|
HC OPEN TREAT METACARPAL FX SNGL
|
Facility
|
IP
|
$16,022.00
|
|
|
Service Code
|
CPT 26615
|
| Hospital Charge Code |
900501555
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,204.40 |
| Max. Negotiated Rate |
$14,419.80 |
| Rate for Payer: Adventist Health Commercial |
$3,204.40
|
| Rate for Payer: Cash Price |
$7,209.90
|
| Rate for Payer: Central Health Plan Commercial |
$12,817.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,408.80
|
| Rate for Payer: EPIC Health Plan Senior |
$6,408.80
|
| Rate for Payer: Galaxy Health WC |
$13,618.70
|
| Rate for Payer: Global Benefits Group Commercial |
$9,613.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,419.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,686.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,104.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,917.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,204.40
|
| Rate for Payer: Multiplan Commercial |
$12,016.50
|
| Rate for Payer: Networks By Design Commercial |
$10,414.30
|
| Rate for Payer: Prime Health Services Commercial |
$13,618.70
|
|
|
HC OPEN TREAT METACARPAL FX SNGL
|
Facility
|
OP
|
$16,022.00
|
|
|
Service Code
|
CPT 26615
|
| Hospital Charge Code |
900501555
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$112.48 |
| Max. Negotiated Rate |
$14,419.80 |
| Rate for Payer: Adventist Health Commercial |
$3,204.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,122.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,581.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,568.63
|
| Rate for Payer: Cash Price |
$7,209.90
|
| Rate for Payer: Cash Price |
$7,209.90
|
| Rate for Payer: Cash Price |
$7,209.90
|
| Rate for Payer: Cash Price |
$7,209.90
|
| Rate for Payer: Central Health Plan Commercial |
$12,817.60
|
| Rate for Payer: Cigna of CA HMO |
$10,254.08
|
| Rate for Payer: Cigna of CA PPO |
$11,856.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,534.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,122.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,565.51
|
| Rate for Payer: EPIC Health Plan Senior |
$4,122.60
|
| Rate for Payer: Galaxy Health WC |
$13,618.70
|
| Rate for Payer: Global Benefits Group Commercial |
$9,613.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,419.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,761.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,122.60
|
| Rate for Payer: InnovAge PACE Commercial |
$6,183.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,686.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$112.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,122.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,204.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,524.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,524.28
|
| Rate for Payer: Multiplan Commercial |
$12,016.50
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$10,414.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,122.60
|
| Rate for Payer: Preferred Health Network WC |
$6,702.68
|
| Rate for Payer: Prime Health Services Commercial |
$13,618.70
|
| Rate for Payer: Prime Health Services Medicare |
$4,369.96
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Riverside University Health System MISP |
$4,534.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,613.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,011.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,011.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,011.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,011.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,122.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4,122.60
|
|
|
HC OPEN TREAT METATARSAL FX, EA
|
Facility
|
IP
|
$20,200.00
|
|
|
Service Code
|
CPT 28485
|
| Hospital Charge Code |
900501691
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4,040.00 |
| Max. Negotiated Rate |
$18,180.00 |
| Rate for Payer: Adventist Health Commercial |
$4,040.00
|
| Rate for Payer: Cash Price |
$9,090.00
|
| Rate for Payer: Central Health Plan Commercial |
$16,160.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,080.00
|
| Rate for Payer: EPIC Health Plan Senior |
$8,080.00
|
| Rate for Payer: Galaxy Health WC |
$17,170.00
|
| Rate for Payer: Global Benefits Group Commercial |
$12,120.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,180.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,473.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,696.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,503.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,040.00
|
| Rate for Payer: Multiplan Commercial |
$15,150.00
|
| Rate for Payer: Networks By Design Commercial |
$13,130.00
|
| Rate for Payer: Prime Health Services Commercial |
$17,170.00
|
|
|
HC OPEN TREAT METATARSAL FX, EA
|
Facility
|
OP
|
$20,200.00
|
|
|
Service Code
|
CPT 28485
|
| Hospital Charge Code |
900501691
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$18,180.00 |
| Rate for Payer: Adventist Health Commercial |
$4,040.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,615.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,984.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,076.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,581.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,462.30
|
| Rate for Payer: Cash Price |
$9,090.00
|
| Rate for Payer: Cash Price |
$9,090.00
|
| Rate for Payer: Cash Price |
$9,090.00
|
| Rate for Payer: Cash Price |
$9,090.00
|
| Rate for Payer: Central Health Plan Commercial |
$16,160.00
|
| Rate for Payer: Cigna of CA HMO |
$12,928.00
|
| Rate for Payer: Cigna of CA PPO |
