|
HC PRIMOBOOT BARIATRIC PRPL/NAVY
|
Facility
|
IP
|
$297.29
|
|
| Hospital Charge Code |
901698652
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$59.46 |
| Max. Negotiated Rate |
$267.56 |
| Rate for Payer: Adventist Health Commercial |
$59.46
|
| Rate for Payer: Cash Price |
$133.78
|
| Rate for Payer: Central Health Plan Commercial |
$237.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$208.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$118.92
|
| Rate for Payer: EPIC Health Plan Senior |
$118.92
|
| Rate for Payer: Galaxy Health WC |
$252.70
|
| Rate for Payer: Global Benefits Group Commercial |
$178.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$267.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$188.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$175.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.46
|
| Rate for Payer: Multiplan Commercial |
$222.97
|
| Rate for Payer: Networks By Design Commercial |
$193.24
|
| Rate for Payer: Prime Health Services Commercial |
$252.70
|
|
|
HC PRIMOBOOT BARIATRIC PRPL/NAVY
|
Facility
|
OP
|
$297.29
|
|
| Hospital Charge Code |
901698652
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$59.46 |
| Max. Negotiated Rate |
$267.56 |
| Rate for Payer: Adventist Health Commercial |
$59.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$180.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$252.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$163.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$222.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$143.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$172.93
|
| Rate for Payer: Blue Shield of California Commercial |
$188.48
|
| Rate for Payer: Blue Shield of California EPN |
$118.62
|
| Rate for Payer: Cash Price |
$133.78
|
| Rate for Payer: Central Health Plan Commercial |
$237.83
|
| Rate for Payer: Cigna of CA HMO |
$190.27
|
| Rate for Payer: Cigna of CA PPO |
$219.99
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$252.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$252.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$252.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$208.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$118.92
|
| Rate for Payer: EPIC Health Plan Senior |
$118.92
|
| Rate for Payer: Galaxy Health WC |
$252.70
|
| Rate for Payer: Global Benefits Group Commercial |
$178.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$267.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$188.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$107.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$175.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$208.10
|
| Rate for Payer: Multiplan Commercial |
$222.97
|
| Rate for Payer: Networks By Design Commercial |
$193.24
|
| Rate for Payer: Prime Health Services Commercial |
$252.70
|
| Rate for Payer: Riverside University Health System MISP |
$118.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$178.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$178.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$148.65
|
| Rate for Payer: United Healthcare All Other HMO |
$148.65
|
| Rate for Payer: United Healthcare HMO Rider |
$148.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$148.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$252.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$252.70
|
| Rate for Payer: Vantage Medical Group Senior |
$252.70
|
|
|
HC PRIMOBOOT STD PURPLE/NAVY
|
Facility
|
OP
|
$268.17
|
|
| Hospital Charge Code |
901698653
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$53.63 |
| Max. Negotiated Rate |
$241.35 |
| Rate for Payer: Adventist Health Commercial |
$53.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$162.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$227.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$201.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$129.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$155.99
|
| Rate for Payer: Blue Shield of California Commercial |
$170.02
|
| Rate for Payer: Blue Shield of California EPN |
$107.00
|
| Rate for Payer: Cash Price |
$120.68
|
| Rate for Payer: Central Health Plan Commercial |
$214.54
|
| Rate for Payer: Cigna of CA HMO |
$171.63
|
| Rate for Payer: Cigna of CA PPO |
$198.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$227.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$227.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$227.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$187.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$107.27
|
| Rate for Payer: EPIC Health Plan Senior |
$107.27
|
| Rate for Payer: Galaxy Health WC |
$227.94
|
| Rate for Payer: Global Benefits Group Commercial |
$160.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$241.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$170.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$97.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$158.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$187.72
|
| Rate for Payer: Multiplan Commercial |
$201.13
|
| Rate for Payer: Networks By Design Commercial |
$174.31
|
| Rate for Payer: Prime Health Services Commercial |
$227.94
|
| Rate for Payer: Riverside University Health System MISP |
$107.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$160.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$160.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$134.09
|
| Rate for Payer: United Healthcare All Other HMO |
$134.09
|
| Rate for Payer: United Healthcare HMO Rider |
$134.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$134.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$227.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$227.94
|
| Rate for Payer: Vantage Medical Group Senior |
$227.94
