|
HC PARTIAL HAND NO FINGER REMAIN
|
Facility
|
OP
|
$3,878.00
|
|
|
Service Code
|
CPT L6020
|
| Hospital Charge Code |
915356020
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,270.05 |
| Max. Negotiated Rate |
$3,490.20 |
| Rate for Payer: Adventist Health Commercial |
$1,589.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,296.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,132.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,908.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,255.83
|
| Rate for Payer: Blue Shield of California Commercial |
$3,110.16
|
| Rate for Payer: Blue Shield of California EPN |
$1,954.51
|
| Rate for Payer: Cash Price |
$1,745.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,102.40
|
| Rate for Payer: Cigna of CA HMO |
$2,714.60
|
| Rate for Payer: Cigna of CA PPO |
$2,714.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,296.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,296.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,296.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,714.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,551.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,551.20
|
| Rate for Payer: Galaxy Health WC |
$3,296.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,326.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,490.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,462.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,407.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,288.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,589.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,714.60
|
| Rate for Payer: Multiplan Commercial |
$2,908.50
|
| Rate for Payer: Networks By Design Commercial |
$1,939.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,296.30
|
| Rate for Payer: Riverside University Health System MISP |
$1,551.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,326.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,326.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,455.41
|
| Rate for Payer: United Healthcare All Other HMO |
$1,416.63
|
| Rate for Payer: United Healthcare HMO Rider |
$1,386.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,270.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,296.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,296.30
|
| Rate for Payer: Vantage Medical Group Senior |
$3,296.30
|
|
|
HC PARTIAL HAND THUMB REMAINING
|
Facility
|
IP
|
$4,040.00
|
|
|
Service Code
|
CPT L6000
|
| Hospital Charge Code |
905356000
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$808.00 |
| Max. Negotiated Rate |
$3,636.00 |
| Rate for Payer: Adventist Health Commercial |
$808.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,240.08
|
| Rate for Payer: Blue Shield of California EPN |
$2,036.16
|
| Rate for Payer: Cash Price |
$1,818.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,232.00
|
| Rate for Payer: Cigna of CA HMO |
$2,828.00
|
| Rate for Payer: Cigna of CA PPO |
$2,828.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,828.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,616.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,616.00
|
| Rate for Payer: Galaxy Health WC |
$3,434.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,424.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,636.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,565.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,383.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$808.00
|
| Rate for Payer: Multiplan Commercial |
$3,030.00
|
| Rate for Payer: Networks By Design Commercial |
$2,626.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,434.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,516.21
|
| Rate for Payer: United Healthcare All Other HMO |
$1,475.81
|
| Rate for Payer: United Healthcare HMO Rider |
$1,443.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,323.10
|
|
|
HC PARTIAL HAND THUMB REMAINING
|
Facility
|
OP
|
$4,040.00
|
|
|
Service Code
|
CPT L6000
|
| Hospital Charge Code |
915356000
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,323.10 |
| Max. Negotiated Rate |
$3,636.00 |
| Rate for Payer: Adventist Health Commercial |
$1,656.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,434.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,222.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,030.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,350.07
|
| Rate for Payer: Blue Shield of California Commercial |
$3,240.08
|
| Rate for Payer: Blue Shield of California EPN |
$2,036.16
|
| Rate for Payer: Cash Price |
$1,818.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,232.00
|
| Rate for Payer: Cigna of CA HMO |
$2,828.00
|
| Rate for Payer: Cigna of CA PPO |
$2,828.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,434.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,434.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,434.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,828.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,616.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,616.00
|
| Rate for Payer: Galaxy Health WC |
$3,434.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,424.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,636.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,565.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,466.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,383.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,656.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,828.00
|
| Rate for Payer: Multiplan Commercial |
$3,030.00
|
| Rate for Payer: Networks By Design Commercial |
$2,020.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,434.00
|
| Rate for Payer: Riverside University Health System MISP |
