|
HC I&D OF VULVA OR PERI ABSC
|
Facility
|
IP
|
$1,590.00
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
900501168
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$318.00 |
| Max. Negotiated Rate |
$1,431.00 |
| Rate for Payer: Adventist Health Commercial |
$318.00
|
| Rate for Payer: Cash Price |
$715.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,272.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$636.00
|
| Rate for Payer: EPIC Health Plan Senior |
$636.00
|
| Rate for Payer: Galaxy Health WC |
$1,351.50
|
| Rate for Payer: Global Benefits Group Commercial |
$954.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,431.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,060.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$605.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$984.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$318.00
|
| Rate for Payer: Multiplan Commercial |
$1,192.50
|
| Rate for Payer: Networks By Design Commercial |
$1,033.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,351.50
|
|
|
HC I&D OF VULVA OR PERI ABSC
|
Facility
|
IP
|
$1,590.00
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
900501168
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$318.00 |
| Max. Negotiated Rate |
$1,431.00 |
| Rate for Payer: Adventist Health Commercial |
$318.00
|
| Rate for Payer: Cash Price |
$715.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,272.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$636.00
|
| Rate for Payer: EPIC Health Plan Senior |
$636.00
|
| Rate for Payer: Galaxy Health WC |
$1,351.50
|
| Rate for Payer: Global Benefits Group Commercial |
$954.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,431.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,060.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$605.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$984.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$318.00
|
| Rate for Payer: Multiplan Commercial |
$1,192.50
|
| Rate for Payer: Networks By Design Commercial |
$1,033.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,351.50
|
|
|
HC I&D OF VULVA OR PERI ABSC
|
Facility
|
OP
|
$1,590.00
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
900501168
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$172.33 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Commercial |
$651.90
|
| 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 |
$579.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$386.50
|
| 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 |
$615.83
|
| Rate for Payer: Cash Price |
$715.50
|
| Rate for Payer: Cash Price |
$715.50
|
| Rate for Payer: Cash Price |
$715.50
|
| Rate for Payer: Cash Price |
$715.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,272.00
|
| Rate for Payer: Cigna of CA HMO |
$1,017.60
|
| Rate for Payer: Cigna of CA PPO |
$1,176.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$579.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$425.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$386.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$521.77
|
| Rate for Payer: EPIC Health Plan Senior |
$386.50
|
| Rate for Payer: Galaxy Health WC |
$1,351.50
|
| Rate for Payer: Global Benefits Group Commercial |
$954.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,431.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$633.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$386.50
|
| Rate for Payer: InnovAge PACE Commercial |
$579.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,060.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$172.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$386.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$318.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$517.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$517.91
|
| Rate for Payer: Multiplan Commercial |
$1,192.50
|
| Rate for Payer: Multiplan WC |
$615.83
|
| Rate for Payer: Networks By Design Commercial |
$1,033.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$386.50
|
| Rate for Payer: Preferred Health Network WC |
$628.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,351.50
|
| Rate for Payer: Prime Health Services Medicare |
$409.69
|
| Rate for Payer: Prime Health Services WC |
$609.55
|
| Rate for Payer: Riverside University Health System MISP |
$425.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$954.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$954.00
|
| 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 |
$386.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Vantage Medical Group Senior |
$386.50
|
|
|
HC I&D OF VULVA OR PERI ABSC
|
Facility
|
OP
|
$1,590.00
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
900501168
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$156.00 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Commercial |
$318.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$386.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$386.50
|
| 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 |
$615.83
|
| 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 |
$715.50
|
| Rate for Payer: Cash Price |
$715.50
|
| Rate for Payer: Cash Price |
$715.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,272.00
|
| Rate for Payer: Cigna of CA HMO |
$1,017.60
|
| Rate for Payer: Cigna of CA PPO |
$1,176.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$579.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$425.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$386.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$521.77
|
| Rate for Payer: EPIC Health Plan Senior |
$386.50
|
| Rate for Payer: Galaxy Health WC |
$1,351.50
|
| Rate for Payer: Global Benefits Group Commercial |
$954.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,431.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$633.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$156.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$386.50
|
| Rate for Payer: InnovAge PACE Commercial |
$579.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,060.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$172.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$386.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$318.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$517.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$517.91