|
|
|
HC PRIMOBOOT STD PURPLE/NAVY
|
Facility
|
IP
|
$268.17
|
|
| Hospital Charge Code |
901698653
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$53.63 |
| Max. Negotiated Rate |
$241.35 |
| Rate for Payer: Adventist Health Commercial |
$53.63
|
| Rate for Payer: Cash Price |
$120.68
|
| Rate for Payer: Central Health Plan Commercial |
$214.54
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$187.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$107.27
|
| Rate for Payer: EPIC Health Plan Senior |
$107.27
|
| Rate for Payer: Galaxy Health WC |
$227.94
|
| Rate for Payer: Global Benefits Group Commercial |
$160.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$241.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$170.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$158.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.63
|
| Rate for Payer: Multiplan Commercial |
$201.13
|
| Rate for Payer: Networks By Design Commercial |
$174.31
|
| Rate for Payer: Prime Health Services Commercial |
$227.94
|
|
|
HC PRIMOBOOT STD W/WEDGE PUR/NAVY
|
Facility
|
IP
|
$297.22
|
|
| Hospital Charge Code |
901698678
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$59.44 |
| Max. Negotiated Rate |
$267.50 |
| Rate for Payer: Adventist Health Commercial |
$59.44
|
| Rate for Payer: Cash Price |
$133.75
|
| Rate for Payer: Central Health Plan Commercial |
$237.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$208.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$118.89
|
| Rate for Payer: EPIC Health Plan Senior |
$118.89
|
| Rate for Payer: Galaxy Health WC |
$252.64
|
| Rate for Payer: Global Benefits Group Commercial |
$178.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$267.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$188.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$175.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.44
|
| Rate for Payer: Multiplan Commercial |
$222.91
|
| Rate for Payer: Networks By Design Commercial |
$193.19
|
| Rate for Payer: Prime Health Services Commercial |
$252.64
|
|
|
HC PRIMOBOOT STD W/WEDGE PUR/NAVY
|
Facility
|
OP
|
$297.22
|
|
| Hospital Charge Code |
901698678
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$59.44 |
| Max. Negotiated Rate |
$267.50 |
| Rate for Payer: Adventist Health Commercial |
$59.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$180.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$252.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$163.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$222.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$143.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$172.89
|
| Rate for Payer: Blue Shield of California Commercial |
$188.44
|
| Rate for Payer: Blue Shield of California EPN |
$118.59
|
| Rate for Payer: Cash Price |
$133.75
|
| Rate for Payer: Central Health Plan Commercial |
$237.78
|
| Rate for Payer: Cigna of CA HMO |
$190.22
|
| Rate for Payer: Cigna of CA PPO |
$219.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$252.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$252.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$252.64
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$208.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$118.89
|
| Rate for Payer: EPIC Health Plan Senior |
$118.89
|
| Rate for Payer: Galaxy Health WC |
$252.64
|
| Rate for Payer: Global Benefits Group Commercial |
$178.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$267.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$188.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$107.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$175.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$208.05
|
| Rate for Payer: Multiplan Commercial |
$222.91
|
| Rate for Payer: Networks By Design Commercial |
$193.19
|
| Rate for Payer: Prime Health Services Commercial |
$252.64
|
| Rate for Payer: Riverside University Health System MISP |
$118.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$178.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$178.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$148.61
|
| Rate for Payer: United Healthcare All Other HMO |
$148.61
|
| Rate for Payer: United Healthcare HMO Rider |
$148.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$148.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$252.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$252.64
|
| Rate for Payer: Vantage Medical Group Senior |
$252.64
|
|
|
HC PROBE NASOLACRIMAL DUCT W/ANES
|
Facility
|
OP
|
$5,678.00
|
|
|
Service Code
|
CPT 68811
|
| Hospital Charge Code |
900501656
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$212.91 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,135.60
|
| 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 |
$4,586.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,363.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,057.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$4,723.01
|
| Rate for Payer: Cash Price |
$2,555.10
|
| Rate for Payer: Cash Price |
$2,555.10
|
| Rate for Payer: Cash Price |
$2,555.10
|
| Rate for Payer: Cash Price |
$2,555.10
|
| Rate for Payer: Central Health Plan Commercial |
$4,542.40
|
| Rate for Payer: Cigna of CA HMO |
$3,633.92
|
| Rate for Payer: Cigna of CA PPO |
$4,201.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,586.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,363.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,057.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,974.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,045.44
|
| Rate for Payer: EPIC Health Plan Senior |
$3,363.62
|
| Rate for Payer: Galaxy Health WC |
