|
HC INCISION OF EYE
|
Facility
|
IP
|
$9,475.00
|
|
|
Service Code
|
CPT 66172
|
| Hospital Charge Code |
900501631
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,895.00 |
| Max. Negotiated Rate |
$8,527.50 |
| Rate for Payer: Adventist Health Commercial |
$1,895.00
|
| Rate for Payer: Cash Price |
$5,211.25
|
| Rate for Payer: Central Health Plan Commercial |
$7,580.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,790.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,790.00
|
| Rate for Payer: Galaxy Health WC |
$8,053.75
|
| Rate for Payer: Global Benefits Group Commercial |
$5,685.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,527.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,319.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,609.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,865.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,895.00
|
| Rate for Payer: Multiplan Commercial |
$7,106.25
|
| Rate for Payer: Networks By Design Commercial |
$6,158.75
|
| Rate for Payer: Prime Health Services Commercial |
$8,053.75
|
|
|
HC INCISION OF EYE
|
Facility
|
OP
|
$9,475.00
|
|
|
Service Code
|
CPT 66172
|
| Hospital Charge Code |
900501631
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$332.46 |
| Max. Negotiated Rate |
$10,567.00 |
| Rate for Payer: Adventist Health Commercial |
$1,895.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,187.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,897.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,581.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$4,617.28
|
| Rate for Payer: Cash Price |
$5,211.25
|
| Rate for Payer: Cash Price |
$5,211.25
|
| Rate for Payer: Cash Price |
$5,211.25
|
| Rate for Payer: Cash Price |
$5,211.25
|
| Rate for Payer: Central Health Plan Commercial |
$7,580.00
|
| Rate for Payer: Cigna of CA HMO |
$6,064.00
|
| Rate for Payer: Cigna of CA PPO |
$7,011.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,187.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,897.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,912.16
|
| Rate for Payer: EPIC Health Plan Senior |
$2,897.90
|
| Rate for Payer: Galaxy Health WC |
$8,053.75
|
| Rate for Payer: Global Benefits Group Commercial |
$5,685.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,527.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,752.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,897.90
|
| Rate for Payer: InnovAge PACE Commercial |
$4,346.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,319.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$332.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,897.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,895.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,883.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,883.19
|
| Rate for Payer: Multiplan Commercial |
$7,106.25
|
| Rate for Payer: Multiplan WC |
$4,617.28
|
| Rate for Payer: Networks By Design Commercial |
$6,158.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,897.90
|
| Rate for Payer: Preferred Health Network WC |
$4,711.51
|
| Rate for Payer: Prime Health Services Commercial |
$8,053.75
|
| Rate for Payer: Prime Health Services Medicare |
$3,071.77
|
| Rate for Payer: Prime Health Services WC |
$4,570.16
|
| Rate for Payer: Riverside University Health System MISP |
$3,187.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,685.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,737.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,737.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,737.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,737.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,897.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,187.69
|
| Rate for Payer: Vantage Medical Group Senior |
$2,897.90
|
|
|
HC INCISION OF LABIAL FRENUM
|
Facility
|
IP
|
$1,543.00
|
|
|
Service Code
|
CPT 40806
|
| Hospital Charge Code |
900501559
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$308.60 |
| Max. Negotiated Rate |
$1,388.70 |
| Rate for Payer: Adventist Health Commercial |
$308.60
|
| Rate for Payer: Cash Price |
$848.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,234.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$617.20
|
| Rate for Payer: EPIC Health Plan Senior |
$617.20
|
| Rate for Payer: Galaxy Health WC |
$1,311.55
|
| Rate for Payer: Global Benefits Group Commercial |
$925.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,388.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,029.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$587.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$955.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$308.60
|
| Rate for Payer: Multiplan Commercial |
$1,157.25
|
| Rate for Payer: Networks By Design Commercial |
$1,002.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,311.55
|
|
|
HC INCISION OF LABIAL FRENUM
|
Facility
|
OP
|
$1,543.00
|
|
|
Service Code
|
CPT 40806
|
| Hospital Charge Code |
900501559
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$308.60 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$308.60
|
| 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 |
$970.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$711.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$647.05
|
| 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 |
$1,030.97
|
| Rate for Payer: Cash Price |
$848.65
|
| Rate for Payer: Cash Price |
$848.65
|
| Rate for Payer: Cash Price |
$848.65
|
| Rate for Payer: Cash Price |
$848.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,234.40
|
