|
HC LEAD REPAIR SINGLE A OR V
|
Facility
|
OP
|
$12,576.00
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
906820113
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$362.44 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$2,515.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,624.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,320.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$7,367.67
|
| Rate for Payer: Blue Shield of California Commercial |
$12,745.22
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$6,916.80
|
| Rate for Payer: Cash Price |
$6,916.80
|
| Rate for Payer: Cash Price |
$6,916.80
|
| Rate for Payer: Central Health Plan Commercial |
$10,060.80
|
| Rate for Payer: Cigna of CA HMO |
$8,048.64
|
| Rate for Payer: Cigna of CA PPO |
$9,306.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,242.52
|
| Rate for Payer: EPIC Health Plan Senior |
$4,624.09
|
| Rate for Payer: Galaxy Health WC |
$10,689.60
|
| Rate for Payer: Global Benefits Group Commercial |
$7,545.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,318.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,583.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$362.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: InnovAge PACE Commercial |
$6,936.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,388.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$400.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,624.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,515.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,196.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,196.28
|
| Rate for Payer: Multiplan Commercial |
$9,432.00
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: Networks By Design Commercial |
$8,174.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Preferred Health Network WC |
$7,518.03
|
| Rate for Payer: Prime Health Services Commercial |
$10,689.60
|
| Rate for Payer: Prime Health Services Medicare |
$4,901.54
|
| Rate for Payer: Prime Health Services WC |
$7,292.49
|
| Rate for Payer: Riverside University Health System MISP |
$5,086.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,545.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,624.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC LEAD REPAIR SINGLE A OR V
|
Facility
|
OP
|
$10,690.00
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
906811355
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$362.44 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$2,138.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,624.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,624.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,320.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$7,367.67
|
| Rate for Payer: Blue Shield of California Commercial |
$12,745.22
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$5,879.50
|
| Rate for Payer: Cash Price |
$5,879.50
|
| Rate for Payer: Cash Price |
$5,879.50
|
| Rate for Payer: Central Health Plan Commercial |
$8,552.00
|
| Rate for Payer: Cigna of CA HMO |
$6,841.60
|
| Rate for Payer: Cigna of CA PPO |
$7,910.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,086.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,624.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,242.52
|
| Rate for Payer: EPIC Health Plan Senior |
$4,624.09
|
| Rate for Payer: Galaxy Health WC |
$9,086.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6,414.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,621.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,583.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$362.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,624.09
|
| Rate for Payer: InnovAge PACE Commercial |
$6,936.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,130.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$400.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,624.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,138.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,196.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,196.28
|
| Rate for Payer: Multiplan Commercial |
$8,017.50
|
| Rate for Payer: Multiplan WC |
$7,367.67
|
| Rate for Payer: Networks By Design Commercial |
$6,948.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,624.09
|
| Rate for Payer: Preferred Health Network WC |
$7,518.03
|
| Rate for Payer: Prime Health Services Commercial |
$9,086.50
|
| Rate for Payer: Prime Health Services Medicare |
$4,901.54
|
| Rate for Payer: Prime Health Services WC |
$7,292.49
|
| Rate for Payer: Riverside University Health System MISP |
$5,086.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,414.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,624.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,936.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,086.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,624.09
|
|
|
HC LEAD REPAIR SINGLE A OR V
|
Facility
|
IP
|
$12,576.00
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
906820113
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,515.20 |
| Max. Negotiated Rate |
$11,318.40 |
| Rate for Payer: Adventist Health Commercial |
$2,515.20
|
| Rate for Payer: Cash Price |
$6,916.80
|
| Rate for Payer: Central Health Plan Commercial |
$10,060.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,030.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,030.40
|
| Rate for Payer: Galaxy Health WC |
$10,689.60
|
| Rate for Payer: Global Benefits Group Commercial |
$7,545.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,318.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,388.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,791.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,784.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,515.20
|
| Rate for Payer: Multiplan Commercial |
$9,432.00
|
| Rate for Payer: Networks By Design Commercial |
$8,174.40
|
| Rate for Payer: Prime Health Services Commercial |
$10,689.60
|
|
|
HC LEAD REPOSITION A OR V
|
Facility
|
IP
|
$4,219.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
906812213
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$843.80 |
| Max. Negotiated Rate |
$3,797.10 |
| Rate for Payer: Adventist Health Commercial |
$843.80
|
| Rate for Payer: Cash Price |
$2,320.45
