|
HC INCISIONAL BX SKIN SINGLE LSN
|
Facility
|
OP
|
$1,538.00
|
|
|
Service Code
|
CPT 11106
|
| Hospital Charge Code |
900511106
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$233.73 |
| Max. Negotiated Rate |
$6,333.00 |
| Rate for Payer: Adventist Health Commercial |
$307.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$777.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,166.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$855.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$777.77
|
| 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 |
$1,239.24
|
| 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 |
$845.90
|
| Rate for Payer: Cash Price |
$845.90
|
| Rate for Payer: Cash Price |
$845.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,230.40
|
| Rate for Payer: Cigna of CA HMO |
$984.32
|
| Rate for Payer: Cigna of CA PPO |
$1,138.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,166.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$855.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$777.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,049.99
|
| Rate for Payer: EPIC Health Plan Senior |
$777.77
|
| Rate for Payer: Galaxy Health WC |
$1,307.30
|
| Rate for Payer: Global Benefits Group Commercial |
$922.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,384.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,275.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$233.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$777.77
|
| Rate for Payer: InnovAge PACE Commercial |
$1,166.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,025.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$258.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$777.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$307.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,042.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,042.21
|
| Rate for Payer: Multiplan Commercial |
$1,153.50
|
| Rate for Payer: Multiplan WC |
$1,239.24
|
| Rate for Payer: Networks By Design Commercial |
$999.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$777.77
|
| Rate for Payer: Preferred Health Network WC |
$1,264.53
|
| Rate for Payer: Prime Health Services Commercial |
$1,307.30
|
| Rate for Payer: Prime Health Services Medicare |
$824.44
|
| Rate for Payer: Prime Health Services WC |
$1,226.59
|
| Rate for Payer: Riverside University Health System MISP |
$855.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$922.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$777.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,166.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$855.55
|
| Rate for Payer: Vantage Medical Group Senior |
$777.77
|
|
|
HC INCISION DRAIN DEEP RECTAL ABSCESS
|
Facility
|
OP
|
$8,004.00
|
|
|
Service Code
|
CPT 45020
|
| Hospital Charge Code |
900501241
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$384.81 |
| Max. Negotiated Rate |
$7,203.60 |
| Rate for Payer: Adventist Health Commercial |
$3,281.64
|
| 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 |
$5,226.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,832.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,484.48
|
| 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 |
$5,551.91
|
| Rate for Payer: Cash Price |
$4,402.20
|
| Rate for Payer: Cash Price |
$4,402.20
|
| Rate for Payer: Cash Price |
$4,402.20
|
| Rate for Payer: Cash Price |
$4,402.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,403.20
|
| Rate for Payer: Cigna of CA HMO |
$5,122.56
|
| Rate for Payer: Cigna of CA PPO |
$5,922.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,226.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,832.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,484.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,704.05
|
| Rate for Payer: EPIC Health Plan Senior |
$3,484.48
|
| Rate for Payer: Galaxy Health WC |
$6,803.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,802.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,203.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,714.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,484.48
|
| Rate for Payer: InnovAge PACE Commercial |
$5,226.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,338.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$384.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,484.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,600.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,669.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,669.20
|
| Rate for Payer: Multiplan Commercial |
$6,003.00
|
| Rate for Payer: Multiplan WC |
$5,551.91
|
| Rate for Payer: Networks By Design Commercial |
$5,202.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,484.48
|
| Rate for Payer: Preferred Health Network WC |
$5,665.21
|
| Rate for Payer: Prime Health Services Commercial |
$6,803.40
|
| Rate for Payer: Prime Health Services Medicare |
$3,693.55
|
| Rate for Payer: Prime Health Services WC |
$5,495.25
|
| Rate for Payer: Riverside University Health System MISP |
$3,832.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,802.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,802.40
|
| 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 |
$3,484.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,226.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,832.93
|
| Rate for Payer: Vantage Medical Group Senior |
$3,484.48
|
|
|
HC INCISION DRAIN DEEP RECTAL ABSCESS
|
Facility
|
IP
|
$8,004.00
|
|
|
Service Code
|
CPT 45020
|
| Hospital Charge Code |
900501241
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,600.80 |
| Max. Negotiated Rate |
$7,203.60 |
| Rate for Payer: Adventist Health Commercial |
$1,600.80
|
| Rate for Payer: Cash Price |
$4,402.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,403.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,201.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,201.60