$4,826.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,406.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,110.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,014.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,057.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,605.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$212.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,287.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,135.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,097.51
|
| Rate for Payer: Multiplan Commercial |
$4,258.50
|
| Rate for Payer: Multiplan WC |
$4,723.01
|
| Rate for Payer: Networks By Design Commercial |
$3,690.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,057.84
|
| Rate for Payer: Preferred Health Network WC |
$4,819.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,826.30
|
| Rate for Payer: Prime Health Services Medicare |
$3,241.31
|
| Rate for Payer: Prime Health Services WC |
$4,674.82
|
| Rate for Payer: Riverside University Health System MISP |
$3,363.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,406.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,839.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,839.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,839.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,839.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,057.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,586.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,363.62
|
| Rate for Payer: Vantage Medical Group Senior |
$3,057.84
|
|
|
HC PROBE NASOLACRIMAL DUCT W/ANES
|
Facility
|
IP
|
$5,678.00
|
|
|
Service Code
|
CPT 68811
|
| Hospital Charge Code |
900501656
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,135.60 |
| Max. Negotiated Rate |
$5,110.20 |
| Rate for Payer: Adventist Health Commercial |
$1,135.60
|
| Rate for Payer: Cash Price |
$2,555.10
|
| Rate for Payer: Central Health Plan Commercial |
$4,542.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,974.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,271.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,271.20
|
| Rate for Payer: Galaxy Health WC |
$4,826.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,406.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,110.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,605.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,350.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,135.60
|
| Rate for Payer: Multiplan Commercial |
$4,258.50
|
| Rate for Payer: Networks By Design Commercial |
$3,690.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,826.30
|
|
|
HC PROBE NASOLACRIMAL DUCT W/TUBE
|
Facility
|
IP
|
$10,012.00
|
|
|
Service Code
|
CPT 68815
|
| Hospital Charge Code |
900501677
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,002.40 |
| Max. Negotiated Rate |
$9,010.80 |
| Rate for Payer: Adventist Health Commercial |
$2,002.40
|
| Rate for Payer: Cash Price |
$4,505.40
|
| Rate for Payer: Central Health Plan Commercial |
$8,009.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,008.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,004.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,004.80
|
| Rate for Payer: Galaxy Health WC |
$8,510.20
|
| Rate for Payer: Global Benefits Group Commercial |
$6,007.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,010.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,357.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,907.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,002.40
|
| Rate for Payer: Multiplan Commercial |
$7,509.00
|
| Rate for Payer: Networks By Design Commercial |
$6,507.80
|
| Rate for Payer: Prime Health Services Commercial |
$8,510.20
|
|
|
HC PROBE NASOLACRIMAL DUCT W/TUBE
|
Facility
|
OP
|
$10,012.00
|
|
|
Service Code
|
CPT 68815
|
| Hospital Charge Code |
900501677
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$84.17 |
| Max. Negotiated Rate |
$9,010.80 |
| Rate for Payer: Adventist Health Commercial |
$2,002.40
|
| 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 |
$4,586.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,363.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,057.84
|
| 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 |
$4,723.01
|
| Rate for Payer: Cash Price |
$4,505.40
|
| Rate for Payer: Cash Price |
$4,505.40
|
| Rate for Payer: Cash Price |
$4,505.40
|
| Rate for Payer: Cash Price |
$4,505.40
|
| Rate for Payer: Central Health Plan Commercial |
$8,009.60
|
| Rate for Payer: Cigna of CA HMO |
$6,407.68
|
| Rate for Payer: Cigna of CA PPO |
$7,408.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,586.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,363.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,057.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,008.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,045.44
|
| Rate for Payer: EPIC Health Plan Senior |
$3,363.62
|
| Rate for Payer: Galaxy Health WC |
$8,510.20
|
| Rate for Payer: Global Benefits Group Commercial |
$6,007.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,010.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,014.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,057.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,357.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$84.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,287.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,002.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,097.51
|
| Rate for Payer: Multiplan Commercial |
$7,509.00
|
| Rate for Payer: Multiplan WC |
$4,723.01
|
| Rate for Payer: Networks By Design Commercial |
$6,507.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,057.84
|
| Rate for Payer: Preferred Health Network WC |
$4,819.40
|
| Rate for Payer: Prime Health Services Commercial |
$8,510.20
|
| Rate for Payer: Prime Health Services Medicare |
