|
HC PROSTH SHEATH UPPER LIMB EACH
|
Facility
|
IP
|
$78.00
|
|
|
Service Code
|
CPT L8415
|
| Hospital Charge Code |
915358415
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$70.20 |
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Blue Shield of California Commercial |
$62.56
|
| Rate for Payer: Blue Shield of California EPN |
$39.31
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Central Health Plan Commercial |
$62.40
|
| Rate for Payer: Cigna of CA HMO |
$54.60
|
| Rate for Payer: Cigna of CA PPO |
$54.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$54.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.20
|
| Rate for Payer: EPIC Health Plan Senior |
$31.20
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$49.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$46.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.60
|
| Rate for Payer: Multiplan Commercial |
$58.50
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$29.27
|
| Rate for Payer: United Healthcare All Other HMO |
$28.49
|
| Rate for Payer: United Healthcare HMO Rider |
$27.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.55
|
|
|
HC PROSTH SHEATH UPPER LIMB EACH
|
Facility
|
IP
|
$78.00
|
|
|
Service Code
|
CPT L8415
|
| Hospital Charge Code |
905358415
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$70.20 |
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Blue Shield of California Commercial |
$62.56
|
| Rate for Payer: Blue Shield of California EPN |
$39.31
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Central Health Plan Commercial |
$62.40
|
| Rate for Payer: Cigna of CA HMO |
$54.60
|
| Rate for Payer: Cigna of CA PPO |
$54.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$54.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.20
|
| Rate for Payer: EPIC Health Plan Senior |
$31.20
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$49.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$46.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.60
|
| Rate for Payer: Multiplan Commercial |
$58.50
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$29.27
|
| Rate for Payer: United Healthcare All Other HMO |
$28.49
|
| Rate for Payer: United Healthcare HMO Rider |
$27.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.55
|
|
|
HC PROSTH SHEATH UPPER LIMB EACH
|
Facility
|
OP
|
$78.00
|
|
|
Service Code
|
CPT L8415
|
| Hospital Charge Code |
905358415
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$18.82 |
| Max. Negotiated Rate |
$70.20 |
| Rate for Payer: Adventist Health Commercial |
$31.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$66.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$42.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$58.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45.37
|
| Rate for Payer: Blue Shield of California Commercial |
$62.56
|
| Rate for Payer: Blue Shield of California EPN |
$39.31
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Central Health Plan Commercial |
$62.40
|
| Rate for Payer: Cigna of CA HMO |
$54.60
|
| Rate for Payer: Cigna of CA PPO |
$54.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$66.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$66.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$66.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$54.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.20
|
| Rate for Payer: EPIC Health Plan Senior |
$31.20
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$49.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$46.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$54.60
|
| Rate for Payer: Multiplan Commercial |
$58.50
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
| Rate for Payer: Riverside University Health System MISP |
$31.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$29.27
|
| Rate for Payer: United Healthcare All Other HMO |
$28.49
|
| Rate for Payer: United Healthcare HMO Rider |
$27.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$66.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$66.30
|
| Rate for Payer: Vantage Medical Group Senior |
$66.30
|
|
|
HC PROSTH SHEATH UPPER LIMB EACH
|
Facility
|
OP
|
$78.00
|
|
|
Service Code
|
CPT L8415
|
| Hospital Charge Code |
915358415
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$18.82 |
| Max. Negotiated Rate |
$70.20 |
| Rate for Payer: Adventist Health Commercial |
$31.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$66.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$42.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$58.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45.37
|
| Rate for Payer: Blue Shield of California Commercial |
$62.56
|
| Rate for Payer: Blue Shield of California EPN |
$39.31
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Central Health Plan Commercial |
$62.40
|
| Rate for Payer: Cigna of CA HMO |
$54.60
|
| Rate for Payer: Cigna of CA PPO |
$54.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$66.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$66.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$66.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$54.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.20
|
| Rate for Payer: EPIC Health Plan Senior |
$31.20
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$49.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$46.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$54.60
|