|
| Rate for Payer: Galaxy Health WC |
$6,803.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,802.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,203.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,338.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,049.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,954.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,600.80
|
| Rate for Payer: Multiplan Commercial |
$6,003.00
|
| Rate for Payer: Networks By Design Commercial |
$5,202.60
|
| Rate for Payer: Prime Health Services Commercial |
$6,803.40
|
|
|
HC INCISION DRAIN DEEP RECTAL ABSCESS
|
Facility
|
IP
|
$8,004.00
|
|
|
Service Code
|
CPT 45020
|
| Hospital Charge Code |
900501241
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,600.80 |
| Max. Negotiated Rate |
$7,203.60 |
| Rate for Payer: Adventist Health Commercial |
$1,600.80
|
| Rate for Payer: Cash Price |
$4,402.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,403.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,201.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,201.60
|
| Rate for Payer: Galaxy Health WC |
$6,803.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,802.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,203.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,338.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,049.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,954.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,600.80
|
| Rate for Payer: Multiplan Commercial |
$6,003.00
|
| Rate for Payer: Networks By Design Commercial |
$5,202.60
|
| Rate for Payer: Prime Health Services Commercial |
$6,803.40
|
|
|
HC INCISION DRAIN DEEP RECTAL ABSCESS
|
Facility
|
OP
|
$8,004.00
|
|
|
Service Code
|
CPT 45020
|
| Hospital Charge Code |
900501241
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$384.81 |
| Max. Negotiated Rate |
$7,203.60 |
| Rate for Payer: Adventist Health Commercial |
$1,600.80
|
| 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 |
$5,226.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,832.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,484.48
|
| 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 |
$5,551.91
|
| Rate for Payer: Cash Price |
$4,402.20
|
| Rate for Payer: Cash Price |
$4,402.20
|
| Rate for Payer: Cash Price |
$4,402.20
|
| Rate for Payer: Cash Price |
$4,402.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,403.20
|
| Rate for Payer: Cigna of CA HMO |
$5,122.56
|
| Rate for Payer: Cigna of CA PPO |
$5,922.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,226.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,832.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,484.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,704.05
|
| Rate for Payer: EPIC Health Plan Senior |
$3,484.48
|
| Rate for Payer: Galaxy Health WC |
$6,803.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,802.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,203.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,714.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,484.48
|
| Rate for Payer: InnovAge PACE Commercial |
$5,226.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,338.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$384.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,484.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,600.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,669.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,669.20
|
| Rate for Payer: Multiplan Commercial |
$6,003.00
|
| Rate for Payer: Multiplan WC |
$5,551.91
|
| Rate for Payer: Networks By Design Commercial |
$5,202.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,484.48
|
| Rate for Payer: Preferred Health Network WC |
$5,665.21
|
| Rate for Payer: Prime Health Services Commercial |
$6,803.40
|
| Rate for Payer: Prime Health Services Medicare |
$3,693.55
|
| Rate for Payer: Prime Health Services WC |
$5,495.25
|
| Rate for Payer: Riverside University Health System MISP |
$3,832.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,802.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,002.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,002.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,002.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,002.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,484.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,226.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,832.93
|
| Rate for Payer: Vantage Medical Group Senior |
$3,484.48
|
|
|
HC INCISION/DRAIN FOREARM/WRIST
|
Facility
|
IP
|
$10,830.00
|
|
|
Service Code
|
CPT 25028
|
| Hospital Charge Code |
900501423
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,166.00 |
| Max. Negotiated Rate |
$9,747.00 |
| Rate for Payer: Adventist Health Commercial |
$2,166.00
|
| Rate for Payer: Cash Price |
$5,956.50
|
| Rate for Payer: Central Health Plan Commercial |
$8,664.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,332.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,332.00
|
| Rate for Payer: Galaxy Health WC |
$9,205.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6,498.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,747.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,223.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,126.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,703.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,166.00
|
| Rate for Payer: Multiplan Commercial |
$8,122.50
|
| Rate for Payer: Networks By Design Commercial |
$7,039.50
|
| Rate for Payer: Prime Health Services Commercial |
$9,205.50
|
|
|
HC INCISION/DRAIN FOREARM/WRIST
|
Facility
|
OP
|
$10,830.00
|
|
|
Service Code
|
CPT 25028
|
| Hospital Charge Code |
900501423
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$9,747.00 |
