|
HC PLEURAL DRAINAGE, PERC W INS OF IND CATH W IG
|
Facility
|
OP
|
$5,753.00
|
|
|
Service Code
|
CPT 32557
|
| Hospital Charge Code |
900200009
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$174.18 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,150.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,024.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,227.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,024.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,144.90
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$2,588.85
|
| Rate for Payer: Cash Price |
$2,588.85
|
| Rate for Payer: Cash Price |
$2,588.85
|
| Rate for Payer: Central Health Plan Commercial |
$4,602.40
|
| Rate for Payer: Cigna of CA HMO |
$3,681.92
|
| Rate for Payer: Cigna of CA PPO |
$4,257.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,227.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,024.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,027.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,340.64
|
| Rate for Payer: EPIC Health Plan Senior |
$2,227.09
|
| Rate for Payer: Galaxy Health WC |
$4,890.05
|
| Rate for Payer: Global Benefits Group Commercial |
$3,451.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,177.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,320.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$174.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,024.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,653.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$192.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,834.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,150.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,713.00
|
| Rate for Payer: Multiplan Commercial |
$4,314.75
|
| Rate for Payer: Multiplan WC |
$3,144.90
|
| Rate for Payer: Networks By Design Commercial |
$3,739.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,024.63
|
| Rate for Payer: Preferred Health Network WC |
$3,209.08
|
| Rate for Payer: Prime Health Services Commercial |
$4,890.05
|
| Rate for Payer: Prime Health Services Medicare |
$2,146.11
|
| Rate for Payer: Prime Health Services WC |
$3,112.81
|
| Rate for Payer: Riverside University Health System MISP |
$2,227.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,451.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,876.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,024.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,227.09
|
| Rate for Payer: Vantage Medical Group Senior |
$2,024.63
|
|
|
HC PLEURAL DRAINAGE, PERC W INS OF IND CATH WO IG
|
Facility
|
OP
|
$6,836.00
|
|
|
Service Code
|
CPT 32556
|
| Hospital Charge Code |
900200008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$158.81 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,367.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,468.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,840.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$3,076.20
|
| Rate for Payer: Cash Price |
$3,076.20
|
| Rate for Payer: Cash Price |
$3,076.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,468.80
|
| Rate for Payer: Cigna of CA HMO |
$4,375.04
|
| Rate for Payer: Cigna of CA PPO |
$5,058.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,785.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$5,810.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,101.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,152.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$158.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,340.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$175.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,367.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$5,127.00
|
| Rate for Payer: Multiplan WC |
$3,840.40
|
| Rate for Payer: Networks By Design Commercial |
$4,443.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Preferred Health Network WC |
$3,918.78
|
| Rate for Payer: Prime Health Services Commercial |
$5,810.60
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Prime Health Services WC |
$3,801.22
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,101.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,418.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC PLEURAL DRAINAGE, PERC W INS OF IND CATH WO IG
|
Facility
|
IP
|
$6,836.00
|
|
|
Service Code
|
CPT 32556
|
| Hospital Charge Code |
900200008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,367.20 |
| Max. Negotiated Rate |
$6,152.40 |
| Rate for Payer: Adventist Health Commercial |
$1,367.20
|
| Rate for Payer: Cash Price |
$3,076.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,468.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,785.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,734.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,734.40
|
| Rate for Payer: Galaxy Health WC |
$5,810.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,101.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,152.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,340.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,033.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,367.20
|
| Rate for Payer: Multiplan Commercial |
$5,127.00
|
| Rate for Payer: Networks By Design Commercial |
$4,443.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,810.60