| Rate for Payer: Multiplan Commercial |
$58.50
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
| Rate for Payer: Riverside University Health System MISP |
$31.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$29.27
|
| Rate for Payer: United Healthcare All Other HMO |
$28.49
|
| Rate for Payer: United Healthcare HMO Rider |
$27.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$66.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$66.30
|
| Rate for Payer: Vantage Medical Group Senior |
$66.30
|
|
|
HC PROSTH SHRINKER UPPER LIMB EA
|
Facility
|
OP
|
$91.00
|
|
|
Service Code
|
CPT L8465
|
| Hospital Charge Code |
915358465
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$29.80 |
| Max. Negotiated Rate |
$81.90 |
| Rate for Payer: Dignity Health Medi-Cal |
$77.35
|
| Rate for Payer: Adventist Health Commercial |
$37.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$77.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$50.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$68.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.93
|
| Rate for Payer: Blue Shield of California Commercial |
$72.98
|
| Rate for Payer: Blue Shield of California EPN |
$45.86
|
| Rate for Payer: Cash Price |
$40.95
|
| Rate for Payer: Cash Price |
$40.95
|
| Rate for Payer: Central Health Plan Commercial |
$72.80
|
| Rate for Payer: Cigna of CA HMO |
$63.70
|
| Rate for Payer: Cigna of CA PPO |
$63.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$77.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$77.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$63.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.40
|
| Rate for Payer: EPIC Health Plan Senior |
$36.40
|
| Rate for Payer: Galaxy Health WC |
$77.35
|
| Rate for Payer: Global Benefits Group Commercial |
$54.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$81.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$32.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$57.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$36.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$53.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$63.70
|
| Rate for Payer: Multiplan Commercial |
$68.25
|
| Rate for Payer: Networks By Design Commercial |
$45.50
|
| Rate for Payer: Prime Health Services Commercial |
$77.35
|
| Rate for Payer: Riverside University Health System MISP |
$36.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$54.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$54.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$34.15
|
| Rate for Payer: United Healthcare All Other HMO |
$33.24
|
| Rate for Payer: United Healthcare HMO Rider |
$32.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$29.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$77.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$77.35
|
| Rate for Payer: Vantage Medical Group Senior |
$77.35
|
|
|
HC PROSTH SHRINKER UPPER LIMB EA
|
Facility
|
IP
|
$91.00
|
|
|
Service Code
|
CPT L8465
|
| Hospital Charge Code |
905358465
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$18.20 |
| Max. Negotiated Rate |
$81.90 |
| Rate for Payer: Adventist Health Commercial |
$18.20
|
| Rate for Payer: Blue Shield of California Commercial |
$72.98
|
| Rate for Payer: Blue Shield of California EPN |
$45.86
|
| Rate for Payer: Cash Price |
$40.95
|
| Rate for Payer: Central Health Plan Commercial |
$72.80
|
| Rate for Payer: Cigna of CA HMO |
$63.70
|
| Rate for Payer: Cigna of CA PPO |
$63.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$63.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.40
|
| Rate for Payer: EPIC Health Plan Senior |
$36.40
|
| Rate for Payer: Galaxy Health WC |
$77.35
|
| Rate for Payer: Global Benefits Group Commercial |
$54.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$81.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$57.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$53.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.20
|
| Rate for Payer: Multiplan Commercial |
$68.25
|
| Rate for Payer: Networks By Design Commercial |
$59.15
|
| Rate for Payer: Prime Health Services Commercial |
$77.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$34.15
|
| Rate for Payer: United Healthcare All Other HMO |
$33.24
|
| Rate for Payer: United Healthcare HMO Rider |
$32.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$29.80
|
|
|
HC PROSTH SHRINKER UPPER LIMB EA
|
Facility
|
IP
|
$91.00
|
|
|
Service Code
|
CPT L8465
|
| Hospital Charge Code |
915358465
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$18.20 |
| Max. Negotiated Rate |
$81.90 |
| Rate for Payer: Adventist Health Commercial |
$18.20
|
| Rate for Payer: Blue Shield of California Commercial |
$72.98
|
| Rate for Payer: Blue Shield of California EPN |
$45.86
|
| Rate for Payer: Cash Price |
$40.95
|
| Rate for Payer: Central Health Plan Commercial |
$72.80
|
| Rate for Payer: Cigna of CA HMO |
$63.70
|
| Rate for Payer: Cigna of CA PPO |
$63.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$63.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.40
|
| Rate for Payer: EPIC Health Plan Senior |
$36.40
|
| Rate for Payer: Galaxy Health WC |
$77.35
|
| Rate for Payer: Global Benefits Group Commercial |
$54.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$81.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$57.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$53.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.20
