|
HC IN111 PENTETRTID/OCTRE/LT 6MCI
|
Facility
|
OP
|
$19,095.00
|
|
|
Service Code
|
CPT A9572
|
| Hospital Charge Code |
909301570
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3,819.00 |
| Max. Negotiated Rate |
$19,518.58 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16,230.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,502.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,502.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,826.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19,518.58
|
| Rate for Payer: Blue Distinction Transplant |
$11,457.00
|
| Rate for Payer: Blue Shield of California Commercial |
$12,010.76
|
| Rate for Payer: Blue Shield of California EPN |
$9,337.46
|
| Rate for Payer: Cash Price |
$8,592.75
|
| Rate for Payer: Cash Price |
$8,592.75
|
| Rate for Payer: Central Health Plan Commercial |
$15,276.00
|
| Rate for Payer: Cigna of CA HMO |
$13,366.50
|
| Rate for Payer: Cigna of CA PPO |
$13,366.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16,230.75
|
| Rate for Payer: Dignity Health Media |
$16,230.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,230.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,638.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,638.00
|
| Rate for Payer: Galaxy Health WC |
$16,230.75
|
| Rate for Payer: Global Benefits Group Commercial |
$11,457.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,185.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$14,321.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,683.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,736.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,819.00
|
| Rate for Payer: Multiplan Commercial |
$14,321.25
|
| Rate for Payer: Networks By Design Commercial |
$9,547.50
|
| Rate for Payer: Prime Health Services Commercial |
$16,230.75
|
| Rate for Payer: Riverside University Health System MISP |
$7,638.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,457.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11,457.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,547.50
|
| Rate for Payer: United Healthcare All Other HMO |
$9,547.50
|
| Rate for Payer: United Healthcare HMO Rider |
$9,547.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,547.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,230.75
|
| Rate for Payer: Vantage Medical Group Senior |
$16,230.75
|
|
|
HC IN111 PROSTASCINT UP TO 10 MCI
|
Facility
|
OP
|
$8,469.00
|
|
|
Service Code
|
CPT A9507
|
| Hospital Charge Code |
909301255
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,693.80 |
| Max. Negotiated Rate |
$7,622.10 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,198.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,657.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,657.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,805.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,166.79
|
| Rate for Payer: Blue Distinction Transplant |
$5,081.40
|
| Rate for Payer: Blue Shield of California Commercial |
$5,327.00
|
| Rate for Payer: Blue Shield of California EPN |
$4,141.34
|
| Rate for Payer: Cash Price |
$3,811.05
|
| Rate for Payer: Cash Price |
$3,811.05
|
| Rate for Payer: Central Health Plan Commercial |
$6,775.20
|
| Rate for Payer: Cigna of CA HMO |
$5,928.30
|
| Rate for Payer: Cigna of CA PPO |
$5,928.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,198.65
|
| Rate for Payer: Dignity Health Media |
$7,198.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,198.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,387.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,387.60
|
| Rate for Payer: Galaxy Health WC |
$7,198.65
|
| Rate for Payer: Global Benefits Group Commercial |
$5,081.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,622.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,351.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,964.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,648.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,279.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,693.80
|
| Rate for Payer: Multiplan Commercial |
$6,351.75
|
| Rate for Payer: Networks By Design Commercial |
$4,234.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,198.65
|
| Rate for Payer: Riverside University Health System MISP |
$3,387.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,081.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,081.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,234.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,234.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,234.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,234.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,198.65
|
| Rate for Payer: Vantage Medical Group Senior |
$7,198.65
|
|
|
HC IN111 PROSTASCINT UP TO 10 MCI
|
Facility
|
IP
|
$8,469.00
|
|
|
Service Code
|
CPT A9507
|
| Hospital Charge Code |
909301255
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,693.80 |
| Max. Negotiated Rate |
$7,622.10 |
| Rate for Payer: Blue Shield of California Commercial |
$6,351.75
|
| Rate for Payer: Blue Shield of California EPN |
$4,522.45
|
| Rate for Payer: Cash Price |
$3,811.05
|
| Rate for Payer: Central Health Plan Commercial |
$6,775.20
|
| Rate for Payer: Cigna of CA HMO |
$5,928.30
|
| Rate for Payer: Cigna of CA PPO |
$5,928.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,387.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,387.60
|
| Rate for Payer: Galaxy Health WC |
$7,198.65
|
| Rate for Payer: Global Benefits Group Commercial |
$5,081.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,622.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,648.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,226.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,693.80
|
| Rate for Payer: Multiplan Commercial |
$6,351.75
|
| Rate for Payer: Networks By Design Commercial |
$4,234.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,198.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,197.89