|
| Rate for Payer: Multiplan Commercial |
$1,192.50
|
| Rate for Payer: Multiplan WC |
$615.83
|
| Rate for Payer: Networks By Design Commercial |
$1,033.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$386.50
|
| Rate for Payer: Preferred Health Network WC |
$628.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,351.50
|
| Rate for Payer: Prime Health Services Medicare |
$409.69
|
| Rate for Payer: Prime Health Services WC |
$609.55
|
| Rate for Payer: Riverside University Health System MISP |
$425.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$954.00
|
| 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 |
$386.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Vantage Medical Group Senior |
$386.50
|
|
|
HC I&D OF VULVA OR PERI ABSC
|
Facility
|
OP
|
$1,590.00
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
900501168
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$172.33 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Commercial |
$318.00
|
| 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 |
$579.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$386.50
|
| 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 |
$615.83
|
| Rate for Payer: Cash Price |
$715.50
|
| Rate for Payer: Cash Price |
$715.50
|
| Rate for Payer: Cash Price |
$715.50
|
| Rate for Payer: Cash Price |
$715.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,272.00
|
| Rate for Payer: Cigna of CA HMO |
$1,017.60
|
| Rate for Payer: Cigna of CA PPO |
$1,176.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$579.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$425.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$386.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$521.77
|
| Rate for Payer: EPIC Health Plan Senior |
$386.50
|
| Rate for Payer: Galaxy Health WC |
$1,351.50
|
| Rate for Payer: Global Benefits Group Commercial |
$954.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,431.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$633.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$386.50
|
| Rate for Payer: InnovAge PACE Commercial |
$579.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,060.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$172.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$386.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$318.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$517.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$517.91
|
| Rate for Payer: Multiplan Commercial |
$1,192.50
|
| Rate for Payer: Multiplan WC |
$615.83
|
| Rate for Payer: Networks By Design Commercial |
$1,033.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$386.50
|
| Rate for Payer: Preferred Health Network WC |
$628.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,351.50
|
| Rate for Payer: Prime Health Services Medicare |
$409.69
|
| Rate for Payer: Prime Health Services WC |
$609.55
|
| Rate for Payer: Riverside University Health System MISP |
$425.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$954.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$795.00
|
| Rate for Payer: United Healthcare All Other HMO |
$795.00
|
| Rate for Payer: United Healthcare HMO Rider |
$795.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$795.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$386.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Vantage Medical Group Senior |
$386.50
|
|
|
HC I.D. PENTAGASTRIN CONCENTRATIO
|
Facility
|
IP
|
$152.00
|
|
| Hospital Charge Code |
909301533
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$30.40 |
| Max. Negotiated Rate |
$136.80 |
| Rate for Payer: Adventist Health Commercial |
$30.40
|
| Rate for Payer: Blue Shield of California Commercial |
$117.50
|
| Rate for Payer: Blue Shield of California EPN |
$76.61
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Central Health Plan Commercial |
$121.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.80
|
| Rate for Payer: EPIC Health Plan Senior |
$60.80
|
| Rate for Payer: Galaxy Health WC |
$129.20
|
| Rate for Payer: Global Benefits Group Commercial |
$91.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$136.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$101.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$94.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.40
|
| Rate for Payer: Multiplan Commercial |
$114.00
|
| Rate for Payer: Networks By Design Commercial |
$98.80
|
| Rate for Payer: Prime Health Services Commercial |
$129.20
|
|
|
HC I.D. PENTAGASTRIN CONCENTRATIO
|
Facility
|
OP
|
$152.00
|
|
| Hospital Charge Code |
909301533
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$30.40 |
| Max. Negotiated Rate |
$136.80 |
| Rate for Payer: Adventist Health Commercial |
$30.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$92.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$129.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$114.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$73.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$89.27
|
| Rate for Payer: Blue Shield of California Commercial |
$92.87
|
| Rate for Payer: Blue Shield of California EPN |
$60.65
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Central Health Plan Commercial |
$121.60
|
| Rate for Payer: Cigna of CA HMO |
$97.28
|
| Rate for Payer: Cigna of CA PPO |
$112.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$129.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$129.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$129.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.80
|
| Rate for Payer: EPIC Health Plan Senior |
$60.80
|
| Rate for Payer: Galaxy Health WC |
$129.20
|
| Rate for Payer: Global Benefits Group Commercial |
$91.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$136.80
|
| Rate for Payer: InnovAge PACE Commercial |
$76.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$101.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$94.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$106.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$106.40
|
| Rate for Payer: Multiplan Commercial |
$114.00
|
| Rate for Payer: Networks By Design Commercial |