|
|
|
HC PLEURAL DRAIN PERC CATH WO IMAGE
|
Facility
|
IP
|
$3,029.00
|
|
|
Service Code
|
CPT 32556
|
| Hospital Charge Code |
909032556
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$605.80 |
| Max. Negotiated Rate |
$2,726.10 |
| Rate for Payer: Adventist Health Commercial |
$605.80
|
| Rate for Payer: Cash Price |
$1,363.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,423.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,120.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,211.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,211.60
|
| Rate for Payer: Galaxy Health WC |
$2,574.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,817.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,726.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,923.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,787.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$605.80
|
| Rate for Payer: Multiplan Commercial |
$2,271.75
|
| Rate for Payer: Networks By Design Commercial |
$1,968.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,574.65
|
|
|
HC PLEURAL DRAIN PERC CATH WO IMAGE
|
Facility
|
OP
|
$3,029.00
|
|
|
Service Code
|
CPT 32556
|
| Hospital Charge Code |
909032556
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$158.81 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$605.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,468.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,840.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,363.05
|
| Rate for Payer: Cash Price |
$1,363.05
|
| Rate for Payer: Cash Price |
$1,363.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,423.20
|
| Rate for Payer: Cigna of CA HMO |
$1,938.56
|
| Rate for Payer: Cigna of CA PPO |
$2,241.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,120.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$2,574.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,817.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,726.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$158.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,923.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$175.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$605.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$2,271.75
|
| Rate for Payer: Multiplan WC |
$3,840.40
|
| Rate for Payer: Networks By Design Commercial |
$1,968.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Preferred Health Network WC |
$3,918.78
|
| Rate for Payer: Prime Health Services Commercial |
$2,574.65
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Prime Health Services WC |
$3,801.22
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,817.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,514.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC PLEURAL DRAIN PLCMNT NO TUNN
|
Facility
|
IP
|
$6,810.00
|
|
|
Service Code
|
CPT 32557
|
| Hospital Charge Code |
909020159
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,362.00 |
| Max. Negotiated Rate |
$6,129.00 |
| Rate for Payer: Adventist Health Commercial |
$1,362.00
|
| Rate for Payer: Cash Price |
$3,064.50
|
| Rate for Payer: Central Health Plan Commercial |
$5,448.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,767.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,724.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,724.00
|
| Rate for Payer: Galaxy Health WC |
$5,788.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,086.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,129.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,324.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,017.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,362.00
|
| Rate for Payer: Multiplan Commercial |
$5,107.50
|
| Rate for Payer: Networks By Design Commercial |
$4,426.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,788.50
|
|
|
HC PLEURAL DRAIN PLCMNT NO TUNN
|
Facility
|
OP
|
$6,810.00
|
|
|
Service Code
|
CPT 32557
|
| Hospital Charge Code |
909020159
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$174.18 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,362.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,024.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,227.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,024.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,144.90
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$3,064.50
|
| Rate for Payer: Cash Price |
$3,064.50
|
| Rate for Payer: Cash Price |
$3,064.50
|
| Rate for Payer: Central Health Plan Commercial |
$5,448.00
|
| Rate for Payer: Cigna of CA HMO |
$4,358.40
|
| Rate for Payer: Cigna of CA PPO |
$5,039.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,227.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,024.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,767.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,340.64
|
| Rate for Payer: EPIC Health Plan Senior |
$2,227.09
|
| Rate for Payer: Galaxy Health WC |
$5,788.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,086.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,129.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,320.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$174.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,024.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,324.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$192.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,834.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,362.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,713.00