|
| Rate for Payer: Central Health Plan Commercial |
$3,375.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,687.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,687.60
|
| Rate for Payer: Galaxy Health WC |
$3,586.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,531.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,797.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,814.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,607.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,611.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$843.80
|
| Rate for Payer: Multiplan Commercial |
$3,164.25
|
| Rate for Payer: Networks By Design Commercial |
$2,742.35
|
| Rate for Payer: Prime Health Services Commercial |
$3,586.15
|
|
|
HC LEAD REPOSITION A OR V
|
Facility
|
OP
|
$4,219.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
906812213
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$51.88 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$843.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,320.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| Rate for Payer: Blue Shield of California Commercial |
$12,745.22
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$2,320.45
|
| Rate for Payer: Cash Price |
$2,320.45
|
| Rate for Payer: Cash Price |
$2,320.45
|
| Rate for Payer: Central Health Plan Commercial |
$3,375.20
|
| Rate for Payer: Cigna of CA HMO |
$2,700.16
|
| Rate for Payer: Cigna of CA PPO |
$3,122.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$3,586.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,531.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,797.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$51.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: InnovAge PACE Commercial |
$5,998.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,814.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$843.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$3,164.25
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$2,742.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$3,586.15
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,531.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC LEAD REPOSITION A OR V
|
Facility
|
OP
|
$4,964.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
906820134
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$51.88 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$992.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,320.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| Rate for Payer: Blue Shield of California Commercial |
$12,745.22
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$2,730.20
|
| Rate for Payer: Cash Price |
$2,730.20
|
| Rate for Payer: Cash Price |
$2,730.20
|
| Rate for Payer: Central Health Plan Commercial |
$3,971.20
|
| Rate for Payer: Cigna of CA HMO |
$3,176.96
|
| Rate for Payer: Cigna of CA PPO |
$3,673.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$4,219.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,978.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,467.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$51.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: InnovAge PACE Commercial |
$5,998.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,310.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$992.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$3,723.00
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$3,226.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$4,219.40
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,978.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC LEAD REPOSITION A OR V
|
Facility
|
IP
|
$4,964.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
906820134
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$992.80 |
| Max. Negotiated Rate |
$4,467.60 |
| Rate for Payer: Adventist Health Commercial |
$992.80
|
| Rate for Payer: Cash Price |
$2,730.20
|
| Rate for Payer: Central Health Plan Commercial |
$3,971.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,985.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,985.60
|
| Rate for Payer: Galaxy Health WC |
$4,219.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,978.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,467.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,310.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,891.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,072.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$992.80
|
| Rate for Payer: Multiplan Commercial |
$3,723.00
|
| Rate for Payer: Networks By Design Commercial |
$3,226.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,219.40
|
|
|
HC LEAD REPOSITION CS
|
Facility
|
IP
|
$5,225.00
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
906820137
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,045.00 |
| Max. Negotiated Rate |
$4,702.50 |
| Rate for Payer: Adventist Health Commercial |
$1,045.00
|
| Rate for Payer: Cash Price |
$2,873.75
|
| Rate for Payer: Central Health Plan Commercial |
$4,180.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,090.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,090.00
|
| Rate for Payer: Galaxy Health WC |
$4,441.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,135.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,702.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,485.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,990.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,234.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,045.00
|
| Rate for Payer: Multiplan Commercial |
$3,918.75
|
| Rate for Payer: Networks By Design Commercial |
$3,396.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,441.25
|
|
|
HC LEAD REPOSITION CS
|
Facility
|
IP
|
$4,441.00
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
906812216
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$888.20 |
| Max. Negotiated Rate |
$3,996.90 |
| Rate for Payer: Adventist Health Commercial |
$888.20
|
| Rate for Payer: Cash Price |
$2,442.55
|
| Rate for Payer: Central Health Plan Commercial |
$3,552.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,776.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,776.40
|
| Rate for Payer: Galaxy Health WC |