|
| Rate for Payer: United Healthcare All Other HMO |
$3,123.37
|
| Rate for Payer: United Healthcare HMO Rider |
$3,055.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,794.77
|
|
|
HC IN111 ZEVALIN UP TO 5 MCI
|
Facility
|
OP
|
$18,111.00
|
|
|
Service Code
|
CPT A9542
|
| Hospital Charge Code |
909301342
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$3,622.20 |
| Max. Negotiated Rate |
$16,299.90 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,394.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,961.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,961.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,075.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,556.99
|
| Rate for Payer: Blue Distinction Transplant |
$10,866.60
|
| Rate for Payer: Blue Shield of California Commercial |
$11,192.60
|
| Rate for Payer: Blue Shield of California EPN |
$8,801.95
|
| Rate for Payer: Cash Price |
$8,149.95
|
| Rate for Payer: Cash Price |
$8,149.95
|
| Rate for Payer: Central Health Plan Commercial |
$14,488.80
|
| Rate for Payer: Cigna of CA HMO |
$11,591.04
|
| Rate for Payer: Cigna of CA PPO |
$13,402.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,394.35
|
| Rate for Payer: Dignity Health Media |
$15,394.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,394.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,244.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,244.40
|
| Rate for Payer: Galaxy Health WC |
$15,394.35
|
| Rate for Payer: Global Benefits Group Commercial |
$10,866.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,299.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$13,583.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,338.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,080.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,631.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,622.20
|
| Rate for Payer: Multiplan Commercial |
$13,583.25
|
| Rate for Payer: Networks By Design Commercial |
$11,772.15
|
| Rate for Payer: Prime Health Services Commercial |
$15,394.35
|
| Rate for Payer: Riverside University Health System MISP |
$7,244.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,866.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10,866.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,055.50
|
| Rate for Payer: United Healthcare All Other HMO |
$9,055.50
|
| Rate for Payer: United Healthcare HMO Rider |
$9,055.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,055.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,394.35
|
| Rate for Payer: Vantage Medical Group Senior |
$15,394.35
|
|
|
HC IN111 ZEVALIN UP TO 5 MCI
|
Facility
|
IP
|
$18,111.00
|
|
|
Service Code
|
CPT A9542
|
| Hospital Charge Code |
909301342
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$3,622.20 |
| Max. Negotiated Rate |
$16,299.90 |
| Rate for Payer: Cash Price |
$8,149.95
|
| Rate for Payer: Central Health Plan Commercial |
$14,488.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,244.40
|
| Rate for Payer: Galaxy Health WC |
$15,394.35
|
| Rate for Payer: Global Benefits Group Commercial |
$10,866.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,299.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,080.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,900.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,622.20
|
| Rate for Payer: Multiplan Commercial |
$13,583.25
|
| Rate for Payer: Networks By Design Commercial |
$11,772.15
|
| Rate for Payer: Prime Health Services Commercial |
$15,394.35
|
|
|
HC INACT POLIO ADMINISTRATION
|
Facility
|
IP
|
$23.00
|
|
| Hospital Charge Code |
902890241
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$20.70 |
| Rate for Payer: Cash Price |
$10.35
|
| Rate for Payer: Central Health Plan Commercial |
$18.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.20
|
| Rate for Payer: Galaxy Health WC |
$19.55
|
| Rate for Payer: Global Benefits Group Commercial |
$13.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.60
|
| Rate for Payer: Multiplan Commercial |
$17.25
|
| Rate for Payer: Networks By Design Commercial |
$14.95
|
| Rate for Payer: Prime Health Services Commercial |
$19.55
|
|
|
HC INACT POLIO ADMINISTRATION
|
Facility
|
OP
|
$23.00
|
|
| Hospital Charge Code |
902890241
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$13.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$13.80
|
| Rate for Payer: Blue Shield of California Commercial |
$14.47
|
| Rate for Payer: Blue Shield of California EPN |
$11.25
|
| Rate for Payer: Cash Price |
$10.35
|
| Rate for Payer: Cash Price |
$10.35
|
| Rate for Payer: Central Health Plan Commercial |
$18.40
|
| Rate for Payer: Cigna of CA HMO |
$14.72
|
| Rate for Payer: Cigna of CA PPO |
$17.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.55
|
| Rate for Payer: Dignity Health Media |
$19.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.20
|
| Rate for Payer: Galaxy Health WC |
$19.55
|
| Rate for Payer: Global Benefits Group Commercial |
$13.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$17.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.60
|
| Rate for Payer: Multiplan Commercial |
$17.25
|
| Rate for Payer: Networks By Design Commercial |
$14.95
|
| Rate for Payer: Prime Health Services Commercial |
$19.55
|
| Rate for Payer: Riverside University Health System MISP |
$9.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.50
|
| Rate for Payer: United Healthcare All Other HMO |
$11.50
|
| Rate for Payer: United Healthcare HMO Rider |
$11.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.55
|
| Rate for Payer: Vantage Medical Group Senior |
$19.55
|
|
|
HC INCISE/DRAIN TEAR GLAND
|
Facility
|
IP
|
$3,039.00
|
|
|
Service Code
|
CPT 68400
|
| Hospital Charge Code |
900501642
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$607.80 |
| Max. Negotiated Rate |
$2,735.10 |
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,431.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,215.60
