|
HC MR ANGIO LOW EXT W&WO CON
|
Facility
|
IP
|
$13,235.00
|
|
|
Service Code
|
CPT 73725
|
| Hospital Charge Code |
908801036
|
|
Hospital Revenue Code
|
616
|
| Min. Negotiated Rate |
$2,647.00 |
| Max. Negotiated Rate |
$11,911.50 |
| Rate for Payer: Adventist Health Commercial |
$2,647.00
|
| Rate for Payer: Cash Price |
$5,955.75
|
| Rate for Payer: Central Health Plan Commercial |
$10,588.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,264.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,294.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,294.00
|
| Rate for Payer: Galaxy Health WC |
$11,249.75
|
| Rate for Payer: Global Benefits Group Commercial |
$7,941.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,911.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,404.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,808.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,647.00
|
| Rate for Payer: Multiplan Commercial |
$9,926.25
|
| Rate for Payer: Networks By Design Commercial |
$8,602.75
|
| Rate for Payer: Prime Health Services Commercial |
$11,249.75
|
|
|
HC MR ANGIO LOW EXT W&WO CON
|
Facility
|
OP
|
$13,235.00
|
|
|
Service Code
|
CPT 73725
|
| Hospital Charge Code |
908801036
|
|
Hospital Revenue Code
|
616
|
| Min. Negotiated Rate |
$567.69 |
| Max. Negotiated Rate |
$11,911.50 |
| Rate for Payer: Adventist Health Commercial |
$2,647.00
|
| Rate for Payer: Adventist Health Commercial |
$1,162.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,055.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,055.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,939.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,249.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,279.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,196.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,358.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,926.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,308.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,308.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,698.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,380.26
|
| Rate for Payer: Blue Shield of California Commercial |
$3,660.93
|
| Rate for Payer: Blue Shield of California Commercial |
$8,338.05
|
| Rate for Payer: Blue Shield of California EPN |
$2,306.97
|
| Rate for Payer: Blue Shield of California EPN |
$5,254.30
|
| Rate for Payer: Cash Price |
$5,955.75
|
| Rate for Payer: Cash Price |
$2,614.95
|
| Rate for Payer: Cash Price |
$2,614.95
|
| Rate for Payer: Cash Price |
$5,955.75
|
| Rate for Payer: Central Health Plan Commercial |
$4,648.80
|
| Rate for Payer: Central Health Plan Commercial |
$10,588.00
|
| Rate for Payer: Cigna of CA HMO |
$8,470.40
|
| Rate for Payer: Cigna of CA HMO |
$3,719.04
|
| Rate for Payer: Cigna of CA PPO |
$4,300.14
|
| Rate for Payer: Cigna of CA PPO |
$9,793.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,249.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,939.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,249.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,939.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11,249.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,939.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,067.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,264.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,294.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,324.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,324.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,294.00
|
| Rate for Payer: Galaxy Health WC |
$11,249.75
|
| Rate for Payer: Galaxy Health WC |
$4,939.35
|
| Rate for Payer: Global Benefits Group Commercial |
$7,941.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,486.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,911.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,229.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$567.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$567.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,689.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,404.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$627.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$627.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,428.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,808.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,162.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,647.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,067.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,264.50
|
| Rate for Payer: Multiplan Commercial |
$9,926.25
|
| Rate for Payer: Multiplan Commercial |
$4,358.25
|
| Rate for Payer: Networks By Design Commercial |
$3,777.15
|
| Rate for Payer: Networks By Design Commercial |
$8,602.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,939.35
|
| Rate for Payer: Prime Health Services Commercial |
$11,249.75
|
| Rate for Payer: Riverside University Health System MISP |
$5,294.00
|
| Rate for Payer: Riverside University Health System MISP |
$2,324.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,941.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,486.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,486.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,941.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,114.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,114.46
|
| Rate for Payer: United Healthcare All Other HMO |
$1,114.46
|
| Rate for Payer: United Healthcare All Other HMO |
$1,114.46
|
| Rate for Payer: United Healthcare HMO Rider |
$1,114.46
|
| Rate for Payer: United Healthcare HMO Rider |
$1,114.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,114.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,114.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,249.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,939.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,249.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,939.35
|
| Rate for Payer: Vantage Medical Group Senior |
$11,249.75
|
| Rate for Payer: Vantage Medical Group Senior |
$4,939.35
|
|
|
HC MR ANGIO PELVIS W/CONT
|
Facility
|
OP
|
$8,158.00
|
|
|
Service Code
|
CPT 72198
|
| Hospital Charge Code |
908801097
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$569.99 |
| Max. Negotiated Rate |
$7,342.20 |
| Rate for Payer: Adventist Health Commercial |
$1,631.60
|
| Rate for Payer: Adventist Health Commercial |
$750.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,189.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,934.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,486.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,063.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,118.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,814.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,308.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,308.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,182.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,745.51
|
| Rate for Payer: Blue Shield of California Commercial |
$2,363.76
|
| Rate for Payer: Blue Shield of California Commercial |
$5,139.54
|
| Rate for Payer: Blue Shield of California EPN |
$3,238.73
|
| Rate for Payer: Blue Shield of California EPN |
$1,489.54
|
| Rate for Payer: Cash Price |
$1,688.40
|
| Rate for Payer: Cash Price |
$1,688.40
|
| Rate for Payer: Cash Price |
$3,671.10
|
| Rate for Payer: Cash Price |
$3,671.10
|
| Rate for Payer: Cash Price |
$1,688.40
|
| Rate for Payer: Cash Price |
$3,671.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,001.60
|
| Rate for Payer: Central Health Plan Commercial |
$6,526.40
|
| Rate for Payer: Cigna of CA HMO |
$2,401.28
|
| Rate for Payer: Cigna of CA HMO |
$5,221.12
|
| Rate for Payer: Cigna of CA PPO |
$2,776.48
|
| Rate for Payer: Cigna of CA PPO |
$6,036.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,189.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,934.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,934.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,189.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,189.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,934.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,710.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,626.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,500.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,263.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,263.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,500.80