$1,616.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,424.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,424.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,516.21
|
| Rate for Payer: United Healthcare All Other HMO |
$1,475.81
|
| Rate for Payer: United Healthcare HMO Rider |
$1,443.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,323.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,434.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,434.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,434.00
|
|
|
HC PARTIAL HAND THUMB REMAINING
|
Facility
|
OP
|
$4,040.00
|
|
|
Service Code
|
CPT L6000
|
| Hospital Charge Code |
905356000
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,323.10 |
| Max. Negotiated Rate |
$3,636.00 |
| Rate for Payer: Adventist Health Commercial |
$1,656.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,434.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,222.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,030.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,350.07
|
| Rate for Payer: Blue Shield of California Commercial |
$3,240.08
|
| Rate for Payer: Blue Shield of California EPN |
$2,036.16
|
| Rate for Payer: Cash Price |
$1,818.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,232.00
|
| Rate for Payer: Cigna of CA HMO |
$2,828.00
|
| Rate for Payer: Cigna of CA PPO |
$2,828.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,434.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,434.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,434.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,828.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,616.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,616.00
|
| Rate for Payer: Galaxy Health WC |
$3,434.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,424.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,636.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,565.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,466.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,383.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,656.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,828.00
|
| Rate for Payer: Multiplan Commercial |
$3,030.00
|
| Rate for Payer: Networks By Design Commercial |
$2,020.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,434.00
|
| Rate for Payer: Riverside University Health System MISP |
$1,616.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,424.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,424.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,516.21
|
| Rate for Payer: United Healthcare All Other HMO |
$1,475.81
|
| Rate for Payer: United Healthcare HMO Rider |
$1,443.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,323.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,434.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,434.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,434.00
|
|
|
HC PARTIAL HAND THUMB REMAINING
|
Facility
|
IP
|
$4,040.00
|
|
|
Service Code
|
CPT L6000
|
| Hospital Charge Code |
915356000
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$808.00 |
| Max. Negotiated Rate |
$3,636.00 |
| Rate for Payer: Adventist Health Commercial |
$808.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,240.08
|
| Rate for Payer: Blue Shield of California EPN |
$2,036.16
|
| Rate for Payer: Cash Price |
$1,818.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,232.00
|
| Rate for Payer: Cigna of CA HMO |
$2,828.00
|
| Rate for Payer: Cigna of CA PPO |
$2,828.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,828.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,616.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,616.00
|
| Rate for Payer: Galaxy Health WC |
$3,434.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,424.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,636.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,565.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,383.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$808.00
|
| Rate for Payer: Multiplan Commercial |
$3,030.00
|
| Rate for Payer: Networks By Design Commercial |
$2,626.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,434.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,516.21
|
| Rate for Payer: United Healthcare All Other HMO |
$1,475.81
|
| Rate for Payer: United Healthcare HMO Rider |
$1,443.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,323.10
|
|
|
HC PARTIAL RMVL DIST PHALANX FNGR
|
Facility
|
OP
|
$10,697.00
|
|
|
Service Code
|
CPT 26236
|
| Hospital Charge Code |
900501314
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$9,627.30 |
| Rate for Payer: Adventist Health Commercial |
$2,139.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,068.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,240.00
|
| Rate for Payer: Cash Price |
$4,813.65
|
| Rate for Payer: Cash Price |
$4,813.65
|
| Rate for Payer: Cash Price |
$4,813.65
|
| Rate for Payer: Cash Price |
$4,813.65
|
| Rate for Payer: Central Health Plan Commercial |
$8,557.60
|
| Rate for Payer: Cigna of CA HMO |
$6,846.08
|
| Rate for Payer: Cigna of CA PPO |
$7,915.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,274.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,068.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,487.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,412.45
|
| Rate for Payer: EPIC Health Plan Senior |
$2,274.97
|
| Rate for Payer: Galaxy Health WC |
$9,092.45
|
| Rate for Payer: Global Benefits Group Commercial |
$6,418.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,627.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,391.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,792.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$505.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,139.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$8,022.75