$3,241.31
|
| Rate for Payer: Prime Health Services WC |
$4,674.82
|
| Rate for Payer: Riverside University Health System MISP |
$3,363.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,007.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,006.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,006.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,006.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,006.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,057.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,586.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,363.62
|
| Rate for Payer: Vantage Medical Group Senior |
$3,057.84
|
|
|
HC PROB NASOLACRIMAL DUCT
|
Facility
|
OP
|
$3,648.00
|
|
|
Service Code
|
CPT 68810
|
| Hospital Charge Code |
900501582
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$352.98 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$729.60
|
| 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 |
$612.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$449.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$408.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$605.18
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,918.40
|
| Rate for Payer: Cigna of CA HMO |
$2,334.72
|
| Rate for Payer: Cigna of CA PPO |
$2,699.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$612.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$449.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$408.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,553.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$673.60
|
| Rate for Payer: EPIC Health Plan Senior |
$449.06
|
| Rate for Payer: Galaxy Health WC |
$3,100.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,188.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,283.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$669.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$408.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,316.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$352.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$438.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$729.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$547.04
|
| Rate for Payer: Multiplan Commercial |
$2,736.00
|
| Rate for Payer: Multiplan WC |
$605.18
|
| Rate for Payer: Networks By Design Commercial |
$2,371.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$408.24
|
| Rate for Payer: Preferred Health Network WC |
$617.53
|
| Rate for Payer: Prime Health Services Commercial |
$3,100.80
|
| Rate for Payer: Prime Health Services Medicare |
$432.73
|
| Rate for Payer: Prime Health Services WC |
$599.00
|
| Rate for Payer: Riverside University Health System MISP |
$449.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,188.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,824.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,824.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,824.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,824.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$408.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$612.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$449.06
|
| Rate for Payer: Vantage Medical Group Senior |
$408.24
|
|
|
HC PROB NASOLACRIMAL DUCT
|
Facility
|
IP
|
$3,648.00
|
|
|
Service Code
|
CPT 68810
|
| Hospital Charge Code |
900501582
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$729.60 |
| Max. Negotiated Rate |
$3,283.20 |
| Rate for Payer: Adventist Health Commercial |
$729.60
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,918.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,553.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,459.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,459.20
|
| Rate for Payer: Galaxy Health WC |
$3,100.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,188.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,283.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,316.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,152.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$729.60
|
| Rate for Payer: Multiplan Commercial |
$2,736.00
|
| Rate for Payer: Networks By Design Commercial |
$2,371.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,100.80
|
|
|
HC PROB-NATRIURETIC PEPTIDE
|
Facility
|
IP
|
$655.00
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
900912306
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$131.00 |
| Max. Negotiated Rate |
$589.50 |
| Rate for Payer: Adventist Health Commercial |
$131.00
|
| Rate for Payer: Cash Price |
$294.75
|
| Rate for Payer: Central Health Plan Commercial |
$524.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$458.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$262.00
|
| Rate for Payer: EPIC Health Plan Senior |
$262.00
|
| Rate for Payer: Galaxy Health WC |
$556.75
|
| Rate for Payer: Global Benefits Group Commercial |
$393.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$589.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$415.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$386.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$131.00
|
| Rate for Payer: Multiplan Commercial |
$491.25
|
| Rate for Payer: Networks By Design Commercial |
$425.75
|
| Rate for Payer: Prime Health Services Commercial |
$556.75
|
|
|
HC PROB-NATRIURETIC PEPTIDE
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
900912306
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.80 |
| Max. Negotiated Rate |
$343.38 |
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Adventist Health Commercial |
$131.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$39.26
|
| Rate for Payer: Adventist Health Medi-Cal |