| Rate for Payer: Cigna of CA HMO |
$987.52
|
| Rate for Payer: Cigna of CA PPO |
$1,141.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$970.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$711.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$647.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$873.52
|
| Rate for Payer: EPIC Health Plan Senior |
$647.05
|
| Rate for Payer: Galaxy Health WC |
$1,311.55
|
| Rate for Payer: Global Benefits Group Commercial |
$925.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,388.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,061.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$647.05
|
| Rate for Payer: InnovAge PACE Commercial |
$970.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,029.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$587.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$647.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$308.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$867.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$867.05
|
| Rate for Payer: Multiplan Commercial |
$1,157.25
|
| Rate for Payer: Multiplan WC |
$1,030.97
|
| Rate for Payer: Networks By Design Commercial |
$1,002.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$647.05
|
| Rate for Payer: Preferred Health Network WC |
$1,052.01
|
| Rate for Payer: Prime Health Services Commercial |
$1,311.55
|
| Rate for Payer: Prime Health Services Medicare |
$685.87
|
| Rate for Payer: Prime Health Services WC |
$1,020.45
|
| Rate for Payer: Riverside University Health System MISP |
$711.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$925.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$771.50
|
| Rate for Payer: United Healthcare All Other HMO |
$771.50
|
| Rate for Payer: United Healthcare HMO Rider |
$771.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$771.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$647.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$970.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$711.75
|
| Rate for Payer: Vantage Medical Group Senior |
$647.05
|
|
|
HC INCISION OF URETHRA
|
Facility
|
OP
|
$9,187.00
|
|
|
Service Code
|
CPT 53000
|
| Hospital Charge Code |
902400991
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$265.74 |
| Max. Negotiated Rate |
$8,268.30 |
| Rate for Payer: Adventist Health Commercial |
$1,837.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,602.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,904.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,863.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,602.84
|
| 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: Blue Shield of California Commercial |
$5,613.26
|
| Rate for Payer: Blue Shield of California EPN |
$3,665.61
|
| Rate for Payer: Cash Price |
$5,052.85
|
| Rate for Payer: Cash Price |
$5,052.85
|
| Rate for Payer: Cash Price |
$5,052.85
|
| Rate for Payer: Central Health Plan Commercial |
$7,349.60
|
| Rate for Payer: Cigna of CA HMO |
$5,879.68
|
| Rate for Payer: Cigna of CA PPO |
$6,798.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,904.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,863.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,602.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,513.83
|
| Rate for Payer: EPIC Health Plan Senior |
$2,602.84
|
| Rate for Payer: Galaxy Health WC |
$7,808.95
|
| Rate for Payer: Global Benefits Group Commercial |
$5,512.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,268.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,268.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$265.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,602.84
|
| Rate for Payer: InnovAge PACE Commercial |
$3,904.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,127.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$293.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,602.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,837.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,487.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,487.81
|
| Rate for Payer: Multiplan Commercial |
$6,890.25
|
| Rate for Payer: Networks By Design Commercial |
$5,971.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,602.84
|
| Rate for Payer: Prime Health Services Commercial |
$7,808.95
|
| Rate for Payer: Prime Health Services Medicare |
$2,759.01
|
| Rate for Payer: Riverside University Health System MISP |
$2,863.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,512.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,512.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,091.00
|
| Rate for Payer: United Healthcare All Other HMO |
$839.00
|
| Rate for Payer: United Healthcare HMO Rider |
$635.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$581.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,602.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,904.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,863.12
|
| Rate for Payer: Vantage Medical Group Senior |
$2,602.84
|
|
|
HC INCISION OF URETHRA
|
Facility
|
IP
|
$9,187.00
|
|
|
Service Code
|
CPT 53000
|
| Hospital Charge Code |
902400991
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,837.40 |
| Max. Negotiated Rate |
$8,268.30 |
| Rate for Payer: Adventist Health Commercial |
$1,837.40
|
| Rate for Payer: Cash Price |
$5,052.85
|
| Rate for Payer: Central Health Plan Commercial |
$7,349.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,674.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,674.80
|
| Rate for Payer: Galaxy Health WC |
$7,808.95
|
