |
$68,558.45
|
|
|
HC ICD REMV REPL EX SINGLE LEAD
|
Facility
|
OP
|
$94,891.00
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
906820215
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$518.68 |
| Max. Negotiated Rate |
$109,559.00 |
| Rate for Payer: Adventist Health Commercial |
$18,978.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$28,520.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28,520.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,438.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$45,441.74
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$52,190.05
|
| Rate for Payer: Cash Price |
$52,190.05
|
| Rate for Payer: Cash Price |
$52,190.05
|
| Rate for Payer: Central Health Plan Commercial |
$75,912.80
|
| Rate for Payer: Cigna of CA HMO |
$60,730.24
|
| Rate for Payer: Cigna of CA PPO |
$70,219.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$31,372.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28,520.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,502.18
|
| Rate for Payer: EPIC Health Plan Senior |
$28,520.13
|
| Rate for Payer: Galaxy Health WC |
$80,657.35
|
| Rate for Payer: Global Benefits Group Commercial |
$56,934.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$85,401.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$46,773.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$518.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,520.13
|
| Rate for Payer: InnovAge PACE Commercial |
$42,780.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63,292.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$572.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,520.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,978.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,216.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,216.97
|
| Rate for Payer: Multiplan Commercial |
$71,168.25
|
| Rate for Payer: Multiplan WC |
$45,441.74
|
| Rate for Payer: Networks By Design Commercial |
$61,679.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$28,520.13
|
| Rate for Payer: Preferred Health Network WC |
$46,369.12
|
| Rate for Payer: Prime Health Services Commercial |
$80,657.35
|
| Rate for Payer: Prime Health Services Medicare |
$30,231.34
|
| Rate for Payer: Prime Health Services WC |
$44,978.05
|
| Rate for Payer: Riverside University Health System MISP |
$31,372.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$56,934.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$109,559.00
|
| Rate for Payer: United Healthcare All Other HMO |
$97,437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$84,191.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$77,134.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$28,520.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Vantage Medical Group Senior |
$28,520.13
|
|
|
HC ICE INTRACARDIAC ECHO
|
Facility
|
OP
|
$10,757.00
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
906812082
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$465.36 |
| Max. Negotiated Rate |
$9,681.30 |
| Rate for Payer: Adventist Health Commercial |
$2,151.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,532.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9,143.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,916.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,067.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$483.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,317.59
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$5,916.35
|
| Rate for Payer: Cash Price |
$5,916.35
|
| Rate for Payer: Cash Price |
$5,916.35
|
| Rate for Payer: Central Health Plan Commercial |
$8,605.60
|
| Rate for Payer: Cigna of CA HMO |
$6,884.48
|
| Rate for Payer: Cigna of CA PPO |
$7,960.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,143.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,143.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,143.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,302.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,302.80
|
| Rate for Payer: Galaxy Health WC |
$9,143.45
|
| Rate for Payer: Global Benefits Group Commercial |
$6,454.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,681.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$465.36
|
| Rate for Payer: InnovAge PACE Commercial |
$5,378.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,174.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$514.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,658.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,151.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7,529.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7,529.90
|
| Rate for Payer: Multiplan Commercial |
$8,067.75
|
| Rate for Payer: Networks By Design Commercial |
$6,992.05
|
| Rate for Payer: Prime Health Services Commercial |
$9,143.45
|
| Rate for Payer: Riverside University Health System MISP |
$4,302.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,454.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,454.20
|
| 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 |
$9,143.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,143.45
|
| Rate for Payer: Vantage Medical Group Senior |
$9,143.45
|
|
|
HC ICE INTRACARDIAC ECHO
|
Facility
|
OP
|
$9,354.00
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
906820078
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$465.36 |
| Max. Negotiated Rate |
$8,418.60 |
| Rate for Payer: Adventist Health Commercial |
$1,870.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5,680.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,950.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,144.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,015.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$483.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,493.60
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$5,144.70
|
| Rate for Payer: Cash Price |
$5,144.70
|
| Rate for Payer: Cash Price |
$5,144.70
|
| Rate for Payer: Central Health Plan Commercial |
$7,483.20
|
| Rate for Payer: Cigna of CA HMO |
$5,986.56
|
| Rate for Payer: Cigna of CA PPO |
$6,921.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,950.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,950.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,950.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,741.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,741.60
|
| Rate for Payer: Galaxy Health WC |
$7,950.90
|
| Rate for Payer: Global Benefits Group Commercial |
$5,612.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,418.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$465.36
|
| Rate for Payer: InnovAge PACE Commercial |