$39.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$249.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$249.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$58.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$58.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$43.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$43.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$39.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$39.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$246.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$246.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$343.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$343.38
|
| Rate for Payer: Blue Shield of California Commercial |
$412.65
|
| Rate for Payer: Blue Shield of California Commercial |
$132.30
|
| Rate for Payer: Blue Shield of California EPN |
$260.04
|
| Rate for Payer: Blue Shield of California EPN |
$83.37
|
| Rate for Payer: Cash Price |
$294.75
|
| Rate for Payer: Cash Price |
$294.75
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Central Health Plan Commercial |
$168.00
|
| Rate for Payer: Central Health Plan Commercial |
$524.00
|
| Rate for Payer: Cigna of CA HMO |
$419.20
|
| Rate for Payer: Cigna of CA HMO |
$134.40
|
| Rate for Payer: Cigna of CA PPO |
$484.70
|
| Rate for Payer: Cigna of CA PPO |
$155.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$58.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$58.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$43.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$43.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$39.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$39.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$458.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$64.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$64.78
|
| Rate for Payer: EPIC Health Plan Senior |
$43.19
|
| Rate for Payer: EPIC Health Plan Senior |
$43.19
|
| Rate for Payer: Galaxy Health WC |
$556.75
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$393.00
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$589.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$64.39
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$64.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$51.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$51.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$415.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$57.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$57.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$54.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$54.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$131.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$52.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$52.61
|
| Rate for Payer: Multiplan Commercial |
$491.25
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Networks By Design Commercial |
$425.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$39.26
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$39.26
|
| Rate for Payer: Prime Health Services Commercial |
$556.75
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
| Rate for Payer: Prime Health Services Medicare |
$41.62
|
| Rate for Payer: Prime Health Services Medicare |
$41.62
|
| Rate for Payer: Riverside University Health System MISP |
$43.19
|
| Rate for Payer: Riverside University Health System MISP |
$43.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$126.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$393.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$393.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$126.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$31.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$31.80
|
| Rate for Payer: United Healthcare All Other HMO |
$31.80
|
| Rate for Payer: United Healthcare All Other HMO |
$31.80
|
| Rate for Payer: United Healthcare HMO Rider |
$31.80
|
| Rate for Payer: United Healthcare HMO Rider |
$31.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31.80
|
| Rate for Payer: Upland Medical Group Pediatric |
$39.26
|
| Rate for Payer: Upland Medical Group Pediatric |
$39.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$58.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$58.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$43.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$43.19
|
| Rate for Payer: Vantage Medical Group Senior |
$39.26
|
| Rate for Payer: Vantage Medical Group Senior |
$39.26
|
|
|
HC PROCALCITONIN
|
Facility
|
OP
|
$183.00
|
|
|
Service Code
|
CPT 84145
|
| Hospital Charge Code |
900912171
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.05 |
| Max. Negotiated Rate |
$196.59 |
| Rate for Payer: Adventist Health Commercial |
$36.60
|
| Rate for Payer: Adventist Health Commercial |
$57.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$27.22
|
| Rate for Payer: Adventist Health Medi-Cal |
$27.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$196.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$196.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$124.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$124.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$173.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$173.15
|
| Rate for Payer: Blue Shield of California Commercial |
$181.44
|
| Rate for Payer: Blue Shield of California Commercial |
$115.29
|
| Rate for Payer: Blue Shield of California EPN |
$114.34
|
| Rate for Payer: Blue Shield of California EPN |
$72.65
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cash Price |
$82.35
|
| Rate for Payer: Cash Price |
$82.35
|
| Rate for Payer: Central Health Plan Commercial |
$146.40
|
| Rate for Payer: Central Health Plan Commercial |
$230.40
|
| Rate for Payer: Cigna of CA HMO |
$184.32
|
| Rate for Payer: Cigna of CA HMO |