|
| Rate for Payer: Galaxy Health WC |
$3,189.20
|
| Rate for Payer: Galaxy Health WC |
$6,934.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,251.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,894.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,342.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,376.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$569.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$569.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,180.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,382.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$629.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$629.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,813.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,213.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,631.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$750.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,626.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,710.60
|
| Rate for Payer: Multiplan Commercial |
$6,118.50
|
| Rate for Payer: Multiplan Commercial |
$2,814.00
|
| Rate for Payer: Networks By Design Commercial |
$2,438.80
|
| Rate for Payer: Networks By Design Commercial |
$5,302.70
|
| Rate for Payer: Prime Health Services Commercial |
$6,934.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,189.20
|
| Rate for Payer: Riverside University Health System MISP |
$1,500.80
|
| Rate for Payer: Riverside University Health System MISP |
$3,263.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,894.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,251.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,251.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,894.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,113.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,113.60
|
| Rate for Payer: United Healthcare All Other HMO |
$1,113.60
|
| Rate for Payer: United Healthcare All Other HMO |
$1,113.60
|
| Rate for Payer: United Healthcare HMO Rider |
$1,113.60
|
| Rate for Payer: United Healthcare HMO Rider |
$1,113.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,113.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,113.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,189.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,934.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,934.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,189.20
|
| Rate for Payer: Vantage Medical Group Senior |
$6,934.30
|
| Rate for Payer: Vantage Medical Group Senior |
$3,189.20
|
|
|
HC MR ANGIO PELVIS W/CONT
|
Facility
|
IP
|
$8,158.00
|
|
|
Service Code
|
CPT 72198
|
| Hospital Charge Code |
908801097
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,631.60 |
| Max. Negotiated Rate |
$7,342.20 |
| Rate for Payer: Adventist Health Commercial |
$1,631.60
|
| Rate for Payer: Cash Price |
$3,671.10
|
| Rate for Payer: Central Health Plan Commercial |
$6,526.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,710.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,263.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,263.20
|
| Rate for Payer: Galaxy Health WC |
$6,934.30
|
| Rate for Payer: Global Benefits Group Commercial |
$4,894.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,342.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,180.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,813.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,631.60
|
| Rate for Payer: Multiplan Commercial |
$6,118.50
|
| Rate for Payer: Networks By Design Commercial |
$5,302.70
|
| Rate for Payer: Prime Health Services Commercial |
$6,934.30
|
|
|
HC MR ANGIO PELVIS WO CONT
|
Facility
|
OP
|
$7,770.00
|
|
|
Service Code
|
CPT 72198
|
| Hospital Charge Code |
908801098
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$569.99 |
| Max. Negotiated Rate |
$6,993.00 |
| Rate for Payer: Adventist Health Commercial |
$1,554.00
|
| Rate for Payer: Adventist Health Commercial |
$659.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,803.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,604.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,273.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,813.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,827.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,473.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,308.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,308.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,918.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,519.81
|
| Rate for Payer: Blue Shield of California Commercial |
$2,077.74
|
| Rate for Payer: Blue Shield of California Commercial |
$4,895.10
|
| Rate for Payer: Blue Shield of California EPN |
$3,084.69
|
| Rate for Payer: Blue Shield of California EPN |
$1,309.31
|
| Rate for Payer: Cash Price |
$1,484.10
|
| Rate for Payer: Cash Price |
$1,484.10
|
| Rate for Payer: Cash Price |
$3,496.50
|
| Rate for Payer: Cash Price |
$3,496.50
|
| Rate for Payer: Cash Price |
$1,484.10
|
| Rate for Payer: Cash Price |
$3,496.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,638.40
|
| Rate for Payer: Central Health Plan Commercial |
$6,216.00
|
| Rate for Payer: Cigna of CA HMO |
$2,110.72
|
| Rate for Payer: Cigna of CA HMO |
$4,972.80
|
| Rate for Payer: Cigna of CA PPO |
$2,440.52
|
| Rate for Payer: Cigna of CA PPO |
$5,749.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,803.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,604.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,604.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,803.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,803.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,604.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,439.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,308.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,319.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,108.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,108.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,319.20
|
| Rate for Payer: Galaxy Health WC |
$2,803.30
|
| Rate for Payer: Galaxy Health WC |
$6,604.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,978.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,662.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,993.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,968.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$569.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$569.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,933.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,094.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$629.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$629.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,584.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,945.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,554.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$659.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,308.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,439.00
|
| Rate for Payer: Multiplan Commercial |
$5,827.50
|
| Rate for Payer: Multiplan Commercial |
$2,473.50
|
| Rate for Payer: Networks By Design Commercial |
$2,143.70
|
| Rate for Payer: Networks By Design Commercial |
$5,050.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,604.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,803.30
|
| Rate for Payer: Riverside University Health System MISP |
$1,319.20
|
| Rate for Payer: Riverside University Health System MISP |
$3,108.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,662.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,978.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,978.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,662.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,113.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,113.60
|
| Rate for Payer: United Healthcare All Other HMO |
$1,113.60
|
| Rate for Payer: United Healthcare All Other HMO |
$1,113.60
|
| Rate for Payer: United Healthcare HMO Rider |
$1,113.60
|
| Rate for Payer: United Healthcare HMO Rider |
$1,113.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,113.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,113.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,803.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,604.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,604.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,803.30