$4,677.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,239.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$514.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,790.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,870.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,547.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,547.80
|
| Rate for Payer: Multiplan Commercial |
$7,015.50
|
| Rate for Payer: Networks By Design Commercial |
$6,080.10
|
| Rate for Payer: Prime Health Services Commercial |
$7,950.90
|
| Rate for Payer: Riverside University Health System MISP |
$3,741.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,612.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,612.40
|
| 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 |
$7,950.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,950.90
|
| Rate for Payer: Vantage Medical Group Senior |
$7,950.90
|
|
|
HC ICE INTRACARDIAC ECHO
|
Facility
|
IP
|
$10,757.00
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
906812082
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,151.40 |
| Max. Negotiated Rate |
$9,681.30 |
| Rate for Payer: Adventist Health Commercial |
$2,151.40
|
| Rate for Payer: Cash Price |
$5,916.35
|
| Rate for Payer: Central Health Plan Commercial |
$8,605.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,302.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,302.80
|
| Rate for Payer: Galaxy Health WC |
$9,143.45
|
| Rate for Payer: Global Benefits Group Commercial |
$6,454.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,681.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,174.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,098.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,658.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,151.40
|
| Rate for Payer: Multiplan Commercial |
$8,067.75
|
| Rate for Payer: Networks By Design Commercial |
$6,992.05
|
| Rate for Payer: Prime Health Services Commercial |
$9,143.45
|
|
|
HC ICE INTRACARDIAC ECHO
|
Facility
|
IP
|
$9,354.00
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
906820078
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,870.80 |
| Max. Negotiated Rate |
$8,418.60 |
| Rate for Payer: Adventist Health Commercial |
$1,870.80
|
| Rate for Payer: Cash Price |
$5,144.70
|
| Rate for Payer: Central Health Plan Commercial |
$7,483.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,741.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,741.60
|
| Rate for Payer: Galaxy Health WC |
$7,950.90
|
| Rate for Payer: Global Benefits Group Commercial |
$5,612.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,418.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,239.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,563.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,790.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,870.80
|
| Rate for Payer: Multiplan Commercial |
$7,015.50
|
| Rate for Payer: Networks By Design Commercial |
$6,080.10
|
| Rate for Payer: Prime Health Services Commercial |
$7,950.90
|
|
|
HC I & D ABSCESS COMPL OR MULT
|
Facility
|
OP
|
$2,656.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
900501001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$143.94 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$531.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$507.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$808.84
|
| Rate for Payer: Cash Price |
$1,460.80
|
| Rate for Payer: Cash Price |
$1,460.80
|
| Rate for Payer: Cash Price |
$1,460.80
|
| Rate for Payer: Cash Price |
$1,460.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,124.80
|
| Rate for Payer: Cigna of CA HMO |
$1,699.84
|
| Rate for Payer: Cigna of CA PPO |
$1,965.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$761.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$558.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$507.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$685.31
|
| Rate for Payer: EPIC Health Plan Senior |
$507.64
|
| Rate for Payer: Galaxy Health WC |
$2,257.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,593.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,390.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$832.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$507.64
|
| Rate for Payer: InnovAge PACE Commercial |
$761.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,771.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$507.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$531.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$680.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$680.24
|
| Rate for Payer: Multiplan Commercial |
$1,992.00
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$1,726.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$507.64
|
| Rate for Payer: Preferred Health Network WC |
$825.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,257.60
|
| Rate for Payer: Prime Health Services Medicare |
$538.10
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Riverside University Health System MISP |
$558.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,593.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,328.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,328.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,328.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,328.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$507.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Vantage Medical Group Senior |
$507.64
|
|
|
HC I & D ABSCESS COMPL OR MULT
|
Facility
|
IP
|
$2,656.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
900501001
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$531.20 |
| Max. Negotiated Rate |
$2,390.40 |
| Rate for Payer: Adventist Health Commercial |
$531.20
|
| Rate for Payer: Cash Price |
$1,460.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,124.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,062.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,062.40
|
| Rate for Payer: Galaxy Health WC |
$2,257.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,593.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,390.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,771.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,011.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,644.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$531.20
|
| Rate for Payer: Multiplan Commercial |
$1,992.00
|
| Rate for Payer: Networks By Design Commercial |
$1,726.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,257.60
|
|
|
HC I & D ABSCESS COMPL OR MULT
|
Facility
|
OP
|
$2,656.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