$14,948.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,615.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,984.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,076.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,253.71
|
| Rate for Payer: EPIC Health Plan Senior |
$9,076.82
|
| Rate for Payer: Galaxy Health WC |
$17,170.00
|
| Rate for Payer: Global Benefits Group Commercial |
$12,120.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,180.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14,885.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,076.82
|
| Rate for Payer: InnovAge PACE Commercial |
$13,615.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,473.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$891.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,076.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,040.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,162.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,162.94
|
| Rate for Payer: Multiplan Commercial |
$15,150.00
|
| Rate for Payer: Multiplan WC |
$14,462.30
|
| Rate for Payer: Networks By Design Commercial |
$13,130.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9,076.82
|
| Rate for Payer: Preferred Health Network WC |
$14,757.45
|
| Rate for Payer: Prime Health Services Commercial |
$17,170.00
|
| Rate for Payer: Prime Health Services Medicare |
$9,621.43
|
| Rate for Payer: Prime Health Services WC |
$14,314.73
|
| Rate for Payer: Riverside University Health System MISP |
$9,984.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,120.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,100.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,100.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,100.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10,100.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$9,076.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,615.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,984.50
|
| Rate for Payer: Vantage Medical Group Senior |
$9,076.82
|
|
|
HC OPEN TREAT TALUS FRACTURE
|
Facility
|
IP
|
$13,490.00
|
|
|
Service Code
|
CPT 28445
|
| Hospital Charge Code |
900501370
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,698.00 |
| Max. Negotiated Rate |
$12,141.00 |
| Rate for Payer: Adventist Health Commercial |
$2,698.00
|
| Rate for Payer: Cash Price |
$6,070.50
|
| Rate for Payer: Central Health Plan Commercial |
$10,792.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,396.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,396.00
|
| Rate for Payer: Galaxy Health WC |
$11,466.50
|
| Rate for Payer: Global Benefits Group Commercial |
$8,094.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,141.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,997.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,139.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,350.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,698.00
|
| Rate for Payer: Multiplan Commercial |
$10,117.50
|
| Rate for Payer: Networks By Design Commercial |
$8,768.50
|
| Rate for Payer: Prime Health Services Commercial |
$11,466.50
|
|
|
HC OPEN TREAT TALUS FRACTURE
|
Facility
|
OP
|
$13,490.00
|
|
|
Service Code
|
CPT 28445
|
| Hospital Charge Code |
900501370
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$14,885.98 |
| Rate for Payer: Adventist Health Commercial |
$2,698.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,615.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,984.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,076.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,764.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,462.30
|
| Rate for Payer: Cash Price |
$6,070.50
|
| Rate for Payer: Cash Price |
$6,070.50
|
| Rate for Payer: Cash Price |
$6,070.50
|
| Rate for Payer: Cash Price |
$6,070.50
|
| Rate for Payer: Central Health Plan Commercial |
$10,792.00
|
| Rate for Payer: Cigna of CA HMO |
$8,633.60
|
| Rate for Payer: Cigna of CA PPO |
$9,982.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,615.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,984.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,076.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,253.71
|
| Rate for Payer: EPIC Health Plan Senior |
$9,076.82
|
| Rate for Payer: Galaxy Health WC |
$11,466.50
|
| Rate for Payer: Global Benefits Group Commercial |
$8,094.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,141.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14,885.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,076.82
|
| Rate for Payer: InnovAge PACE Commercial |
$13,615.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,997.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$801.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,076.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,698.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,162.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,162.94
|
| Rate for Payer: Multiplan Commercial |
$10,117.50
|
| Rate for Payer: Multiplan WC |
$14,462.30
|
| Rate for Payer: Networks By Design Commercial |
$8,768.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9,076.82
|
| Rate for Payer: Preferred Health Network WC |
$14,757.45
|
| Rate for Payer: Prime Health Services Commercial |
$11,466.50
|
| Rate for Payer: Prime Health Services Medicare |
$9,621.43
|
| Rate for Payer: Prime Health Services WC |
$14,314.73
|
| Rate for Payer: Riverside University Health System MISP |