$98.80
|
| Rate for Payer: Prime Health Services Commercial |
$129.20
|
| Rate for Payer: Riverside University Health System MISP |
$60.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$91.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$76.00
|
| Rate for Payer: United Healthcare All Other HMO |
$76.00
|
| Rate for Payer: United Healthcare HMO Rider |
$76.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$76.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$129.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$129.20
|
| Rate for Payer: Vantage Medical Group Senior |
$129.20
|
|
|
HC I&D PERIANAL ABSCESS SUPERFICIAL
|
Facility
|
IP
|
$3,744.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
900501156
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$748.80 |
| Max. Negotiated Rate |
$3,369.60 |
| Rate for Payer: Adventist Health Commercial |
$748.80
|
| Rate for Payer: Cash Price |
$1,684.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,995.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,497.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,497.60
|
| Rate for Payer: Galaxy Health WC |
$3,182.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,246.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,369.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,497.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,426.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,317.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$748.80
|
| Rate for Payer: Multiplan Commercial |
$2,808.00
|
| Rate for Payer: Networks By Design Commercial |
$2,433.60
|
| Rate for Payer: Prime Health Services Commercial |
$3,182.40
|
|
|
HC I&D PERIANAL ABSCESS SUPERFICIAL
|
Facility
|
OP
|
$3,744.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
900501156
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$151.37 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$1,535.04
|
| 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 |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| 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 |
$1,845.73
|
| Rate for Payer: Cash Price |
$1,684.80
|
| Rate for Payer: Cash Price |
$1,684.80
|
| Rate for Payer: Cash Price |
$1,684.80
|
| Rate for Payer: Cash Price |
$1,684.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,995.20
|
| Rate for Payer: Cigna of CA HMO |
$2,396.16
|
| Rate for Payer: Cigna of CA PPO |
$2,770.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,563.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1,158.42
|
| Rate for Payer: Galaxy Health WC |
$3,182.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,246.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,369.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,899.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: InnovAge PACE Commercial |
$1,737.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,497.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$151.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,158.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$748.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,552.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,552.28
|
| Rate for Payer: Multiplan Commercial |
$2,808.00
|
| Rate for Payer: Multiplan WC |
$1,845.73
|
| Rate for Payer: Networks By Design Commercial |
$2,433.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Preferred Health Network WC |
$1,883.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,182.40
|
| Rate for Payer: Prime Health Services Medicare |
$1,227.93
|
| Rate for Payer: Prime Health Services WC |
$1,826.90
|
| Rate for Payer: Riverside University Health System MISP |
$1,274.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,246.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,246.40
|
| 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 |
$1,158.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC I&D PERIANAL ABSCESS SUPERFICIAL
|
Facility
|
OP
|
$3,744.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
900501156
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$151.37 |
| Max. Negotiated Rate |
$3,369.60 |
| Rate for Payer: Adventist Health Commercial |
$748.80
|
| 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 |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| 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 |
$1,845.73
|
| Rate for Payer: Cash Price |
$1,684.80
|
| Rate for Payer: Cash Price |
$1,684.80
|
| Rate for Payer: Cash Price |
$1,684.80
|
| Rate for Payer: Cash Price |
$1,684.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,995.20
|
| Rate for Payer: Cigna of CA HMO |
$2,396.16
|
| Rate for Payer: Cigna of CA PPO |
$2,770.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,563.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1,158.42
|
| Rate for Payer: Galaxy Health WC |
$3,182.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,246.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,369.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,899.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: InnovAge PACE Commercial |
$1,737.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,497.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$151.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,158.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$748.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,552.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,552.28
|
| Rate for Payer: Multiplan Commercial |
$2,808.00
|
| Rate for Payer: Multiplan WC |
$1,845.73
|
| Rate for Payer: Networks By Design Commercial |
$2,433.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Preferred Health Network WC |
$1,883.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,182.40
|
| Rate for Payer: Prime Health Services Medicare |
$1,227.93
|
| Rate for Payer: Prime Health Services WC |
$1,826.90
|
| Rate for Payer: Riverside University Health System MISP |
$1,274.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,246.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,872.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,872.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,872.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,158.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC I&D PERIANAL ABSCESS SUPERFICIAL