| Rate for Payer: Global Benefits Group Commercial |
$5,512.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,268.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,127.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,500.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,686.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,837.40
|
| Rate for Payer: Multiplan Commercial |
$6,890.25
|
| Rate for Payer: Networks By Design Commercial |
$5,971.55
|
| Rate for Payer: Prime Health Services Commercial |
$7,808.95
|
|
|
HC INCISION THROMBOSED HEMORRHOID
|
Facility
|
IP
|
$2,607.00
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
900501157
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$521.40 |
| Max. Negotiated Rate |
$2,346.30 |
| Rate for Payer: Adventist Health Commercial |
$521.40
|
| Rate for Payer: Cash Price |
$1,433.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,085.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,042.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,042.80
|
| Rate for Payer: Galaxy Health WC |
$2,215.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,564.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,346.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,738.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$993.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,613.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$521.40
|
| Rate for Payer: Multiplan Commercial |
$1,955.25
|
| Rate for Payer: Networks By Design Commercial |
$1,694.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,215.95
|
|
|
HC INCISION THROMBOSED HEMORRHOID
|
Facility
|
OP
|
$2,607.00
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
900501157
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$309.02 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$521.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$309.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$463.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$339.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$309.02
|
| 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: Blue Shield of California Commercial |
$1,592.88
|
| Rate for Payer: Blue Shield of California EPN |
$1,040.19
|
| Rate for Payer: Cash Price |
$1,433.85
|
| Rate for Payer: Cash Price |
$1,433.85
|
| Rate for Payer: Cash Price |
$1,433.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,085.60
|
| Rate for Payer: Cigna of CA HMO |
$1,668.48
|
| Rate for Payer: Cigna of CA PPO |
$1,929.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$463.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$339.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$309.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$417.18
|
| Rate for Payer: EPIC Health Plan Senior |
$309.02
|
| Rate for Payer: Galaxy Health WC |
$2,215.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,564.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,346.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$506.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$328.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$309.02
|
| Rate for Payer: InnovAge PACE Commercial |
$463.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,738.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$362.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$309.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$521.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$414.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$414.09
|
| Rate for Payer: Multiplan Commercial |
$1,955.25
|
| Rate for Payer: Networks By Design Commercial |
$1,694.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$309.02
|
| Rate for Payer: Prime Health Services Commercial |
$2,215.95
|
| Rate for Payer: Prime Health Services Medicare |
$327.56
|
| Rate for Payer: Riverside University Health System MISP |
$339.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,564.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,564.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,091.00
|
| Rate for Payer: United Healthcare All Other HMO |
$839.00
|
| Rate for Payer: United Healthcare HMO Rider |
$635.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$581.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$309.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$463.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$339.92
|
| Rate for Payer: Vantage Medical Group Senior |
$309.02
|
|
|
HC INCISION THROMBOSED HEMORRHOID
|
Facility
|
IP
|
$2,607.00
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
900501157
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$521.40 |
| Max. Negotiated Rate |
$2,346.30 |
| Rate for Payer: Adventist Health Commercial |
$521.40
|
| Rate for Payer: Cash Price |
$1,433.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,085.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,042.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,042.80
|
| Rate for Payer: Galaxy Health WC |
$2,215.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,564.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,346.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,738.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$993.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,613.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$521.40
|
| Rate for Payer: Multiplan Commercial |
$1,955.25
|
| Rate for Payer: Networks By Design Commercial |
$1,694.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,215.95
|
|
|
HC INCISION THROMBOSED HEMORRHOID
|
Facility
|
IP
|
$2,607.00