|
| Rate for Payer: Multiplan Commercial |
$68.25
|
| Rate for Payer: Networks By Design Commercial |
$59.15
|
| Rate for Payer: Prime Health Services Commercial |
$77.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$34.15
|
| Rate for Payer: United Healthcare All Other HMO |
$33.24
|
| Rate for Payer: United Healthcare HMO Rider |
$32.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$29.80
|
|
|
HC PROSTH SHRINKER UPPER LIMB EA
|
Facility
|
OP
|
$91.00
|
|
|
Service Code
|
CPT L8465
|
| Hospital Charge Code |
905358465
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$29.80 |
| Max. Negotiated Rate |
$81.90 |
| Rate for Payer: Adventist Health Commercial |
$37.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$77.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$50.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$68.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.93
|
| Rate for Payer: Blue Shield of California Commercial |
$72.98
|
| Rate for Payer: Blue Shield of California EPN |
$45.86
|
| Rate for Payer: Cash Price |
$40.95
|
| Rate for Payer: Cash Price |
$40.95
|
| Rate for Payer: Central Health Plan Commercial |
$72.80
|
| Rate for Payer: Cigna of CA HMO |
$63.70
|
| Rate for Payer: Cigna of CA PPO |
$63.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$77.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$77.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$77.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$63.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.40
|
| Rate for Payer: EPIC Health Plan Senior |
$36.40
|
| Rate for Payer: Galaxy Health WC |
$77.35
|
| Rate for Payer: Global Benefits Group Commercial |
$54.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$81.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$32.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$57.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$36.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$53.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$63.70
|
| Rate for Payer: Multiplan Commercial |
$68.25
|
| Rate for Payer: Networks By Design Commercial |
$45.50
|
| Rate for Payer: Prime Health Services Commercial |
$77.35
|
| Rate for Payer: Riverside University Health System MISP |
$36.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$54.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$54.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$34.15
|
| Rate for Payer: United Healthcare All Other HMO |
$33.24
|
| Rate for Payer: United Healthcare HMO Rider |
$32.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$29.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$77.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$77.35
|
| Rate for Payer: Vantage Medical Group Senior |
$77.35
|
|
|
HC PROSTH SOCK WOOL UPPER LIMB
|
Facility
|
IP
|
$84.00
|
|
|
Service Code
|
CPT L8435
|
| Hospital Charge Code |
905358435
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$75.60 |
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Blue Shield of California Commercial |
$67.37
|
| Rate for Payer: Blue Shield of California EPN |
$42.34
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Central Health Plan Commercial |
$67.20
|
| Rate for Payer: Cigna of CA HMO |
$58.80
|
| Rate for Payer: Cigna of CA PPO |
$58.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$58.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.60
|
| Rate for Payer: EPIC Health Plan Senior |
$33.60
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$53.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$49.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$31.53
|
| Rate for Payer: United Healthcare All Other HMO |
$30.69
|
| Rate for Payer: United Healthcare HMO Rider |
$30.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.51
|
|
|
HC PROSTH SOCK WOOL UPPER LIMB
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT L8435
|
| Hospital Charge Code |
905358435
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$20.62 |
| Max. Negotiated Rate |
$75.60 |
| Rate for Payer: Adventist Health Commercial |
$34.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$71.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$46.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$63.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48.86
|
| Rate for Payer: Blue Shield of California Commercial |
$67.37
|
| Rate for Payer: Blue Shield of California EPN |
$42.34
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Central Health Plan Commercial |
$67.20
|
| Rate for Payer: Cigna of CA HMO |
$58.80
|
| Rate for Payer: Cigna of CA PPO |
$58.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$71.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$71.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$71.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$58.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.60
|
| Rate for Payer: EPIC Health Plan Senior |
$33.60
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$20.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$53.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$49.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$58.80
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: Networks By Design Commercial |
$42.00
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
| Rate for Payer: Riverside University Health System MISP |