|
| Rate for Payer: Multiplan Commercial |
$5,107.50
|
| Rate for Payer: Multiplan WC |
$3,144.90
|
| Rate for Payer: Networks By Design Commercial |
$4,426.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,024.63
|
| Rate for Payer: Preferred Health Network WC |
$3,209.08
|
| Rate for Payer: Prime Health Services Commercial |
$5,788.50
|
| Rate for Payer: Prime Health Services Medicare |
$2,146.11
|
| Rate for Payer: Prime Health Services WC |
$3,112.81
|
| Rate for Payer: Riverside University Health System MISP |
$2,227.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,086.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,405.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,024.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,227.09
|
| Rate for Payer: Vantage Medical Group Senior |
$2,024.63
|
|
|
HC PLEURA VAC
|
Facility
|
OP
|
$265.00
|
|
| Hospital Charge Code |
909081710
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.00 |
| Max. Negotiated Rate |
$238.50 |
| Rate for Payer: Adventist Health Commercial |
$53.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$160.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$225.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$145.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$198.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$128.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$154.15
|
| Rate for Payer: Blue Shield of California Commercial |
$168.01
|
| Rate for Payer: Blue Shield of California EPN |
$105.73
|
| Rate for Payer: Cash Price |
$119.25
|
| Rate for Payer: Central Health Plan Commercial |
$212.00
|
| Rate for Payer: Cigna of CA HMO |
$169.60
|
| Rate for Payer: Cigna of CA PPO |
$196.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$225.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$225.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$185.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.00
|
| Rate for Payer: EPIC Health Plan Senior |
$106.00
|
| Rate for Payer: Galaxy Health WC |
$225.25
|
| Rate for Payer: Global Benefits Group Commercial |
$159.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$238.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$168.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$96.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$156.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$185.50
|
| Rate for Payer: Multiplan Commercial |
$198.75
|
| Rate for Payer: Networks By Design Commercial |
$172.25
|
| Rate for Payer: Prime Health Services Commercial |
$225.25
|
| Rate for Payer: Riverside University Health System MISP |
$106.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$159.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$159.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$132.50
|
| Rate for Payer: United Healthcare All Other HMO |
$132.50
|
| Rate for Payer: United Healthcare HMO Rider |
$132.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$132.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$225.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$225.25
|
| Rate for Payer: Vantage Medical Group Senior |
$225.25
|
|
|
HC PLEURA VAC
|
Facility
|
IP
|
$265.00
|
|
| Hospital Charge Code |
909081710
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.00 |
| Max. Negotiated Rate |
$238.50 |
| Rate for Payer: Adventist Health Commercial |
$53.00
|
| Rate for Payer: Cash Price |
$119.25
|
| Rate for Payer: Central Health Plan Commercial |
$212.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$185.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.00
|
| Rate for Payer: EPIC Health Plan Senior |
$106.00
|
| Rate for Payer: Galaxy Health WC |
$225.25
|
| Rate for Payer: Global Benefits Group Commercial |
$159.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$238.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$168.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$156.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.00
|
| Rate for Payer: Multiplan Commercial |
$198.75
|
| Rate for Payer: Networks By Design Commercial |
$172.25
|
| Rate for Payer: Prime Health Services Commercial |
$225.25
|
|
|
HC PLEURODESIS
|
Facility
|
IP
|
$2,348.00
|
|
|
Service Code
|
CPT 32560
|
| Hospital Charge Code |
909000202
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$469.60 |
| Max. Negotiated Rate |
$2,113.20 |
| Rate for Payer: Adventist Health Commercial |
$469.60
|
| Rate for Payer: Cash Price |
$1,056.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,878.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,643.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$939.20
|
| Rate for Payer: EPIC Health Plan Senior |
$939.20
|
| Rate for Payer: Galaxy Health WC |
$1,995.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,408.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,113.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,490.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,385.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$469.60
|
| Rate for Payer: Multiplan Commercial |