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
900501157
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$521.40 |
| Max. Negotiated Rate |
$2,346.30 |
| Rate for Payer: Adventist Health Commercial |
$521.40
|
| Rate for Payer: Cash Price |
$1,433.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,085.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,042.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,042.80
|
| Rate for Payer: Galaxy Health WC |
$2,215.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,564.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,346.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,738.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$993.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,613.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$521.40
|
| Rate for Payer: Multiplan Commercial |
$1,955.25
|
| Rate for Payer: Networks By Design Commercial |
$1,694.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,215.95
|
|
|
HC INCISION THROMBOSED HEMORRHOID
|
Facility
|
OP
|
$2,607.00
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
900501157
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$309.02 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$1,068.87
|
| 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 |
$463.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$339.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$309.02
|
| 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 |
$492.37
|
| Rate for Payer: Cash Price |
$1,433.85
|
| Rate for Payer: Cash Price |
$1,433.85
|
| Rate for Payer: Cash Price |
$1,433.85
|
| Rate for Payer: Cash Price |
$1,433.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,085.60
|
| Rate for Payer: Cigna of CA HMO |
$1,668.48
|
| Rate for Payer: Cigna of CA PPO |
$1,929.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$463.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$339.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$309.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$417.18
|
| Rate for Payer: EPIC Health Plan Senior |
$309.02
|
| Rate for Payer: Galaxy Health WC |
$2,215.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,564.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,346.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$506.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$309.02
|
| Rate for Payer: InnovAge PACE Commercial |
$463.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,738.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$362.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$309.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$521.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$414.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$414.09
|
| Rate for Payer: Multiplan Commercial |
$1,955.25
|
| Rate for Payer: Multiplan WC |
$492.37
|
| Rate for Payer: Networks By Design Commercial |
$1,694.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$309.02
|
| Rate for Payer: Preferred Health Network WC |
$502.42
|
| Rate for Payer: Prime Health Services Commercial |
$2,215.95
|
| Rate for Payer: Prime Health Services Medicare |
$327.56
|
| Rate for Payer: Prime Health Services WC |
$487.35
|
| Rate for Payer: Riverside University Health System MISP |
$339.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,564.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,564.20
|
| 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 |
$309.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$463.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$339.92
|
| Rate for Payer: Vantage Medical Group Senior |
$309.02
|
|
|
HC INCISION THROMBOSED HEMORRHOID
|
Facility
|
OP
|
$2,607.00
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
900501157
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$309.02 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$521.40
|
| 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 |
$463.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$339.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$309.02
|
| 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 |
$492.37
|
| Rate for Payer: Cash Price |
$1,433.85
|
| Rate for Payer: Cash Price |
$1,433.85
|
| Rate for Payer: Cash Price |
$1,433.85
|
| Rate for Payer: Cash Price |
$1,433.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,085.60
|
| Rate for Payer: Cigna of CA HMO |
$1,668.48
|
| Rate for Payer: Cigna of CA PPO |
$1,929.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$463.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$339.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$309.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$417.18
|
| Rate for Payer: EPIC Health Plan Senior |
$309.02
|
| Rate for Payer: Galaxy Health WC |
$2,215.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,564.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,346.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$506.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$309.02
|
| Rate for Payer: InnovAge PACE Commercial |
$463.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,738.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$362.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$309.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$521.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$414.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$414.09
|
| Rate for Payer: Multiplan Commercial |
$1,955.25
|
| Rate for Payer: Multiplan WC |
$492.37
|
| Rate for Payer: Networks By Design Commercial |