|
| Rate for Payer: Vantage Medical Group Senior |
$6,604.50
|
| Rate for Payer: Vantage Medical Group Senior |
$2,803.30
|
|
|
HC MR ANGIO PELVIS WO CONT
|
Facility
|
IP
|
$7,770.00
|
|
|
Service Code
|
CPT 72198
|
| Hospital Charge Code |
908801098
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,554.00 |
| Max. Negotiated Rate |
$6,993.00 |
| Rate for Payer: Adventist Health Commercial |
$1,554.00
|
| Rate for Payer: Cash Price |
$3,496.50
|
| Rate for Payer: Central Health Plan Commercial |
$6,216.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,439.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,108.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,108.00
|
| Rate for Payer: Galaxy Health WC |
$6,604.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,662.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,993.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,933.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,584.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,554.00
|
| Rate for Payer: Multiplan Commercial |
$5,827.50
|
| Rate for Payer: Networks By Design Commercial |
$5,050.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,604.50
|
|
|
HC MR ANGIO PELVIS WO FOL W CONT
|
Facility
|
OP
|
$8,568.00
|
|
|
Service Code
|
CPT 72198
|
| Hospital Charge Code |
908801099
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$569.99 |
| Max. Negotiated Rate |
$7,711.20 |
| Rate for Payer: Adventist Health Commercial |
$1,713.60
|
| Rate for Payer: Adventist Health Commercial |
$842.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,579.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,282.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,712.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,316.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,426.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,158.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,308.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,308.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,449.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,652.93
|
| Rate for Payer: Blue Shield of California Commercial |
$5,397.84
|
| Rate for Payer: Blue Shield of California EPN |
$3,401.50
|
| Rate for Payer: Blue Shield of California EPN |
$1,671.77
|
| Rate for Payer: Cash Price |
$1,894.95
|
| Rate for Payer: Cash Price |
$1,894.95
|
| Rate for Payer: Cash Price |
$3,855.60
|
| Rate for Payer: Cash Price |
$3,855.60
|
| Rate for Payer: Cash Price |
$1,894.95
|
| Rate for Payer: Cash Price |
$3,855.60
|
| Rate for Payer: Central Health Plan Commercial |
$3,368.80
|
| Rate for Payer: Central Health Plan Commercial |
$6,854.40
|
| Rate for Payer: Cigna of CA HMO |
$2,695.04
|
| Rate for Payer: Cigna of CA HMO |
$5,483.52
|
| Rate for Payer: Cigna of CA PPO |
$3,116.14
|
| Rate for Payer: Cigna of CA PPO |
$6,340.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,579.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,282.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,282.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,579.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,579.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,282.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,997.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,947.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,684.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,427.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,427.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,684.40
|
| Rate for Payer: Galaxy Health WC |
$3,579.35
|
| Rate for Payer: Galaxy Health WC |
$7,282.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,526.60
|
| Rate for Payer: Global Benefits Group Commercial |
$5,140.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,711.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,789.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$569.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$569.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,440.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,673.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$629.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$629.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,055.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,484.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,713.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$842.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,947.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,997.60
|
| Rate for Payer: Multiplan Commercial |
$6,426.00
|
| Rate for Payer: Multiplan Commercial |
$3,158.25
|
| Rate for Payer: Networks By Design Commercial |
$2,737.15
|
| Rate for Payer: Networks By Design Commercial |
$5,569.20
|
| Rate for Payer: Prime Health Services Commercial |
$7,282.80
|
| Rate for Payer: Prime Health Services Commercial |
$3,579.35
|
| Rate for Payer: Riverside University Health System MISP |
$1,684.40
|
| Rate for Payer: Riverside University Health System MISP |
$3,427.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,140.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,526.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,526.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,140.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,113.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,113.60
|
| Rate for Payer: United Healthcare All Other HMO |
$1,113.60
|
| Rate for Payer: United Healthcare All Other HMO |
$1,113.60
|
| Rate for Payer: United Healthcare HMO Rider |
$1,113.60
|
| Rate for Payer: United Healthcare HMO Rider |
$1,113.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,113.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,113.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,579.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,282.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,282.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,579.35
|
| Rate for Payer: Vantage Medical Group Senior |
$7,282.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,579.35
|
|
|
HC MR ANGIO PELVIS WO FOL W CONT
|
Facility
|
IP
|
$8,568.00
|
|
|
Service Code
|
CPT 72198
|
| Hospital Charge Code |
908801099
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,713.60 |
| Max. Negotiated Rate |
$7,711.20 |
| Rate for Payer: Adventist Health Commercial |
$1,713.60
|
| Rate for Payer: Cash Price |
$3,855.60
|
| Rate for Payer: Central Health Plan Commercial |
$6,854.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,997.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,427.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,427.20
|
| Rate for Payer: Galaxy Health WC |
$7,282.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5,140.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,711.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,440.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,055.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,713.60
|
| Rate for Payer: Multiplan Commercial |
$6,426.00
|
| Rate for Payer: Networks By Design Commercial |
$5,569.20
|
| Rate for Payer: Prime Health Services Commercial |
$7,282.80
|
|
|
HC MR ANGIO PELVIS WO FOL W CONT
|
Facility
|
OP
|
$8,568.00
|
|
|
Service Code
|
CPT 72198
|
| Hospital Charge Code |
908801034
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$569.99 |
| Max. Negotiated Rate |
$7,711.20 |
| Rate for Payer: Adventist Health Commercial |
$1,713.60
|
| Rate for Payer: Adventist Health Commercial |
$842.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,579.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,282.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,712.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,316.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,426.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,158.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,308.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,308.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,449.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,652.93
|
| Rate for Payer: Blue Shield of California Commercial |
$5,397.84
|
| Rate for Payer: Blue Shield of California EPN |
$3,401.50
|
| Rate for Payer: Blue Shield of California EPN |
$1,671.77
|
| Rate for Payer: Cash Price |
$1,894.95
|
| Rate for Payer: Cash Price |
$1,894.95