|
Facility
|
IP
|
$3,744.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
900501156
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$748.80 |
| Max. Negotiated Rate |
$3,369.60 |
| Rate for Payer: Adventist Health Commercial |
$748.80
|
| Rate for Payer: Cash Price |
$1,684.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,995.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,497.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,497.60
|
| Rate for Payer: Galaxy Health WC |
$3,182.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,246.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,369.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,497.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,426.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,317.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$748.80
|
| Rate for Payer: Multiplan Commercial |
$2,808.00
|
| Rate for Payer: Networks By Design Commercial |
$2,433.60
|
| Rate for Payer: Prime Health Services Commercial |
$3,182.40
|
|
|
HC I&D PERITONSILAR ABSCESS
|
Facility
|
OP
|
$1,283.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
900501151
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$138.64 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$526.03
|
| 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 |
$442.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$295.06
|
| 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 |
$470.13
|
| Rate for Payer: Cash Price |
$577.35
|
| Rate for Payer: Cash Price |
$577.35
|
| Rate for Payer: Cash Price |
$577.35
|
| Rate for Payer: Cash Price |
$577.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,026.40
|
| Rate for Payer: Cigna of CA HMO |
$821.12
|
| Rate for Payer: Cigna of CA PPO |
$949.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$442.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$295.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$398.33
|
| Rate for Payer: EPIC Health Plan Senior |
$295.06
|
| Rate for Payer: Galaxy Health WC |
$1,090.55
|
| Rate for Payer: Global Benefits Group Commercial |
$769.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,154.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$295.06
|
| Rate for Payer: InnovAge PACE Commercial |
$442.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$855.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$138.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$295.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$395.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$395.38
|
| Rate for Payer: Multiplan Commercial |
$962.25
|
| Rate for Payer: Multiplan WC |
$470.13
|
| Rate for Payer: Networks By Design Commercial |
$833.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$295.06
|
| Rate for Payer: Preferred Health Network WC |
$479.72
|
| Rate for Payer: Prime Health Services Commercial |
$1,090.55
|
| Rate for Payer: Prime Health Services Medicare |
$312.76
|
| Rate for Payer: Prime Health Services WC |
$465.33
|
| Rate for Payer: Riverside University Health System MISP |
$324.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$769.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$769.80
|
| 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 |
$295.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$442.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.57
|
| Rate for Payer: Vantage Medical Group Senior |
$295.06
|
|
|
HC I&D PERITONSILAR ABSCESS
|
Facility
|
IP
|
$1,283.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
900501151
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$256.60 |
| Max. Negotiated Rate |
$1,154.70 |
| Rate for Payer: Adventist Health Commercial |
$256.60
|
| Rate for Payer: Cash Price |
$577.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,026.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$513.20
|
| Rate for Payer: EPIC Health Plan Senior |
$513.20
|
| Rate for Payer: Galaxy Health WC |
$1,090.55
|
| Rate for Payer: Global Benefits Group Commercial |
$769.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,154.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$855.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$488.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$794.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.60
|
| Rate for Payer: Multiplan Commercial |
$962.25
|
| Rate for Payer: Networks By Design Commercial |
$833.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,090.55
|
|
|
HC I&D PERITONSILAR ABSCESS
|
Facility
|
IP
|
$1,283.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
900501151
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$256.60 |
| Max. Negotiated Rate |
$1,154.70 |
| Rate for Payer: Adventist Health Commercial |
$256.60
|
| Rate for Payer: Cash Price |
$577.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,026.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$513.20
|
| Rate for Payer: EPIC Health Plan Senior |
$513.20
|
| Rate for Payer: Galaxy Health WC |
$1,090.55
|
| Rate for Payer: Global Benefits Group Commercial |
$769.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,154.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$855.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$488.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$794.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.60
|
| Rate for Payer: Multiplan Commercial |
$962.25
|
| Rate for Payer: Networks By Design Commercial |
$833.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,090.55
|
|
|
HC I&D PERITONSILAR ABSCESS
|
Facility
|
OP
|
$1,283.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
900501151
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$138.64 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$256.60
|
| 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 |
$442.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$295.06
|
| 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 |
$470.13
|
| Rate for Payer: Cash Price |
$577.35
|
| Rate for Payer: Cash Price |
$577.35
|
| Rate for Payer: Cash Price |
$577.35
|
| Rate for Payer: Cash Price |
$577.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,026.40
|