|
| Rate for Payer: Galaxy Health WC |
$2,583.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,823.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,735.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,027.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,157.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$607.80
|
| Rate for Payer: Multiplan Commercial |
$2,279.25
|
| Rate for Payer: Networks By Design Commercial |
$1,975.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,583.15
|
|
|
HC INCISE/DRAIN TEAR GLAND
|
Facility
|
OP
|
$3,039.00
|
|
|
Service Code
|
CPT 68400
|
| Hospital Charge Code |
900501642
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,264.97
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,897.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,391.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,264.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,823.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,911.53
|
| Rate for Payer: Blue Shield of California EPN |
$1,486.07
|
| Rate for Payer: Caremore Medicare Advantage |
$1,264.97
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,431.20
|
| Rate for Payer: Cigna of CA HMO |
$1,944.96
|
| Rate for Payer: Cigna of CA PPO |
$2,248.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,897.46
|
| Rate for Payer: Dignity Health Media |
$1,264.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,391.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,707.71
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,264.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,264.97
|
| Rate for Payer: Galaxy Health WC |
$2,583.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,823.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,735.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,279.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,074.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,087.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,264.97
|
| Rate for Payer: InnovAge PACE Commercial |
$1,897.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,027.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$69.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,264.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$607.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,695.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,695.06
|
| Rate for Payer: Multiplan Commercial |
$2,279.25
|
| Rate for Payer: Networks By Design Commercial |
$1,975.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,583.15
|
| Rate for Payer: Prime Health Services Medicare |
$1,340.87
|
| Rate for Payer: Riverside University Health System MISP |
$1,391.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,823.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,823.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,519.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,519.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,519.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,519.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,897.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,391.47
|
| Rate for Payer: Vantage Medical Group Senior |
$1,264.97
|
|
|
HC INCISE/DRAIN TEAR GLAND
|
Facility
|
IP
|
$3,039.00
|
|
|
Service Code
|
CPT 68400
|
| Hospital Charge Code |
900501642
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$607.80 |
| Max. Negotiated Rate |
$2,735.10 |
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,431.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,215.60
|
| Rate for Payer: Galaxy Health WC |
$2,583.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,823.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,735.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,027.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,157.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$607.80
|
| Rate for Payer: Multiplan Commercial |
$2,279.25
|
| Rate for Payer: Networks By Design Commercial |
$1,975.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,583.15
|
|
|
HC INCISE/DRAIN TEAR GLAND
|
Facility
|
OP
|
$3,039.00
|
|
|
Service Code
|
CPT 68400
|
| Hospital Charge Code |
900501642
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,897.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,391.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,264.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,823.40
|
| Rate for Payer: Caremore Medicare Advantage |
$1,264.97
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,431.20
|
| Rate for Payer: Cigna of CA PPO |
$2,248.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,897.46
|
| Rate for Payer: Dignity Health Media |
$1,264.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,391.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,707.71
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,264.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,264.97
|
| Rate for Payer: Galaxy Health WC |
$2,583.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,823.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,735.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,279.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,074.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,264.97
|
| Rate for Payer: InnovAge PACE Commercial |
$1,897.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,027.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$69.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,264.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$607.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,695.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,695.06
|
| Rate for Payer: Multiplan Commercial |
$2,279.25
|
| Rate for Payer: Networks By Design Commercial |
$1,975.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,583.15
|
| Rate for Payer: Prime Health Services Medicare |
$1,340.87
|
| Rate for Payer: Riverside University Health System MISP |