$9,984.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,094.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,745.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6,745.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6,745.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,745.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$9,076.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,615.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,984.50
|
| Rate for Payer: Vantage Medical Group Senior |
$9,076.82
|
|
|
HC OPERATING MICROSCOPE
|
Facility
|
OP
|
$1,096.00
|
|
|
Service Code
|
CPT 69990
|
| Hospital Charge Code |
900501663
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$70.03 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$219.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$931.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$602.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$822.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Cash Price |
$493.20
|
| Rate for Payer: Cash Price |
$493.20
|
| Rate for Payer: Cash Price |
$493.20
|
| Rate for Payer: Cash Price |
$493.20
|
| Rate for Payer: Central Health Plan Commercial |
$876.80
|
| Rate for Payer: Cigna of CA HMO |
$701.44
|
| Rate for Payer: Cigna of CA PPO |
$811.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$931.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$931.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$931.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$438.40
|
| Rate for Payer: EPIC Health Plan Senior |
$438.40
|
| Rate for Payer: Galaxy Health WC |
$931.60
|
| Rate for Payer: Global Benefits Group Commercial |
$657.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$986.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: InnovAge PACE Commercial |
$548.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$731.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$678.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$767.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$767.20
|
| Rate for Payer: Multiplan Commercial |
$822.00
|
| Rate for Payer: Networks By Design Commercial |
$712.40
|
| Rate for Payer: Prime Health Services Commercial |
$931.60
|
| Rate for Payer: Riverside University Health System MISP |
$438.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$657.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$548.00
|
| Rate for Payer: United Healthcare All Other HMO |
$548.00
|
| Rate for Payer: United Healthcare HMO Rider |
$548.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$548.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$931.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$931.60
|
| Rate for Payer: Vantage Medical Group Senior |
$931.60
|
|
|
HC OPERATING MICROSCOPE
|
Facility
|
IP
|
$1,096.00
|
|
|
Service Code
|
CPT 69990
|
| Hospital Charge Code |
900501663
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$219.20 |
| Max. Negotiated Rate |
$986.40 |
| Rate for Payer: Adventist Health Commercial |
$219.20
|
| Rate for Payer: Cash Price |
$493.20
|
| Rate for Payer: Central Health Plan Commercial |
$876.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$438.40
|
| Rate for Payer: EPIC Health Plan Senior |
$438.40
|
| Rate for Payer: Galaxy Health WC |
$931.60
|
| Rate for Payer: Global Benefits Group Commercial |
$657.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$986.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$731.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$417.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$678.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.20
|
| Rate for Payer: Multiplan Commercial |
$822.00
|
| Rate for Payer: Networks By Design Commercial |
$712.40
|
| Rate for Payer: Prime Health Services Commercial |
$931.60
|
|
|
HC OPERATIVE ANGIOGRAM
|
Facility
|
IP
|
$1,366.00
|
|
|
Service Code
|
CPT 76499
|
| Hospital Charge Code |
909001054
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$273.20 |
| Max. Negotiated Rate |
$1,229.40 |
| Rate for Payer: Adventist Health Commercial |
$273.20
|
| Rate for Payer: Cash Price |
$614.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,092.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$546.40
|
| Rate for Payer: EPIC Health Plan Senior |
$546.40
|
| Rate for Payer: Galaxy Health WC |
$1,161.10
|
| Rate for Payer: Global Benefits Group Commercial |
$819.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,229.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$911.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$520.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$845.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$273.20
|
| Rate for Payer: Multiplan Commercial |
$1,024.50
|
| Rate for Payer: Networks By Design Commercial |
$887.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,161.10
|
|
|
HC OPERATIVE ANGIOGRAM
|
Facility
|
OP
|
$1,366.00
|
|
|
Service Code
|
CPT 76499
|
| Hospital Charge Code |
909001054
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$111.88 |
| Max. Negotiated Rate |
$1,229.40 |
| Rate for Payer: Adventist Health Commercial |
$273.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$111.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$829.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$661.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$802.25
|
| Rate for Payer: Blue Shield of California Commercial |
$829.16
|
| Rate for Payer: Blue Shield of California EPN |
$542.30
|
| Rate for Payer: Cash Price |
$614.70
|
| Rate for Payer: Cash Price |
$614.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,092.80
|
| Rate for Payer: Cigna of CA HMO |
$874.24
|
| Rate for Payer: Cigna of CA PPO |
$1,010.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$151.04