900501001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$130.31 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$531.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$507.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$507.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$808.84
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,460.80
|
| Rate for Payer: Cash Price |
$1,460.80
|
| Rate for Payer: Cash Price |
$1,460.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,124.80
|
| Rate for Payer: Cigna of CA HMO |
$1,699.84
|
| Rate for Payer: Cigna of CA PPO |
$1,965.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$761.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$558.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$507.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$685.31
|
| Rate for Payer: EPIC Health Plan Senior |
$507.64
|
| Rate for Payer: Galaxy Health WC |
$2,257.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,593.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,390.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$832.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$130.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$507.64
|
| Rate for Payer: InnovAge PACE Commercial |
$761.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,771.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$507.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$531.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$680.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$680.24
|
| Rate for Payer: Multiplan Commercial |
$1,992.00
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$1,726.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$507.64
|
| Rate for Payer: Preferred Health Network WC |
$825.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,257.60
|
| Rate for Payer: Prime Health Services Medicare |
$538.10
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Riverside University Health System MISP |
$558.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,593.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$507.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Vantage Medical Group Senior |
$507.64
|
|
|
HC I & D ABSCESS COMPL OR MULT
|
Facility
|
OP
|
$2,656.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
900501001
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$143.94 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$1,088.96
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$507.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$808.84
|
| Rate for Payer: Cash Price |
$1,460.80
|
| Rate for Payer: Cash Price |
$1,460.80
|
| Rate for Payer: Cash Price |
$1,460.80
|
| Rate for Payer: Cash Price |
$1,460.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,124.80
|
| Rate for Payer: Cigna of CA HMO |
$1,699.84
|
| Rate for Payer: Cigna of CA PPO |
$1,965.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$761.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$558.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$507.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$685.31
|
| Rate for Payer: EPIC Health Plan Senior |
$507.64
|
| Rate for Payer: Galaxy Health WC |
$2,257.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,593.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,390.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$832.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$507.64
|
| Rate for Payer: InnovAge PACE Commercial |
$761.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,771.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$507.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$531.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$680.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$680.24
|
| Rate for Payer: Multiplan Commercial |
$1,992.00
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$1,726.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$507.64
|
| Rate for Payer: Preferred Health Network WC |
$825.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,257.60
|
| Rate for Payer: Prime Health Services Medicare |
$538.10
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Riverside University Health System MISP |
$558.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,593.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,593.60
|
| 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 |
$507.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Vantage Medical Group Senior |
$507.64
|
|
|
HC I & D ABSCESS COMPL OR MULT
|
Facility
|
IP
|
$2,656.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
900501001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$531.20 |
| Max. Negotiated Rate |
$2,390.40 |
| Rate for Payer: Adventist Health Commercial |
$531.20
|
| Rate for Payer: Cash Price |
$1,460.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,124.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,062.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,062.40
|
| Rate for Payer: Galaxy Health WC |
$2,257.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,593.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,390.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,771.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,011.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,644.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$531.20
|
| Rate for Payer: Multiplan Commercial |
$1,992.00
|
| Rate for Payer: Networks By Design Commercial |
$1,726.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,257.60
|
|
|
HC I & D ABSCESS COMPL OR MULT
|
Facility
|
IP
|
$2,656.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
900501001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$531.20 |
| Max. Negotiated Rate |
$2,390.40 |
| Rate for Payer: Adventist Health Commercial |
$531.20
|
| Rate for Payer: Cash Price |
$1,460.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,124.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,062.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,062.40
|
| Rate for Payer: Galaxy Health WC |
$2,257.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,593.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,390.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,771.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,011.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,644.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$531.20
|
| Rate for Payer: Multiplan Commercial |
$1,992.00
|
| Rate for Payer: Networks By Design Commercial |
$1,726.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,257.60
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
IP
|
$2,339.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$467.80 |
| Max. Negotiated Rate |
$2,105.10 |
| Rate for Payer: Adventist Health Commercial |
$467.80
|
| Rate for Payer: Cash Price |