|
| Rate for Payer: Cash Price |
$3,855.60
|
| Rate for Payer: Cash Price |
$3,855.60
|
| Rate for Payer: Cash Price |
$1,894.95
|
| Rate for Payer: Cash Price |
$3,855.60
|
| Rate for Payer: Central Health Plan Commercial |
$3,368.80
|
| Rate for Payer: Central Health Plan Commercial |
$6,854.40
|
| Rate for Payer: Cigna of CA HMO |
$2,695.04
|
| Rate for Payer: Cigna of CA HMO |
$5,483.52
|
| Rate for Payer: Cigna of CA PPO |
$3,116.14
|
| Rate for Payer: Cigna of CA PPO |
$6,340.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,579.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,282.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,282.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,579.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,579.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,282.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,997.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,947.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,684.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,427.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,427.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,684.40
|
| Rate for Payer: Galaxy Health WC |
$3,579.35
|
| Rate for Payer: Galaxy Health WC |
$7,282.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,526.60
|
| Rate for Payer: Global Benefits Group Commercial |
$5,140.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,711.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,789.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$569.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$569.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,440.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,673.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$629.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$629.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,055.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,484.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,713.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$842.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,947.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,997.60
|
| Rate for Payer: Multiplan Commercial |
$6,426.00
|
| Rate for Payer: Multiplan Commercial |
$3,158.25
|
| Rate for Payer: Networks By Design Commercial |
$2,737.15
|
| Rate for Payer: Networks By Design Commercial |
$5,569.20
|
| Rate for Payer: Prime Health Services Commercial |
$7,282.80
|
| Rate for Payer: Prime Health Services Commercial |
$3,579.35
|
| Rate for Payer: Riverside University Health System MISP |
$1,684.40
|
| Rate for Payer: Riverside University Health System MISP |
$3,427.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,140.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,526.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,526.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,140.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,113.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,113.60
|
| Rate for Payer: United Healthcare All Other HMO |
$1,113.60
|
| Rate for Payer: United Healthcare All Other HMO |
$1,113.60
|
| Rate for Payer: United Healthcare HMO Rider |
$1,113.60
|
| Rate for Payer: United Healthcare HMO Rider |
$1,113.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,113.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,113.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,579.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,282.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,282.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,579.35
|
| Rate for Payer: Vantage Medical Group Senior |
$7,282.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,579.35
|
|
|
HC MR ANGIO PELVIS WO FOL W CONT
|
Facility
|
IP
|
$8,568.00
|
|
|
Service Code
|
CPT 72198
|
| Hospital Charge Code |
908801034
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,713.60 |
| Max. Negotiated Rate |
$7,711.20 |
| Rate for Payer: Adventist Health Commercial |
$1,713.60
|
| Rate for Payer: Cash Price |
$3,855.60
|
| Rate for Payer: Central Health Plan Commercial |
$6,854.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,997.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,427.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,427.20
|
| Rate for Payer: Galaxy Health WC |
$7,282.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5,140.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,711.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,440.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,055.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,713.60
|
| Rate for Payer: Multiplan Commercial |
$6,426.00
|
| Rate for Payer: Networks By Design Commercial |
$5,569.20
|
| Rate for Payer: Prime Health Services Commercial |
$7,282.80
|
|
|
HC MR ANGIO SPINAL CAN W OR WO CO
|
Facility
|
OP
|
$2,696.00
|
|
|
Service Code
|
CPT 72159
|
| Hospital Charge Code |
908801033
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$539.20 |
| Max. Negotiated Rate |
$2,559.78 |
| Rate for Payer: Adventist Health Commercial |
$539.20
|
| Rate for Payer: Adventist Health Commercial |
$1,116.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,055.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,055.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,743.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,291.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,482.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,069.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,185.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,022.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,559.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,559.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,568.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,246.47
|
| Rate for Payer: Blue Shield of California Commercial |
$3,516.03
|
| Rate for Payer: Blue Shield of California Commercial |
$1,698.48
|
| Rate for Payer: Blue Shield of California EPN |
$2,215.66
|
| Rate for Payer: Blue Shield of California EPN |
$1,070.31
|
| Rate for Payer: Cash Price |
$1,213.20
|
| Rate for Payer: Cash Price |
$2,511.45
|
| Rate for Payer: Cash Price |
$2,511.45
|
| Rate for Payer: Cash Price |
$1,213.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,464.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,156.80
|
| Rate for Payer: Cigna of CA HMO |
$1,725.44
|
| Rate for Payer: Cigna of CA HMO |
$3,571.84
|
| Rate for Payer: Cigna of CA PPO |
$4,129.94
|
| Rate for Payer: Cigna of CA PPO |
$1,995.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,291.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,743.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,291.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,743.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,291.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,743.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,906.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,887.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,078.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,232.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,232.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,078.40
|
| Rate for Payer: Galaxy Health WC |
$2,291.60
|
| Rate for Payer: Galaxy Health WC |
$4,743.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,617.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,348.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,426.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,022.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$586.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$586.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,543.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,711.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$647.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$647.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,292.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,590.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,116.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$539.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,906.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,887.20
|
| Rate for Payer: Multiplan Commercial |
$2,022.00
|
| Rate for Payer: Multiplan Commercial |
$4,185.75
|
| Rate for Payer: Networks By Design Commercial |
$3,627.65
|