| Rate for Payer: Adventist Health Commercial |
$2,166.00
|
| 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 |
$6,183.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,122.60
|
| 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 |
$6,568.63
|
| Rate for Payer: Cash Price |
$5,956.50
|
| Rate for Payer: Cash Price |
$5,956.50
|
| Rate for Payer: Cash Price |
$5,956.50
|
| Rate for Payer: Cash Price |
$5,956.50
|
| Rate for Payer: Central Health Plan Commercial |
$8,664.00
|
| Rate for Payer: Cigna of CA HMO |
$6,931.20
|
| Rate for Payer: Cigna of CA PPO |
$8,014.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,534.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,122.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,565.51
|
| Rate for Payer: EPIC Health Plan Senior |
$4,122.60
|
| Rate for Payer: Galaxy Health WC |
$9,205.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6,498.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,747.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,761.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,122.60
|
| Rate for Payer: InnovAge PACE Commercial |
$6,183.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,223.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$865.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,122.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,166.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,524.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,524.28
|
| Rate for Payer: Multiplan Commercial |
$8,122.50
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$7,039.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,122.60
|
| Rate for Payer: Preferred Health Network WC |
$6,702.68
|
| Rate for Payer: Prime Health Services Commercial |
$9,205.50
|
| Rate for Payer: Prime Health Services Medicare |
$4,369.96
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Riverside University Health System MISP |
$4,534.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,498.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,415.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,415.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,415.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,415.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,122.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4,122.60
|
|
|
HC INCISION/DRAIN PERIRECTAL ABSC
|
Facility
|
IP
|
$8,004.00
|
|
|
Service Code
|
CPT 45005
|
| Hospital Charge Code |
900501237
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,600.80 |
| Max. Negotiated Rate |
$7,203.60 |
| Rate for Payer: Adventist Health Commercial |
$1,600.80
|
| Rate for Payer: Cash Price |
$4,402.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,403.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,201.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,201.60
|
| Rate for Payer: Galaxy Health WC |
$6,803.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,802.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,203.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,338.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,049.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,954.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,600.80
|
| Rate for Payer: Multiplan Commercial |
$6,003.00
|
| Rate for Payer: Networks By Design Commercial |
$5,202.60
|
| Rate for Payer: Prime Health Services Commercial |
$6,803.40
|
|
|
HC INCISION/DRAIN PERIRECTAL ABSC
|
Facility
|
IP
|
$8,004.00
|
|
|
Service Code
|
CPT 45005
|
| Hospital Charge Code |
900501237
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,600.80 |
| Max. Negotiated Rate |
$7,203.60 |
| Rate for Payer: Adventist Health Commercial |
$1,600.80
|
| Rate for Payer: Cash Price |
$4,402.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,403.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,201.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,201.60
|
| Rate for Payer: Galaxy Health WC |
$6,803.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,802.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,203.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,338.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,049.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,954.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,600.80
|
| Rate for Payer: Multiplan Commercial |
$6,003.00
|
| Rate for Payer: Networks By Design Commercial |
$5,202.60
|
| Rate for Payer: Prime Health Services Commercial |
$6,803.40
|
|
|
HC INCISION/DRAIN PERIRECTAL ABSC
|
Facility
|
OP
|
$8,004.00
|
|
|
Service Code
|
CPT 45005
|
| Hospital Charge Code |
900501237
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$240.50 |
| Max. Negotiated Rate |
$7,203.60 |
| Rate for Payer: Adventist Health Commercial |
$1,600.80
|
| 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 |
$2,247.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,498.14
|
| 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 |
$2,387.03
|
| Rate for Payer: Cash Price |
$4,402.20
|
| Rate for Payer: Cash Price |
$4,402.20
|
| Rate for Payer: Cash Price |
$4,402.20
|
| Rate for Payer: Cash Price |
$4,402.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,403.20
|
| Rate for Payer: Cigna of CA HMO |
$5,122.56
|
| Rate for Payer: Cigna of CA PPO |
$5,922.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,647.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,498.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,022.49
|
| Rate for Payer: EPIC Health Plan Senior |
$1,498.14
|
| Rate for Payer: Galaxy Health WC |
$6,803.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,802.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,203.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,456.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: InnovAge PACE Commercial |