|
| Rate for Payer: EPIC Health Plan Senior |
$111.88
|
| Rate for Payer: Galaxy Health WC |
$1,161.10
|
| Rate for Payer: Global Benefits Group Commercial |
$819.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,229.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$183.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.88
|
| Rate for Payer: InnovAge PACE Commercial |
$167.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$911.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$111.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$273.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$149.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$149.92
|
| Rate for Payer: Multiplan Commercial |
$1,024.50
|
| Rate for Payer: Networks By Design Commercial |
$887.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$111.88
|
| Rate for Payer: Prime Health Services Commercial |
$1,161.10
|
| Rate for Payer: Prime Health Services Medicare |
$118.59
|
| Rate for Payer: Riverside University Health System MISP |
$123.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$819.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$819.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$111.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Vantage Medical Group Senior |
$111.88
|
|
|
HC OPERATIVE CHOLANGIO, ADDL FILM
|
Facility
|
IP
|
$460.00
|
|
|
Service Code
|
CPT 74301
|
| Hospital Charge Code |
909001826
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$92.00 |
| Max. Negotiated Rate |
$414.00 |
| Rate for Payer: Adventist Health Commercial |
$92.00
|
| Rate for Payer: Cash Price |
$207.00
|
| Rate for Payer: Central Health Plan Commercial |
$368.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.00
|
| Rate for Payer: EPIC Health Plan Senior |
$184.00
|
| Rate for Payer: Galaxy Health WC |
$391.00
|
| Rate for Payer: Global Benefits Group Commercial |
$276.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$414.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$306.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$175.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$284.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.00
|
| Rate for Payer: Multiplan Commercial |
$345.00
|
| Rate for Payer: Networks By Design Commercial |
$299.00
|
| Rate for Payer: Prime Health Services Commercial |
$391.00
|
|
|
HC OPERATIVE CHOLANGIO, ADDL FILM
|
Facility
|
OP
|
$460.00
|
|
|
Service Code
|
CPT 74301
|
| Hospital Charge Code |
909001826
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$28.91 |
| Max. Negotiated Rate |
$414.00 |
| Rate for Payer: Adventist Health Commercial |
$92.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$279.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$391.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$253.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$345.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$142.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.91
|
| Rate for Payer: Blue Shield of California Commercial |
$279.22
|
| Rate for Payer: Blue Shield of California EPN |
$182.62
|
| Rate for Payer: Cash Price |
$207.00
|
| Rate for Payer: Cash Price |
$207.00
|
| Rate for Payer: Central Health Plan Commercial |
$368.00
|
| Rate for Payer: Cigna of CA HMO |
$294.40
|
| Rate for Payer: Cigna of CA PPO |
$340.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$391.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$391.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.00
|
| Rate for Payer: EPIC Health Plan Senior |
$184.00
|
| Rate for Payer: Galaxy Health WC |
$391.00
|
| Rate for Payer: Global Benefits Group Commercial |
$276.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$414.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$37.19
|
| Rate for Payer: InnovAge PACE Commercial |
$230.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$306.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$284.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$322.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$322.00
|
| Rate for Payer: Multiplan Commercial |
$345.00
|
| Rate for Payer: Networks By Design Commercial |
$299.00
|
| Rate for Payer: Prime Health Services Commercial |
$391.00
|
| Rate for Payer: Riverside University Health System MISP |
$184.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$276.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$276.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$230.00
|
| Rate for Payer: United Healthcare All Other HMO |
$230.00
|
| Rate for Payer: United Healthcare HMO Rider |
$230.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$230.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$391.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$391.00
|
| Rate for Payer: Vantage Medical Group Senior |
$391.00
|
|
|
HC OPERATIVE CHOLANGIOG
|
Facility
|
IP
|
$876.00
|
|
|
Service Code
|
CPT 74300
|
| Hospital Charge Code |
909001827
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$175.20 |
| Max. Negotiated Rate |
$788.40 |
| Rate for Payer: Adventist Health Commercial |
$175.20
|
| Rate for Payer: Cash Price |
$394.20
|
| Rate for Payer: Central Health Plan Commercial |
$700.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$350.40
|
| Rate for Payer: EPIC Health Plan Senior |
$350.40
|
| Rate for Payer: Galaxy Health WC |
$744.60
|
| Rate for Payer: Global Benefits Group Commercial |
$525.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$788.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$584.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$333.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$542.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$175.20