$33.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$50.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$31.53
|
| Rate for Payer: United Healthcare All Other HMO |
$30.69
|
| Rate for Payer: United Healthcare HMO Rider |
$30.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$71.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$71.40
|
| Rate for Payer: Vantage Medical Group Senior |
$71.40
|
|
|
HC PROSTH SOCK WOOL UPPER LIMB
|
Facility
|
IP
|
$84.00
|
|
|
Service Code
|
CPT L8435
|
| Hospital Charge Code |
915358435
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$75.60 |
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Blue Shield of California Commercial |
$67.37
|
| Rate for Payer: Blue Shield of California EPN |
$42.34
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Central Health Plan Commercial |
$67.20
|
| Rate for Payer: Cigna of CA HMO |
$58.80
|
| Rate for Payer: Cigna of CA PPO |
$58.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$58.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.60
|
| Rate for Payer: EPIC Health Plan Senior |
$33.60
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$53.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$49.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$31.53
|
| Rate for Payer: United Healthcare All Other HMO |
$30.69
|
| Rate for Payer: United Healthcare HMO Rider |
$30.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.51
|
|
|
HC PROSTH SOCK WOOL UPPER LIMB
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT L8435
|
| Hospital Charge Code |
915358435
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$20.62 |
| Max. Negotiated Rate |
$75.60 |
| Rate for Payer: Adventist Health Commercial |
$34.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$71.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$46.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$63.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48.86
|
| Rate for Payer: Blue Shield of California Commercial |
$67.37
|
| Rate for Payer: Blue Shield of California EPN |
$42.34
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Central Health Plan Commercial |
$67.20
|
| Rate for Payer: Cigna of CA HMO |
$58.80
|
| Rate for Payer: Cigna of CA PPO |
$58.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$71.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$71.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$71.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$58.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.60
|
| Rate for Payer: EPIC Health Plan Senior |
$33.60
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$20.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$53.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$49.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$58.80
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: Networks By Design Commercial |
$42.00
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
| Rate for Payer: Riverside University Health System MISP |
$33.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$50.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$31.53
|
| Rate for Payer: United Healthcare All Other HMO |
$30.69
|
| Rate for Payer: United Healthcare HMO Rider |
$30.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$71.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$71.40
|
| Rate for Payer: Vantage Medical Group Senior |
$71.40
|
|
|
HC PROTECTIVE BODY SOCK EA
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT L0984
|
| Hospital Charge Code |
915350984
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Blue Shield of California Commercial |
$168.42
|
| Rate for Payer: Blue Shield of California EPN |
$105.84
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Central Health Plan Commercial |
$168.00
|
| Rate for Payer: Cigna of CA HMO |
$147.00
|
| Rate for Payer: Cigna of CA PPO |
$147.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Senior |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$123.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.00
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$78.81
|
| Rate for Payer: United Healthcare All Other HMO |
$76.71
|
| Rate for Payer: United Healthcare HMO Rider |
$75.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$68.78
|
|
|
HC PROTECTIVE BODY SOCK EA
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT L0984
|
| Hospital Charge Code |
905350984
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Blue Shield of California Commercial |
$168.42
|
| Rate for Payer: Blue Shield of California EPN |
$105.84
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Central Health Plan Commercial |
$168.00
|
| Rate for Payer: Cigna of CA HMO |
$147.00
|
| Rate for Payer: Cigna of CA PPO |
$147.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Senior |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$123.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.00
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$78.81
|
| Rate for Payer: United Healthcare All Other HMO |
$76.71
|
| Rate for Payer: United Healthcare HMO Rider |
$75.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$68.78
|
|
|
HC PROTECTIVE BODY SOCK EA
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT L0984
|
| Hospital Charge Code |
915350984
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$65.53 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Adventist Health Commercial |