$1,286.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,871.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$935.60
|
| Rate for Payer: EPIC Health Plan Senior |
$935.60
|
| Rate for Payer: Galaxy Health WC |
$1,988.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,403.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,105.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,560.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$891.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,447.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$467.80
|
| Rate for Payer: Multiplan Commercial |
$1,754.25
|
| Rate for Payer: Networks By Design Commercial |
$1,520.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,988.15
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
OP
|
$2,339.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$207.19 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$958.99
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$252.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,373.69
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$402.27
|
| Rate for Payer: Cash Price |
$1,286.45
|
| Rate for Payer: Cash Price |
$1,286.45
|
| Rate for Payer: Cash Price |
$1,286.45
|
| Rate for Payer: Cash Price |
$1,286.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,871.20
|
| Rate for Payer: Cigna of CA HMO |
$1,496.96
|
| Rate for Payer: Cigna of CA PPO |
$1,730.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$378.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$252.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.83
|
| Rate for Payer: EPIC Health Plan Senior |
$252.47
|
| Rate for Payer: Galaxy Health WC |
$1,988.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,403.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,105.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$414.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$252.47
|
| Rate for Payer: InnovAge PACE Commercial |
$378.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,560.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$207.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$252.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$467.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$338.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$338.31
|
| Rate for Payer: Multiplan Commercial |
$1,754.25
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: Networks By Design Commercial |
$1,520.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$252.47
|
| Rate for Payer: Preferred Health Network WC |
$410.48
|
| Rate for Payer: Prime Health Services Commercial |
$1,988.15
|
| Rate for Payer: Prime Health Services Medicare |
$267.62
|
| Rate for Payer: Prime Health Services WC |
$398.17
|
| Rate for Payer: Riverside University Health System MISP |
$277.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,403.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,403.40
|
| 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 |
$252.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Vantage Medical Group Senior |
$252.47
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
IP
|
$2,339.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$467.80 |
| Max. Negotiated Rate |
$2,105.10 |
| Rate for Payer: Adventist Health Commercial |
$467.80
|
| Rate for Payer: Cash Price |
$1,286.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,871.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$935.60
|
| Rate for Payer: EPIC Health Plan Senior |
$935.60
|
| Rate for Payer: Galaxy Health WC |
$1,988.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,403.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,105.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,560.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$891.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,447.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$467.80
|
| Rate for Payer: Multiplan Commercial |
$1,754.25
|
| Rate for Payer: Networks By Design Commercial |
$1,520.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,988.15
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
OP
|
$2,339.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$187.57 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$467.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$252.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$252.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,132.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,373.69
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$402.27
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$1,286.45
|
| Rate for Payer: Cash Price |
$1,286.45
|
| Rate for Payer: Cash Price |
$1,286.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,871.20
|
| Rate for Payer: Cigna of CA HMO |
$1,496.96
|
| Rate for Payer: Cigna of CA PPO |
$1,730.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$378.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$252.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.83
|
| Rate for Payer: EPIC Health Plan Senior |
$252.47
|
| Rate for Payer: Galaxy Health WC |
$1,988.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,403.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,105.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$414.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$187.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$252.47
|
| Rate for Payer: InnovAge PACE Commercial |
$378.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,560.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$207.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$252.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$467.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$338.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$338.31
|
| Rate for Payer: Multiplan Commercial |
$1,754.25
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: Networks By Design Commercial |
$1,520.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$252.47
|
| Rate for Payer: Preferred Health Network WC |
$410.48
|
| Rate for Payer: Prime Health Services Commercial |
$1,988.15
|
| Rate for Payer: Prime Health Services Medicare |
$267.62
|
| Rate for Payer: Prime Health Services WC |
$398.17
|
| Rate for Payer: Riverside University Health System MISP |
$277.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,403.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$252.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Vantage Medical Group Senior |
$252.47
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
OP
|
$2,339.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$187.57 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$467.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$252.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$252.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,132.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,373.69