|
| Rate for Payer: Multiplan Commercial |
$657.00
|
| Rate for Payer: Networks By Design Commercial |
$569.40
|
| Rate for Payer: Prime Health Services Commercial |
$744.60
|
|
|
HC OPERATIVE CHOLANGIOG
|
Facility
|
OP
|
$876.00
|
|
|
Service Code
|
CPT 74300
|
| Hospital Charge Code |
909001827
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$74.44 |
| Max. Negotiated Rate |
$788.40 |
| Rate for Payer: Adventist Health Commercial |
$175.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$531.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$744.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$481.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$657.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$424.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$514.47
|
| Rate for Payer: Blue Shield of California Commercial |
$531.73
|
| Rate for Payer: Blue Shield of California EPN |
$347.77
|
| Rate for Payer: Cash Price |
$394.20
|
| Rate for Payer: Cash Price |
$394.20
|
| Rate for Payer: Central Health Plan Commercial |
$700.80
|
| Rate for Payer: Cigna of CA HMO |
$560.64
|
| Rate for Payer: Cigna of CA PPO |
$648.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$744.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$744.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$744.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$350.40
|
| Rate for Payer: EPIC Health Plan Senior |
$350.40
|
| Rate for Payer: Galaxy Health WC |
$744.60
|
| Rate for Payer: Global Benefits Group Commercial |
$525.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$788.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$74.44
|
| Rate for Payer: InnovAge PACE Commercial |
$438.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$584.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$542.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$175.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$613.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$613.20
|
| Rate for Payer: Multiplan Commercial |
$657.00
|
| Rate for Payer: Networks By Design Commercial |
$569.40
|
| Rate for Payer: Prime Health Services Commercial |
$744.60
|
| Rate for Payer: Riverside University Health System MISP |
$350.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$525.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$525.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$438.00
|
| Rate for Payer: United Healthcare All Other HMO |
$438.00
|
| Rate for Payer: United Healthcare HMO Rider |
$438.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$438.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$744.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$744.60
|
| Rate for Payer: Vantage Medical Group Senior |
$744.60
|
|
|
HC OPERATIVE LARYNGOSCOPY W/FB RM
|
Facility
|
IP
|
$14,392.00
|
|
|
Service Code
|
CPT 31530
|
| Hospital Charge Code |
900501438
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,878.40 |
| Max. Negotiated Rate |
$12,952.80 |
| Rate for Payer: Adventist Health Commercial |
$2,878.40
|
| Rate for Payer: Cash Price |
$6,476.40
|
| Rate for Payer: Central Health Plan Commercial |
$11,513.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,756.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,756.80
|
| Rate for Payer: Galaxy Health WC |
$12,233.20
|
| Rate for Payer: Global Benefits Group Commercial |
$8,635.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,952.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,599.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,483.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,908.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,878.40
|
| Rate for Payer: Multiplan Commercial |
$10,794.00
|
| Rate for Payer: Networks By Design Commercial |
$9,354.80
|
| Rate for Payer: Prime Health Services Commercial |
$12,233.20
|
|
|
HC OPERATIVE LARYNGOSCOPY W/FB RM
|
Facility
|
OP
|
$14,392.00
|
|
|
Service Code
|
CPT 31530
|
| Hospital Charge Code |
900501438
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$12,952.80 |
| Rate for Payer: Adventist Health Commercial |
$2,878.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,410.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,191.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,491.15
|
| Rate for Payer: Cash Price |
$6,476.40
|
| Rate for Payer: Cash Price |
$6,476.40
|
| Rate for Payer: Cash Price |
$6,476.40
|
| Rate for Payer: Cash Price |
$6,476.40
|
| Rate for Payer: Central Health Plan Commercial |
$11,513.60
|
| Rate for Payer: Cigna of CA HMO |
$9,210.88
|
| Rate for Payer: Cigna of CA PPO |
$10,650.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,410.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,191.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,958.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,191.11
|
| Rate for Payer: Galaxy Health WC |
$12,233.20
|
| Rate for Payer: Global Benefits Group Commercial |
$8,635.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,952.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,593.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,191.11
|
| Rate for Payer: InnovAge PACE Commercial |
$3,286.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,599.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$424.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,191.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,878.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,936.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,936.09