| Rate for Payer: Networks By Design Commercial |
$1,752.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,743.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,291.60
|
| Rate for Payer: Riverside University Health System MISP |
$1,078.40
|
| Rate for Payer: Riverside University Health System MISP |
$2,232.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,617.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,348.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,348.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,617.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,168.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,168.48
|
| Rate for Payer: United Healthcare All Other HMO |
$1,168.48
|
| Rate for Payer: United Healthcare All Other HMO |
$1,168.48
|
| Rate for Payer: United Healthcare HMO Rider |
$1,168.48
|
| Rate for Payer: United Healthcare HMO Rider |
$1,168.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,168.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,168.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,291.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,743.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,291.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,743.85
|
| Rate for Payer: Vantage Medical Group Senior |
$2,291.60
|
| Rate for Payer: Vantage Medical Group Senior |
$4,743.85
|
|
|
HC MR ANGIO SPINAL CAN W OR WO CO
|
Facility
|
IP
|
$5,581.00
|
|
|
Service Code
|
CPT 72159
|
| Hospital Charge Code |
908801033
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,116.20 |
| Max. Negotiated Rate |
$5,022.90 |
| Rate for Payer: Adventist Health Commercial |
$1,116.20
|
| Rate for Payer: Cash Price |
$2,511.45
|
| Rate for Payer: Central Health Plan Commercial |
$4,464.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,906.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,232.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,232.40
|
| Rate for Payer: Galaxy Health WC |
$4,743.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,348.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,022.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,543.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,292.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,116.20
|
| Rate for Payer: Multiplan Commercial |
$4,185.75
|
| Rate for Payer: Networks By Design Commercial |
$3,627.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,743.85
|
|
|
HC MR ANGIO UPPER EXT W/WO CONTR
|
Facility
|
IP
|
$5,013.00
|
|
|
Service Code
|
CPT 73225
|
| Hospital Charge Code |
908801035
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,002.60 |
| Max. Negotiated Rate |
$4,511.70 |
| Rate for Payer: Adventist Health Commercial |
$1,002.60
|
| Rate for Payer: Cash Price |
$2,255.85
|
| Rate for Payer: Central Health Plan Commercial |
$4,010.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,509.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,005.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,005.20
|
| Rate for Payer: Galaxy Health WC |
$4,261.05
|
| Rate for Payer: Global Benefits Group Commercial |
$3,007.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,511.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,183.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,957.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,002.60
|
| Rate for Payer: Multiplan Commercial |
$3,759.75
|
| Rate for Payer: Networks By Design Commercial |
$3,258.45
|
| Rate for Payer: Prime Health Services Commercial |
$4,261.05
|
|
|
HC MR ANGIO UPPER EXT W/WO CONTR
|
Facility
|
OP
|
$5,013.00
|
|
|
Service Code
|
CPT 73225
|
| Hospital Charge Code |
908801035
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$581.88 |
| Max. Negotiated Rate |
$4,511.70 |
| Rate for Payer: Adventist Health Commercial |
$1,002.60
|
| Rate for Payer: Adventist Health Commercial |
$506.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,151.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,261.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,757.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,392.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,759.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,898.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,306.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,306.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,472.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,916.06
|
| Rate for Payer: Blue Shield of California Commercial |
$1,594.53
|
| Rate for Payer: Blue Shield of California Commercial |
$3,158.19
|
| Rate for Payer: Blue Shield of California EPN |
$1,990.16
|
| Rate for Payer: Blue Shield of California EPN |
$1,004.81
|
| Rate for Payer: Cash Price |
$1,138.95
|
| Rate for Payer: Cash Price |
$1,138.95
|
| Rate for Payer: Cash Price |
$2,255.85
|
| Rate for Payer: Cash Price |
$2,255.85
|
| Rate for Payer: Cash Price |
$1,138.95
|
| Rate for Payer: Cash Price |
$2,255.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,024.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,010.40
|
| Rate for Payer: Cigna of CA HMO |
$1,619.84
|
| Rate for Payer: Cigna of CA HMO |
$3,208.32
|
| Rate for Payer: Cigna of CA PPO |
$1,872.94
|
| Rate for Payer: Cigna of CA PPO |
$3,709.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,151.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,261.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,261.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,151.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,151.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,261.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,509.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,771.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,012.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,005.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,005.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,012.40
|
| Rate for Payer: Galaxy Health WC |
$2,151.35
|
| Rate for Payer: Galaxy Health WC |
$4,261.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,518.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,007.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,511.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,277.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$581.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$581.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,183.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,607.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$642.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$642.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,957.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,493.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,002.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$506.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,771.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,509.10
|
| Rate for Payer: Multiplan Commercial |
$3,759.75
|
| Rate for Payer: Multiplan Commercial |
$1,898.25
|
| Rate for Payer: Networks By Design Commercial |
$1,645.15
|
| Rate for Payer: Networks By Design Commercial |
$3,258.45
|
| Rate for Payer: Prime Health Services Commercial |
$4,261.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,151.35
|
| Rate for Payer: Riverside University Health System MISP |
$1,012.40
|
| Rate for Payer: Riverside University Health System MISP |
$2,005.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,007.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,518.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,518.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,007.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,124.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,124.94
|
| Rate for Payer: United Healthcare All Other HMO |
$1,124.94
|
| Rate for Payer: United Healthcare All Other HMO |
$1,124.94
|
| Rate for Payer: United Healthcare HMO Rider |
$1,124.94
|
| Rate for Payer: United Healthcare HMO Rider |
$1,124.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,124.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,124.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,151.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,261.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,261.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,151.35
|
| Rate for Payer: Vantage Medical Group Senior |
$4,261.05
|
| Rate for Payer: Vantage Medical Group Senior |