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$6,953.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Preferred Health Network WC |
$3,306.12
|
| Rate for Payer: Prime Health Services Commercial |
$9,092.45
|
| Rate for Payer: Prime Health Services Medicare |
$2,192.24
|
| Rate for Payer: Prime Health Services WC |
$3,206.94
|
| Rate for Payer: Riverside University Health System MISP |
$2,274.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,418.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,348.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,348.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,348.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,348.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,068.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Vantage Medical Group Senior |
$2,068.15
|
|
|
HC PARTIAL RMVL DIST PHALANX FNGR
|
Facility
|
IP
|
$10,697.00
|
|
|
Service Code
|
CPT 26236
|
| Hospital Charge Code |
900501314
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,139.40 |
| Max. Negotiated Rate |
$9,627.30 |
| Rate for Payer: Adventist Health Commercial |
$2,139.40
|
| Rate for Payer: Cash Price |
$4,813.65
|
| Rate for Payer: Central Health Plan Commercial |
$8,557.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,487.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,278.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,278.80
|
| Rate for Payer: Galaxy Health WC |
$9,092.45
|
| Rate for Payer: Global Benefits Group Commercial |
$6,418.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,627.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,792.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,311.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,139.40
|
| Rate for Payer: Multiplan Commercial |
$8,022.75
|
| Rate for Payer: Networks By Design Commercial |
$6,953.05
|
| Rate for Payer: Prime Health Services Commercial |
$9,092.45
|
|
|
HC PARTIAL RMVL OF EYE FLUID
|
Facility
|
IP
|
$12,215.00
|
|
|
Service Code
|
CPT 67005
|
| Hospital Charge Code |
900501540
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,443.00 |
| Max. Negotiated Rate |
$10,993.50 |
| Rate for Payer: Adventist Health Commercial |
$2,443.00
|
| Rate for Payer: Cash Price |
$5,496.75
|
| Rate for Payer: Central Health Plan Commercial |
$9,772.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,550.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,886.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,886.00
|
| Rate for Payer: Galaxy Health WC |
$10,382.75
|
| Rate for Payer: Global Benefits Group Commercial |
$7,329.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,993.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,756.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,206.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,443.00
|
| Rate for Payer: Multiplan Commercial |
$9,161.25
|
| Rate for Payer: Networks By Design Commercial |
$7,939.75
|
| Rate for Payer: Prime Health Services Commercial |
$10,382.75
|
|
|
HC PARTIAL RMVL OF EYE FLUID
|
Facility
|
OP
|
$12,215.00
|
|
|
Service Code
|
CPT 67005
|
| Hospital Charge Code |
900501540
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$212.21 |
| Max. Negotiated Rate |
$10,993.50 |
| Rate for Payer: Adventist Health Commercial |
$2,443.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,452.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,265.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,968.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$4,617.28
|
| Rate for Payer: Cash Price |
$5,496.75
|
| Rate for Payer: Cash Price |
$5,496.75
|
| Rate for Payer: Cash Price |
$5,496.75
|
| Rate for Payer: Cash Price |
$5,496.75
|
| Rate for Payer: Central Health Plan Commercial |
$9,772.00
|
| Rate for Payer: Cigna of CA HMO |
$7,817.60
|
| Rate for Payer: Cigna of CA PPO |
$9,039.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,452.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,265.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,968.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,550.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,897.61
|
| Rate for Payer: EPIC Health Plan Senior |
$3,265.07
|
| Rate for Payer: Galaxy Health WC |
$10,382.75
|
| Rate for Payer: Global Benefits Group Commercial |
$7,329.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,993.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,867.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,968.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,756.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$212.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,190.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,443.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,977.45
|
| Rate for Payer: Multiplan Commercial |
$9,161.25
|
| Rate for Payer: Multiplan WC |
$4,617.28
|
| Rate for Payer: Networks By Design Commercial |
$7,939.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,968.25
|
| Rate for Payer: Preferred Health Network WC |
$4,711.51
|
| Rate for Payer: Prime Health Services Commercial |
$10,382.75
|
| Rate for Payer: Prime Health Services Medicare |
$3,146.34
|
| Rate for Payer: Prime Health Services WC |
$4,570.16
|
| Rate for Payer: Riverside University Health System MISP |
$3,265.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,329.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,107.50
|
| Rate for Payer: United Healthcare All Other HMO |
$6,107.50
|
| Rate for Payer: United Healthcare HMO Rider |
$6,107.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,107.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,968.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,452.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,265.07
|
| Rate for Payer: Vantage Medical Group Senior |
$2,968.25
|
|
|
HC PARTL HAND EXT POWRD SELF-SUSP
|
Facility
|
IP
|
$12,600.00
|
|
|
Service Code