|
| Rate for Payer: Multiplan Commercial |
$10,794.00
|
| Rate for Payer: Multiplan WC |
$3,491.15
|
| Rate for Payer: Networks By Design Commercial |
$9,354.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,191.11
|
| Rate for Payer: Preferred Health Network WC |
$3,562.40
|
| Rate for Payer: Prime Health Services Commercial |
$12,233.20
|
| Rate for Payer: Prime Health Services Medicare |
$2,322.58
|
| Rate for Payer: Prime Health Services WC |
$3,455.53
|
| Rate for Payer: Riverside University Health System MISP |
$2,410.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,635.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,196.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,196.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,196.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,196.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,191.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,410.22
|
| Rate for Payer: Vantage Medical Group Senior |
$2,191.11
|
|
|
HC OP EXTEND RECOVERY ADDL 30 MIN
|
Facility
|
OP
|
$151.00
|
|
| Hospital Charge Code |
988100100
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$30.20 |
| Max. Negotiated Rate |
$135.90 |
| Rate for Payer: Adventist Health Commercial |
$30.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$91.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$128.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$113.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$73.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$88.68
|
| Rate for Payer: Blue Shield of California Commercial |
$92.26
|
| Rate for Payer: Blue Shield of California EPN |
$60.25
|
| Rate for Payer: Cash Price |
$67.95
|
| Rate for Payer: Central Health Plan Commercial |
$120.80
|
| Rate for Payer: Cigna of CA HMO |
$96.64
|
| Rate for Payer: Cigna of CA PPO |
$111.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$128.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$128.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$128.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.40
|
| Rate for Payer: EPIC Health Plan Senior |
$60.40
|
| Rate for Payer: Galaxy Health WC |
$128.35
|
| Rate for Payer: Global Benefits Group Commercial |
$90.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$135.90
|
| Rate for Payer: InnovAge PACE Commercial |
$75.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$100.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$93.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$105.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$105.70
|
| Rate for Payer: Multiplan Commercial |
$113.25
|
| Rate for Payer: Networks By Design Commercial |
$98.15
|
| Rate for Payer: Prime Health Services Commercial |
$128.35
|
| Rate for Payer: Riverside University Health System MISP |
$60.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$90.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$90.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$75.50
|
| Rate for Payer: United Healthcare All Other HMO |
$75.50
|
| Rate for Payer: United Healthcare HMO Rider |
$75.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$75.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$128.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$128.35
|
| Rate for Payer: Vantage Medical Group Senior |
$128.35
|
|
|
HC OP EXTEND RECOVERY ADDL 30 MIN
|
Facility
|
IP
|
$151.00
|
|
| Hospital Charge Code |
988100100
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$30.20 |
| Max. Negotiated Rate |
$135.90 |
| Rate for Payer: Adventist Health Commercial |
$30.20
|
| Rate for Payer: Cash Price |
$67.95
|
| Rate for Payer: Central Health Plan Commercial |
$120.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.40
|
| Rate for Payer: EPIC Health Plan Senior |
$60.40
|
| Rate for Payer: Galaxy Health WC |
$128.35
|
| Rate for Payer: Global Benefits Group Commercial |
$90.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$135.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$100.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$93.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.20
|
| Rate for Payer: Multiplan Commercial |
$113.25
|
| Rate for Payer: Networks By Design Commercial |
$98.15
|
| Rate for Payer: Prime Health Services Commercial |
$128.35
|
|
|
HC OPHTH ULTRASOUND-B-SCAN
|
Facility
|
OP
|
$469.00
|
|
|
Service Code
|
CPT 76512
|
| Hospital Charge Code |
950402000
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$74.11 |
| Max. Negotiated Rate |
$422.10 |
| Rate for Payer: Adventist Health Commercial |
$93.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$135.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$284.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$319.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$275.44
|
| Rate for Payer: Blue Shield of California Commercial |
$284.68
|
| Rate for Payer: Blue Shield of California EPN |
$186.19
|
| Rate for Payer: Cash Price |
$211.05
|
| Rate for Payer: Cash Price |
$211.05
|
| Rate for Payer: Central Health Plan Commercial |
$375.20
|
| Rate for Payer: Cigna of CA HMO |
$300.16
|
| Rate for Payer: Cigna of CA PPO |
$347.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.41
|
| Rate for Payer: EPIC Health Plan Senior |
$135.12
|
| Rate for Payer: Galaxy Health WC |
$398.65
|
| Rate for Payer: Global Benefits Group Commercial |
$281.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$422.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$221.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$74.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: InnovAge PACE Commercial |