$117.12
|
| Rate for Payer: Cigna of CA PPO |
$213.12
|
| Rate for Payer: Cigna of CA PPO |
$135.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$128.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$201.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.91
|
| Rate for Payer: EPIC Health Plan Senior |
$29.94
|
| Rate for Payer: EPIC Health Plan Senior |
$29.94
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Galaxy Health WC |
$155.55
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Global Benefits Group Commercial |
$109.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$259.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$164.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$44.64
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$44.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$38.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$38.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$116.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$182.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$42.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$42.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$36.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$36.47
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Multiplan Commercial |
$137.25
|
| Rate for Payer: Networks By Design Commercial |
$118.95
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$27.22
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$27.22
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
| Rate for Payer: Prime Health Services Commercial |
$155.55
|
| Rate for Payer: Prime Health Services Medicare |
$28.85
|
| Rate for Payer: Prime Health Services Medicare |
$28.85
|
| Rate for Payer: Riverside University Health System MISP |
$29.94
|
| Rate for Payer: Riverside University Health System MISP |
$29.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$109.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$109.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$22.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$22.05
|
| Rate for Payer: United Healthcare All Other HMO |
$22.05
|
| Rate for Payer: United Healthcare All Other HMO |
$22.05
|
| Rate for Payer: United Healthcare HMO Rider |
$22.05
|
| Rate for Payer: United Healthcare HMO Rider |
$22.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22.05
|
| Rate for Payer: Upland Medical Group Pediatric |
$27.22
|
| Rate for Payer: Upland Medical Group Pediatric |
$27.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.94
|
| Rate for Payer: Vantage Medical Group Senior |
$27.22
|
| Rate for Payer: Vantage Medical Group Senior |
$27.22
|
|
|
HC PROCALCITONIN
|
Facility
|
IP
|
$288.00
|
|
|
Service Code
|
CPT 84145
|
| Hospital Charge Code |
900912171
|
|
Hospital Revenue Code
|
301
|
| 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 PROC BILIARY TRACT
|
Facility
|
OP
|
$12,026.00
|
|
|
Service Code
|
CPT 47999
|
| Hospital Charge Code |
907247999
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$10,823.40 |
| Rate for Payer: Adventist Health Commercial |
$2,405.20
|
| 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 |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,685.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,898.06
|
| Rate for Payer: Cash Price |
$5,411.70
|
| Rate for Payer: Cash Price |
$5,411.70
|
| Rate for Payer: Cash Price |
$5,411.70
|
| Rate for Payer: Cash Price |
$5,411.70
|
| Rate for Payer: Central Health Plan Commercial |
$9,620.80
|
| Rate for Payer: Cigna of CA HMO |
$7,696.64
|
| Rate for Payer: Cigna of CA PPO |
$8,899.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,418.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.77
|
| Rate for Payer: EPIC Health Plan Senior |
$1,283.18
|
| Rate for Payer: Galaxy Health WC |
$10,222.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,215.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,823.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,913.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,636.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,254.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,405.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,563.15
|
| Rate for Payer: Multiplan Commercial |
$9,019.50
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: Networks By Design Commercial |
$7,816.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Preferred Health Network WC |
$1,936.80
|
| Rate for Payer: Prime Health Services Commercial |
$10,222.10
|
| Rate for Payer: Prime Health Services Medicare |
$1,236.52
|
| Rate for Payer: Prime Health Services WC |
$1,878.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,283.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,215.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,013.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6,013.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6,013.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,013.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
|
|
HC PROC BILIARY TRACT
|
Facility
|
IP
|
$12,026.00
|
|
|
Service Code
|
CPT 47999
|
| Hospital Charge Code |
907247999
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,405.20 |
| Max. Negotiated Rate |
$10,823.40 |
| Rate for Payer: Adventist Health Commercial |
$2,405.20
|
| Rate for Payer: Cash Price |
$5,411.70
|
| Rate for Payer: Central Health Plan Commercial |
$9,620.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,418.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,810.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,810.40
|
| Rate for Payer: Galaxy Health WC |