$1,391.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,823.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,519.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,519.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,519.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,519.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,897.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,391.47
|
| Rate for Payer: Vantage Medical Group Senior |
$1,264.97
|
|
|
HC INCISIONAL BX SKIN SINGLE LSN
|
Facility
|
OP
|
$1,163.00
|
|
|
Service Code
|
CPT 11106
|
| Hospital Charge Code |
900511106
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$232.60 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$784.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,177.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$863.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$784.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$697.80
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$784.71
|
| Rate for Payer: Cash Price |
$523.35
|
| Rate for Payer: Cash Price |
$523.35
|
| Rate for Payer: Central Health Plan Commercial |
$930.40
|
| Rate for Payer: Cigna of CA PPO |
$860.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,177.06
|
| Rate for Payer: Dignity Health Media |
$784.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$863.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,059.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$784.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$784.71
|
| Rate for Payer: Galaxy Health WC |
$988.55
|
| Rate for Payer: Global Benefits Group Commercial |
$697.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,046.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$872.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,286.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,294.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$784.71
|
| Rate for Payer: InnovAge PACE Commercial |
$1,177.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$775.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$258.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$232.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,051.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,051.51
|
| Rate for Payer: Multiplan Commercial |
$872.25
|
| Rate for Payer: Networks By Design Commercial |
$755.95
|
| Rate for Payer: Prime Health Services Commercial |
$988.55
|
| Rate for Payer: Prime Health Services Medicare |
$831.79
|
| Rate for Payer: Riverside University Health System MISP |
$863.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$697.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,177.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.18
|
| Rate for Payer: Vantage Medical Group Senior |
$784.71
|
|
|
HC INCISIONAL BX SKIN SINGLE LSN
|
Facility
|
IP
|
$1,163.00
|
|
|
Service Code
|
CPT 11106
|
| Hospital Charge Code |
900511106
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$232.60 |
| Max. Negotiated Rate |
$1,046.70 |
| Rate for Payer: Cash Price |
$523.35
|
| Rate for Payer: Central Health Plan Commercial |
$930.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$465.20
|
| Rate for Payer: Galaxy Health WC |
$988.55
|
| Rate for Payer: Global Benefits Group Commercial |
$697.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,046.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$775.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$443.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$232.60
|
| Rate for Payer: Multiplan Commercial |
$872.25
|
| Rate for Payer: Networks By Design Commercial |
$755.95
|
| Rate for Payer: Prime Health Services Commercial |
$988.55
|
|
|
HC INCISION DRAIN DEEP RECTAL ABSCESS
|
Facility
|
OP
|
$6,052.00
|
|
|
Service Code
|
CPT 45020
|
| Hospital Charge Code |
900501241
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$384.81 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,262.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,858.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,508.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,631.20
|
| Rate for Payer: Caremore Medicare Advantage |
$3,508.15
|
| Rate for Payer: Cash Price |
$2,723.40
|
| Rate for Payer: Cash Price |
$2,723.40
|
| Rate for Payer: Cash Price |
$2,723.40
|
| Rate for Payer: Cash Price |
$2,723.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,841.60
|
| Rate for Payer: Cigna of CA PPO |
$4,478.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,262.22
|
| Rate for Payer: Dignity Health Media |
$3,508.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,858.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,736.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,508.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,508.15
|
| Rate for Payer: Galaxy Health WC |
$5,144.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,631.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,446.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,539.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,753.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,508.15
|
| Rate for Payer: InnovAge PACE Commercial |
$5,262.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,036.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$384.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,508.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,210.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,700.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,700.92
|
| Rate for Payer: Multiplan Commercial |
$4,539.00
|
| Rate for Payer: Networks By Design Commercial |
$3,933.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,144.20
|
| Rate for Payer: Prime Health Services Medicare |
$3,718.64
|
| Rate for Payer: Riverside University Health System MISP |