$202.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$312.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$135.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$181.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$181.06
|
| Rate for Payer: Multiplan Commercial |
$351.75
|
| Rate for Payer: Networks By Design Commercial |
$304.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$135.12
|
| Rate for Payer: Prime Health Services Commercial |
$398.65
|
| Rate for Payer: Prime Health Services Medicare |
$143.23
|
| Rate for Payer: Riverside University Health System MISP |
$148.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$281.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$281.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$246.56
|
| Rate for Payer: United Healthcare All Other HMO |
$246.56
|
| Rate for Payer: United Healthcare HMO Rider |
$246.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$246.56
|
| Rate for Payer: Upland Medical Group Pediatric |
$135.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC OPHTH ULTRASOUND-B-SCAN
|
Facility
|
IP
|
$469.00
|
|
|
Service Code
|
CPT 76512
|
| Hospital Charge Code |
950402000
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$93.80 |
| Max. Negotiated Rate |
$422.10 |
| Rate for Payer: Adventist Health Commercial |
$93.80
|
| Rate for Payer: Cash Price |
$211.05
|
| Rate for Payer: Central Health Plan Commercial |
$375.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$187.60
|
| Rate for Payer: EPIC Health Plan Senior |
$187.60
|
| Rate for Payer: Galaxy Health WC |
$398.65
|
| Rate for Payer: Global Benefits Group Commercial |
$281.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$422.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$312.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$178.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$290.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.80
|
| Rate for Payer: Multiplan Commercial |
$351.75
|
| Rate for Payer: Networks By Design Commercial |
$304.85
|
| Rate for Payer: Prime Health Services Commercial |
$398.65
|
|
|
HC OPIATES CONF & ID
|
Facility
|
OP
|
$298.00
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
900910516
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.55 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Adventist Health Commercial |
$59.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$180.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$253.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$163.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$223.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$135.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27.55
|
| Rate for Payer: Blue Shield of California Commercial |
$180.89
|
| Rate for Payer: Blue Shield of California EPN |
$118.31
|
| Rate for Payer: Cash Price |
$134.10
|
| Rate for Payer: Cash Price |
$134.10
|
| Rate for Payer: Central Health Plan Commercial |
$238.40
|
| Rate for Payer: Cigna of CA HMO |
$190.72
|
| Rate for Payer: Cigna of CA PPO |
$220.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$253.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$253.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$253.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.20
|
| Rate for Payer: EPIC Health Plan Senior |
$119.20
|
| Rate for Payer: Galaxy Health WC |
$253.30
|
| Rate for Payer: Global Benefits Group Commercial |
$178.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$268.20
|
| Rate for Payer: InnovAge PACE Commercial |
$149.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$198.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$113.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$184.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$208.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$208.60
|
| Rate for Payer: Multiplan Commercial |
$223.50
|
| Rate for Payer: Networks By Design Commercial |
$193.70
|
| Rate for Payer: Prime Health Services Commercial |
$253.30
|
| Rate for Payer: Riverside University Health System MISP |
$119.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$178.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$178.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$149.00
|
| Rate for Payer: United Healthcare All Other HMO |
$149.00
|
| Rate for Payer: United Healthcare HMO Rider |
$149.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$149.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$253.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$253.30
|
| Rate for Payer: Vantage Medical Group Senior |
$253.30
|
|
|
HC OPIATES CONF & ID
|
Facility
|
IP
|
$359.00
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
900910516
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$71.80 |
| Max. Negotiated Rate |
$323.10 |
| Rate for Payer: Adventist Health Commercial |
$71.80
|
| Rate for Payer: Cash Price |
$161.55
|
| Rate for Payer: Central Health Plan Commercial |
$287.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$143.60
|
| Rate for Payer: EPIC Health Plan Senior |
$143.60
|
| Rate for Payer: Galaxy Health WC |
$305.15
|
| Rate for Payer: Global Benefits Group Commercial |
$215.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$323.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$239.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$136.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$222.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.80
|
| Rate for Payer: Multiplan Commercial |
$269.25
|
| Rate for Payer: Networks By Design Commercial |
$233.35
|
| Rate for Payer: Prime Health Services Commercial |