| Rate for Payer: Cigna of CA HMO |
$821.12
|
| Rate for Payer: Cigna of CA PPO |
$949.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$442.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$295.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$398.33
|
| Rate for Payer: EPIC Health Plan Senior |
$295.06
|
| Rate for Payer: Galaxy Health WC |
$1,090.55
|
| Rate for Payer: Global Benefits Group Commercial |
$769.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,154.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$295.06
|
| Rate for Payer: InnovAge PACE Commercial |
$442.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$855.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$138.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$295.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$395.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$395.38
|
| Rate for Payer: Multiplan Commercial |
$962.25
|
| Rate for Payer: Multiplan WC |
$470.13
|
| Rate for Payer: Networks By Design Commercial |
$833.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$295.06
|
| Rate for Payer: Preferred Health Network WC |
$479.72
|
| Rate for Payer: Prime Health Services Commercial |
$1,090.55
|
| Rate for Payer: Prime Health Services Medicare |
$312.76
|
| Rate for Payer: Prime Health Services WC |
$465.33
|
| Rate for Payer: Riverside University Health System MISP |
$324.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$769.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$641.50
|
| Rate for Payer: United Healthcare All Other HMO |
$641.50
|
| Rate for Payer: United Healthcare HMO Rider |
$641.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$641.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$295.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$442.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.57
|
| Rate for Payer: Vantage Medical Group Senior |
$295.06
|
|
|
HC I & D PILONIDAL CYST COMPLICAT
|
Facility
|
OP
|
$6,800.00
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
900501530
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$219.51 |
| Max. Negotiated Rate |
$6,120.00 |
| Rate for Payer: Adventist Health Commercial |
$2,788.00
|
| 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 |
$1,340.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$893.98
|
| 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 |
$1,424.40
|
| Rate for Payer: Cash Price |
$3,060.00
|
| Rate for Payer: Cash Price |
$3,060.00
|
| Rate for Payer: Cash Price |
$3,060.00
|
| Rate for Payer: Cash Price |
$3,060.00
|
| Rate for Payer: Central Health Plan Commercial |
$5,440.00
|
| Rate for Payer: Cigna of CA HMO |
$4,352.00
|
| Rate for Payer: Cigna of CA PPO |
$5,032.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$983.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$893.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,206.87
|
| Rate for Payer: EPIC Health Plan Senior |
$893.98
|
| Rate for Payer: Galaxy Health WC |
$5,780.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,080.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,120.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,466.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$893.98
|
| Rate for Payer: InnovAge PACE Commercial |
$1,340.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,535.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$219.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$893.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,360.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,197.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,197.93
|
| Rate for Payer: Multiplan Commercial |
$5,100.00
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$4,420.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$893.98
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$5,780.00
|
| Rate for Payer: Prime Health Services Medicare |
$947.62
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$983.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,080.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,080.00
|
| 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 |
$893.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Vantage Medical Group Senior |
$893.98
|
|
|
HC I & D PILONIDAL CYST COMPLICAT
|
Facility
|
IP
|
$6,800.00
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
900501530
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,360.00 |
| Max. Negotiated Rate |
$6,120.00 |
| Rate for Payer: Adventist Health Commercial |
$1,360.00
|
| Rate for Payer: Cash Price |
$3,060.00
|
| Rate for Payer: Central Health Plan Commercial |
$5,440.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,720.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,720.00
|
| Rate for Payer: Galaxy Health WC |
$5,780.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,080.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,120.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,535.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,590.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,209.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,360.00
|
| Rate for Payer: Multiplan Commercial |
$5,100.00
|
| Rate for Payer: Networks By Design Commercial |
$4,420.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,780.00
|
|
|
HC I & D PILONIDAL CYST COMPLICAT
|
Facility
|
OP
|
$6,800.00
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
900501530
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$219.51 |
| Max. Negotiated Rate |
$6,120.00 |
| Rate for Payer: Adventist Health Commercial |
$1,360.00
|
| 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 |
$1,340.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$893.98
|
| 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 |
$1,424.40
|
| Rate for Payer: Cash Price |
$3,060.00
|
| Rate for Payer: Cash Price |
$3,060.00
|
| Rate for Payer: Cash Price |
$3,060.00
|
| Rate for Payer: Cash Price |
$3,060.00
|
| Rate for Payer: Central Health Plan Commercial |
$5,440.00
|
| Rate for Payer: Cigna of CA HMO |
$4,352.00
|
| Rate for Payer: Cigna of CA PPO |
$5,032.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$983.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$893.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,206.87