$2,247.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,338.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$240.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,600.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,007.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,007.51
|
| Rate for Payer: Multiplan Commercial |
$6,003.00
|
| Rate for Payer: Multiplan WC |
$2,387.03
|
| Rate for Payer: Networks By Design Commercial |
$5,202.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Preferred Health Network WC |
$2,435.74
|
| Rate for Payer: Prime Health Services Commercial |
$6,803.40
|
| Rate for Payer: Prime Health Services Medicare |
$1,588.03
|
| Rate for Payer: Prime Health Services WC |
$2,362.67
|
| Rate for Payer: Riverside University Health System MISP |
$1,647.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,802.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,002.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,002.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,002.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,002.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,498.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,498.14
|
|
|
HC INCISION/DRAIN PERIRECTAL ABSC
|
Facility
|
OP
|
$8,004.00
|
|
|
Service Code
|
CPT 45005
|
| Hospital Charge Code |
900501237
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$240.50 |
| Max. Negotiated Rate |
$7,203.60 |
| Rate for Payer: Adventist Health Commercial |
$3,281.64
|
| 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 |
$2,247.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,498.14
|
| 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 |
$2,387.03
|
| Rate for Payer: Cash Price |
$4,402.20
|
| Rate for Payer: Cash Price |
$4,402.20
|
| Rate for Payer: Cash Price |
$4,402.20
|
| Rate for Payer: Cash Price |
$4,402.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,403.20
|
| Rate for Payer: Cigna of CA HMO |
$5,122.56
|
| Rate for Payer: Cigna of CA PPO |
$5,922.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,647.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,498.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,022.49
|
| Rate for Payer: EPIC Health Plan Senior |
$1,498.14
|
| Rate for Payer: Galaxy Health WC |
$6,803.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,802.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,203.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,456.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: InnovAge PACE Commercial |
$2,247.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,338.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$240.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,600.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,007.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,007.51
|
| Rate for Payer: Multiplan Commercial |
$6,003.00
|
| Rate for Payer: Multiplan WC |
$2,387.03
|
| Rate for Payer: Networks By Design Commercial |
$5,202.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Preferred Health Network WC |
$2,435.74
|
| Rate for Payer: Prime Health Services Commercial |
$6,803.40
|
| Rate for Payer: Prime Health Services Medicare |
$1,588.03
|
| Rate for Payer: Prime Health Services WC |
$2,362.67
|
| Rate for Payer: Riverside University Health System MISP |
$1,647.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,802.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,802.40
|
| 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 |
$1,498.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,498.14
|
|
|
HC INCISION/DRAIN THIGH/KNEE LESI
|
Facility
|
OP
|
$8,133.00
|
|
|
Service Code
|
CPT 27301
|
| Hospital Charge Code |
909000271
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$133.68 |
| Max. Negotiated Rate |
$8,114.00 |
| Rate for Payer: Adventist Health Commercial |
$1,626.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,636.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,764.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$5,794.14
|
| Rate for Payer: Cash Price |
$4,473.15
|
| Rate for Payer: Cash Price |
$4,473.15
|
| Rate for Payer: Cash Price |
$4,473.15
|
| Rate for Payer: Cash Price |
$4,473.15
|
| Rate for Payer: Central Health Plan Commercial |
$6,506.40
|
| Rate for Payer: Cigna of CA HMO |
$5,205.12
|
| Rate for Payer: Cigna of CA PPO |
$6,018.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,000.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,636.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,909.30
|
| Rate for Payer: EPIC Health Plan Senior |
$3,636.52
|
| Rate for Payer: Galaxy Health WC |
$6,913.05
|
| Rate for Payer: Global Benefits Group Commercial |
$4,879.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,319.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,963.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,636.52
|
| Rate for Payer: InnovAge PACE Commercial |
$5,454.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,424.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,636.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,626.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,872.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,872.94
|
| Rate for Payer: Multiplan Commercial |
$6,099.75
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: Networks By Design Commercial |
$5,286.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,636.52
|
| Rate for Payer: Preferred Health Network WC |
$5,912.39
|
| Rate for Payer: Prime Health Services Commercial |
$6,913.05
|
| Rate for Payer: Prime Health Services Medicare |
$3,854.71
|
| Rate for Payer: Prime Health Services WC |
$5,735.02
|
| Rate for Payer: Riverside University Health System MISP |