$3,774.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,664.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,996.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,962.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,692.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,748.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$888.20
|
| Rate for Payer: Multiplan Commercial |
$3,330.75
|
| Rate for Payer: Networks By Design Commercial |
$2,886.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,774.85
|
|
|
HC LEAD REPOSITION CS
|
Facility
|
OP
|
$4,441.00
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
906812216
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$462.34 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$888.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,764.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| Rate for Payer: Blue Shield of California Commercial |
$4,851.77
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$2,442.55
|
| Rate for Payer: Cash Price |
$2,442.55
|
| Rate for Payer: Cash Price |
$2,442.55
|
| Rate for Payer: Central Health Plan Commercial |
$3,552.80
|
| Rate for Payer: Cigna of CA HMO |
$2,842.24
|
| Rate for Payer: Cigna of CA PPO |
$3,286.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$3,774.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,664.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,996.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$462.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: InnovAge PACE Commercial |
$5,998.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,962.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$510.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$888.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$3,330.75
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$2,886.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$3,774.85
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,664.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC LEAD REPOSITION CS
|
Facility
|
OP
|
$5,225.00
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
906820137
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$462.34 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$1,045.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,764.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| Rate for Payer: Blue Shield of California Commercial |
$4,851.77
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$2,873.75
|
| Rate for Payer: Cash Price |
$2,873.75
|
| Rate for Payer: Cash Price |
$2,873.75
|
| Rate for Payer: Central Health Plan Commercial |
$4,180.00
|
| Rate for Payer: Cigna of CA HMO |
$3,344.00
|
| Rate for Payer: Cigna of CA PPO |
$3,866.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$4,441.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,135.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,702.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$462.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: InnovAge PACE Commercial |
$5,998.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,485.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$510.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,045.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$3,918.75
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$3,396.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$4,441.25
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,135.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC LEAD STJ DURATA 7120
|
Facility
|
OP
|
$14,375.00
|
|
|
Service Code
|
CPT C1895
|
| Hospital Charge Code |
906813604
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,875.00 |
| Max. Negotiated Rate |
$12,937.50 |
| Rate for Payer: Adventist Health Commercial |
$2,875.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,218.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,906.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,781.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,563.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,959.44
|
| Rate for Payer: Blue Shield of California Commercial |
$11,111.88
|
| Rate for Payer: Blue Shield of California EPN |
$7,245.00
|
| Rate for Payer: Cash Price |
$7,906.25
|
| Rate for Payer: Central Health Plan Commercial |
$11,500.00
|
| Rate for Payer: Cigna of CA HMO |
$10,062.50
|
| Rate for Payer: Cigna of CA PPO |
$10,062.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,218.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$12,218.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12,218.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,750.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,750.00
|
| Rate for Payer: Galaxy Health WC |
$12,218.75
|
| Rate for Payer: Global Benefits Group Commercial |
$8,625.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,937.50
|
| Rate for Payer: InnovAge PACE Commercial |
$7,187.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,588.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,898.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,875.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,062.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,062.50
|
| Rate for Payer: Multiplan Commercial |
$10,781.25
|
| Rate for Payer: Networks By Design Commercial |
$7,187.50
|
| Rate for Payer: Prime Health Services Commercial |
$12,218.75
|
| Rate for Payer: Riverside University Health System MISP |
$5,750.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,625.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,625.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,394.94
|
| Rate for Payer: United Healthcare All Other HMO |
$5,251.19
|
| Rate for Payer: United Healthcare HMO Rider |
$5,137.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,707.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,218.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12,218.75
|
| Rate for Payer: Vantage Medical Group Senior |
$12,218.75
|
|
|
HC LEAD STJ DURATA 7120
|
Facility
|
IP
|
$14,375.00
|
|
|
Service Code
|
CPT C1895
|
| Hospital Charge Code |
906813604
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,875.00 |
| Max. Negotiated Rate |
$12,937.50 |
| Rate for Payer: Adventist Health Commercial |
$2,875.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,111.88
|