|
| Rate for Payer: Blue Shield of California Commercial |
$1,429.13
|
| Rate for Payer: Blue Shield of California EPN |
$933.26
|
| Rate for Payer: Cash Price |
$1,286.45
|
| Rate for Payer: Cash Price |
$1,286.45
|
| Rate for Payer: Cash Price |
$1,286.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,871.20
|
| Rate for Payer: Cigna of CA HMO |
$1,496.96
|
| Rate for Payer: Cigna of CA PPO |
$1,730.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$378.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$252.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.83
|
| Rate for Payer: EPIC Health Plan Senior |
$252.47
|
| Rate for Payer: Galaxy Health WC |
$1,988.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,403.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,105.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$414.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$187.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$252.47
|
| Rate for Payer: InnovAge PACE Commercial |
$378.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,560.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$207.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$252.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$467.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$338.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$338.31
|
| Rate for Payer: Multiplan Commercial |
$1,754.25
|
| Rate for Payer: Networks By Design Commercial |
$1,520.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$252.47
|
| Rate for Payer: Prime Health Services Commercial |
$1,988.15
|
| Rate for Payer: Prime Health Services Medicare |
$267.62
|
| Rate for Payer: Riverside University Health System MISP |
$277.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,403.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,403.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,091.00
|
| Rate for Payer: United Healthcare All Other HMO |
$839.00
|
| Rate for Payer: United Healthcare HMO Rider |
$635.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$581.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$252.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Vantage Medical Group Senior |
$252.47
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
IP
|
$2,339.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$467.80 |
| Max. Negotiated Rate |
$2,105.10 |
| Rate for Payer: Adventist Health Commercial |
$467.80
|
| Rate for Payer: Cash Price |
$1,286.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,871.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$935.60
|
| Rate for Payer: EPIC Health Plan Senior |
$935.60
|
| Rate for Payer: Galaxy Health WC |
$1,988.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,403.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,105.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,560.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$891.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,447.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$467.80
|
| Rate for Payer: Multiplan Commercial |
$1,754.25
|
| Rate for Payer: Networks By Design Commercial |
$1,520.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,988.15
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
IP
|
$2,339.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$467.80 |
| Max. Negotiated Rate |
$2,105.10 |
| Rate for Payer: Adventist Health Commercial |
$467.80
|
| Rate for Payer: Cash Price |
$1,286.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,871.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$935.60
|
| Rate for Payer: EPIC Health Plan Senior |
$935.60
|
| Rate for Payer: Galaxy Health WC |
$1,988.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,403.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,105.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,560.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$891.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,447.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$467.80
|
| Rate for Payer: Multiplan Commercial |
$1,754.25
|
| Rate for Payer: Networks By Design Commercial |
$1,520.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,988.15
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
OP
|
$2,339.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$207.19 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$467.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$252.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$402.27
|
| Rate for Payer: Cash Price |
$1,286.45
|
| Rate for Payer: Cash Price |
$1,286.45
|
| Rate for Payer: Cash Price |
$1,286.45
|
| Rate for Payer: Cash Price |
$1,286.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,871.20
|
| Rate for Payer: Cigna of CA HMO |
$1,496.96
|
| Rate for Payer: Cigna of CA PPO |
$1,730.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$378.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$252.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.83
|
| Rate for Payer: EPIC Health Plan Senior |
$252.47
|
| Rate for Payer: Galaxy Health WC |
$1,988.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,403.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,105.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$414.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$252.47
|
| Rate for Payer: InnovAge PACE Commercial |
$378.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,560.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$207.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$252.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$467.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$338.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$338.31
|
| Rate for Payer: Multiplan Commercial |
$1,754.25
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: Networks By Design Commercial |
$1,520.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$252.47
|
| Rate for Payer: Preferred Health Network WC |
$410.48
|
| Rate for Payer: Prime Health Services Commercial |
$1,988.15
|
| Rate for Payer: Prime Health Services Medicare |
$267.62
|
| Rate for Payer: Prime Health Services WC |
$398.17
|
| Rate for Payer: Riverside University Health System MISP |
$277.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,403.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,169.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,169.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,169.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,169.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$252.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Vantage Medical Group Senior |