$4,000.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,879.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,066.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,066.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,066.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,066.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,636.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Vantage Medical Group Senior |
$3,636.52
|
|
|
HC INCISION/DRAIN THIGH/KNEE LESI
|
Facility
|
OP
|
$8,133.00
|
|
|
Service Code
|
CPT 27301
|
| Hospital Charge Code |
909000271
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$133.68 |
| Max. Negotiated Rate |
$8,114.00 |
| Rate for Payer: Adventist Health Commercial |
$3,334.53
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,636.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,764.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$5,794.14
|
| Rate for Payer: Cash Price |
$4,473.15
|
| Rate for Payer: Cash Price |
$4,473.15
|
| Rate for Payer: Cash Price |
$4,473.15
|
| Rate for Payer: Cash Price |
$4,473.15
|
| Rate for Payer: Central Health Plan Commercial |
$6,506.40
|
| Rate for Payer: Cigna of CA HMO |
$5,205.12
|
| Rate for Payer: Cigna of CA PPO |
$6,018.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,000.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,636.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,909.30
|
| Rate for Payer: EPIC Health Plan Senior |
$3,636.52
|
| Rate for Payer: Galaxy Health WC |
$6,913.05
|
| Rate for Payer: Global Benefits Group Commercial |
$4,879.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,319.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,963.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,636.52
|
| Rate for Payer: InnovAge PACE Commercial |
$5,454.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,424.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,636.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,626.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,872.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,872.94
|
| Rate for Payer: Multiplan Commercial |
$6,099.75
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: Networks By Design Commercial |
$5,286.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,636.52
|
| Rate for Payer: Preferred Health Network WC |
$5,912.39
|
| Rate for Payer: Prime Health Services Commercial |
$6,913.05
|
| Rate for Payer: Prime Health Services Medicare |
$3,854.71
|
| Rate for Payer: Prime Health Services WC |
$5,735.02
|
| Rate for Payer: Riverside University Health System MISP |
$4,000.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,879.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,879.80
|
| 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 |
$3,636.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Vantage Medical Group Senior |
$3,636.52
|
|
|
HC INCISION/DRAIN THIGH/KNEE LESI
|
Facility
|
IP
|
$8,133.00
|
|
|
Service Code
|
CPT 27301
|
| Hospital Charge Code |
909000271
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,626.60 |
| Max. Negotiated Rate |
$7,319.70 |
| Rate for Payer: Adventist Health Commercial |
$1,626.60
|
| Rate for Payer: Cash Price |
$4,473.15
|
| Rate for Payer: Central Health Plan Commercial |
$6,506.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,253.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,253.20
|
| Rate for Payer: Galaxy Health WC |
$6,913.05
|
| Rate for Payer: Global Benefits Group Commercial |
$4,879.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,319.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,424.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,098.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,034.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,626.60
|
| Rate for Payer: Multiplan Commercial |
$6,099.75
|
| Rate for Payer: Networks By Design Commercial |
$5,286.45
|
| Rate for Payer: Prime Health Services Commercial |
$6,913.05
|
|
|
HC INCISION/DRAIN THIGH/KNEE LESI
|
Facility
|
OP
|
$8,133.00
|
|
|
Service Code
|
CPT 27301
|
| Hospital Charge Code |
909000271
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$121.02 |
| Max. Negotiated Rate |
$16,122.00 |
| Rate for Payer: Adventist Health Commercial |
$1,626.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,636.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,636.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,764.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$5,794.14
|
| Rate for Payer: Blue Shield of California Commercial |
$4,851.77
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$4,473.15
|
| Rate for Payer: Cash Price |
$4,473.15
|
| Rate for Payer: Cash Price |
$4,473.15
|
| Rate for Payer: Central Health Plan Commercial |
$6,506.40
|
| Rate for Payer: Cigna of CA HMO |
$5,205.12
|
| Rate for Payer: Cigna of CA PPO |
$6,018.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,000.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,636.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,909.30
|
| Rate for Payer: EPIC Health Plan Senior |
$3,636.52
|
| Rate for Payer: Galaxy Health WC |
$6,913.05
|
| Rate for Payer: Global Benefits Group Commercial |
$4,879.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,319.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,963.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$121.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,636.52
|
| Rate for Payer: InnovAge PACE Commercial |
$5,454.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,424.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,636.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,626.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,872.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,872.94
|
| Rate for Payer: Multiplan Commercial |
$6,099.75
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: Networks By Design Commercial |
$5,286.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,636.52
|
| Rate for Payer: Preferred Health Network WC |
$5,912.39
|