$1,761.00
|
| Rate for Payer: Networks By Design Commercial |
$1,526.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,995.80
|
|
|
HC PLEURODESIS
|
Facility
|
OP
|
$2,348.00
|
|
|
Service Code
|
CPT 32560
|
| Hospital Charge Code |
909000202
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$388.70 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$469.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$806.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$887.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$806.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,251.66
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,056.60
|
| Rate for Payer: Cash Price |
$1,056.60
|
| Rate for Payer: Cash Price |
$1,056.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,878.40
|
| Rate for Payer: Cigna of CA HMO |
$1,502.72
|
| Rate for Payer: Cigna of CA PPO |
$1,737.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$887.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$806.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,643.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,331.25
|
| Rate for Payer: EPIC Health Plan Senior |
$887.50
|
| Rate for Payer: Galaxy Health WC |
$1,995.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,408.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,113.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,323.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$388.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$806.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,490.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$429.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,129.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$469.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,081.14
|
| Rate for Payer: Multiplan Commercial |
$1,761.00
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$1,526.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$806.82
|
| Rate for Payer: Preferred Health Network WC |
$1,277.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,995.80
|
| Rate for Payer: Prime Health Services Medicare |
$855.23
|
| Rate for Payer: Prime Health Services WC |
$1,238.88
|
| Rate for Payer: Riverside University Health System MISP |
$887.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,408.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,174.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$806.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$887.50
|
| Rate for Payer: Vantage Medical Group Senior |
$806.82
|
|
|
HC PLEURX CHEST DRAIN
|
Facility
|
IP
|
$1,205.20
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909020015
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$241.04 |
| Max. Negotiated Rate |
$1,084.68 |
| Rate for Payer: Adventist Health Commercial |
$241.04
|
| Rate for Payer: Blue Shield of California Commercial |
$966.57
|
| Rate for Payer: Blue Shield of California EPN |
$607.42
|
| Rate for Payer: Cash Price |
$542.34
|
| Rate for Payer: Central Health Plan Commercial |
$964.16
|
| Rate for Payer: Cigna of CA HMO |
$843.64
|
| Rate for Payer: Cigna of CA PPO |
$843.64
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$843.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$482.08
|
| Rate for Payer: EPIC Health Plan Senior |
$482.08
|
| Rate for Payer: Galaxy Health WC |
$1,024.42
|
| Rate for Payer: Global Benefits Group Commercial |
$723.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,084.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$765.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$711.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.04
|
| Rate for Payer: Multiplan Commercial |
$903.90
|
| Rate for Payer: Networks By Design Commercial |
$602.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,024.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$452.31
|
| Rate for Payer: United Healthcare All Other HMO |
$440.26
|
| Rate for Payer: United Healthcare HMO Rider |
$430.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$394.70
|
|
|
HC PLEURX CHEST DRAIN
|
Facility
|
OP
|
$1,205.20
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909020015
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$241.04 |
| Max. Negotiated Rate |
$1,084.68 |
| Rate for Payer: Adventist Health Commercial |
$241.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,024.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$662.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$903.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$550.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$660.93
|
| Rate for Payer: Blue Shield of California Commercial |
$966.57
|
| Rate for Payer: Blue Shield of California EPN |
$607.42
|
| Rate for Payer: Cash Price |
$542.34
|
| Rate for Payer: Central Health Plan Commercial |
$964.16
|
| Rate for Payer: Cigna of CA HMO |
$843.64
|
| Rate for Payer: Cigna of CA PPO |
$843.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,024.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,024.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,024.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$843.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$482.08
|
| Rate for Payer: EPIC Health Plan Senior |
$482.08
|
| Rate for Payer: Galaxy Health WC |
