|
HC LIFT HEEL PER INCH
|
Facility
OP
|
$80.00
|
|
|
Service Code
|
CPT L3334
|
| Hospital Charge Code |
905353334
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$28.00 |
| Max. Negotiated Rate |
$151.31 |
| Rate for Payer: Aetna of CA HMO/PPO |
$151.31
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$68.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$44.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$44.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.26
|
| Rate for Payer: BCBS Transplant Transplant |
$48.00
|
| Rate for Payer: Blue Shield of California Commercial |
$60.00
|
| Rate for Payer: Blue Shield of California EPN |
$43.52
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Central Health Plan Commercial |
$64.00
|
| Rate for Payer: Cigna of CA HMO |
$56.00
|
| Rate for Payer: Cigna of CA PPO |
$56.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$68.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$32.00
|
| Rate for Payer: Galaxy Health WC |
$68.00
|
| Rate for Payer: Global Benefits Group Commercial |
$48.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$72.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$60.00
|
| Rate for Payer: IEHP medi-cal |
$28.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.80
|
| Rate for Payer: Multiplan Commercial |
$60.00
|
| Rate for Payer: Networks By Design Commercial |
$40.00
|
| Rate for Payer: Prime Health Services Commercial |
$68.00
|
| Rate for Payer: Riverside University Health MISP |
$32.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$48.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$48.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$40.00
|
| Rate for Payer: United Healthcare All Other HMO |
$40.00
|
| Rate for Payer: United Healthcare HMO Rider |
$40.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$40.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.00
|
| Rate for Payer: Vantage Medical Group Senior |
$68.00
|
|
|
HC LIFT HEEL PER INCH
|
Facility
IP
|
$80.00
|
|
|
Service Code
|
CPT L3334
|
| Hospital Charge Code |
905353334
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Blue Shield of California EPN |
$42.72
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Central Health Plan Commercial |
$64.00
|
| Rate for Payer: Cigna of CA HMO |
$56.00
|
| Rate for Payer: Cigna of CA PPO |
$56.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$32.00
|
| Rate for Payer: Galaxy Health WC |
$68.00
|
| Rate for Payer: Global Benefits Group Commercial |
$48.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$72.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.00
|
| Rate for Payer: Multiplan Commercial |
$60.00
|
| Rate for Payer: Networks By Design Commercial |
$40.00
|
| Rate for Payer: Prime Health Services Commercial |
$68.00
|
|
|
HC LIFT HEEL TAPPERED TO MET/INCH
|
Facility
IP
|
$103.00
|
|
|
Service Code
|
CPT L3300
|
| Hospital Charge Code |
905353300
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$20.60 |
| Max. Negotiated Rate |
$92.70 |
| Rate for Payer: Blue Shield of California EPN |
$55.00
|
| Rate for Payer: Cash Price |
$46.35
|
| Rate for Payer: Central Health Plan Commercial |
$82.40
|
| Rate for Payer: Cigna of CA HMO |
$72.10
|
| Rate for Payer: Cigna of CA PPO |
$72.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$41.20
|
| Rate for Payer: Galaxy Health WC |
$87.55
|
| Rate for Payer: Global Benefits Group Commercial |
$61.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.60
|
| Rate for Payer: Multiplan Commercial |
$77.25
|
| Rate for Payer: Networks By Design Commercial |
$51.50
|
| Rate for Payer: Prime Health Services Commercial |
$87.55
|
|
|
HC LIFT HEEL TAPPERED TO MET/INCH
|
Facility
OP
|
$103.00
|
|
|
Service Code
|
CPT L3300
|
| Hospital Charge Code |
905353300
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$36.05 |
| Max. Negotiated Rate |
$206.77 |
| Rate for Payer: Aetna of CA HMO/PPO |
$206.77
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$87.55
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$56.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$56.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$60.85
|
| Rate for Payer: BCBS Transplant Transplant |
$61.80
|
| Rate for Payer: Blue Shield of California Commercial |
$77.25
|
| Rate for Payer: Blue Shield of California EPN |
$56.03
|
| Rate for Payer: Cash Price |
$46.35
|
| Rate for Payer: Cash Price |
$46.35
|
| Rate for Payer: Central Health Plan Commercial |
$82.40
|
| Rate for Payer: Cigna of CA HMO |
$72.10
|
| Rate for Payer: Cigna of CA PPO |
$72.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$41.20
|
| Rate for Payer: Galaxy Health WC |
$87.55
|
| Rate for Payer: Global Benefits Group Commercial |
$61.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$77.25
|
| Rate for Payer: IEHP medi-cal |
$36.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.23
|