$10,222.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,215.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,823.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,636.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,095.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,405.20
|
| Rate for Payer: Multiplan Commercial |
$9,019.50
|
| Rate for Payer: Networks By Design Commercial |
$7,816.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,222.10
|
|
|
HC PROC BILIARY TRACT
|
Facility
|
OP
|
$12,026.00
|
|
|
Service Code
|
CPT 47999
|
| Hospital Charge Code |
907247999
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,166.53 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,405.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,166.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,822.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,995.52
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,898.06
|
| 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 |
$5,411.70
|
| Rate for Payer: Cash Price |
$5,411.70
|
| Rate for Payer: Cash Price |
$5,411.70
|
| Rate for Payer: Central Health Plan Commercial |
$9,620.80
|
| Rate for Payer: Cigna of CA HMO |
$7,696.64
|
| Rate for Payer: Cigna of CA PPO |
$8,899.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,418.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.77
|
| Rate for Payer: EPIC Health Plan Senior |
$1,283.18
|
| Rate for Payer: Galaxy Health WC |
$10,222.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,215.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,823.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,913.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,636.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,633.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,405.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,563.15
|
| Rate for Payer: Multiplan Commercial |
$9,019.50
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: Networks By Design Commercial |
$7,816.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Preferred Health Network WC |
$1,936.80
|
| Rate for Payer: Prime Health Services Commercial |
$10,222.10
|
| Rate for Payer: Prime Health Services Medicare |
$1,236.52
|
| Rate for Payer: Prime Health Services WC |
$1,878.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,283.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,215.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,013.00
|
| 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 |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
|
|
HC PROC BILIARY TRACT
|
Facility
|
IP
|
$12,026.00
|
|
|
Service Code
|
CPT 47999
|
| Hospital Charge Code |
907247999
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,405.20 |
| Max. Negotiated Rate |
$10,823.40 |
| Rate for Payer: Adventist Health Commercial |
$2,405.20
|
| Rate for Payer: Cash Price |
$5,411.70
|
| Rate for Payer: Central Health Plan Commercial |
$9,620.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,418.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,810.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,810.40
|
| Rate for Payer: Galaxy Health WC |
$10,222.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,215.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,823.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,636.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,095.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,405.20
|
| Rate for Payer: Multiplan Commercial |
$9,019.50
|
| Rate for Payer: Networks By Design Commercial |
$7,816.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,222.10
|
|
|
HC PROC DENTOALVEOLAR STRUCTR
|
Facility
|
IP
|
$9,965.00
|
|
|
Service Code
|
CPT 41899
|
| Hospital Charge Code |
900501221
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,993.00 |
| Max. Negotiated Rate |
$8,968.50 |
| Rate for Payer: Adventist Health Commercial |
$1,993.00
|
| Rate for Payer: Cash Price |
$4,484.25
|
| Rate for Payer: Central Health Plan Commercial |
$7,972.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,975.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,986.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,986.00
|
| Rate for Payer: Galaxy Health WC |
$8,470.25
|
| Rate for Payer: Global Benefits Group Commercial |
$5,979.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,968.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,327.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,879.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,993.00
|
| Rate for Payer: Multiplan Commercial |
$7,473.75
|
| Rate for Payer: Networks By Design Commercial |
$6,477.25
|
| Rate for Payer: Prime Health Services Commercial |
$8,470.25
|
|
|
HC PROC DENTOALVEOLAR STRUCTR
|
Facility
|
IP
|
$9,965.00
|
|
|
Service Code
|
CPT 41899
|
| Hospital Charge Code |
900501221
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,993.00 |
| Max. Negotiated Rate |
$8,968.50 |
| Rate for Payer: Adventist Health Commercial |
$1,993.00
|
| Rate for Payer: Cash Price |
$4,484.25
|
| Rate for Payer: Central Health Plan Commercial |
$7,972.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,975.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,986.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,986.00
|
| Rate for Payer: Galaxy Health WC |
$8,470.25
|
| Rate for Payer: Global Benefits Group Commercial |
$5,979.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,968.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,327.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,879.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,993.00
|
| Rate for Payer: Multiplan Commercial |
$7,473.75
|
| Rate for Payer: Networks By Design Commercial |
$6,477.25
|
| Rate for Payer: Prime Health Services Commercial |
$8,470.25
|
|
|
HC PROC DENTOALVEOLAR STRUCTR
|
Facility
|
OP
|
$9,965.00
|
|
|
Service Code
|
CPT 41899
|
| Hospital Charge Code |
900501221