|
CPT L6025
|
| Hospital Charge Code |
915356025
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$2,520.00 |
| Max. Negotiated Rate |
$11,340.00 |
| Rate for Payer: Adventist Health Commercial |
$2,520.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,105.20
|
| Rate for Payer: Blue Shield of California EPN |
$6,350.40
|
| Rate for Payer: Cash Price |
$5,670.00
|
| Rate for Payer: Central Health Plan Commercial |
$10,080.00
|
| Rate for Payer: Cigna of CA HMO |
$8,820.00
|
| Rate for Payer: Cigna of CA PPO |
$8,820.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,820.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,040.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,040.00
|
| Rate for Payer: Galaxy Health WC |
$10,710.00
|
| Rate for Payer: Global Benefits Group Commercial |
$7,560.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,340.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,001.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,434.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,520.00
|
| Rate for Payer: Multiplan Commercial |
$9,450.00
|
| Rate for Payer: Networks By Design Commercial |
$8,190.00
|
| Rate for Payer: Prime Health Services Commercial |
$10,710.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,728.78
|
| Rate for Payer: United Healthcare All Other HMO |
$4,602.78
|
| Rate for Payer: United Healthcare HMO Rider |
$4,503.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,126.50
|
|
|
HC PARTL HAND EXT POWRD SELF-SUSP
|
Facility
|
OP
|
$12,600.00
|
|
|
Service Code
|
CPT L6025
|
| Hospital Charge Code |
915356025
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$4,126.50 |
| Max. Negotiated Rate |
$11,340.00 |
| Rate for Payer: Adventist Health Commercial |
$5,166.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,710.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,930.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,450.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,329.42
|
| Rate for Payer: Blue Shield of California Commercial |
$10,105.20
|
| Rate for Payer: Blue Shield of California EPN |
$6,350.40
|
| Rate for Payer: Cash Price |
$5,670.00
|
| Rate for Payer: Central Health Plan Commercial |
$10,080.00
|
| Rate for Payer: Cigna of CA HMO |
$8,820.00
|
| Rate for Payer: Cigna of CA PPO |
$8,820.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,710.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,710.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,710.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,820.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,040.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,040.00
|
| Rate for Payer: Galaxy Health WC |
$10,710.00
|
| Rate for Payer: Global Benefits Group Commercial |
$7,560.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,340.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,001.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,573.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,434.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,166.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8,820.00
|
| Rate for Payer: Multiplan Commercial |
$9,450.00
|
| Rate for Payer: Networks By Design Commercial |
$6,300.00
|
| Rate for Payer: Prime Health Services Commercial |
$10,710.00
|
| Rate for Payer: Riverside University Health System MISP |
$5,040.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,560.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,560.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,728.78
|
| Rate for Payer: United Healthcare All Other HMO |
$4,602.78
|
| Rate for Payer: United Healthcare HMO Rider |
$4,503.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,126.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,710.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,710.00
|
| Rate for Payer: Vantage Medical Group Senior |
$10,710.00
|
|
|
HC PASSY MUIR VALVE FOR VENTS
|
Facility
|
OP
|
$288.00
|
|
| Hospital Charge Code |
900800705
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$259.20 |
| Rate for Payer: Adventist Health Commercial |
$57.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$174.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$244.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$158.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$216.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$139.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.53
|
| Rate for Payer: Blue Shield of California Commercial |
$182.59
|
| Rate for Payer: Blue Shield of California EPN |
$114.91
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Central Health Plan Commercial |
$230.40
|
| Rate for Payer: Cigna of CA HMO |
$184.32
|
| Rate for Payer: Cigna of CA PPO |
$213.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$244.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$244.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$244.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$201.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$259.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$182.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$104.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$169.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$201.60
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
| Rate for Payer: Riverside University Health System MISP |
$115.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$144.00
|
| Rate for Payer: United Healthcare All Other HMO |
$144.00
|
| Rate for Payer: United Healthcare HMO Rider |
$144.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$144.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$244.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$244.80
|
| Rate for Payer: Vantage Medical Group Senior |
$244.80
|
|
|
HC PASSY MUIR VALVE FOR VENTS
|
Facility
|
IP
|
$288.00