| Rate for Payer: Multiplan Commercial |
$77.25
|
| Rate for Payer: Networks By Design Commercial |
$51.50
|
| Rate for Payer: Prime Health Services Commercial |
$87.55
|
| Rate for Payer: Riverside University Health MISP |
$41.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.50
|
| Rate for Payer: United Healthcare All Other HMO |
$51.50
|
| Rate for Payer: United Healthcare HMO Rider |
$51.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$51.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$87.55
|
| Rate for Payer: Vantage Medical Group Senior |
$87.55
|
|
|
HC LIFT INSIDE SHOE TAPERED
|
Facility
OP
|
$180.00
|
|
|
Service Code
|
CPT L3332
|
| Hospital Charge Code |
905353332
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$292.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$292.55
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$153.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$99.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$99.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$87.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$106.34
|
| Rate for Payer: BCBS Transplant Transplant |
$108.00
|
| Rate for Payer: Blue Shield of California Commercial |
$135.00
|
| Rate for Payer: Blue Shield of California EPN |
$97.92
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Central Health Plan Commercial |
$144.00
|
| Rate for Payer: Cigna of CA HMO |
$126.00
|
| Rate for Payer: Cigna of CA PPO |
$126.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$153.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$72.00
|
| Rate for Payer: Galaxy Health WC |
$153.00
|
| Rate for Payer: Global Benefits Group Commercial |
$108.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$162.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$135.00
|
| Rate for Payer: IEHP medi-cal |
$63.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$120.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.80
|
| Rate for Payer: Multiplan Commercial |
$135.00
|
| Rate for Payer: Networks By Design Commercial |
$90.00
|
| Rate for Payer: Prime Health Services Commercial |
$153.00
|
| Rate for Payer: Riverside University Health MISP |
$72.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$108.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$108.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$90.00
|
| Rate for Payer: United Healthcare All Other HMO |
$90.00
|
| Rate for Payer: United Healthcare HMO Rider |
$90.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$90.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$153.00
|
| Rate for Payer: Vantage Medical Group Senior |
$153.00
|
|
|
HC LIFT INSIDE SHOE TAPERED
|
Facility
IP
|
$180.00
|
|
|
Service Code
|
CPT L3332
|
| Hospital Charge Code |
905353332
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$162.00 |
| Rate for Payer: Blue Shield of California EPN |
$96.12
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Central Health Plan Commercial |
$144.00
|
| Rate for Payer: Cigna of CA HMO |
$126.00
|
| Rate for Payer: Cigna of CA PPO |
$126.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$72.00
|
| Rate for Payer: Galaxy Health WC |
$153.00
|
| Rate for Payer: Global Benefits Group Commercial |
$108.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$162.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$120.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.00
|
| Rate for Payer: Multiplan Commercial |
$135.00
|
| Rate for Payer: Networks By Design Commercial |
$90.00
|
| Rate for Payer: Prime Health Services Commercial |
$153.00
|
|
|
HC LIGATION/BIOPSY,TEMP ARTERY
|
Facility
OP
|
$7,123.00
|
|
|
Service Code
|
CPT 37609
|
| Hospital Charge Code |
900501523
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,410.70 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,273.80
|
| Rate for Payer: Caremore Medicare Advantage |
$2,025.69
|
| Rate for Payer: Cash Price |
$3,205.35
|
| Rate for Payer: Cash Price |
$3,205.35
|
| Rate for Payer: Cash Price |
$3,205.35
|
| Rate for Payer: Cash Price |
$3,205.35
|
| Rate for Payer: Central Health Plan Commercial |
$5,698.40
|
| Rate for Payer: Cigna of CA PPO |
$5,271.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
| Rate for Payer: Galaxy Health WC |
$6,054.55
|
| Rate for Payer: Global Benefits Group Commercial |
$4,273.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,410.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,342.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,322.13
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$2,025.69
|
| Rate for Payer: Innovage PACE Commercial |
$3,038.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,751.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,424.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,714.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
| Rate for Payer: Multiplan Commercial |