$2,151.35
|
|
|
HC MR ANGIO W/O FOL W/CONT, ABD
|
Facility
|
OP
|
$7,718.00
|
|
|
Service Code
|
CPT 74185
|
| Hospital Charge Code |
908801096
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$571.09 |
| Max. Negotiated Rate |
$6,946.20 |
| Rate for Payer: Adventist Health Commercial |
$1,543.60
|
| Rate for Payer: Adventist Health Commercial |
$3,323.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14,125.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,560.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,244.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,139.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,788.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12,463.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,308.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,308.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,666.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,489.56
|
| Rate for Payer: Blue Shield of California Commercial |
$10,469.34
|
| Rate for Payer: Blue Shield of California Commercial |
$4,862.34
|
| Rate for Payer: Blue Shield of California EPN |
$3,064.05
|
| Rate for Payer: Blue Shield of California EPN |
$6,597.35
|
| Rate for Payer: Cash Price |
$7,478.10
|
| Rate for Payer: Cash Price |
$7,478.10
|
| Rate for Payer: Cash Price |
$3,473.10
|
| Rate for Payer: Cash Price |
$3,473.10
|
| Rate for Payer: Cash Price |
$7,478.10
|
| Rate for Payer: Cash Price |
$3,473.10
|
| Rate for Payer: Central Health Plan Commercial |
$13,294.40
|
| Rate for Payer: Central Health Plan Commercial |
$6,174.40
|
| Rate for Payer: Cigna of CA HMO |
$10,635.52
|
| Rate for Payer: Cigna of CA HMO |
$4,939.52
|
| Rate for Payer: Cigna of CA PPO |
$12,297.32
|
| Rate for Payer: Cigna of CA PPO |
$5,711.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14,125.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,560.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,560.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,125.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,125.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,560.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,402.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,632.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,647.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,087.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,087.20
|
| Rate for Payer: EPIC Health Plan Senior |
$6,647.20
|
| Rate for Payer: Galaxy Health WC |
$14,125.30
|
| Rate for Payer: Galaxy Health WC |
$6,560.30
|
| Rate for Payer: Global Benefits Group Commercial |
$9,970.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,630.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,946.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,956.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$571.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$571.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,900.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,552.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$630.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$630.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,553.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,804.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,543.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,323.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11,632.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,402.60
|
| Rate for Payer: Multiplan Commercial |
$5,788.50
|
| Rate for Payer: Multiplan Commercial |
$12,463.50
|
| Rate for Payer: Networks By Design Commercial |
$10,801.70
|
| Rate for Payer: Networks By Design Commercial |
$5,016.70
|
| Rate for Payer: Prime Health Services Commercial |
$6,560.30
|
| Rate for Payer: Prime Health Services Commercial |
$14,125.30
|
| Rate for Payer: Riverside University Health System MISP |
$6,647.20
|
| Rate for Payer: Riverside University Health System MISP |
$3,087.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,630.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,970.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,970.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,630.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,111.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,111.86
|
| Rate for Payer: United Healthcare All Other HMO |
$1,111.86
|
| Rate for Payer: United Healthcare All Other HMO |
$1,111.86
|
| Rate for Payer: United Healthcare HMO Rider |
$1,111.86
|
| Rate for Payer: United Healthcare HMO Rider |
$1,111.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,111.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,111.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14,125.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,560.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,560.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,125.30
|
| Rate for Payer: Vantage Medical Group Senior |
$6,560.30
|
| Rate for Payer: Vantage Medical Group Senior |
$14,125.30
|
|
|
HC MR ANGIO W/O FOL W/CONT, ABD
|
Facility
|
IP
|
$16,618.00
|
|
|
Service Code
|
CPT 74185
|
| Hospital Charge Code |
908801096
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$3,323.60 |
| Max. Negotiated Rate |
$14,956.20 |
| Rate for Payer: Adventist Health Commercial |
$3,323.60
|
| Rate for Payer: Cash Price |
$7,478.10
|
| Rate for Payer: Central Health Plan Commercial |
$13,294.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,632.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,647.20
|
| Rate for Payer: EPIC Health Plan Senior |
$6,647.20
|
| Rate for Payer: Galaxy Health WC |
$14,125.30
|
| Rate for Payer: Global Benefits Group Commercial |
$9,970.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,956.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,552.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,804.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,323.60
|
| Rate for Payer: Multiplan Commercial |
$12,463.50
|
| Rate for Payer: Networks By Design Commercial |
$10,801.70
|
| Rate for Payer: Prime Health Services Commercial |
$14,125.30
|
|
|
HC MRI ABDOMEN W/CONTRAST
|
Facility
|
IP
|
$12,103.00
|
|
|
Service Code
|
CPT 74182
|
| Hospital Charge Code |
908801301
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,420.60 |
| Max. Negotiated Rate |
$10,892.70 |
| Rate for Payer: Adventist Health Commercial |
$2,420.60
|
| Rate for Payer: Cash Price |
$5,446.35
|
| Rate for Payer: Central Health Plan Commercial |
$9,682.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,472.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,841.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4,841.20
|
| Rate for Payer: Galaxy Health WC |
$10,287.55
|
| Rate for Payer: Global Benefits Group Commercial |
$7,261.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,892.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,685.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,140.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,420.60
|
| Rate for Payer: Multiplan Commercial |
$9,077.25
|
| Rate for Payer: Networks By Design Commercial |
$7,866.95
|
| Rate for Payer: Prime Health Services Commercial |
$10,287.55
|
|
|
HC MRI ABDOMEN W/CONTRAST
|
Facility
|
OP
|
$12,103.00
|
|
|
Service Code
|
CPT 74182
|
| Hospital Charge Code |
908801301
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$448.71 |
| Max. Negotiated Rate |
$10,892.70 |
| Rate for Payer: Adventist Health Commercial |
$2,420.60
|
| Rate for Payer: Adventist Health Commercial |
$1,075.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,814.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,814.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,040.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,126.64
|
| Rate for Payer: Blue Shield of California Commercial |
$3,386.25
|
| Rate for Payer: Blue Shield of California Commercial |
$7,624.89
|
| Rate for Payer: Blue Shield of California EPN |
$4,804.89
|
| Rate for Payer: Blue Shield of California EPN |
$2,133.88
|
| Rate for Payer: Cash Price |
$5,446.35
|
| Rate for Payer: Cash Price |
$5,446.35
|
| Rate for Payer: Cash Price |
$5,446.35
|
| Rate for Payer: Cash Price |
$2,418.75
|
| Rate for Payer: Cash Price |
$2,418.75
|
| Rate for Payer: Cash Price |
$2,418.75
|
| Rate for Payer: Central Health Plan Commercial |
$4,300.00
|
| Rate for Payer: Central Health Plan Commercial |
$9,682.40
|
| Rate for Payer: Cigna of CA HMO |
$3,440.00
|