$1,694.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$309.02
|
| Rate for Payer: Preferred Health Network WC |
$502.42
|
| Rate for Payer: Prime Health Services Commercial |
$2,215.95
|
| Rate for Payer: Prime Health Services Medicare |
$327.56
|
| Rate for Payer: Prime Health Services WC |
$487.35
|
| Rate for Payer: Riverside University Health System MISP |
$339.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,564.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,303.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,303.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,303.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,303.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$309.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$463.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$339.92
|
| Rate for Payer: Vantage Medical Group Senior |
$309.02
|
|
|
HC INC OF CONJUNCTIVA, DRNG OF CYST
|
Facility
|
OP
|
$3,077.00
|
|
|
Service Code
|
CPT 68020
|
| Hospital Charge Code |
900501900
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$218.35 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$615.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,230.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,845.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,353.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,230.63
|
| 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 |
$1,960.77
|
| 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 |
$1,692.35
|
| Rate for Payer: Cash Price |
$1,692.35
|
| Rate for Payer: Cash Price |
$1,692.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,461.60
|
| Rate for Payer: Cigna of CA HMO |
$1,969.28
|
| Rate for Payer: Cigna of CA PPO |
$2,276.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,845.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,353.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,230.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,661.35
|
| Rate for Payer: EPIC Health Plan Senior |
$1,230.63
|
| Rate for Payer: Galaxy Health WC |
$2,615.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,846.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,769.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,018.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$218.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,230.63
|
| Rate for Payer: InnovAge PACE Commercial |
$1,845.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,052.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$241.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,230.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$615.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,649.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,649.04
|
| Rate for Payer: Multiplan Commercial |
$2,307.75
|
| Rate for Payer: Multiplan WC |
$1,960.77
|
| Rate for Payer: Networks By Design Commercial |
$2,000.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,230.63
|
| Rate for Payer: Preferred Health Network WC |
$2,000.79
|
| Rate for Payer: Prime Health Services Commercial |
$2,615.45
|
| Rate for Payer: Prime Health Services Medicare |
$1,304.47
|
| Rate for Payer: Prime Health Services WC |
$1,940.77
|
| Rate for Payer: Riverside University Health System MISP |
$1,353.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,846.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,230.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,845.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,353.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,230.63
|
|
|
HC INC OF CONJUNCTIVA, DRNG OF CYST
|
Facility
|
IP
|
$3,077.00
|
|
|
Service Code
|
CPT 68020
|
| Hospital Charge Code |
900501900
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$615.40 |
| Max. Negotiated Rate |
$2,769.30 |
| Rate for Payer: Adventist Health Commercial |
$615.40
|
| Rate for Payer: Cash Price |
$1,692.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,461.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,230.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,230.80
|
| Rate for Payer: Galaxy Health WC |
$2,615.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,846.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,769.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,052.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,172.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,904.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$615.40
|
| Rate for Payer: Multiplan Commercial |
$2,307.75
|
| Rate for Payer: Networks By Design Commercial |
$2,000.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,615.45
|
|
|
HC INC & REM F/B SUBQ TIS COMPL
|
Facility
|
IP
|
$10,859.00
|
|
|
Service Code
|
CPT 10121
|
| Hospital Charge Code |
900501004
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,171.80 |
| Max. Negotiated Rate |
$9,773.10 |
| Rate for Payer: Adventist Health Commercial |
$2,171.80
|
| Rate for Payer: Cash Price |
$5,972.45
|
| Rate for Payer: Central Health Plan Commercial |
$8,687.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,343.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,343.60
|
| Rate for Payer: Galaxy Health WC |
$9,230.15
|
| Rate for Payer: Global Benefits Group Commercial |
$6,515.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,773.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,242.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,137.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,721.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,171.80
|
| Rate for Payer: Multiplan Commercial |
$8,144.25