|
|
| Hospital Charge Code |
900800705
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$259.20 |
| Rate for Payer: Adventist Health Commercial |
$57.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Central Health Plan Commercial |
$230.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$201.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$259.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$182.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$169.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.60
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
|
|
HC PASSY MUIR VALVE SPEAKING
|
Facility
|
OP
|
$288.00
|
|
|
Service Code
|
CPT L8501
|
| Hospital Charge Code |
900800700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$534.30 |
| Rate for Payer: Adventist Health Commercial |
$57.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$534.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$244.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$158.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$216.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$139.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.53
|
| Rate for Payer: Blue Shield of California Commercial |
$182.59
|
| Rate for Payer: Blue Shield of California EPN |
$114.91
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Central Health Plan Commercial |
$230.40
|
| Rate for Payer: Cigna of CA HMO |
$184.32
|
| Rate for Payer: Cigna of CA PPO |
$213.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$244.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$244.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$244.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$201.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$259.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$182.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$104.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$169.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$201.60
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
| Rate for Payer: Riverside University Health System MISP |
$115.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$144.00
|
| Rate for Payer: United Healthcare All Other HMO |
$144.00
|
| Rate for Payer: United Healthcare HMO Rider |
$144.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$144.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$244.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$244.80
|
| Rate for Payer: Vantage Medical Group Senior |
$244.80
|
|
|
HC PASSY MUIR VALVE SPEAKING
|
Facility
|
IP
|
$288.00
|
|
|
Service Code
|
CPT L8501
|
| Hospital Charge Code |
900800700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$259.20 |
| Rate for Payer: Adventist Health Commercial |
$57.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Central Health Plan Commercial |
$230.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$201.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$259.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$182.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$169.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.60
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
|
|
HC PASTE MEDIHONEY TUBE .5FL OZ
|
Facility
|
OP
|
$39.61
|
|
|
Service Code
|
CPT A6240
|
| Hospital Charge Code |
901698328
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.92 |
| Max. Negotiated Rate |
$35.65 |
| Rate for Payer: Adventist Health Commercial |
$7.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$30.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.04
|
| Rate for Payer: Blue Shield of California Commercial |
$25.11
|
| Rate for Payer: Blue Shield of California EPN |
$15.80
|
| Rate for Payer: Cash Price |
$17.82
|
| Rate for Payer: Cash Price |
$17.82
|
| Rate for Payer: Central Health Plan Commercial |
$31.69
|
| Rate for Payer: Cigna of CA HMO |
$25.35
|
| Rate for Payer: Cigna of CA PPO |
$29.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$33.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.84
|
| Rate for Payer: EPIC Health Plan Senior |
$15.84
|
| Rate for Payer: Galaxy Health WC |
$33.67
|
| Rate for Payer: Global Benefits Group Commercial |
$23.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27.73
|
| Rate for Payer: Multiplan Commercial |
$29.71
|
| Rate for Payer: Networks By Design Commercial |
$25.75
|
| Rate for Payer: Prime Health Services Commercial |
$33.67
|
| Rate for Payer: Riverside University Health System MISP |
$15.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.77
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.80
|
| Rate for Payer: United Healthcare All Other HMO |
$19.80
|
| Rate for Payer: United Healthcare HMO Rider |
$19.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$33.67
|
| Rate for Payer: Vantage Medical Group Senior |
$33.67
|
|
|
HC PASTE MEDIHONEY TUBE .5FL OZ
|
Facility
|
IP
|
$39.61
|
|
|
Service Code
|
CPT A6240
|
| Hospital Charge Code |
901698328
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.92 |
| Max. Negotiated Rate |
$35.65 |
| Rate for Payer: Adventist Health Commercial |
$7.92
|
| Rate for Payer: Cash Price |
$17.82
|
| Rate for Payer: Central Health Plan Commercial |
$31.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.84
|
| Rate for Payer: EPIC Health Plan Senior |
$15.84
|
| Rate for Payer: Galaxy Health WC |
$33.67
|
| Rate for Payer: Global Benefits Group Commercial |
$23.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.92
|
| Rate for Payer: Multiplan Commercial |
$29.71
|
| Rate for Payer: Networks By Design Commercial |
$25.75
|
| Rate for Payer: Prime Health Services Commercial |
$33.67
|
|
|
HC PATH CONSULT SURG ADDL BLOCK P
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
903800220
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$84.36 |