$1,024.42
|
| Rate for Payer: Global Benefits Group Commercial |
$723.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,084.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$765.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$437.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$711.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$843.64
|
| Rate for Payer: Multiplan Commercial |
$903.90
|
| Rate for Payer: Networks By Design Commercial |
$602.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,024.42
|
| Rate for Payer: Riverside University Health System MISP |
$482.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$723.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$723.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$452.31
|
| Rate for Payer: United Healthcare All Other HMO |
$440.26
|
| Rate for Payer: United Healthcare HMO Rider |
$430.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$394.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,024.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,024.42
|
| Rate for Payer: Vantage Medical Group Senior |
$1,024.42
|
|
|
HC PLEURX PERITONEAL DRAIN
|
Facility
|
OP
|
$1,973.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909020016
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$394.60 |
| Max. Negotiated Rate |
$1,775.70 |
| Rate for Payer: Adventist Health Commercial |
$394.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,677.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,085.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,479.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$900.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,081.99
|
| Rate for Payer: Blue Shield of California Commercial |
$1,582.35
|
| Rate for Payer: Blue Shield of California EPN |
$994.39
|
| Rate for Payer: Cash Price |
$887.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,578.40
|
| Rate for Payer: Cigna of CA HMO |
$1,381.10
|
| Rate for Payer: Cigna of CA PPO |
$1,381.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,677.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,677.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,677.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,381.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$789.20
|
| Rate for Payer: EPIC Health Plan Senior |
$789.20
|
| Rate for Payer: Galaxy Health WC |
$1,677.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,183.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,775.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,252.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$716.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,164.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$394.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,381.10
|
| Rate for Payer: Multiplan Commercial |
$1,479.75
|
| Rate for Payer: Networks By Design Commercial |
$986.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,677.05
|
| Rate for Payer: Riverside University Health System MISP |
$789.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,183.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,183.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$740.47
|
| Rate for Payer: United Healthcare All Other HMO |
$720.74
|
| Rate for Payer: United Healthcare HMO Rider |
$705.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$646.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,677.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,677.05
|
| Rate for Payer: Vantage Medical Group Senior |
$1,677.05
|
|
|
HC PLEURX PERITONEAL DRAIN
|
Facility
|
IP
|
$1,973.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909020016
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$394.60 |
| Max. Negotiated Rate |
$1,775.70 |
| Rate for Payer: Adventist Health Commercial |
$394.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1,582.35
|
| Rate for Payer: Blue Shield of California EPN |
$994.39
|
| Rate for Payer: Cash Price |
$887.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,578.40
|
| Rate for Payer: Cigna of CA HMO |
$1,381.10
|
| Rate for Payer: Cigna of CA PPO |
$1,381.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,381.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$789.20
|
| Rate for Payer: EPIC Health Plan Senior |
$789.20
|
| Rate for Payer: Galaxy Health WC |
$1,677.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,183.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,775.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,252.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,164.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$394.60
|
| Rate for Payer: Multiplan Commercial |
$1,479.75
|
| Rate for Payer: Networks By Design Commercial |
$986.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,677.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$740.47
|
| Rate for Payer: United Healthcare All Other HMO |
$720.74
|
| Rate for Payer: United Healthcare HMO Rider |
$705.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$646.16
|
|
|
HC PLUG DECANNULATION 10.0
|
Facility
|
IP
|
$38.62
|
|
| Hospital Charge Code |
900800861
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$34.76 |
| Rate for Payer: Adventist Health Commercial |
$7.72
|
| Rate for Payer: Cash Price |
$17.38
|