$3,858.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,631.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,026.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,026.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,026.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,026.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,262.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,858.96
|
| Rate for Payer: Vantage Medical Group Senior |
$3,508.15
|
|
|
HC INCISION DRAIN DEEP RECTAL ABSCESS
|
Facility
|
IP
|
$6,052.00
|
|
|
Service Code
|
CPT 45020
|
| Hospital Charge Code |
900501241
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,210.40 |
| Max. Negotiated Rate |
$5,446.80 |
| Rate for Payer: Cash Price |
$2,723.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,841.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,420.80
|
| Rate for Payer: Galaxy Health WC |
$5,144.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,631.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,446.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,036.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,305.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,210.40
|
| Rate for Payer: Multiplan Commercial |
$4,539.00
|
| Rate for Payer: Networks By Design Commercial |
$3,933.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,144.20
|
|
|
HC INCISION DRAIN DEEP RECTAL ABSCESS
|
Facility
|
OP
|
$6,052.00
|
|
|
Service Code
|
CPT 45020
|
| Hospital Charge Code |
900501241
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$384.81 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,508.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,262.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,858.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,508.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,631.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,806.71
|
| Rate for Payer: Blue Shield of California EPN |
$2,959.43
|
| Rate for Payer: Caremore Medicare Advantage |
$3,508.15
|
| Rate for Payer: Cash Price |
$2,723.40
|
| Rate for Payer: Cash Price |
$2,723.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,841.60
|
| Rate for Payer: Cigna of CA HMO |
$3,873.28
|
| Rate for Payer: Cigna of CA PPO |
$4,478.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,262.22
|
| Rate for Payer: Dignity Health Media |
$3,508.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,858.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,736.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,508.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,508.15
|
| Rate for Payer: Galaxy Health WC |
$5,144.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,631.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,446.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,539.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,753.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,788.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,508.15
|
| Rate for Payer: InnovAge PACE Commercial |
$5,262.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,036.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$384.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,508.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,210.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,700.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,700.92
|
| Rate for Payer: Multiplan Commercial |
$4,539.00
|
| Rate for Payer: Networks By Design Commercial |
$3,933.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,144.20
|
| Rate for Payer: Prime Health Services Medicare |
$3,718.64
|
| Rate for Payer: Riverside University Health System MISP |
$3,858.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,631.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,631.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,026.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,026.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,026.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,026.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,262.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,858.96
|
| Rate for Payer: Vantage Medical Group Senior |
$3,508.15
|
|
|
HC INCISION DRAIN DEEP RECTAL ABSCESS
|
Facility
|
IP
|
$6,052.00
|
|
|
Service Code
|
CPT 45020
|
| Hospital Charge Code |
900501241
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$1,210.40 |
| Max. Negotiated Rate |
$5,446.80 |
| Rate for Payer: Cash Price |
$2,723.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,841.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,420.80
|
| Rate for Payer: Galaxy Health WC |
$5,144.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,631.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,446.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,036.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,305.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,210.40
|
| Rate for Payer: Multiplan Commercial |
$4,539.00
|
| Rate for Payer: Networks By Design Commercial |
$3,933.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,144.20
|
|
|
HC INCISION/DRAIN FOREARM/WRIST
|
Facility
|
OP
|
$8,189.00
|
|
|
Service Code
|
CPT 25028
|
| Hospital Charge Code |
900501423
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$7,370.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,913.40
|
| Rate for Payer: Caremore Medicare Advantage |
$4,044.21
|
| Rate for Payer: Cash Price |
$3,685.05
|
| Rate for Payer: Cash Price |
$3,685.05
|
| Rate for Payer: Cash Price |
$3,685.05
|
| Rate for Payer: Cash Price |
$3,685.05
|
| Rate for Payer: Central Health Plan Commercial |
$6,551.20
|
| Rate for Payer: Cigna of CA PPO |
$6,059.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Dignity Health Media |
$4,044.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,459.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,044.21
|
| Rate for Payer: Galaxy Health WC |