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$70.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$60.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$84.36
|
| Rate for Payer: Blue Shield of California Commercial |
$15.75
|
| Rate for Payer: Blue Shield of California EPN |
$9.93
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: Cigna of CA HMO |
$16.00
|
| Rate for Payer: Cigna of CA PPO |
$18.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$33.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$36.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.50
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
| Rate for Payer: Riverside University Health System MISP |
$10.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.90
|
| Rate for Payer: United Healthcare All Other HMO |
$19.90
|
| Rate for Payer: United Healthcare HMO Rider |
$19.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.25
|
| Rate for Payer: Vantage Medical Group Senior |
$21.25
|
|
|
HC PATH CONSULT SURG ADDL BLOCK P
|
Facility
|
IP
|
$25.00
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
903800220
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
|
|
HC PATH CONSULT SURGERY FRZN PG
|
Facility
|
OP
|
$170.00
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
903800219
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$361.55 |
| Rate for Payer: Adventist Health Commercial |
$34.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$219.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$202.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$161.03
|
| Rate for Payer: Blue Shield of California Commercial |
$107.10
|
| Rate for Payer: Blue Shield of California EPN |
$67.49
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Central Health Plan Commercial |
$136.00
|
| Rate for Payer: Cigna of CA HMO |
$108.80
|
| Rate for Payer: Cigna of CA PPO |
$125.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$241.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$119.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.55
|
| Rate for Payer: EPIC Health Plan Senior |
$241.03
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$153.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$359.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$76.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$219.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$107.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$84.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$306.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$293.62
|
| Rate for Payer: Multiplan Commercial |
$127.50
|
| Rate for Payer: Networks By Design Commercial |
$110.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$219.12
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
| Rate for Payer: Prime Health Services Medicare |
$232.27
|
| Rate for Payer: Riverside University Health System MISP |
$241.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$102.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$102.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Upland Medical Group Pediatric |
$219.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Vantage Medical Group Senior |
$219.12
|
|
|
HC PATH CONSULT SURGERY FRZN PG
|
Facility
|
IP
|
$170.00
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
903800219
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Adventist Health Commercial |
$34.00
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Central Health Plan Commercial |
$136.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$119.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.00
|
| Rate for Payer: EPIC Health Plan Senior |
$68.00
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$153.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$107.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$100.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.00
|
| Rate for Payer: Multiplan Commercial |
$127.50
|
| Rate for Payer: Networks By Design Commercial |
$110.50
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
|
|
HC PATTEN BOTTOM ADDITION LE
|
Facility
|
OP
|
$754.00
|
|
|
Service Code
|
CPT L2370
|
| Hospital Charge Code |
905352370
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$246.94 |
| Max. Negotiated Rate |
$678.60 |
| Rate for Payer: Adventist Health Commercial |
$309.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$640.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$414.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$565.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$438.60
|
| Rate for Payer: Blue Shield of California Commercial |
$604.71
|
| Rate for Payer: Blue Shield of California EPN |
$380.02
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Central Health Plan Commercial |
$603.20
|
| Rate for Payer: Cigna of CA HMO |
$527.80
|
| Rate for Payer: Cigna of CA PPO |
$527.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$640.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$640.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$640.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$527.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$301.60
|
| Rate for Payer: EPIC Health Plan Senior |
$301.60
|
| Rate for Payer: Galaxy Health WC |
$640.90
|
| Rate for Payer: Global Benefits Group Commercial |
$452.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$678.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$354.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$478.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$391.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$444.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$309.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$527.80
|
| Rate for Payer: Multiplan Commercial |
$565.50
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$640.90
|
| Rate for Payer: Riverside University Health System MISP |