$5,342.25
|
| Rate for Payer: Networks By Design Commercial |
$4,629.95
|
| Rate for Payer: Prime Health Services Commercial |
$6,054.55
|
| Rate for Payer: Prime Health Services Medicare |
$2,147.23
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,273.80
|
| Rate for Payer: Riverside University Health MISP |
$2,228.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,273.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,561.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,561.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,561.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,561.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC LIGATION/BIOPSY,TEMP ARTERY
|
Facility
IP
|
$7,123.00
|
|
|
Service Code
|
CPT 37609
|
| Hospital Charge Code |
900501523
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,424.60 |
| Max. Negotiated Rate |
$6,410.70 |
| Rate for Payer: Cash Price |
$3,205.35
|
| Rate for Payer: Central Health Plan Commercial |
$5,698.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,849.20
|
| Rate for Payer: Galaxy Health WC |
$6,054.55
|
| Rate for Payer: Global Benefits Group Commercial |
$4,273.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,410.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,751.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,424.60
|
| Rate for Payer: Multiplan Commercial |
$5,342.25
|
| Rate for Payer: Networks By Design Commercial |
$4,629.95
|
| Rate for Payer: Prime Health Services Commercial |
$6,054.55
|
|
|
HC LIGATION DIV/EXC VARICOSEVEIN
|
Facility
OP
|
$13,116.00
|
|
|
Service Code
|
CPT 37785
|
| Hospital Charge Code |
900501325
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$11,804.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: BCBS Transplant Transplant |
$7,869.60
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$5,902.20
|
| Rate for Payer: Cash Price |
$5,902.20
|
| Rate for Payer: Cash Price |
$5,902.20
|
| Rate for Payer: Cash Price |
$5,902.20
|
| Rate for Payer: Central Health Plan Commercial |
$10,492.80
|
| Rate for Payer: Cigna of CA PPO |
$9,705.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$11,148.60
|
| Rate for Payer: Global Benefits Group Commercial |
$7,869.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,804.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9,837.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Innovage PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,748.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,623.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$9,837.00
|
| Rate for Payer: Networks By Design Commercial |
$8,525.40
|
| Rate for Payer: Prime Health Services Commercial |
$11,148.60
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7,869.60
|
| Rate for Payer: Riverside University Health MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,869.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,558.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6,558.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6,558.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,558.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC LIGATION DIV/EXC VARICOSEVEIN
|
Facility
IP
|
$13,116.00
|
|
|
Service Code
|
CPT 37785
|
| Hospital Charge Code |
900501325
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,623.20 |
| Max. Negotiated Rate |
$11,804.40 |
| Rate for Payer: Cash Price |
$5,902.20
|
| Rate for Payer: Central Health Plan Commercial |
$10,492.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,246.40
|
| Rate for Payer: Galaxy Health WC |
$11,148.60
|
| Rate for Payer: Global Benefits Group Commercial |
$7,869.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,804.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,748.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,623.20
|
| Rate for Payer: Multiplan Commercial |
$9,837.00
|
| Rate for Payer: Networks By Design Commercial |
$8,525.40
|
| Rate for Payer: Prime Health Services Commercial |
$11,148.60
|
|
|
HC LIGATION HEMORRHOID(S)
|
Facility
IP
|
$5,078.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
906746221
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,015.60 |
| Max. Negotiated Rate |
$4,570.20 |
| Rate for Payer: Cash Price |
$2,285.10
|
| Rate for Payer: Central Health Plan Commercial |
$4,062.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,031.20
|
| Rate for Payer: Galaxy Health WC |
$4,316.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,046.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,570.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,387.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,015.60
|
| Rate for Payer: Multiplan Commercial |
$3,808.50
|
| Rate for Payer: Networks By Design Commercial |
$3,300.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,316.30
|
|
|
HC LIGATION HEMORRHOID(S)
|
Facility