$305.15
|
|
|
HC OPN FEM ART DELV END PRO, UNI
|
Facility
|
OP
|
$5,294.00
|
|
|
Service Code
|
CPT 34812
|
| Hospital Charge Code |
900034812
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$109.50 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,058.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,499.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,911.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,970.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,563.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,109.17
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$2,382.30
|
| Rate for Payer: Cash Price |
$2,382.30
|
| Rate for Payer: Cash Price |
$2,382.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,235.20
|
| Rate for Payer: Cigna of CA HMO |
$3,388.16
|
| Rate for Payer: Cigna of CA PPO |
$3,917.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,499.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,499.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,499.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,117.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,117.60
|
| Rate for Payer: Galaxy Health WC |
$4,499.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,176.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,764.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$109.50
|
| Rate for Payer: InnovAge PACE Commercial |
$2,647.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,531.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$120.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,276.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,058.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,705.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,705.80
|
| Rate for Payer: Multiplan Commercial |
$3,970.50
|
| Rate for Payer: Networks By Design Commercial |
$3,441.10
|
| Rate for Payer: Prime Health Services Commercial |
$4,499.90
|
| Rate for Payer: Riverside University Health System MISP |
$2,117.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,176.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,499.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,499.90
|
| Rate for Payer: Vantage Medical Group Senior |
$4,499.90
|
|
|
HC OPN FEM ART DELV END PRO, UNI
|
Facility
|
IP
|
$5,294.00
|
|
|
Service Code
|
CPT 34812
|
| Hospital Charge Code |
900034812
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,058.80 |
| Max. Negotiated Rate |
$4,764.60 |
| Rate for Payer: Adventist Health Commercial |
$1,058.80
|
| Rate for Payer: Cash Price |
$2,382.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,235.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,117.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,117.60
|
| Rate for Payer: Galaxy Health WC |
$4,499.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,176.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,764.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,531.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,017.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,276.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,058.80
|
| Rate for Payer: Multiplan Commercial |
$3,970.50
|
| Rate for Payer: Networks By Design Commercial |
$3,441.10
|
| Rate for Payer: Prime Health Services Commercial |
$4,499.90
|
|
|
HC OP SVC LEVEL I 1ST HR
|
Facility
|
OP
|
$746.00
|
|
| Hospital Charge Code |
909401010
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$149.20 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$149.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$634.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$410.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$559.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$361.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$438.13
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$335.70
|
| Rate for Payer: Cash Price |
$335.70
|
| Rate for Payer: Central Health Plan Commercial |
$596.80
|
| Rate for Payer: Cigna of CA HMO |
$477.44
|
| Rate for Payer: Cigna of CA PPO |
$552.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$634.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$634.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$634.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$298.40
|
| Rate for Payer: EPIC Health Plan Senior |
$298.40
|
| Rate for Payer: Galaxy Health WC |
$634.10
|
| Rate for Payer: Global Benefits Group Commercial |
$447.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$671.40
|
| Rate for Payer: InnovAge PACE Commercial |
$373.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$497.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$284.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$461.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$149.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$522.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$522.20
|
| Rate for Payer: Multiplan Commercial |
$559.50
|
| Rate for Payer: Networks By Design Commercial |
$484.90
|
| Rate for Payer: Prime Health Services Commercial |
$634.10
|
| Rate for Payer: Riverside University Health System MISP |
$298.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$447.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$373.00
|
| Rate for Payer: United Healthcare All Other HMO |
$373.00
|
| Rate for Payer: United Healthcare HMO Rider |
$373.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$373.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$634.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$634.10
|
| Rate for Payer: Vantage Medical Group Senior |
$634.10
|
|