$301.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$452.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$452.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$282.98
|
| Rate for Payer: United Healthcare All Other HMO |
$275.44
|
| Rate for Payer: United Healthcare HMO Rider |
$269.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$246.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$640.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$640.90
|
| Rate for Payer: Vantage Medical Group Senior |
$640.90
|
|
|
HC PATTEN BOTTOM ADDITION LE
|
Facility
|
IP
|
$754.00
|
|
|
Service Code
|
CPT L2370
|
| Hospital Charge Code |
905352370
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$150.80 |
| Max. Negotiated Rate |
$678.60 |
| Rate for Payer: Adventist Health Commercial |
$150.80
|
| Rate for Payer: Blue Shield of California Commercial |
$604.71
|
| Rate for Payer: Blue Shield of California EPN |
$380.02
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Central Health Plan Commercial |
$603.20
|
| Rate for Payer: Cigna of CA HMO |
$527.80
|
| Rate for Payer: Cigna of CA PPO |
$527.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$527.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$301.60
|
| Rate for Payer: EPIC Health Plan Senior |
$301.60
|
| Rate for Payer: Galaxy Health WC |
$640.90
|
| Rate for Payer: Global Benefits Group Commercial |
$452.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$678.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$478.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$444.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.80
|
| Rate for Payer: Multiplan Commercial |
$565.50
|
| Rate for Payer: Networks By Design Commercial |
$490.10
|
| Rate for Payer: Prime Health Services Commercial |
$640.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$282.98
|
| Rate for Payer: United Healthcare All Other HMO |
$275.44
|
| Rate for Payer: United Healthcare HMO Rider |
$269.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$246.94
|
|
|
HC PATTEN BOTTOM ADDITION LE
|
Facility
|
OP
|
$754.00
|
|
|
Service Code
|
CPT L2370
|
| Hospital Charge Code |
915352370
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$246.94 |
| Max. Negotiated Rate |
$678.60 |
| Rate for Payer: Adventist Health Commercial |
$309.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$640.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$414.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$565.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$438.60
|
| Rate for Payer: Blue Shield of California Commercial |
$604.71
|
| Rate for Payer: Blue Shield of California EPN |
$380.02
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Central Health Plan Commercial |
$603.20
|
| Rate for Payer: Cigna of CA HMO |
$527.80
|
| Rate for Payer: Cigna of CA PPO |
$527.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$640.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$640.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$640.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$527.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$301.60
|
| Rate for Payer: EPIC Health Plan Senior |
$301.60
|
| Rate for Payer: Galaxy Health WC |
$640.90
|
| Rate for Payer: Global Benefits Group Commercial |
$452.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$678.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$354.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$478.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$391.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$444.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$309.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$527.80
|
| Rate for Payer: Multiplan Commercial |
$565.50
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$640.90
|
| Rate for Payer: Riverside University Health System MISP |
$301.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$452.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$452.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$282.98
|
| Rate for Payer: United Healthcare All Other HMO |
$275.44
|
| Rate for Payer: United Healthcare HMO Rider |
$269.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$246.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$640.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$640.90
|
| Rate for Payer: Vantage Medical Group Senior |
$640.90
|
|
|
HC PATTEN BOTTOM ADDITION LE
|
Facility
|
IP
|
$754.00
|
|
|
Service Code
|
CPT L2370
|
| Hospital Charge Code |
915352370
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$150.80 |
| Max. Negotiated Rate |
$678.60 |
| Rate for Payer: Adventist Health Commercial |
$150.80
|
| Rate for Payer: Blue Shield of California Commercial |
$604.71
|
| Rate for Payer: Blue Shield of California EPN |
$380.02
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Central Health Plan Commercial |
$603.20
|
| Rate for Payer: Cigna of CA HMO |
$527.80
|
| Rate for Payer: Cigna of CA PPO |
$527.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$527.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$301.60
|
| Rate for Payer: EPIC Health Plan Senior |
$301.60
|
| Rate for Payer: Galaxy Health WC |
$640.90
|
| Rate for Payer: Global Benefits Group Commercial |
$452.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$678.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$478.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$444.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.80
|
| Rate for Payer: Multiplan Commercial |
$565.50
|
| Rate for Payer: Networks By Design Commercial |
$490.10
|
| Rate for Payer: Prime Health Services Commercial |
$640.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$282.98
|
| Rate for Payer: United Healthcare All Other HMO |
$275.44
|
| Rate for Payer: United Healthcare HMO Rider |
$269.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$246.94
|
|