| Rate for Payer: Cigna of CA HMO |
$7,745.92
|
| Rate for Payer: Cigna of CA PPO |
$3,977.50
|
| Rate for Payer: Cigna of CA PPO |
$8,956.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,762.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,472.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$10,287.55
|
| Rate for Payer: Galaxy Health WC |
$4,568.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,225.00
|
| Rate for Payer: Global Benefits Group Commercial |
$7,261.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,837.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,892.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$514.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$514.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,413.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,685.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$568.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$568.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,420.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,075.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$4,031.25
|
| Rate for Payer: Multiplan Commercial |
$9,077.25
|
| Rate for Payer: Networks By Design Commercial |
$7,866.95
|
| Rate for Payer: Networks By Design Commercial |
$3,493.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: Prime Health Services Commercial |
$10,287.55
|
| Rate for Payer: Prime Health Services Commercial |
$4,568.75
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,261.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,225.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,261.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,115.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,115.74
|
| Rate for Payer: United Healthcare All Other HMO |
$1,115.74
|
| Rate for Payer: United Healthcare All Other HMO |
$1,115.74
|
| Rate for Payer: United Healthcare HMO Rider |
$1,115.74
|
| Rate for Payer: United Healthcare HMO Rider |
$1,115.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,115.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,115.74
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC MRI ABDOMEN W/O CONTRAST
|
Facility
|
IP
|
$11,002.00
|
|
|
Service Code
|
CPT 74181
|
| Hospital Charge Code |
908801300
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,200.40 |
| Max. Negotiated Rate |
$9,901.80 |
| Rate for Payer: Adventist Health Commercial |
$2,200.40
|
| Rate for Payer: Cash Price |
$4,950.90
|
| Rate for Payer: Central Health Plan Commercial |
$8,801.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,701.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,400.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,400.80
|
| Rate for Payer: Galaxy Health WC |
$9,351.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,601.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,901.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,986.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,491.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,200.40
|
| Rate for Payer: Multiplan Commercial |
$8,251.50
|
| Rate for Payer: Networks By Design Commercial |
$7,151.30
|
| Rate for Payer: Prime Health Services Commercial |
$9,351.70
|
|
|
HC MRI ABDOMEN W/O CONTRAST
|
Facility
|
OP
|
$11,002.00
|
|
|
Service Code
|
CPT 74181
|
| Hospital Charge Code |
908801300
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$306.88 |
| Max. Negotiated Rate |
$9,901.80 |
| Rate for Payer: Adventist Health Commercial |
$2,200.40
|
| Rate for Payer: Adventist Health Commercial |
$937.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$306.88
|
| Rate for Payer: Adventist Health Medi-Cal |
$306.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,305.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,305.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,399.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,726.43
|
| Rate for Payer: Blue Shield of California Commercial |
$2,952.81
|
| Rate for Payer: Blue Shield of California Commercial |
$6,931.26
|
| Rate for Payer: Blue Shield of California EPN |
$4,367.79
|
| Rate for Payer: Blue Shield of California EPN |
$1,860.74
|
| Rate for Payer: Cash Price |
$4,950.90
|
| Rate for Payer: Cash Price |
$4,950.90
|
| Rate for Payer: Cash Price |
$4,950.90
|
| Rate for Payer: Cash Price |
$2,109.15
|
| Rate for Payer: Cash Price |
$2,109.15
|
| Rate for Payer: Cash Price |
$2,109.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,749.60
|
| Rate for Payer: Central Health Plan Commercial |
$8,801.60
|
| Rate for Payer: Cigna of CA HMO |
$2,999.68
|
| Rate for Payer: Cigna of CA HMO |
$7,041.28
|
| Rate for Payer: Cigna of CA PPO |
$3,468.38
|
| Rate for Payer: Cigna of CA PPO |
$8,141.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,280.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,701.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: Galaxy Health WC |
$9,351.70
|
| Rate for Payer: Galaxy Health WC |
$3,983.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,812.20
|
| Rate for Payer: Global Benefits Group Commercial |
$6,601.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,218.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,901.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$328.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$328.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,976.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,986.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$362.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$362.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,200.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$937.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$411.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$411.22
|
| Rate for Payer: Multiplan Commercial |
$3,515.25
|
| Rate for Payer: Multiplan Commercial |
$8,251.50
|
| Rate for Payer: Networks By Design Commercial |
$7,151.30
|
| Rate for Payer: Networks By Design Commercial |
$3,046.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$306.88
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$306.88
|
| Rate for Payer: Prime Health Services Commercial |
$9,351.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,983.95
|
| Rate for Payer: Prime Health Services Medicare |
$325.29
|
| Rate for Payer: Prime Health Services Medicare |
$325.29
|
| Rate for Payer: Riverside University Health System MISP |
$337.57
|
| Rate for Payer: Riverside University Health System MISP |
$337.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,601.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,812.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,601.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,812.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
|
|
HC MRI ABDOMEN W WO CONTRAST
|
Facility
|
IP
|
$14,765.00
|
|
|
Service Code
|
CPT 74183
|
| Hospital Charge Code |
908801302
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,953.00 |
| Max. Negotiated Rate |
$13,288.50 |
| Rate for Payer: Adventist Health Commercial |
$2,953.00
|
| Rate for Payer: Cash Price |
$6,644.25
|
| Rate for Payer: Central Health Plan Commercial |
$11,812.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,335.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,906.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,906.00
|
| Rate for Payer: Galaxy Health WC |
$12,550.25
|
| Rate for Payer: Global Benefits Group Commercial |
$8,859.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,288.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,375.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,711.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,953.00
|
| Rate for Payer: Multiplan Commercial |
$11,073.75
|
| Rate for Payer: Networks By Design Commercial |
$9,597.25
|
| Rate for Payer: Prime Health Services Commercial |
$12,550.25
|
|
|
HC MRI ABDOMEN W WO CONTRAST
|
Facility
|
OP
|
$14,765.00
|
|
|
Service Code
|
CPT 74183
|
| Hospital Charge Code |
908801302
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$448.71 |
| Max. Negotiated Rate |
$13,288.50 |
| Rate for Payer: Adventist Health Commercial |
$2,953.00
|
| Rate for Payer: Adventist Health Commercial |
$1,236.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,208.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,208.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,588.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,594.91
|
| Rate for Payer: Blue Shield of California Commercial |