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$304.63 |
| Max. Negotiated Rate |
$8,968.50 |
| Rate for Payer: Adventist Health Commercial |
$4,085.65
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,051.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$456.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.63
|
| 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 |
$470.13
|
| Rate for Payer: Cash Price |
$4,484.25
|
| Rate for Payer: Cash Price |
$4,484.25
|
| Rate for Payer: Cash Price |
$4,484.25
|
| Rate for Payer: Cash Price |
$4,484.25
|
| Rate for Payer: Central Health Plan Commercial |
$7,972.00
|
| Rate for Payer: Cigna of CA HMO |
$6,377.60
|
| Rate for Payer: Cigna of CA PPO |
$7,374.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$456.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,975.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$502.64
|
| Rate for Payer: EPIC Health Plan Senior |
$335.09
|
| Rate for Payer: Galaxy Health WC |
$8,470.25
|
| Rate for Payer: Global Benefits Group Commercial |
$5,979.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,968.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$499.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,327.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$327.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,993.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$408.20
|
| Rate for Payer: Multiplan Commercial |
$7,473.75
|
| Rate for Payer: Multiplan WC |
$470.13
|
| Rate for Payer: Networks By Design Commercial |
$6,477.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$304.63
|
| Rate for Payer: Preferred Health Network WC |
$479.72
|
| Rate for Payer: Prime Health Services Commercial |
$8,470.25
|
| Rate for Payer: Prime Health Services Medicare |
$322.91
|
| Rate for Payer: Prime Health Services WC |
$465.33
|
| Rate for Payer: Riverside University Health System MISP |
$335.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,979.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,979.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$304.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$456.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Vantage Medical Group Senior |
$304.63
|
|
|
HC PROC DENTOALVEOLAR STRUCTR
|
Facility
|
OP
|
$9,965.00
|
|
|
Service Code
|
CPT 41899
|
| Hospital Charge Code |
900501221
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$304.63 |
| Max. Negotiated Rate |
$8,968.50 |
| Rate for Payer: Adventist Health Commercial |
$1,993.00
|
| 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 |
$456.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.63
|
| 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 |
$470.13
|
| Rate for Payer: Cash Price |
$4,484.25
|
| Rate for Payer: Cash Price |
$4,484.25
|
| Rate for Payer: Cash Price |
$4,484.25
|
| Rate for Payer: Cash Price |
$4,484.25
|
| Rate for Payer: Central Health Plan Commercial |
$7,972.00
|
| Rate for Payer: Cigna of CA HMO |
$6,377.60
|
| Rate for Payer: Cigna of CA PPO |
$7,374.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$456.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,975.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$502.64
|
| Rate for Payer: EPIC Health Plan Senior |
$335.09
|
| Rate for Payer: Galaxy Health WC |
$8,470.25
|
| Rate for Payer: Global Benefits Group Commercial |
$5,979.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,968.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$499.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,327.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$327.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,993.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$408.20
|
| Rate for Payer: Multiplan Commercial |
$7,473.75
|
| Rate for Payer: Multiplan WC |
$470.13
|
| Rate for Payer: Networks By Design Commercial |
$6,477.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$304.63
|
| Rate for Payer: Preferred Health Network WC |
$479.72
|
| Rate for Payer: Prime Health Services Commercial |
$8,470.25
|
| Rate for Payer: Prime Health Services Medicare |
$322.91
|
| Rate for Payer: Prime Health Services WC |
$465.33
|
| Rate for Payer: Riverside University Health System MISP |
$335.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,979.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,982.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,982.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,982.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,982.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$304.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$456.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Vantage Medical Group Senior |
$304.63
|
|
|
HC PROCEDURE ANUS
|
Facility
|
IP
|
$2,288.00
|
|
|
Service Code
|
CPT 46999
|
| Hospital Charge Code |
900501653
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$457.60 |
| Max. Negotiated Rate |
$2,059.20 |
| Rate for Payer: Adventist Health Commercial |
$457.60
|
| Rate for Payer: Cash Price |
$1,029.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,830.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,601.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$915.20
|
| Rate for Payer: EPIC Health Plan Senior |
$915.20
|
| Rate for Payer: Galaxy Health WC |
$1,944.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,372.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,059.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,452.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,349.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$457.60
|
| Rate for Payer: Multiplan Commercial |
$1,716.00
|
| Rate for Payer: Networks By Design Commercial |
$1,487.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,944.80
|
|