$6,960.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,913.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,370.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,141.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,632.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,044.21
|
| Rate for Payer: InnovAge PACE Commercial |
$6,066.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,462.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$865.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,044.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,637.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,419.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,419.24
|
| Rate for Payer: Multiplan Commercial |
$6,141.75
|
| Rate for Payer: Networks By Design Commercial |
$5,322.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,960.65
|
| Rate for Payer: Prime Health Services Medicare |
$4,286.86
|
| Rate for Payer: Riverside University Health System MISP |
$4,448.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,913.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,094.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,094.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,094.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,094.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
|
HC INCISION/DRAIN FOREARM/WRIST
|
Facility
|
IP
|
$8,189.00
|
|
|
Service Code
|
CPT 25028
|
| Hospital Charge Code |
900501423
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,637.80 |
| Max. Negotiated Rate |
$7,370.10 |
| Rate for Payer: Cash Price |
$3,685.05
|
| Rate for Payer: Central Health Plan Commercial |
$6,551.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,275.60
|
| Rate for Payer: Galaxy Health WC |
$6,960.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,913.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,370.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,462.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,120.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,637.80
|
| Rate for Payer: Multiplan Commercial |
$6,141.75
|
| Rate for Payer: Networks By Design Commercial |
$5,322.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,960.65
|
|
|
HC INCISION/DRAIN PERIRECTAL ABSC
|
Facility
|
IP
|
$6,052.00
|
|
|
Service Code
|
CPT 45005
|
| Hospital Charge Code |
900501237
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,210.40 |
| Max. Negotiated Rate |
$5,446.80 |
| Rate for Payer: Cash Price |
$2,723.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,841.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,420.80
|
| Rate for Payer: Galaxy Health WC |
$5,144.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,631.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,446.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,036.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,305.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,210.40
|
| Rate for Payer: Multiplan Commercial |
$4,539.00
|
| Rate for Payer: Networks By Design Commercial |
$3,933.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,144.20
|
|
|
HC INCISION/DRAIN PERIRECTAL ABSC
|
Facility
|
IP
|
$6,052.00
|
|
|
Service Code
|
CPT 45005
|
| Hospital Charge Code |
900501237
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$1,210.40 |
| Max. Negotiated Rate |
$5,446.80 |
| Rate for Payer: Cash Price |
$2,723.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,841.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,420.80
|
| Rate for Payer: Galaxy Health WC |
$5,144.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,631.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,446.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,036.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,305.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,210.40
|
| Rate for Payer: Multiplan Commercial |
$4,539.00
|
| Rate for Payer: Networks By Design Commercial |
$3,933.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,144.20
|
|
|
HC INCISION/DRAIN PERIRECTAL ABSC
|
Facility
|
OP
|
$6,052.00
|
|
|
Service Code
|
CPT 45005
|
| Hospital Charge Code |
900501237
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$240.50 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,474.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,631.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,806.71
|
| Rate for Payer: Blue Shield of California EPN |
$2,959.43
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$2,723.40
|
| Rate for Payer: Cash Price |
$2,723.40
|
| Rate for Payer: Cash Price |
$2,723.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,841.60
|
| Rate for Payer: Cigna of CA HMO |
$3,873.28
|
| Rate for Payer: Cigna of CA PPO |
$4,478.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Dignity Health Media |
$1,474.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,621.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Galaxy Health WC |
$5,144.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,631.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,446.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,539.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,418.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,432.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,474.42
|
| Rate for Payer: InnovAge PACE Commercial |
$2,211.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,036.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$240.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,210.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,975.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Multiplan Commercial |
$4,539.00
|
| Rate for Payer: Networks By Design Commercial |
$3,933.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,144.20
|
| Rate for Payer: Prime Health Services Medicare |
$1,562.89
|
| Rate for Payer: Riverside University Health System MISP |