| Rate for Payer: Prime Health Services Commercial |
$6,913.05
|
| Rate for Payer: Prime Health Services Medicare |
$3,854.71
|
| Rate for Payer: Prime Health Services WC |
$5,735.02
|
| Rate for Payer: Riverside University Health System MISP |
$4,000.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,879.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,984.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,636.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Vantage Medical Group Senior |
$3,636.52
|
|
|
HC INCISION/DRAIN THIGH/KNEE LESI
|
Facility
|
IP
|
$8,133.00
|
|
|
Service Code
|
CPT 27301
|
| Hospital Charge Code |
909000271
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,626.60 |
| Max. Negotiated Rate |
$7,319.70 |
| Rate for Payer: Adventist Health Commercial |
$1,626.60
|
| Rate for Payer: Cash Price |
$4,473.15
|
| Rate for Payer: Central Health Plan Commercial |
$6,506.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,253.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,253.20
|
| Rate for Payer: Galaxy Health WC |
$6,913.05
|
| Rate for Payer: Global Benefits Group Commercial |
$4,879.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,319.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,424.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,098.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,034.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,626.60
|
| Rate for Payer: Multiplan Commercial |
$6,099.75
|
| Rate for Payer: Networks By Design Commercial |
$5,286.45
|
| Rate for Payer: Prime Health Services Commercial |
$6,913.05
|
|
|
HC INCISION/DRAIN THIGH/KNEE LESI
|
Facility
|
IP
|
$8,133.00
|
|
|
Service Code
|
CPT 27301
|
| Hospital Charge Code |
909000271
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,626.60 |
| Max. Negotiated Rate |
$7,319.70 |
| Rate for Payer: Adventist Health Commercial |
$1,626.60
|
| Rate for Payer: Cash Price |
$4,473.15
|
| Rate for Payer: Central Health Plan Commercial |
$6,506.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,253.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,253.20
|
| Rate for Payer: Galaxy Health WC |
$6,913.05
|
| Rate for Payer: Global Benefits Group Commercial |
$4,879.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,319.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,424.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,098.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,034.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,626.60
|
| Rate for Payer: Multiplan Commercial |
$6,099.75
|
| Rate for Payer: Networks By Design Commercial |
$5,286.45
|
| Rate for Payer: Prime Health Services Commercial |
$6,913.05
|
|
|
HC INCISION/DRAIN,UPPER ARM/ELBOW
|
Facility
|
OP
|
$11,664.00
|
|
|
Service Code
|
CPT 23930
|
| Hospital Charge Code |
900501316
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$308.41 |
| Max. Negotiated Rate |
$10,497.60 |
| Rate for Payer: Adventist Health Commercial |
$4,782.24
|
| 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 |
$5,454.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,636.52
|
| 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 |
$5,794.14
|
| Rate for Payer: Cash Price |
$6,415.20
|
| Rate for Payer: Cash Price |
$6,415.20
|
| Rate for Payer: Cash Price |
$6,415.20
|
| Rate for Payer: Cash Price |
$6,415.20
|
| Rate for Payer: Central Health Plan Commercial |
$9,331.20
|
| Rate for Payer: Cigna of CA HMO |
$7,464.96
|
| Rate for Payer: Cigna of CA PPO |
$8,631.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,000.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,636.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,909.30
|
| Rate for Payer: EPIC Health Plan Senior |
$3,636.52
|
| Rate for Payer: Galaxy Health WC |
$9,914.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,998.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,497.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,963.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,636.52
|
| Rate for Payer: InnovAge PACE Commercial |
$5,454.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,779.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$308.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,636.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,332.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,872.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,872.94
|
| Rate for Payer: Multiplan Commercial |
$8,748.00
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: Networks By Design Commercial |
$7,581.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,636.52
|
| Rate for Payer: Preferred Health Network WC |
$5,912.39
|
| Rate for Payer: Prime Health Services Commercial |
$9,914.40
|
| Rate for Payer: Prime Health Services Medicare |
$3,854.71
|
| Rate for Payer: Prime Health Services WC |
$5,735.02
|
| Rate for Payer: Riverside University Health System MISP |
$4,000.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,998.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,998.40
|
| 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 |
$3,636.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Vantage Medical Group Senior |
$3,636.52
|
|
|
HC INCISION/DRAIN,UPPER ARM/ELBOW
|
Facility
|
IP
|
$11,664.00
|
|
|
Service Code
|
CPT 23930
|
| Hospital Charge Code |
900501316
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$2,332.80 |
| Max. Negotiated Rate |
$10,497.60 |
| Rate for Payer: Adventist Health Commercial |
$2,332.80
|
| Rate for Payer: Cash Price |
$6,415.20
|
| Rate for Payer: Central Health Plan Commercial |
$9,331.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,665.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,665.60
|
| Rate for Payer: Galaxy Health WC |