|
| Rate for Payer: EPIC Health Plan Senior |
$893.98
|
| Rate for Payer: Galaxy Health WC |
$5,780.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,080.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,120.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,466.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$893.98
|
| Rate for Payer: InnovAge PACE Commercial |
$1,340.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,535.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$219.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$893.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,360.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,197.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,197.93
|
| Rate for Payer: Multiplan Commercial |
$5,100.00
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$4,420.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$893.98
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$5,780.00
|
| Rate for Payer: Prime Health Services Medicare |
$947.62
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$983.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,080.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,400.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,400.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,400.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,400.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$893.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Vantage Medical Group Senior |
$893.98
|
|
|
HC I & D PILONIDAL CYST COMPLICAT
|
Facility
|
IP
|
$6,800.00
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
900501530
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,360.00 |
| Max. Negotiated Rate |
$6,120.00 |
| Rate for Payer: Adventist Health Commercial |
$1,360.00
|
| Rate for Payer: Cash Price |
$3,060.00
|
| Rate for Payer: Central Health Plan Commercial |
$5,440.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,720.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,720.00
|
| Rate for Payer: Galaxy Health WC |
$5,780.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,080.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,120.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,535.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,590.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,209.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,360.00
|
| Rate for Payer: Multiplan Commercial |
$5,100.00
|
| Rate for Payer: Networks By Design Commercial |
$4,420.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,780.00
|
|
|
HC I & D PILONIDAL CYST SIMPLE
|
Facility
|
IP
|
$1,449.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
900501002
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$289.80 |
| Max. Negotiated Rate |
$1,304.10 |
| Rate for Payer: Adventist Health Commercial |
$289.80
|
| Rate for Payer: Cash Price |
$652.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,159.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$579.60
|
| Rate for Payer: EPIC Health Plan Senior |
$579.60
|
| Rate for Payer: Galaxy Health WC |
$1,231.65
|
| Rate for Payer: Global Benefits Group Commercial |
$869.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,304.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$966.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$552.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$896.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.80
|
| Rate for Payer: Multiplan Commercial |
$1,086.75
|
| Rate for Payer: Networks By Design Commercial |
$941.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,231.65
|
|
|
HC I & D PILONIDAL CYST SIMPLE
|
Facility
|
OP
|
$1,449.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
900501002
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$289.80 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$289.80
|
| 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 |
$1,340.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$893.98
|
| 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 |
$1,424.40
|
| Rate for Payer: Cash Price |
$652.05
|
| Rate for Payer: Cash Price |
$652.05
|
| Rate for Payer: Cash Price |
$652.05
|
| Rate for Payer: Cash Price |
$652.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,159.20
|
| Rate for Payer: Cigna of CA HMO |
$927.36
|
| Rate for Payer: Cigna of CA PPO |
$1,072.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$983.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$893.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,206.87
|
| Rate for Payer: EPIC Health Plan Senior |
$893.98
|
| Rate for Payer: Galaxy Health WC |
$1,231.65
|
| Rate for Payer: Global Benefits Group Commercial |
$869.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,304.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,466.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$893.98
|
| Rate for Payer: InnovAge PACE Commercial |
$1,340.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$966.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$451.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$893.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,197.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,197.93
|
| Rate for Payer: Multiplan Commercial |
$1,086.75
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$941.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$893.98
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$1,231.65
|
| Rate for Payer: Prime Health Services Medicare |
$947.62
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$983.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$869.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$724.50
|
| Rate for Payer: United Healthcare All Other HMO |
$724.50
|
| Rate for Payer: United Healthcare HMO Rider |
$724.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$724.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$893.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Vantage Medical Group Senior |
$893.98
|
|
|
HC I & D PILONIDAL CYST SIMPLE
|
Facility
|
OP
|
$1,449.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
900501002
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$289.80 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$594.09