$252.47
|
|
|
HC I & D ABSCESS,THROAT INTRAORAL
|
Facility
|
IP
|
$11,085.00
|
|
|
Service Code
|
CPT 42720
|
| Hospital Charge Code |
900501607
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,217.00 |
| Max. Negotiated Rate |
$9,976.50 |
| Rate for Payer: Adventist Health Commercial |
$2,217.00
|
| Rate for Payer: Cash Price |
$6,096.75
|
| Rate for Payer: Central Health Plan Commercial |
$8,868.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,434.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,434.00
|
| Rate for Payer: Galaxy Health WC |
$9,422.25
|
| Rate for Payer: Global Benefits Group Commercial |
$6,651.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,976.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,393.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,223.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,861.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,217.00
|
| Rate for Payer: Multiplan Commercial |
$8,313.75
|
| Rate for Payer: Networks By Design Commercial |
$7,205.25
|
| Rate for Payer: Prime Health Services Commercial |
$9,422.25
|
|
|
HC I & D ABSCESS,THROAT INTRAORAL
|
Facility
|
OP
|
$11,085.00
|
|
|
Service Code
|
CPT 42720
|
| Hospital Charge Code |
900501607
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$329.63 |
| Max. Negotiated Rate |
$9,976.50 |
| Rate for Payer: Adventist Health Commercial |
$2,217.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,120.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,565.51
|
| Rate for Payer: Cash Price |
$6,096.75
|
| Rate for Payer: Cash Price |
$6,096.75
|
| Rate for Payer: Cash Price |
$6,096.75
|
| Rate for Payer: Cash Price |
$6,096.75
|
| Rate for Payer: Central Health Plan Commercial |
$8,868.00
|
| Rate for Payer: Cigna of CA HMO |
$7,094.40
|
| Rate for Payer: Cigna of CA PPO |
$8,202.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,532.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,120.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,562.86
|
| Rate for Payer: EPIC Health Plan Senior |
$4,120.64
|
| Rate for Payer: Galaxy Health WC |
$9,422.25
|
| Rate for Payer: Global Benefits Group Commercial |
$6,651.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,976.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,757.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,120.64
|
| Rate for Payer: InnovAge PACE Commercial |
$6,180.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,393.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$329.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,120.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,217.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,521.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,521.66
|
| Rate for Payer: Multiplan Commercial |
$8,313.75
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: Networks By Design Commercial |
$7,205.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,120.64
|
| Rate for Payer: Preferred Health Network WC |
$6,699.50
|
| Rate for Payer: Prime Health Services Commercial |
$9,422.25
|
| Rate for Payer: Prime Health Services Medicare |
$4,367.88
|
| Rate for Payer: Prime Health Services WC |
$6,498.52
|
| Rate for Payer: Riverside University Health System MISP |
$4,532.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,651.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,542.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,542.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,542.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,542.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,120.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4,120.64
|
|
|
HC I & D ARM BURSA
|
Facility
|
IP
|
$9,439.00
|
|
|
Service Code
|
CPT 23931
|
| Hospital Charge Code |
900501660
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,887.80 |
| Max. Negotiated Rate |
$8,495.10 |
| Rate for Payer: Adventist Health Commercial |
$1,887.80
|
| Rate for Payer: Cash Price |
$5,191.45
|
| Rate for Payer: Central Health Plan Commercial |
$7,551.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,775.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,775.60
|
| Rate for Payer: Galaxy Health WC |
$8,023.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,663.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,495.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,295.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,596.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,842.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,887.80
|
| Rate for Payer: Multiplan Commercial |
$7,079.25
|
| Rate for Payer: Networks By Design Commercial |
$6,135.35
|
| Rate for Payer: Prime Health Services Commercial |
$8,023.15
|
|
|
HC I & D ARM BURSA
|
Facility
|
OP
|
$9,439.00
|
|
|
Service Code
|
CPT 23931
|
| Hospital Charge Code |
900501660
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$216.45 |
| Max. Negotiated Rate |
$8,495.10 |
| Rate for Payer: Adventist Health Commercial |
$1,887.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Cash Price |
$5,191.45
|
| Rate for Payer: Cash Price |
$5,191.45
|
| Rate for Payer: Cash Price |
$5,191.45
|
| Rate for Payer: Cash Price |
$5,191.45
|
| Rate for Payer: Central Health Plan Commercial |
$7,551.20
|
| Rate for Payer: Cigna of CA HMO |
$6,040.96
|
| Rate for Payer: Cigna of CA PPO |
$6,984.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,779.22
|
| Rate for Payer: EPIC Health Plan Senior |
$2,058.68
|
| Rate for Payer: Galaxy Health WC |
$8,023.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,663.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,495.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: InnovAge PACE Commercial |
$3,088.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,295.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$216.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,887.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,758.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,758.63
|
| Rate for Payer: Multiplan Commercial |
$7,079.25
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$6,135.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$8,023.15
|
| Rate for Payer: Prime Health Services Medicare |
$2,182.20
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,264.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,663.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,719.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,719.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,719.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,719.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,058.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