| Rate for Payer: Central Health Plan Commercial |
$30.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.45
|
| Rate for Payer: EPIC Health Plan Senior |
$15.45
|
| Rate for Payer: Galaxy Health WC |
$32.83
|
| Rate for Payer: Global Benefits Group Commercial |
$23.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.72
|
| Rate for Payer: Multiplan Commercial |
$28.96
|
| Rate for Payer: Networks By Design Commercial |
$25.10
|
| Rate for Payer: Prime Health Services Commercial |
$32.83
|
|
|
HC PLUG DECANNULATION 10.0
|
Facility
|
OP
|
$38.62
|
|
| Hospital Charge Code |
900800861
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$34.76 |
| Rate for Payer: Adventist Health Commercial |
$7.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.47
|
| Rate for Payer: Blue Shield of California Commercial |
$24.49
|
| Rate for Payer: Blue Shield of California EPN |
$15.41
|
| Rate for Payer: Cash Price |
$17.38
|
| Rate for Payer: Central Health Plan Commercial |
$30.90
|
| Rate for Payer: Cigna of CA HMO |
$24.72
|
| Rate for Payer: Cigna of CA PPO |
$28.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$32.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.45
|
| Rate for Payer: EPIC Health Plan Senior |
$15.45
|
| Rate for Payer: Galaxy Health WC |
$32.83
|
| Rate for Payer: Global Benefits Group Commercial |
$23.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27.03
|
| Rate for Payer: Multiplan Commercial |
$28.96
|
| Rate for Payer: Networks By Design Commercial |
$25.10
|
| Rate for Payer: Prime Health Services Commercial |
$32.83
|
| Rate for Payer: Riverside University Health System MISP |
$15.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.31
|
| Rate for Payer: United Healthcare All Other HMO |
$19.31
|
| Rate for Payer: United Healthcare HMO Rider |
$19.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.83
|
| Rate for Payer: Vantage Medical Group Senior |
$32.83
|
|
|
HC PLUG DECANNULATION 4.0
|
Facility
|
IP
|
$38.62
|
|
| Hospital Charge Code |
900800858
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$34.76 |
| Rate for Payer: Adventist Health Commercial |
$7.72
|
| Rate for Payer: Cash Price |
$17.38
|
| Rate for Payer: Central Health Plan Commercial |
$30.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.45
|
| Rate for Payer: EPIC Health Plan Senior |
$15.45
|
| Rate for Payer: Galaxy Health WC |
$32.83
|
| Rate for Payer: Global Benefits Group Commercial |
$23.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.72
|
| Rate for Payer: Multiplan Commercial |
$28.96
|
| Rate for Payer: Networks By Design Commercial |
$25.10
|
| Rate for Payer: Prime Health Services Commercial |
$32.83
|
|
|
HC PLUG DECANNULATION 4.0
|
Facility
|
OP
|
$38.62
|
|
| Hospital Charge Code |
900800858
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$34.76 |
| Rate for Payer: Adventist Health Commercial |
$7.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.47
|
| Rate for Payer: Blue Shield of California Commercial |
$24.49
|
| Rate for Payer: Blue Shield of California EPN |
$15.41
|
| Rate for Payer: Cash Price |
$17.38
|
| Rate for Payer: Central Health Plan Commercial |
$30.90
|
| Rate for Payer: Cigna of CA HMO |
$24.72
|
| Rate for Payer: Cigna of CA PPO |
$28.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$32.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.45
|
| Rate for Payer: EPIC Health Plan Senior |
$15.45
|
| Rate for Payer: Galaxy Health WC |
$32.83
|
| Rate for Payer: Global Benefits Group Commercial |
$23.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27.03
|
| Rate for Payer: Multiplan Commercial |
$28.96
|
| Rate for Payer: Networks By Design Commercial |
$25.10
|
| Rate for Payer: Prime Health Services Commercial |
$32.83
|
| Rate for Payer: Riverside University Health System MISP |
$15.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.31
|
| Rate for Payer: United Healthcare All Other HMO |
$19.31
|
| Rate for Payer: United Healthcare HMO Rider |
$19.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.83
|
| Rate for Payer: Vantage Medical Group Senior |
$32.83
|
|
|
HC PLUG DECANNULATION 6.0
|
Facility
|
IP
|
$38.62
|
|
| Hospital Charge Code |
900800859
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$34.76 |
| Rate for Payer: Adventist Health Commercial |
$7.72
|
| Rate for Payer: Cash Price |
$17.38
|
| Rate for Payer: Central Health Plan Commercial |
$30.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.45
|
| Rate for Payer: EPIC Health Plan Senior |
$15.45
|
| Rate for Payer: Galaxy Health WC |
$32.83
|
| Rate for Payer: Global Benefits Group Commercial |
$23.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.72
|
| Rate for Payer: Multiplan Commercial |
$28.96
|
| Rate for Payer: Networks By Design Commercial |
$25.10
|
| Rate for Payer: Prime Health Services Commercial |
$32.83
|
|
|
HC PLUG DECANNULATION 6.0
|
Facility
|
OP
|
$38.62
|
|
| Hospital Charge Code |
900800859
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$34.76 |
| Rate for Payer: Adventist Health Commercial |
$7.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.47
|
| Rate for Payer: Blue Shield of California Commercial |
$24.49
|
| Rate for Payer: Blue Shield of California EPN |
$15.41
|
| Rate for Payer: Cash Price |
$17.38
|
| Rate for Payer: Central Health Plan Commercial |
$30.90
|