| Rate for Payer: Blue Shield of California EPN |
$7,245.00
|
| Rate for Payer: Cash Price |
$7,906.25
|
| Rate for Payer: Central Health Plan Commercial |
$11,500.00
|
| Rate for Payer: Cigna of CA HMO |
$10,062.50
|
| Rate for Payer: Cigna of CA PPO |
$10,062.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,750.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,750.00
|
| Rate for Payer: Galaxy Health WC |
$12,218.75
|
| Rate for Payer: Global Benefits Group Commercial |
$8,625.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,937.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,588.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,476.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,898.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,875.00
|
| Rate for Payer: Multiplan Commercial |
$10,781.25
|
| Rate for Payer: Networks By Design Commercial |
$7,187.50
|
| Rate for Payer: Prime Health Services Commercial |
$12,218.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,394.94
|
| Rate for Payer: United Healthcare All Other HMO |
$5,251.19
|
| Rate for Payer: United Healthcare HMO Rider |
$5,137.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,707.81
|
|
|
HC LEAD STJ GREATBATCH 511212
|
Facility
|
IP
|
$1,968.00
|
|
|
Service Code
|
CPT C1883
|
| Hospital Charge Code |
906813764
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$393.60 |
| Max. Negotiated Rate |
$1,771.20 |
| Rate for Payer: Adventist Health Commercial |
$393.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1,521.26
|
| Rate for Payer: Blue Shield of California EPN |
$991.87
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,574.40
|
| Rate for Payer: Cigna of CA HMO |
$1,377.60
|
| Rate for Payer: Cigna of CA PPO |
$1,377.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$787.20
|
| Rate for Payer: EPIC Health Plan Senior |
$787.20
|
| Rate for Payer: Galaxy Health WC |
$1,672.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,180.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,771.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,312.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$749.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,218.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$393.60
|
| Rate for Payer: Multiplan Commercial |
$1,476.00
|
| Rate for Payer: Networks By Design Commercial |
$984.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,672.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$738.59
|
| Rate for Payer: United Healthcare All Other HMO |
$718.91
|
| Rate for Payer: United Healthcare HMO Rider |
$703.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$644.52
|
|
|
HC LEAD STJ GREATBATCH 511212
|
Facility
|
OP
|
$1,968.00
|
|
|
Service Code
|
CPT C1883
|
| Hospital Charge Code |
906813764
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$393.60 |
| Max. Negotiated Rate |
$1,771.20 |
| Rate for Payer: Adventist Health Commercial |
$393.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,672.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,082.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,476.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$898.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,089.68
|
| Rate for Payer: Blue Shield of California Commercial |
$1,521.26
|
| Rate for Payer: Blue Shield of California EPN |
$991.87
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,574.40
|
| Rate for Payer: Cigna of CA HMO |
$1,377.60
|
| Rate for Payer: Cigna of CA PPO |
$1,377.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,672.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,672.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,672.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$787.20
|
| Rate for Payer: EPIC Health Plan Senior |
$787.20
|
| Rate for Payer: Galaxy Health WC |
$1,672.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,180.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,771.20
|
| Rate for Payer: InnovAge PACE Commercial |
$984.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,312.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$749.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,218.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$393.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,377.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,377.60
|
| Rate for Payer: Multiplan Commercial |
$1,476.00
|
| Rate for Payer: Networks By Design Commercial |
$984.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,672.80
|
| Rate for Payer: Riverside University Health System MISP |
$787.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,180.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,180.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$738.59
|
| Rate for Payer: United Healthcare All Other HMO |
$718.91
|
| Rate for Payer: United Healthcare HMO Rider |
$703.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$644.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,672.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,672.80
|
| Rate for Payer: Vantage Medical Group Senior |
$1,672.80
|
|
|
HC LEAD STJ OPTISENSE 1699TC
|
Facility
|
IP
|
$2,925.00
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
906813595
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$585.00 |
| Max. Negotiated Rate |
$2,632.50 |
| Rate for Payer: Adventist Health Commercial |
$585.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,261.03
|
| Rate for Payer: Blue Shield of California EPN |
$1,474.20
|
| Rate for Payer: Cash Price |
$1,608.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,340.00
|
| Rate for Payer: Cigna of CA HMO |
$2,047.50
|
| Rate for Payer: Cigna of CA PPO |
$2,047.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,170.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,170.00
|
| Rate for Payer: Galaxy Health WC |
$2,486.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,755.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,632.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,950.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,114.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,810.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$585.00
|
| Rate for Payer: Multiplan Commercial |
$2,193.75
|
| Rate for Payer: Networks By Design Commercial |