OP
|
$2,244.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
906746221
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,346.40
|
| Rate for Payer: Caremore Medicare Advantage |
$1,141.93
|
| Rate for Payer: Cash Price |
$1,009.80
|
| Rate for Payer: Cash Price |
$1,009.80
|
| Rate for Payer: Cash Price |
$1,009.80
|
| Rate for Payer: Cash Price |
$1,009.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,795.20
|
| Rate for Payer: Cigna of CA PPO |
$1,660.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$1,907.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,346.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,019.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,683.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,872.77
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$1,141.93
|
| Rate for Payer: Innovage PACE Commercial |
$1,712.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,496.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$448.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$1,683.00
|
| Rate for Payer: Networks By Design Commercial |
$1,458.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,907.40
|
| Rate for Payer: Prime Health Services Medicare |
$1,210.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,346.40
|
| Rate for Payer: Riverside University Health MISP |
$1,256.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,346.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,122.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,122.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC LIGATION HEMORRHOID(S)
|
Facility
IP
|
$5,078.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
906746221
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,015.60 |
| Max. Negotiated Rate |
$4,570.20 |
| Rate for Payer: Cash Price |
$2,285.10
|
| Rate for Payer: Central Health Plan Commercial |
$4,062.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,031.20
|
| Rate for Payer: Galaxy Health WC |
$4,316.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,046.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,570.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,387.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,015.60
|
| Rate for Payer: Multiplan Commercial |
$3,808.50
|
| Rate for Payer: Networks By Design Commercial |
$3,300.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,316.30
|
|
|
HC LIGATION HEMORRHOID(S)
|
Facility
OP
|
$2,244.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
906746221
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$448.80 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,141.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,346.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,141.93
|
| Rate for Payer: Cash Price |
$1,009.80
|
| Rate for Payer: Cash Price |
$1,009.80
|
| Rate for Payer: Cash Price |
$1,009.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,795.20
|
| Rate for Payer: Cigna of CA PPO |
$1,660.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$1,907.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,346.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,019.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,683.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,872.77
|
| Rate for Payer: IEHP medi-cal |
$1,884.18
|
| Rate for Payer: IEHP Medicare Advantage |
$1,141.93
|
| Rate for Payer: Innovage PACE Commercial |
$1,712.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,496.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$448.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$1,683.00
|
| Rate for Payer: Networks By Design Commercial |
$1,458.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,907.40
|
| Rate for Payer: Prime Health Services Medicare |
$1,210.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,256.12
|
| Rate for Payer: Riverside University Health MISP |
$1,256.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,346.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,370.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC LIGATION OF NECK ARTERY
|
Facility
OP
|
$5,001.00
|
|
|
Service Code
|
CPT 37615
|
| Hospital Charge Code |
900501435
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$7,084.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,000.60
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$2,250.45
|
| Rate for Payer: Cash Price |
$2,250.45
|
| Rate for Payer: Cash Price |
$2,250.45
|
| Rate for Payer: Cash Price |
$2,250.45
|
| Rate for Payer: Central Health Plan Commercial |
$4,000.80
|
| Rate for Payer: Cigna of CA PPO |
$3,700.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$4,250.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,000.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,500.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,750.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Innovage PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,335.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,000.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$3,750.75