| Rate for Payer: Cigna of CA HMO |
$24.72
|
| Rate for Payer: Cigna of CA PPO |
$28.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$32.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.45
|
| Rate for Payer: EPIC Health Plan Senior |
$15.45
|
| Rate for Payer: Galaxy Health WC |
$32.83
|
| Rate for Payer: Global Benefits Group Commercial |
$23.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27.03
|
| Rate for Payer: Multiplan Commercial |
$28.96
|
| Rate for Payer: Networks By Design Commercial |
$25.10
|
| Rate for Payer: Prime Health Services Commercial |
$32.83
|
| Rate for Payer: Riverside University Health System MISP |
$15.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.31
|
| Rate for Payer: United Healthcare All Other HMO |
$19.31
|
| Rate for Payer: United Healthcare HMO Rider |
$19.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.83
|
| Rate for Payer: Vantage Medical Group Senior |
$32.83
|
|
|
HC PLUG DECANNULATION 8.0
|
Facility
|
OP
|
$38.62
|
|
| Hospital Charge Code |
900800860
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$34.76 |
| Rate for Payer: Adventist Health Commercial |
$7.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.47
|
| Rate for Payer: Blue Shield of California Commercial |
$24.49
|
| Rate for Payer: Blue Shield of California EPN |
$15.41
|
| Rate for Payer: Cash Price |
$17.38
|
| Rate for Payer: Central Health Plan Commercial |
$30.90
|
| Rate for Payer: Cigna of CA HMO |
$24.72
|
| Rate for Payer: Cigna of CA PPO |
$28.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$32.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.45
|
| Rate for Payer: EPIC Health Plan Senior |
$15.45
|
| Rate for Payer: Galaxy Health WC |
$32.83
|
| Rate for Payer: Global Benefits Group Commercial |
$23.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27.03
|
| Rate for Payer: Multiplan Commercial |
$28.96
|
| Rate for Payer: Networks By Design Commercial |
$25.10
|
| Rate for Payer: Prime Health Services Commercial |
$32.83
|
| Rate for Payer: Riverside University Health System MISP |
$15.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.31
|
| Rate for Payer: United Healthcare All Other HMO |
$19.31
|
| Rate for Payer: United Healthcare HMO Rider |
$19.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.83
|
| Rate for Payer: Vantage Medical Group Senior |
$32.83
|
|
|
HC PLUG DECANNULATION 8.0
|
Facility
|
IP
|
$38.62
|
|
| Hospital Charge Code |
900800860
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$34.76 |
| Rate for Payer: Adventist Health Commercial |
$7.72
|
| Rate for Payer: Cash Price |
$17.38
|
| Rate for Payer: Central Health Plan Commercial |
$30.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.45
|
| Rate for Payer: EPIC Health Plan Senior |
$15.45
|
| Rate for Payer: Galaxy Health WC |
$32.83
|
| Rate for Payer: Global Benefits Group Commercial |
$23.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.72
|
| Rate for Payer: Multiplan Commercial |
$28.96
|
| Rate for Payer: Networks By Design Commercial |
$25.10
|
| Rate for Payer: Prime Health Services Commercial |
$32.83
|
|
|
HC PLUG SHILEY DISP DECANNULATION
|
Facility
|
OP
|
$30.99
|
|
| Hospital Charge Code |
900800857
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.20 |
| Max. Negotiated Rate |
$27.89 |
| Rate for Payer: Adventist Health Commercial |
$6.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.03
|
| Rate for Payer: Blue Shield of California Commercial |
$19.65
|
| Rate for Payer: Blue Shield of California EPN |
$12.37
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Central Health Plan Commercial |
$24.79
|
| Rate for Payer: Cigna of CA HMO |
$19.83
|
| Rate for Payer: Cigna of CA PPO |
$22.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$26.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.40
|
| Rate for Payer: EPIC Health Plan Senior |
$12.40
|
| Rate for Payer: Galaxy Health WC |
$26.34
|
| Rate for Payer: Global Benefits Group Commercial |
$18.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$21.69
|
| Rate for Payer: Multiplan Commercial |
$23.24
|
| Rate for Payer: Networks By Design Commercial |
$20.14
|
| Rate for Payer: Prime Health Services Commercial |
$26.34
|
| Rate for Payer: Riverside University Health System MISP |
$12.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.49
|
| Rate for Payer: United Healthcare All Other HMO |
$15.49
|
| Rate for Payer: United Healthcare HMO Rider |
$15.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.34
|
| Rate for Payer: Vantage Medical Group Senior |
$26.34
|
|
|
HC PLUG SHILEY DISP DECANNULATION
|
Facility
|
IP
|
$30.99
|
|
| Hospital Charge Code |
900800857
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.20 |
| Max. Negotiated Rate |
$27.89 |
| Rate for Payer: Adventist Health Commercial |
$6.20
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Central Health Plan Commercial |
$24.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.40
|
| Rate for Payer: EPIC Health Plan Senior |
$12.40
|
| Rate for Payer: Galaxy Health WC |
$26.34
|
| Rate for Payer: Global Benefits Group Commercial |
$18.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.20
|
| Rate for Payer: Multiplan Commercial |
$23.24
|
| Rate for Payer: Networks By Design Commercial |
$20.14
|
| Rate for Payer: Prime Health Services Commercial |
$26.34
|
|