|
| Rate for Payer: Networks By Design Commercial |
$7,058.35
|
| Rate for Payer: Prime Health Services Commercial |
$9,230.15
|
|
|
HC INC & REM F/B SUBQ TIS COMPL
|
Facility
|
OP
|
$10,859.00
|
|
|
Service Code
|
CPT 10121
|
| Hospital Charge Code |
900501004
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$178.43 |
| Max. Negotiated Rate |
$9,773.10 |
| Rate for Payer: Adventist Health Commercial |
$2,171.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Cash Price |
$5,972.45
|
| Rate for Payer: Cash Price |
$5,972.45
|
| Rate for Payer: Cash Price |
$5,972.45
|
| Rate for Payer: Cash Price |
$5,972.45
|
| Rate for Payer: Central Health Plan Commercial |
$8,687.20
|
| Rate for Payer: Cigna of CA HMO |
$6,949.76
|
| Rate for Payer: Cigna of CA PPO |
$8,035.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,779.22
|
| Rate for Payer: EPIC Health Plan Senior |
$2,058.68
|
| Rate for Payer: Galaxy Health WC |
$9,230.15
|
| Rate for Payer: Global Benefits Group Commercial |
$6,515.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,773.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: InnovAge PACE Commercial |
$3,088.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,242.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$178.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,171.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,758.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,758.63
|
| Rate for Payer: Multiplan Commercial |
$8,144.25
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$7,058.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$9,230.15
|
| Rate for Payer: Prime Health Services Medicare |
$2,182.20
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,264.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,515.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,429.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,429.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,429.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,429.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,058.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
HC INC & REM FB SUBQ TISSUE
|
Facility
|
IP
|
$2,437.00
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
900501003
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$487.40 |
| Max. Negotiated Rate |
$2,193.30 |
| Rate for Payer: Adventist Health Commercial |
$487.40
|
| Rate for Payer: Cash Price |
$1,340.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,949.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$974.80
|
| Rate for Payer: EPIC Health Plan Senior |
$974.80
|
| Rate for Payer: Galaxy Health WC |
$2,071.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,462.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,193.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,625.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$928.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,508.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$487.40
|
| Rate for Payer: Multiplan Commercial |
$1,827.75
|
| Rate for Payer: Networks By Design Commercial |
$1,584.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,071.45
|
|
|
HC INC & REM FB SUBQ TISSUE
|
Facility
|
OP
|
$2,437.00
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
900501003
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$98.33 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$487.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$507.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$808.84
|
| Rate for Payer: Cash Price |
$1,340.35
|
| Rate for Payer: Cash Price |
$1,340.35
|
| Rate for Payer: Cash Price |
$1,340.35
|
| Rate for Payer: Cash Price |
$1,340.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,949.60
|
| Rate for Payer: Cigna of CA HMO |
$1,559.68
|
| Rate for Payer: Cigna of CA PPO |
$1,803.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$761.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$558.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$507.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$685.31
|
| Rate for Payer: EPIC Health Plan Senior |
$507.64
|
| Rate for Payer: Galaxy Health WC |
$2,071.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,462.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,193.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$832.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$507.64
|
| Rate for Payer: InnovAge PACE Commercial |
$761.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,625.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$507.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$487.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$680.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$680.24
|
| Rate for Payer: Multiplan Commercial |
$1,827.75
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$1,584.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$507.64
|
| Rate for Payer: Preferred Health Network WC |
$825.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,071.45
|
| Rate for Payer: Prime Health Services Medicare |
$538.10
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Riverside University Health System MISP |
$558.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,462.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,218.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,218.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,218.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,218.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$507.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Vantage Medical Group Senior |