$3,893.40
|
| Rate for Payer: Blue Shield of California Commercial |
$9,301.95
|
| Rate for Payer: Blue Shield of California EPN |
$5,861.70
|
| Rate for Payer: Blue Shield of California EPN |
$2,453.46
|
| Rate for Payer: Cash Price |
$6,644.25
|
| Rate for Payer: Cash Price |
$6,644.25
|
| Rate for Payer: Cash Price |
$6,644.25
|
| Rate for Payer: Cash Price |
$2,781.00
|
| Rate for Payer: Cash Price |
$2,781.00
|
| Rate for Payer: Cash Price |
$2,781.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,944.00
|
| Rate for Payer: Central Health Plan Commercial |
$11,812.00
|
| Rate for Payer: Cigna of CA HMO |
$3,955.20
|
| Rate for Payer: Cigna of CA HMO |
$9,449.60
|
| Rate for Payer: Cigna of CA PPO |
$4,573.20
|
| Rate for Payer: Cigna of CA PPO |
$10,926.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,326.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,335.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$12,550.25
|
| Rate for Payer: Galaxy Health WC |
$5,253.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,708.00
|
| Rate for Payer: Global Benefits Group Commercial |
$8,859.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,562.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,288.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$573.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$573.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,924.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,375.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$633.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$633.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,953.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,236.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$4,635.00
|
| Rate for Payer: Multiplan Commercial |
$11,073.75
|
| Rate for Payer: Networks By Design Commercial |
$9,597.25
|
| Rate for Payer: Networks By Design Commercial |
$4,017.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: Prime Health Services Commercial |
$12,550.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,253.00
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,859.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,708.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,859.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,708.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,367.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,367.12
|
| Rate for Payer: United Healthcare All Other HMO |
$1,367.12
|
| Rate for Payer: United Healthcare All Other HMO |
$1,367.12
|
| Rate for Payer: United Healthcare HMO Rider |
$1,367.12
|
| Rate for Payer: United Healthcare HMO Rider |
$1,367.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,367.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,367.12
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC MRI ANGIO HEAD WITH CONTRAST
|
Facility
|
IP
|
$10,727.00
|
|
|
Service Code
|
CPT 70545
|
| Hospital Charge Code |
908801084
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$2,145.40 |
| Max. Negotiated Rate |
$9,654.30 |
| Rate for Payer: Adventist Health Commercial |
$2,145.40
|
| Rate for Payer: Cash Price |
$4,827.15
|
| Rate for Payer: Central Health Plan Commercial |
$8,581.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,508.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,290.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,290.80
|
| Rate for Payer: Galaxy Health WC |
$9,117.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,436.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,654.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,811.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,328.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,145.40
|
| Rate for Payer: Multiplan Commercial |
$8,045.25
|
| Rate for Payer: Networks By Design Commercial |
$6,972.55
|
| Rate for Payer: Prime Health Services Commercial |
$9,117.95
|
|
|
HC MRI ANGIO HEAD WITH CONTRAST
|
Facility
|
OP
|
$10,727.00
|
|
|
Service Code
|
CPT 70545
|
| Hospital Charge Code |
908801084
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$383.18 |
| Max. Negotiated Rate |
$9,654.30 |
| Rate for Payer: Adventist Health Commercial |
$2,145.40
|
| Rate for Payer: Adventist Health Commercial |
$1,170.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,369.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,369.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,239.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,404.69
|
| Rate for Payer: Blue Shield of California Commercial |
$3,687.39
|
| Rate for Payer: Blue Shield of California Commercial |
$6,758.01
|
| Rate for Payer: Blue Shield of California EPN |
$4,258.62
|
| Rate for Payer: Blue Shield of California EPN |
$2,323.64
|
| Rate for Payer: Cash Price |
$4,827.15
|
| Rate for Payer: Cash Price |
$4,827.15
|
| Rate for Payer: Cash Price |
$4,827.15
|
| Rate for Payer: Cash Price |
$2,633.85
|
| Rate for Payer: Cash Price |
$2,633.85
|
| Rate for Payer: Cash Price |
$2,633.85
|
| Rate for Payer: Central Health Plan Commercial |
$4,682.40
|
| Rate for Payer: Central Health Plan Commercial |
$8,581.60
|
| Rate for Payer: Cigna of CA HMO |
$3,745.92
|
| Rate for Payer: Cigna of CA HMO |
$6,865.28
|
| Rate for Payer: Cigna of CA PPO |
$4,331.22
|
| Rate for Payer: Cigna of CA PPO |
$7,937.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,097.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,508.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$9,117.95
|
| Rate for Payer: Galaxy Health WC |
$4,975.05
|
| Rate for Payer: Global Benefits Group Commercial |
$3,511.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,436.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,267.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,654.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$383.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$383.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,716.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,811.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$423.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$423.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,145.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,170.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$4,389.75
|
| Rate for Payer: Multiplan Commercial |
$8,045.25
|
| Rate for Payer: Networks By Design Commercial |
$6,972.55
|
| Rate for Payer: Networks By Design Commercial |
$3,804.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: Prime Health Services Commercial |
$9,117.95
|
| Rate for Payer: Prime Health Services Commercial |
$4,975.05
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,436.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,511.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,436.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,511.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,115.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,115.74
|
| Rate for Payer: United Healthcare All Other HMO |
$1,115.74
|
| Rate for Payer: United Healthcare All Other HMO |
$1,115.74
|
| Rate for Payer: United Healthcare HMO Rider |
$1,115.74
|
| Rate for Payer: United Healthcare HMO Rider |
$1,115.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,115.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,115.74
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC MRI ANGIO HEAD WO CNTRAST
|
Facility
|
IP
|
$10,216.00
|
|
|
Service Code
|
CPT 70544
|
| Hospital Charge Code |
908801015
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$2,043.20 |
| Max. Negotiated Rate |
$9,194.40 |
| Rate for Payer: Adventist Health Commercial |
$2,043.20
|
| Rate for Payer: Cash Price |
$4,597.20
|
| Rate for Payer: Central Health Plan Commercial |
$8,172.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,151.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,086.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,086.40
|
| Rate for Payer: Galaxy Health WC |
$8,683.60
|
| Rate for Payer: Global Benefits Group Commercial |
$6,129.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,194.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,487.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,027.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,043.20
|
| Rate for Payer: Multiplan Commercial |
$7,662.00
|
| Rate for Payer: Networks By Design Commercial |
$6,640.40
|
| Rate for Payer: Prime Health Services Commercial |
$8,683.60
|
|