$86.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$178.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$115.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$157.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$122.16
|
| Rate for Payer: Blue Shield of California Commercial |
$168.42
|
| Rate for Payer: Blue Shield of California EPN |
$105.84
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Central Health Plan Commercial |
$168.00
|
| Rate for Payer: Cigna of CA HMO |
$147.00
|
| Rate for Payer: Cigna of CA PPO |
$147.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$178.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$178.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$178.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Senior |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$65.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$72.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$123.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$147.00
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: Networks By Design Commercial |
$105.00
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
| Rate for Payer: Riverside University Health System MISP |
$84.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$126.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$126.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$78.81
|
| Rate for Payer: United Healthcare All Other HMO |
$76.71
|
| Rate for Payer: United Healthcare HMO Rider |
$75.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$68.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$178.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$178.50
|
| Rate for Payer: Vantage Medical Group Senior |
$178.50
|
|
|
HC PROTECTIVE BODY SOCK EA
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT L0984
|
| Hospital Charge Code |
905350984
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$65.53 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Adventist Health Commercial |
$86.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$178.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$115.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$157.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$122.16
|
| Rate for Payer: Blue Shield of California Commercial |
$168.42
|
| Rate for Payer: Blue Shield of California EPN |
$105.84
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Central Health Plan Commercial |
$168.00
|
| Rate for Payer: Cigna of CA HMO |
$147.00
|
| Rate for Payer: Cigna of CA PPO |
$147.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$178.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$178.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$178.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Senior |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$65.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$72.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$123.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$147.00
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: Networks By Design Commercial |
$105.00
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
| Rate for Payer: Riverside University Health System MISP |
$84.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$126.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$126.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$78.81
|
| Rate for Payer: United Healthcare All Other HMO |
$76.71
|
| Rate for Payer: United Healthcare HMO Rider |
$75.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$68.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$178.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$178.50
|
| Rate for Payer: Vantage Medical Group Senior |
$178.50
|
|
|
HC PROTECTOR HEEL HEELMEDIX XL
|
Facility
|
IP
|
$395.04
|
|
|
Service Code
|
CPT E0190
|
| Hospital Charge Code |
901606284
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$79.01 |
| Max. Negotiated Rate |
$355.54 |
| Rate for Payer: Adventist Health Commercial |
$79.01
|
| Rate for Payer: Cash Price |
$177.77
|
| Rate for Payer: Central Health Plan Commercial |
$316.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$276.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$158.02
|
| Rate for Payer: EPIC Health Plan Senior |
$158.02
|
| Rate for Payer: Galaxy Health WC |
$335.78
|
| Rate for Payer: Global Benefits Group Commercial |
$237.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$355.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$250.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$233.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.01
|
| Rate for Payer: Multiplan Commercial |
$296.28
|
| Rate for Payer: Networks By Design Commercial |
$256.78
|
| Rate for Payer: Prime Health Services Commercial |
$335.78
|
|
|
HC PROTECTOR HEEL HEELMEDIX XL
|
Facility
|
OP
|
$395.04
|
|
|
Service Code
|
CPT E0190
|
| Hospital Charge Code |
901606284
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$79.01 |
| Max. Negotiated Rate |
$687.20 |
| Rate for Payer: Adventist Health Commercial |
$79.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$687.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$335.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$217.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$296.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$191.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$229.79