$9,914.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,998.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,497.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,779.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,443.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,220.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,332.80
|
| Rate for Payer: Multiplan Commercial |
$8,748.00
|
| Rate for Payer: Networks By Design Commercial |
$7,581.60
|
| Rate for Payer: Prime Health Services Commercial |
$9,914.40
|
|
|
HC INCISION/DRAIN,UPPER ARM/ELBOW
|
Facility
|
IP
|
$11,664.00
|
|
|
Service Code
|
CPT 23930
|
| Hospital Charge Code |
900501316
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,332.80 |
| Max. Negotiated Rate |
$10,497.60 |
| Rate for Payer: Adventist Health Commercial |
$2,332.80
|
| Rate for Payer: Cash Price |
$6,415.20
|
| Rate for Payer: Central Health Plan Commercial |
$9,331.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,665.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,665.60
|
| Rate for Payer: Galaxy Health WC |
$9,914.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,998.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,497.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,779.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,443.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,220.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,332.80
|
| Rate for Payer: Multiplan Commercial |
$8,748.00
|
| Rate for Payer: Networks By Design Commercial |
$7,581.60
|
| Rate for Payer: Prime Health Services Commercial |
$9,914.40
|
|
|
HC INCISION/DRAIN,UPPER ARM/ELBOW
|
Facility
|
OP
|
$11,664.00
|
|
|
Service Code
|
CPT 23930
|
| Hospital Charge Code |
900501316
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$308.41 |
| Max. Negotiated Rate |
$10,497.60 |
| Rate for Payer: Adventist Health Commercial |
$2,332.80
|
| 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 |
$5,454.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,636.52
|
| 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 |
$5,794.14
|
| Rate for Payer: Cash Price |
$6,415.20
|
| Rate for Payer: Cash Price |
$6,415.20
|
| Rate for Payer: Cash Price |
$6,415.20
|
| Rate for Payer: Cash Price |
$6,415.20
|
| Rate for Payer: Central Health Plan Commercial |
$9,331.20
|
| Rate for Payer: Cigna of CA HMO |
$7,464.96
|
| Rate for Payer: Cigna of CA PPO |
$8,631.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,000.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,636.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,909.30
|
| Rate for Payer: EPIC Health Plan Senior |
$3,636.52
|
| Rate for Payer: Galaxy Health WC |
$9,914.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,998.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,497.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,963.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,636.52
|
| Rate for Payer: InnovAge PACE Commercial |
$5,454.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,779.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$308.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,636.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,332.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,872.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,872.94
|
| Rate for Payer: Multiplan Commercial |
$8,748.00
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: Networks By Design Commercial |
$7,581.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,636.52
|
| Rate for Payer: Preferred Health Network WC |
$5,912.39
|
| Rate for Payer: Prime Health Services Commercial |
$9,914.40
|
| Rate for Payer: Prime Health Services Medicare |
$3,854.71
|
| Rate for Payer: Prime Health Services WC |
$5,735.02
|
| Rate for Payer: Riverside University Health System MISP |
$4,000.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,998.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,832.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,832.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,832.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,832.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,636.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Vantage Medical Group Senior |
$3,636.52
|
|
|
HC INCISION FINGER TENDON EACH
|
Facility
|
OP
|
$10,508.00
|
|
|
Service Code
|
CPT 26455
|
| Hospital Charge Code |
900501536
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$79.93 |
| Max. Negotiated Rate |
$9,457.20 |
| Rate for Payer: Adventist Health Commercial |
$2,101.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,033.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,764.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,240.00
|
| Rate for Payer: Cash Price |
$5,779.40
|
| Rate for Payer: Cash Price |
$5,779.40
|
| Rate for Payer: Cash Price |
$5,779.40
|
| Rate for Payer: Cash Price |
$5,779.40
|
| Rate for Payer: Central Health Plan Commercial |
$8,406.40
|
| Rate for Payer: Cigna of CA HMO |
$6,725.12
|
| Rate for Payer: Cigna of CA PPO |
$7,775.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,236.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,033.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,745.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,033.48
|
| Rate for Payer: Galaxy Health WC |
$8,931.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,304.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,457.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,334.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,033.48
|
| Rate for Payer: InnovAge PACE Commercial |
$3,050.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,008.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$79.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,033.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,101.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,724.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,724.86
|