$1,621.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,631.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,631.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,026.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,026.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,026.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,026.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC INCISION/DRAIN PERIRECTAL ABSC
|
Facility
|
OP
|
$6,052.00
|
|
|
Service Code
|
CPT 45005
|
| Hospital Charge Code |
900501237
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$240.50 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,631.20
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$2,723.40
|
| Rate for Payer: Cash Price |
$2,723.40
|
| Rate for Payer: Cash Price |
$2,723.40
|
| Rate for Payer: Cash Price |
$2,723.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,841.60
|
| Rate for Payer: Cigna of CA PPO |
$4,478.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Dignity Health Media |
$1,474.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,621.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Galaxy Health WC |
$5,144.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,631.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,446.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,539.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,418.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,474.42
|
| Rate for Payer: InnovAge PACE Commercial |
$2,211.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,036.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$240.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,210.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,975.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Multiplan Commercial |
$4,539.00
|
| Rate for Payer: Networks By Design Commercial |
$3,933.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,144.20
|
| Rate for Payer: Prime Health Services Medicare |
$1,562.89
|
| Rate for Payer: Riverside University Health System MISP |
$1,621.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,631.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,026.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,026.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,026.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,026.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC INCISION/DRAIN THIGH/KNEE LESI
|
Facility
|
OP
|
$7,444.00
|
|
|
Service Code
|
CPT 27301
|
| Hospital Charge Code |
909000271
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$133.68 |
| Max. Negotiated Rate |
$8,114.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,550.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,325.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,905.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,550.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,466.40
|
| Rate for Payer: Blue Shield of California Commercial |
$4,682.28
|
| Rate for Payer: Blue Shield of California EPN |
$3,640.12
|
| Rate for Payer: Caremore Medicare Advantage |
$3,550.26
|
| Rate for Payer: Cash Price |
$3,349.80
|
| Rate for Payer: Cash Price |
$3,349.80
|
| Rate for Payer: Central Health Plan Commercial |
$5,955.20
|
| Rate for Payer: Cigna of CA HMO |
$4,764.16
|
| Rate for Payer: Cigna of CA PPO |
$5,508.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,325.39
|
| Rate for Payer: Dignity Health Media |
$3,550.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,905.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,792.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,550.26
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,550.26
|
| Rate for Payer: Galaxy Health WC |
$6,327.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,466.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,699.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,583.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,822.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,857.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,550.26
|
| Rate for Payer: InnovAge PACE Commercial |
$5,325.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,965.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,550.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,488.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,757.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,757.35
|
| Rate for Payer: Multiplan Commercial |
$5,583.00
|
| Rate for Payer: Networks By Design Commercial |
$4,838.60
|
| Rate for Payer: Prime Health Services Commercial |
$6,327.40
|
| Rate for Payer: Prime Health Services Medicare |
$3,763.28
|
| Rate for Payer: Riverside University Health System MISP |
$3,905.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,466.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,466.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,722.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,722.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,722.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,722.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,325.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,905.29
|
| Rate for Payer: Vantage Medical Group Senior |
$3,550.26
|
|
|
HC INCISION/DRAIN THIGH/KNEE LESI
|
Facility
|
IP
|
$7,444.00
|
|
|
Service Code
|
CPT 27301
|
| Hospital Charge Code |
909000271
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,488.80 |
| Max. Negotiated Rate |
$6,699.60 |
| Rate for Payer: Cash Price |
$3,349.80
|
| Rate for Payer: Central Health Plan Commercial |
$5,955.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,977.60
|
| Rate for Payer: Galaxy Health WC |
$6,327.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,466.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,699.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,965.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,836.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,488.80
|
| Rate for Payer: Multiplan Commercial |
$5,583.00
|
| Rate for Payer: Networks By Design Commercial |
$4,838.60
|
| Rate for Payer: Prime Health Services Commercial |
$6,327.40
|
|