$507.64
|
|
|
HC INC & REM FB SUBQ TISSUE
|
Facility
|
OP
|
$2,437.00
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
900501003
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$98.33 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$999.17
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$507.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,431.25
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$808.84
|
| Rate for Payer: Cash Price |
$1,340.35
|
| Rate for Payer: Cash Price |
$1,340.35
|
| Rate for Payer: Cash Price |
$1,340.35
|
| Rate for Payer: Cash Price |
$1,340.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,949.60
|
| Rate for Payer: Cigna of CA HMO |
$1,559.68
|
| Rate for Payer: Cigna of CA PPO |
$1,803.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$761.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$558.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$507.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$685.31
|
| Rate for Payer: EPIC Health Plan Senior |
$507.64
|
| Rate for Payer: Galaxy Health WC |
$2,071.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,462.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,193.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$832.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$507.64
|
| Rate for Payer: InnovAge PACE Commercial |
$761.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,625.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$507.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$487.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$680.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$680.24
|
| Rate for Payer: Multiplan Commercial |
$1,827.75
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$1,584.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$507.64
|
| Rate for Payer: Preferred Health Network WC |
$825.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,071.45
|
| Rate for Payer: Prime Health Services Medicare |
$538.10
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Riverside University Health System MISP |
$558.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,462.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,462.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$507.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Vantage Medical Group Senior |
$507.64
|
|
|
HC INC & REM FB SUBQ TISSUE
|
Facility
|
IP
|
$2,437.00
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
900501003
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$487.40 |
| Max. Negotiated Rate |
$2,193.30 |
| Rate for Payer: Adventist Health Commercial |
$487.40
|
| Rate for Payer: Cash Price |
$1,340.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,949.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$974.80
|
| Rate for Payer: EPIC Health Plan Senior |
$974.80
|
| Rate for Payer: Galaxy Health WC |
$2,071.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,462.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,193.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,625.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$928.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,508.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$487.40
|
| Rate for Payer: Multiplan Commercial |
$1,827.75
|
| Rate for Payer: Networks By Design Commercial |
$1,584.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,071.45
|
|
|
HC INCSNAL BX SKIN EA SEP/ADD LSN
|
Facility
|
IP
|
$769.00
|
|
|
Service Code
|
CPT 11107
|
| Hospital Charge Code |
900511107
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$153.80 |
| Max. Negotiated Rate |
$692.10 |
| Rate for Payer: Adventist Health Commercial |
$153.80
|
| Rate for Payer: Cash Price |
$422.95
|
| Rate for Payer: Central Health Plan Commercial |
$615.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$307.60
|
| Rate for Payer: EPIC Health Plan Senior |
$307.60
|
| Rate for Payer: Galaxy Health WC |
$653.65
|
| Rate for Payer: Global Benefits Group Commercial |
$461.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$692.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$512.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$292.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$476.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$153.80
|
| Rate for Payer: Multiplan Commercial |
$576.75
|
| Rate for Payer: Networks By Design Commercial |
$499.85
|
| Rate for Payer: Prime Health Services Commercial |
$653.65
|
|
|
HC INCSNAL BX SKIN EA SEP/ADD LSN
|
Facility
|
OP
|
$769.00
|
|
|
Service Code
|
CPT 11107
|
| Hospital Charge Code |
900511107
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$114.93 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$153.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$653.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$422.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$576.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$372.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$451.63
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$422.95
|
| Rate for Payer: Cash Price |
$422.95
|
| Rate for Payer: Cash Price |
$422.95
|
| Rate for Payer: Central Health Plan Commercial |
$615.20
|
| Rate for Payer: Cigna of CA HMO |
$492.16
|
| Rate for Payer: Cigna of CA PPO |
$569.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$653.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$653.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$653.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$307.60
|