$1,462.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,486.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,097.75
|
| Rate for Payer: United Healthcare All Other HMO |
$1,068.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,045.39
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$957.94
|
|
|
HC LEAD STJ OPTISENSE 1699TC
|
Facility
|
OP
|
$2,925.00
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
906813595
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$585.00 |
| Max. Negotiated Rate |
$2,632.50 |
| Rate for Payer: Adventist Health Commercial |
$585.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,486.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,608.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,193.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,416.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,717.85
|
| Rate for Payer: Blue Shield of California Commercial |
$2,261.03
|
| Rate for Payer: Blue Shield of California EPN |
$1,474.20
|
| Rate for Payer: Cash Price |
$1,608.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,340.00
|
| Rate for Payer: Cigna of CA HMO |
$2,047.50
|
| Rate for Payer: Cigna of CA PPO |
$2,047.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,486.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,486.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,486.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,170.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,170.00
|
| Rate for Payer: Galaxy Health WC |
$2,486.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,755.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,632.50
|
| Rate for Payer: InnovAge PACE Commercial |
$1,462.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,950.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,114.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,810.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$585.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,047.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,047.50
|
| Rate for Payer: Multiplan Commercial |
$2,193.75
|
| Rate for Payer: Networks By Design Commercial |
$1,462.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,486.25
|
| Rate for Payer: Riverside University Health System MISP |
$1,170.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,755.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,755.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,097.75
|
| Rate for Payer: United Healthcare All Other HMO |
$1,068.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,045.39
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$957.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,486.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,486.25
|
| Rate for Payer: Vantage Medical Group Senior |
$2,486.25
|
|
|
HC LEAD STJ OPTISURE LDA210Q
|
Facility
|
IP
|
$7,363.00
|
|
|
Service Code
|
CPT C1777
|
| Hospital Charge Code |
906813730
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,472.60 |
| Max. Negotiated Rate |
$6,626.70 |
| Rate for Payer: Adventist Health Commercial |
$1,472.60
|
| Rate for Payer: Blue Shield of California Commercial |
$5,691.60
|
| Rate for Payer: Blue Shield of California EPN |
$3,710.95
|
| Rate for Payer: Cash Price |
$4,049.65
|
| Rate for Payer: Central Health Plan Commercial |
$5,890.40
|
| Rate for Payer: Cigna of CA HMO |
$5,154.10
|
| Rate for Payer: Cigna of CA PPO |
$5,154.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,945.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,945.20
|
| Rate for Payer: Galaxy Health WC |
$6,258.55
|
| Rate for Payer: Global Benefits Group Commercial |
$4,417.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,626.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,911.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,805.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,557.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,472.60
|
| Rate for Payer: Multiplan Commercial |
$5,522.25
|
| Rate for Payer: Networks By Design Commercial |
$3,681.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,258.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,763.33
|
| Rate for Payer: United Healthcare All Other HMO |
$2,689.70
|
| Rate for Payer: United Healthcare HMO Rider |
$2,631.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,411.38
|
|
|
HC LEAD STJ OPTISURE LDA210Q
|
Facility
|
OP
|
$7,363.00
|
|
|
Service Code
|
CPT C1777
|
| Hospital Charge Code |
906813730
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,472.60 |
| Max. Negotiated Rate |
$6,626.70 |
| Rate for Payer: Adventist Health Commercial |
$1,472.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,258.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,049.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,522.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,361.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,076.89
|
| Rate for Payer: Blue Shield of California Commercial |
$5,691.60
|
| Rate for Payer: Blue Shield of California EPN |
$3,710.95
|
| Rate for Payer: Cash Price |
$4,049.65
|
| Rate for Payer: Central Health Plan Commercial |
$5,890.40
|
| Rate for Payer: Cigna of CA HMO |
$5,154.10
|
| Rate for Payer: Cigna of CA PPO |
$5,154.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,258.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,258.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,258.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,945.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,945.20
|
| Rate for Payer: Galaxy Health WC |
$6,258.55
|
| Rate for Payer: Global Benefits Group Commercial |
$4,417.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,626.70
|
| Rate for Payer: InnovAge PACE Commercial |
$3,681.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,911.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,557.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,472.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,154.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,154.10
|
| Rate for Payer: Multiplan Commercial |
$5,522.25
|
| Rate for Payer: Networks By Design Commercial |
$3,681.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,258.55
|
| Rate for Payer: Riverside University Health System MISP |