|
| Rate for Payer: Networks By Design Commercial |
$3,250.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,250.85
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,000.60
|
| Rate for Payer: Riverside University Health MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,000.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,500.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,500.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,500.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,500.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC LIGATION OF NECK ARTERY
|
Facility
IP
|
$5,001.00
|
|
|
Service Code
|
CPT 37615
|
| Hospital Charge Code |
900501435
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,000.20 |
| Max. Negotiated Rate |
$4,500.90 |
| Rate for Payer: Cash Price |
$2,250.45
|
| Rate for Payer: Central Health Plan Commercial |
$4,000.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,000.40
|
| Rate for Payer: Galaxy Health WC |
$4,250.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,000.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,500.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,335.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,000.20
|
| Rate for Payer: Multiplan Commercial |
$3,750.75
|
| Rate for Payer: Networks By Design Commercial |
$3,250.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,250.85
|
|
|
HC LIMITED MOTION ANKLE JOINT EA
|
Facility
OP
|
$132.00
|
|
|
Service Code
|
CPT L2200
|
| Hospital Charge Code |
905352200
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$46.20 |
| Max. Negotiated Rate |
$197.39 |
| Rate for Payer: Aetna of CA HMO/PPO |
$197.39
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$112.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$72.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$72.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$63.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$77.99
|
| Rate for Payer: BCBS Transplant Transplant |
$79.20
|
| Rate for Payer: Blue Shield of California Commercial |
$99.00
|
| Rate for Payer: Blue Shield of California EPN |
$71.81
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Central Health Plan Commercial |
$105.60
|
| Rate for Payer: Cigna of CA HMO |
$92.40
|
| Rate for Payer: Cigna of CA PPO |
$92.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$112.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$52.80
|
| Rate for Payer: Galaxy Health WC |
$112.20
|
| Rate for Payer: Global Benefits Group Commercial |
$79.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$118.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$99.00
|
| Rate for Payer: IEHP medi-cal |
$46.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$88.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.12
|
| Rate for Payer: Multiplan Commercial |
$99.00
|
| Rate for Payer: Networks By Design Commercial |
$66.00
|
| Rate for Payer: Prime Health Services Commercial |
$112.20
|
| Rate for Payer: Riverside University Health MISP |
$52.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$79.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$79.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$66.00
|
| Rate for Payer: United Healthcare All Other HMO |
$66.00
|
| Rate for Payer: United Healthcare HMO Rider |
$66.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$66.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$112.20
|
| Rate for Payer: Vantage Medical Group Senior |
$112.20
|
|
|
HC LIMITED MOTION ANKLE JOINT EA
|
Facility
IP
|
$132.00
|
|
|
Service Code
|
CPT L2200
|
| Hospital Charge Code |
905352200
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$118.80 |
| Rate for Payer: Blue Shield of California EPN |
$70.49
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Central Health Plan Commercial |
$105.60
|
| Rate for Payer: Cigna of CA HMO |
$92.40
|
| Rate for Payer: Cigna of CA PPO |
$92.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$52.80
|
| Rate for Payer: Galaxy Health WC |
$112.20
|
| Rate for Payer: Global Benefits Group Commercial |
$79.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$118.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$88.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.40
|
| Rate for Payer: Multiplan Commercial |
$99.00
|
| Rate for Payer: Networks By Design Commercial |
$66.00
|
| Rate for Payer: Prime Health Services Commercial |
$112.20
|
|
|
HC LIPASE
|
Facility
OP
|
$26.00
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
900910334
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.20 |
| Max. Negotiated Rate |
$61.05 |
| Rate for Payer: Adventist Health Medi-Cal |
$6.89
|