| Rate for Payer: Multiplan Commercial |
$7,881.00
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$6,830.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,033.48
|
| Rate for Payer: Preferred Health Network WC |
$3,306.12
|
| Rate for Payer: Prime Health Services Commercial |
$8,931.80
|
| Rate for Payer: Prime Health Services Medicare |
$2,155.49
|
| Rate for Payer: Prime Health Services WC |
$3,206.94
|
| Rate for Payer: Riverside University Health System MISP |
$2,236.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,304.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,254.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,254.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,254.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,254.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,033.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Vantage Medical Group Senior |
$2,033.48
|
|
|
HC INCISION FINGER TENDON EACH
|
Facility
|
IP
|
$10,508.00
|
|
|
Service Code
|
CPT 26455
|
| Hospital Charge Code |
900501536
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,101.60 |
| Max. Negotiated Rate |
$9,457.20 |
| Rate for Payer: Adventist Health Commercial |
$2,101.60
|
| Rate for Payer: Cash Price |
$5,779.40
|
| Rate for Payer: Central Health Plan Commercial |
$8,406.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,203.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4,203.20
|
| Rate for Payer: Galaxy Health WC |
$8,931.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,304.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,457.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,008.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,003.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,504.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,101.60
|
| Rate for Payer: Multiplan Commercial |
$7,881.00
|
| Rate for Payer: Networks By Design Commercial |
$6,830.20
|
| Rate for Payer: Prime Health Services Commercial |
$8,931.80
|
|
|
HC INCISION LINGUAL FRENUM
|
Facility
|
OP
|
$7,626.00
|
|
|
Service Code
|
CPT 41010
|
| Hospital Charge Code |
900501558
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$290.74 |
| Max. Negotiated Rate |
$6,863.40 |
| Rate for Payer: Adventist Health Commercial |
$1,525.20
|
| 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 |
$2,823.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,070.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,882.11
|
| 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 |
$2,998.82
|
| Rate for Payer: Cash Price |
$4,194.30
|
| Rate for Payer: Cash Price |
$4,194.30
|
| Rate for Payer: Cash Price |
$4,194.30
|
| Rate for Payer: Cash Price |
$4,194.30
|
| Rate for Payer: Central Health Plan Commercial |
$6,100.80
|
| Rate for Payer: Cigna of CA HMO |
$4,880.64
|
| Rate for Payer: Cigna of CA PPO |
$5,643.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,823.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,070.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,882.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,540.85
|
| Rate for Payer: EPIC Health Plan Senior |
$1,882.11
|
| Rate for Payer: Galaxy Health WC |
$6,482.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4,575.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,863.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,086.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,882.11
|
| Rate for Payer: InnovAge PACE Commercial |
$2,823.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,086.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$290.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,882.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,525.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,522.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,522.03
|
| Rate for Payer: Multiplan Commercial |
$5,719.50
|
| Rate for Payer: Multiplan WC |
$2,998.82
|
| Rate for Payer: Networks By Design Commercial |
$4,956.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,882.11
|
| Rate for Payer: Preferred Health Network WC |
$3,060.02
|
| Rate for Payer: Prime Health Services Commercial |
$6,482.10
|
| Rate for Payer: Prime Health Services Medicare |
$1,995.04
|
| Rate for Payer: Prime Health Services WC |
$2,968.22
|
| Rate for Payer: Riverside University Health System MISP |
$2,070.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,575.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,813.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,813.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,813.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,882.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,823.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,070.32
|
| Rate for Payer: Vantage Medical Group Senior |
$1,882.11
|
|
|
HC INCISION LINGUAL FRENUM
|
Facility
|
IP
|
$7,626.00
|
|
|
Service Code
|
CPT 41010
|
| Hospital Charge Code |
900501558
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,525.20 |
| Max. Negotiated Rate |
$6,863.40 |
| Rate for Payer: Adventist Health Commercial |
$1,525.20
|
| Rate for Payer: Cash Price |
$4,194.30
|
| Rate for Payer: Central Health Plan Commercial |
$6,100.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,050.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,050.40
|
| Rate for Payer: Galaxy Health WC |
$6,482.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4,575.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,863.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,086.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,905.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,720.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,525.20
|
| Rate for Payer: Multiplan Commercial |
$5,719.50
|
| Rate for Payer: Networks By Design Commercial |
$4,956.90
|
| Rate for Payer: Prime Health Services Commercial |
$6,482.10
|
|