$2,945.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,417.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,417.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,763.33
|
| Rate for Payer: United Healthcare All Other HMO |
$2,689.70
|
| Rate for Payer: United Healthcare HMO Rider |
$2,631.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,411.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,258.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,258.55
|
| Rate for Payer: Vantage Medical Group Senior |
$6,258.55
|
|
|
HC LEAD STJ OPTISURE LDA220Q
|
Facility
|
OP
|
$7,363.00
|
|
|
Service Code
|
CPT C1895
|
| Hospital Charge Code |
906813780
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,472.60 |
| Max. Negotiated Rate |
$6,626.70 |
| Rate for Payer: Adventist Health Commercial |
$1,472.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,258.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,049.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,522.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,361.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,076.89
|
| Rate for Payer: Blue Shield of California Commercial |
$5,691.60
|
| Rate for Payer: Blue Shield of California EPN |
$3,710.95
|
| Rate for Payer: Cash Price |
$4,049.65
|
| Rate for Payer: Central Health Plan Commercial |
$5,890.40
|
| Rate for Payer: Cigna of CA HMO |
$5,154.10
|
| Rate for Payer: Cigna of CA PPO |
$5,154.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,258.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,258.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,258.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,945.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,945.20
|
| Rate for Payer: Galaxy Health WC |
$6,258.55
|
| Rate for Payer: Global Benefits Group Commercial |
$4,417.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,626.70
|
| Rate for Payer: InnovAge PACE Commercial |
$3,681.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,911.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,557.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,472.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,154.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,154.10
|
| Rate for Payer: Multiplan Commercial |
$5,522.25
|
| Rate for Payer: Networks By Design Commercial |
$3,681.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,258.55
|
| Rate for Payer: Riverside University Health System MISP |
$2,945.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,417.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,417.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,763.33
|
| Rate for Payer: United Healthcare All Other HMO |
$2,689.70
|
| Rate for Payer: United Healthcare HMO Rider |
$2,631.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,411.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,258.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,258.55
|
| Rate for Payer: Vantage Medical Group Senior |
$6,258.55
|
|
|
HC LEAD STJ OPTISURE LDA220Q
|
Facility
|
IP
|
$7,363.00
|
|
|
Service Code
|
CPT C1895
|
| Hospital Charge Code |
906813780
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,472.60 |
| Max. Negotiated Rate |
$6,626.70 |
| Rate for Payer: Adventist Health Commercial |
$1,472.60
|
| Rate for Payer: Blue Shield of California Commercial |
$5,691.60
|
| Rate for Payer: Blue Shield of California EPN |
$3,710.95
|
| Rate for Payer: Cash Price |
$4,049.65
|
| Rate for Payer: Central Health Plan Commercial |
$5,890.40
|
| Rate for Payer: Cigna of CA HMO |
$5,154.10
|
| Rate for Payer: Cigna of CA PPO |
$5,154.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,945.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,945.20
|
| Rate for Payer: Galaxy Health WC |
$6,258.55
|
| Rate for Payer: Global Benefits Group Commercial |
$4,417.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,626.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,911.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,805.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,557.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,472.60
|
| Rate for Payer: Multiplan Commercial |
$5,522.25
|
| Rate for Payer: Networks By Design Commercial |
$3,681.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,258.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,763.33
|
| Rate for Payer: United Healthcare All Other HMO |
$2,689.70
|
| Rate for Payer: United Healthcare HMO Rider |
$2,631.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,411.38
|
|
|
HC LEAD STJ QUARTET 1457Q
|
Facility
|
OP
|
$9,500.00
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
906813820
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,900.00 |
| Max. Negotiated Rate |
$8,550.00 |
| Rate for Payer: Adventist Health Commercial |
$1,900.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,075.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,225.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,125.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,337.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,260.15
|
| Rate for Payer: Blue Shield of California Commercial |
$7,343.50
|
| Rate for Payer: Blue Shield of California EPN |
$4,788.00
|
| Rate for Payer: Cash Price |
$5,225.00
|
| Rate for Payer: Central Health Plan Commercial |
$7,600.00
|
| Rate for Payer: Cigna of CA HMO |
$6,650.00
|
| Rate for Payer: Cigna of CA PPO |
$6,650.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,075.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,075.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,075.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,800.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,800.00
|
| Rate for Payer: Galaxy Health WC |
$8,075.00
|
| Rate for Payer: Global Benefits Group Commercial |
$5,700.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,550.00
|
| Rate for Payer: InnovAge PACE Commercial |
$4,750.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,336.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,619.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,880.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,900.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,650.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,650.00
|
| Rate for Payer: Multiplan Commercial |