| Rate for Payer: Aetna of CA HMO/PPO |
$50.56
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$50.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61.05
|
| Rate for Payer: BCBS Transplant Transplant |
$15.60
|
| Rate for Payer: Blue Shield of California Commercial |
$16.07
|
| Rate for Payer: Blue Shield of California EPN |
$12.64
|
| Rate for Payer: Caremore Medicare Advantage |
$6.89
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Central Health Plan Commercial |
$20.80
|
| Rate for Payer: Cigna of CA HMO |
$16.64
|
| Rate for Payer: Cigna of CA PPO |
$19.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.30
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6.89
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.89
|
| Rate for Payer: Galaxy Health WC |
$22.10
|
| Rate for Payer: Global Benefits Group Commercial |
$15.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$19.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11.30
|
| Rate for Payer: IEHP medi-cal |
$11.37
|
| Rate for Payer: IEHP Medicare Advantage |
$6.89
|
| Rate for Payer: Innovage PACE Commercial |
$10.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.23
|
| Rate for Payer: Multiplan Commercial |
$19.50
|
| Rate for Payer: Networks By Design Commercial |
$16.90
|
| Rate for Payer: Prime Health Services Commercial |
$22.10
|
| Rate for Payer: Prime Health Services Medicare |
$7.30
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15.60
|
| Rate for Payer: Riverside University Health MISP |
$7.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.58
|
| Rate for Payer: United Healthcare All Other HMO |
$5.58
|
| Rate for Payer: United Healthcare HMO Rider |
$5.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Vantage Medical Group Senior |
$6.89
|
|
|
HC LIPASE
|
Facility
IP
|
$233.00
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
900910334
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.60 |
| Max. Negotiated Rate |
$209.70 |
| Rate for Payer: Cash Price |
$104.85
|
| Rate for Payer: Central Health Plan Commercial |
$186.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$93.20
|
| Rate for Payer: Galaxy Health WC |
$198.05
|
| Rate for Payer: Global Benefits Group Commercial |
$139.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$209.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$155.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.60
|
| Rate for Payer: Multiplan Commercial |
$174.75
|
| Rate for Payer: Networks By Design Commercial |
$151.45
|
| Rate for Payer: Prime Health Services Commercial |
$198.05
|
|
|
HC LIPASE BODY FLUID
|
Facility
IP
|
$32.00
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
900912244
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.40 |
| Max. Negotiated Rate |
$28.80 |
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Central Health Plan Commercial |
$25.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.80
|
| Rate for Payer: Galaxy Health WC |
$27.20
|
| Rate for Payer: Global Benefits Group Commercial |
$19.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.40
|
| Rate for Payer: Multiplan Commercial |
$24.00
|
| Rate for Payer: Networks By Design Commercial |
$20.80
|
| Rate for Payer: Prime Health Services Commercial |
$27.20
|
|
|
HC LIPASE BODY FLUID
|
Facility
OP
|
$17.00
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
900912244
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$61.05 |
| Rate for Payer: Adventist Health Medi-Cal |
$6.89
|
| Rate for Payer: Aetna of CA HMO/PPO |
$50.56
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$50.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61.05
|
| Rate for Payer: BCBS Transplant Transplant |
$10.20
|
| Rate for Payer: Blue Shield of California Commercial |
$10.51
|
| Rate for Payer: Blue Shield of California EPN |
$8.26
|
| Rate for Payer: Caremore Medicare Advantage |
$6.89
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Central Health Plan Commercial |
$13.60
|
| Rate for Payer: Cigna of CA HMO |
$10.88
|
| Rate for Payer: Cigna of CA PPO |
$12.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.30
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6.89
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.89
|
| Rate for Payer: Galaxy Health WC |
$14.45
|
| Rate for Payer: Global Benefits Group Commercial |
$10.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11.30
|
| Rate for Payer: IEHP medi-cal |
$11.37
|
| Rate for Payer: IEHP Medicare Advantage |
$6.89
|
| Rate for Payer: Innovage PACE Commercial |
$10.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.23
|
| Rate for Payer: Multiplan Commercial |
$12.75
|
| Rate for Payer: Networks By Design Commercial |
$11.05
|
| Rate for Payer: Prime Health Services Commercial |
$14.45
|
| Rate for Payer: Prime Health Services Medicare |
$7.30
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: Riverside University Health MISP |