| Rate for Payer: EPIC Health Plan Senior |
$307.60
|
| Rate for Payer: Galaxy Health WC |
$653.65
|
| Rate for Payer: Global Benefits Group Commercial |
$461.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$692.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$114.93
|
| Rate for Payer: InnovAge PACE Commercial |
$384.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$512.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$126.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$476.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$153.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$538.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$538.30
|
| Rate for Payer: Multiplan Commercial |
$576.75
|
| Rate for Payer: Networks By Design Commercial |
$499.85
|
| Rate for Payer: Prime Health Services Commercial |
$653.65
|
| Rate for Payer: Riverside University Health System MISP |
$307.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$461.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$653.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$653.65
|
| Rate for Payer: Vantage Medical Group Senior |
$653.65
|
|
|
HC IND ABTN GT 1 IA INJ INCL HA
|
Facility
|
IP
|
$12,334.00
|
|
|
Service Code
|
CPT 59850
|
| Hospital Charge Code |
909009850
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,466.80 |
| Max. Negotiated Rate |
$11,100.60 |
| Rate for Payer: Adventist Health Commercial |
$2,466.80
|
| Rate for Payer: Cash Price |
$6,783.70
|
| Rate for Payer: Central Health Plan Commercial |
$9,867.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,933.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,933.60
|
| Rate for Payer: Galaxy Health WC |
$10,483.90
|
| Rate for Payer: Global Benefits Group Commercial |
$7,400.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,100.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,226.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,699.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,634.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,466.80
|
| Rate for Payer: Multiplan Commercial |
$9,250.50
|
| Rate for Payer: Networks By Design Commercial |
$8,017.10
|
| Rate for Payer: Prime Health Services Commercial |
$10,483.90
|
|
|
HC IND ABTN GT 1 IA INJ INCL HA
|
Facility
|
OP
|
$12,334.00
|
|
|
Service Code
|
CPT 59850
|
| Hospital Charge Code |
909009850
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$564.26 |
| Max. Negotiated Rate |
$11,100.60 |
| Rate for Payer: Adventist Health Commercial |
$2,466.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,483.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,783.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,250.50
|
| 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: Blue Shield of California Commercial |
$4,851.77
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$6,783.70
|
| Rate for Payer: Cash Price |
$6,783.70
|
| Rate for Payer: Cash Price |
$6,783.70
|
| Rate for Payer: Central Health Plan Commercial |
$9,867.20
|
| Rate for Payer: Cigna of CA HMO |
$7,893.76
|
| Rate for Payer: Cigna of CA PPO |
$9,127.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,483.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,483.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,483.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,933.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,933.60
|
| Rate for Payer: Galaxy Health WC |
$10,483.90
|
| Rate for Payer: Global Benefits Group Commercial |
$7,400.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,100.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$564.26
|
| Rate for Payer: InnovAge PACE Commercial |
$6,167.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,226.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$623.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,634.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,466.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,633.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,633.80
|
| Rate for Payer: Multiplan Commercial |
$9,250.50
|
| Rate for Payer: Networks By Design Commercial |
$8,017.10
|
| Rate for Payer: Prime Health Services Commercial |
$10,483.90
|
| Rate for Payer: Riverside University Health System MISP |
$4,933.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,400.40
|
| 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: Vantage Medical Group Commercial/Exchange |
$10,483.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,483.90
|
| Rate for Payer: Vantage Medical Group Senior |
$10,483.90
|
|
|
HC IND COOK FLEXOR CHECKFLO
|
Facility
|
IP
|
$522.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
906812403
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$104.40 |
| Max. Negotiated Rate |
$469.80 |
| Rate for Payer: Adventist Health Commercial |
$104.40
|
| Rate for Payer: Cash Price |
$287.10
|
| Rate for Payer: Central Health Plan Commercial |
$417.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$208.80
|
| Rate for Payer: EPIC Health Plan Senior |
$208.80
|
| Rate for Payer: Galaxy Health WC |
$443.70
|
| Rate for Payer: Global Benefits Group Commercial |
$313.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$469.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$348.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$198.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$323.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$104.40
|
| Rate for Payer: Multiplan Commercial |
$391.50
|
| Rate for Payer: Networks By Design Commercial |
$339.30
|
| Rate for Payer: Prime Health Services Commercial |
$443.70
|
|