$7,125.00
|
| Rate for Payer: Networks By Design Commercial |
$4,750.00
|
| Rate for Payer: Prime Health Services Commercial |
$8,075.00
|
| Rate for Payer: Riverside University Health System MISP |
$3,800.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,700.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,700.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,565.35
|
| Rate for Payer: United Healthcare All Other HMO |
$3,470.35
|
| Rate for Payer: United Healthcare HMO Rider |
$3,395.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,111.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,075.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,075.00
|
| Rate for Payer: Vantage Medical Group Senior |
$8,075.00
|
|
|
HC LEAD STJ QUARTET 1457Q
|
Facility
|
IP
|
$9,500.00
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
906813820
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,900.00 |
| Max. Negotiated Rate |
$8,550.00 |
| Rate for Payer: Adventist Health Commercial |
$1,900.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,343.50
|
| Rate for Payer: Blue Shield of California EPN |
$4,788.00
|
| Rate for Payer: Cash Price |
$5,225.00
|
| Rate for Payer: Central Health Plan Commercial |
$7,600.00
|
| Rate for Payer: Cigna of CA HMO |
$6,650.00
|
| Rate for Payer: Cigna of CA PPO |
$6,650.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,800.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,800.00
|
| Rate for Payer: Galaxy Health WC |
$8,075.00
|
| Rate for Payer: Global Benefits Group Commercial |
$5,700.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,550.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,336.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,619.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,880.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,900.00
|
| Rate for Payer: Multiplan Commercial |
$7,125.00
|
| Rate for Payer: Networks By Design Commercial |
$4,750.00
|
| Rate for Payer: Prime Health Services Commercial |
$8,075.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,565.35
|
| Rate for Payer: United Healthcare All Other HMO |
$3,470.35
|
| Rate for Payer: United Healthcare HMO Rider |
$3,395.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,111.25
|
|
|
HC LEAD STJ QUARTET 1458Q-75
|
Facility
|
IP
|
$7,750.00
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
906813726
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,550.00 |
| Max. Negotiated Rate |
$6,975.00 |
| Rate for Payer: Adventist Health Commercial |
$1,550.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,990.75
|
| Rate for Payer: Blue Shield of California EPN |
$3,906.00
|
| Rate for Payer: Cash Price |
$4,262.50
|
| Rate for Payer: Central Health Plan Commercial |
$6,200.00
|
| Rate for Payer: Cigna of CA HMO |
$5,425.00
|
| Rate for Payer: Cigna of CA PPO |
$5,425.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,100.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,100.00
|
| Rate for Payer: Galaxy Health WC |
$6,587.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,650.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,975.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,169.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,952.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,797.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,550.00
|
| Rate for Payer: Multiplan Commercial |
$5,812.50
|
| Rate for Payer: Networks By Design Commercial |
$3,875.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,587.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,908.57
|
| Rate for Payer: United Healthcare All Other HMO |
$2,831.07
|
| Rate for Payer: United Healthcare HMO Rider |
$2,769.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,538.12
|
|
|
HC LEAD STJ QUARTET 1458Q-75
|
Facility
|
OP
|
$7,750.00
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
906813726
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,550.00 |
| Max. Negotiated Rate |
$6,975.00 |
| Rate for Payer: Adventist Health Commercial |
$1,550.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,587.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,262.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,812.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,538.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,291.18
|
| Rate for Payer: Blue Shield of California Commercial |
$5,990.75
|
| Rate for Payer: Blue Shield of California EPN |
$3,906.00
|
| Rate for Payer: Cash Price |
$4,262.50
|
| Rate for Payer: Central Health Plan Commercial |
$6,200.00
|
| Rate for Payer: Cigna of CA HMO |
$5,425.00
|
| Rate for Payer: Cigna of CA PPO |
$5,425.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,587.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,587.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,587.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,100.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,100.00
|
| Rate for Payer: Galaxy Health WC |
$6,587.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,650.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,975.00
|
| Rate for Payer: InnovAge PACE Commercial |
$3,875.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,169.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,952.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,797.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,550.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,425.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,425.00
|
| Rate for Payer: Multiplan Commercial |
$5,812.50
|
| Rate for Payer: Networks By Design Commercial |
$3,875.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,587.50
|
| Rate for Payer: Riverside University Health System MISP |
$3,100.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,650.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,650.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,908.57
|
| Rate for Payer: United Healthcare All Other HMO |
$2,831.07
|
| Rate for Payer: United Healthcare HMO Rider |
$2,769.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,538.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,587.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,587.50
|
| Rate for Payer: Vantage Medical Group Senior |
$6,587.50
|
|