$7.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.58
|
| Rate for Payer: United Healthcare All Other HMO |
$5.58
|
| Rate for Payer: United Healthcare HMO Rider |
$5.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Vantage Medical Group Senior |
$6.89
|
|
|
HC LIPID PANEL MC
|
Facility
IP
|
$98.00
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
900912170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.20
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$65.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
|
|
HC LIPID PANEL MC
|
Facility
OP
|
$28.00
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
900912170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.60 |
| Max. Negotiated Rate |
$118.82 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$98.29
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.08
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.73
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$97.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$118.82
|
| Rate for Payer: BCBS Transplant Transplant |
$16.80
|
| Rate for Payer: Blue Shield of California Commercial |
$17.30
|
| Rate for Payer: Blue Shield of California EPN |
$13.61
|
| Rate for Payer: Caremore Medicare Advantage |
$13.39
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Central Health Plan Commercial |
$22.40
|
| Rate for Payer: Cigna of CA HMO |
$17.92
|
| Rate for Payer: Cigna of CA PPO |
$20.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.08
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.39
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.39
|
| Rate for Payer: Galaxy Health WC |
$23.80
|
| Rate for Payer: Global Benefits Group Commercial |
$16.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$25.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$21.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.96
|
| Rate for Payer: IEHP medi-cal |
$22.09
|
| Rate for Payer: IEHP Medicare Advantage |
$13.39
|
| Rate for Payer: Innovage PACE Commercial |
$20.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.94
|
| Rate for Payer: Multiplan Commercial |
$21.00
|
| Rate for Payer: Networks By Design Commercial |
$18.20
|
| Rate for Payer: Prime Health Services Commercial |
$23.80
|
| Rate for Payer: Prime Health Services Medicare |
$14.19
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$16.80
|
| Rate for Payer: Riverside University Health MISP |
$14.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.84
|
| Rate for Payer: United Healthcare All Other HMO |
$10.84
|
| Rate for Payer: United Healthcare HMO Rider |
$10.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.73
|
| Rate for Payer: Vantage Medical Group Senior |
$13.39
|
|
|
HC LIQUID COILS
|
Facility
OP
|
$1,030.40
|
|
| Hospital Charge Code |
909081813
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$206.08 |
| Max. Negotiated Rate |
$927.36 |
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$875.84
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$566.72
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$566.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$470.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$573.93
|
| Rate for Payer: BCBS Transplant Transplant |
$618.24
|
| Rate for Payer: Blue Shield of California Commercial |
$772.80
|
| Rate for Payer: Blue Shield of California EPN |
$560.54
|
| Rate for Payer: Cash Price |
$463.68
|
| Rate for Payer: Cash Price |
$463.68
|
| Rate for Payer: Central Health Plan Commercial |
$824.32
|
| Rate for Payer: Cigna of CA HMO |
$721.28
|
| Rate for Payer: Cigna of CA PPO |
$721.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$875.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.16
|
| Rate for Payer: EPIC Health Plan Transplant |
$412.16
|
| Rate for Payer: Galaxy Health WC |
$875.84
|
| Rate for Payer: Global Benefits Group Commercial |
$618.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$927.36
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$772.80
|
| Rate for Payer: IEHP medi-cal |
$360.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$687.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$206.08
|
| Rate for Payer: Multiplan Commercial |
$772.80
|
| Rate for Payer: Networks By Design Commercial |
$515.20
|
| Rate for Payer: Prime Health Services Commercial |
$875.84
|
| Rate for Payer: Riverside University Health MISP |
$412.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$618.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$618.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$515.20
|
| Rate for Payer: United Healthcare All Other HMO |
$515.20
|
| Rate for Payer: United Healthcare HMO Rider |
$515.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$515.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$875.84
|
| Rate for Payer: Vantage Medical Group Senior |
$875.84
|
|