|
| 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 |
$1,340.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$893.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$851.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,424.40
|
| Rate for Payer: Cash Price |
$652.05
|
| Rate for Payer: Cash Price |
$652.05
|
| Rate for Payer: Cash Price |
$652.05
|
| Rate for Payer: Cash Price |
$652.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,159.20
|
| Rate for Payer: Cigna of CA HMO |
$927.36
|
| Rate for Payer: Cigna of CA PPO |
$1,072.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$983.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$893.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,206.87
|
| Rate for Payer: EPIC Health Plan Senior |
$893.98
|
| Rate for Payer: Galaxy Health WC |
$1,231.65
|
| Rate for Payer: Global Benefits Group Commercial |
$869.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,304.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,466.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$893.98
|
| Rate for Payer: InnovAge PACE Commercial |
$1,340.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$966.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$451.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$893.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,197.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,197.93
|
| Rate for Payer: Multiplan Commercial |
$1,086.75
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$941.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$893.98
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$1,231.65
|
| Rate for Payer: Prime Health Services Medicare |
$947.62
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$983.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$869.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$869.40
|
| 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 |
$893.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Vantage Medical Group Senior |
$893.98
|
|
|
HC I & D PILONIDAL CYST SIMPLE
|
Facility
|
IP
|
$1,449.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
900501002
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$289.80 |
| Max. Negotiated Rate |
$1,304.10 |
| Rate for Payer: Adventist Health Commercial |
$289.80
|
| Rate for Payer: Cash Price |
$652.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,159.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$579.60
|
| Rate for Payer: EPIC Health Plan Senior |
$579.60
|
| Rate for Payer: Galaxy Health WC |
$1,231.65
|
| Rate for Payer: Global Benefits Group Commercial |
$869.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,304.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$966.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$552.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$896.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.80
|
| Rate for Payer: Multiplan Commercial |
$1,086.75
|
| Rate for Payer: Networks By Design Commercial |
$941.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,231.65
|
|
|
HC IDR CORDIS VISTA BRITE TIPN
|
Facility
|
OP
|
$7,000.00
|
|
|
Service Code
|
CPT 0220T
|
| Hospital Charge Code |
909010220
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$1,400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,950.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,850.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,250.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,389.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,111.10
|
| 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 |
$3,150.00
|
| Rate for Payer: Cash Price |
$3,150.00
|
| Rate for Payer: Central Health Plan Commercial |
$5,600.00
|
| Rate for Payer: Cigna of CA HMO |
$4,480.00
|
| Rate for Payer: Cigna of CA PPO |
$5,180.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,950.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,950.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,950.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,800.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,800.00
|
| Rate for Payer: Galaxy Health WC |
$5,950.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,200.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,300.00
|
| Rate for Payer: InnovAge PACE Commercial |
$3,500.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,669.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,667.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,333.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,400.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,900.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,900.00
|
| Rate for Payer: Multiplan Commercial |
$5,250.00
|
| Rate for Payer: Networks By Design Commercial |
$4,550.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,950.00
|
| Rate for Payer: Riverside University Health System MISP |
$2,800.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,200.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,950.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,950.00
|
| Rate for Payer: Vantage Medical Group Senior |
$5,950.00
|
|
|
HC IDR CORDIS VISTA BRITE TIPN
|
Facility
|
IP
|
$7,000.00
|
|
|
Service Code
|
CPT 0220T
|
| Hospital Charge Code |
909010220
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,400.00 |
| Max. Negotiated Rate |
$6,300.00 |
| Rate for Payer: Adventist Health Commercial |
$1,400.00
|
| Rate for Payer: Cash Price |
$3,150.00
|
| Rate for Payer: Central Health Plan Commercial |
$5,600.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,800.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,800.00
|
| Rate for Payer: Galaxy Health WC |
$5,950.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,200.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,300.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,669.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,667.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,333.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,400.00
|
| Rate for Payer: Multiplan Commercial |
$5,250.00
|
| Rate for Payer: Networks By Design Commercial |
$4,550.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,950.00
|
|