|
| Rate for Payer: Blue Shield of California Commercial |
$250.46
|
| Rate for Payer: Blue Shield of California EPN |
$157.62
|
| Rate for Payer: Cash Price |
$177.77
|
| Rate for Payer: Cash Price |
$177.77
|
| Rate for Payer: Central Health Plan Commercial |
$316.03
|
| Rate for Payer: Cigna of CA HMO |
$252.83
|
| Rate for Payer: Cigna of CA PPO |
$292.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$335.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$335.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$276.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$158.02
|
| Rate for Payer: EPIC Health Plan Senior |
$158.02
|
| Rate for Payer: Galaxy Health WC |
$335.78
|
| Rate for Payer: Global Benefits Group Commercial |
$237.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$355.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$250.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$143.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$233.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$276.53
|
| Rate for Payer: Multiplan Commercial |
$296.28
|
| Rate for Payer: Networks By Design Commercial |
$256.78
|
| Rate for Payer: Prime Health Services Commercial |
$335.78
|
| Rate for Payer: Riverside University Health System MISP |
$158.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$237.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$237.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$197.52
|
| Rate for Payer: United Healthcare All Other HMO |
$197.52
|
| Rate for Payer: United Healthcare HMO Rider |
$197.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$197.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$335.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.78
|
| Rate for Payer: Vantage Medical Group Senior |
$335.78
|
|
|
HC PROTEINASE AB
|
Facility
|
IP
|
$78.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913677
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$70.20 |
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Central Health Plan Commercial |
$62.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$54.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.20
|
| Rate for Payer: EPIC Health Plan Senior |
$31.20
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$49.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$46.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.60
|
| Rate for Payer: Multiplan Commercial |
$58.50
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
|
|
HC PROTEINASE AB
|
Facility
|
OP
|
$70.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913677
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$236.61 |
| Rate for Payer: Adventist Health Commercial |
$14.00
|
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$11.53
|
| Rate for Payer: Adventist Health Medi-Cal |
$11.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$170.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$170.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$236.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$236.61
|
| Rate for Payer: Blue Shield of California Commercial |
$49.14
|
| Rate for Payer: Blue Shield of California Commercial |
$44.10
|
| Rate for Payer: Blue Shield of California EPN |
$30.97
|
| Rate for Payer: Blue Shield of California EPN |
$27.79
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Central Health Plan Commercial |
$56.00
|
| Rate for Payer: Central Health Plan Commercial |
$62.40
|
| Rate for Payer: Cigna of CA HMO |
$49.92
|
| Rate for Payer: Cigna of CA HMO |
$44.80
|
| Rate for Payer: Cigna of CA PPO |
$57.72
|
| Rate for Payer: Cigna of CA PPO |
$51.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$49.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$54.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Senior |
$12.68
|
| Rate for Payer: EPIC Health Plan Senior |
$12.68
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Galaxy Health WC |
$59.50
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Global Benefits Group Commercial |
$42.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$63.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.91
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$44.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$49.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15.45
|
| Rate for Payer: Multiplan Commercial |
$58.50
|
| Rate for Payer: Multiplan Commercial |
$52.50
|
| Rate for Payer: Networks By Design Commercial |
$45.50
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11.53
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11.53
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
| Rate for Payer: Prime Health Services Commercial |
$59.50
|
| Rate for Payer: Prime Health Services Medicare |
$12.22
|
| Rate for Payer: Prime Health Services Medicare |
$12.22
|
| Rate for Payer: Riverside University Health System MISP |
$12.68
|
| Rate for Payer: Riverside University Health System MISP |
$12.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$42.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$42.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
|
|
HC PROTEIN BODY FLUID
|
Facility
|
IP
|
$35.00
|
|
|
Service Code
|
CPT 84157
|
| Hospital Charge Code |
900910248
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.00 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Adventist Health Commercial |
$7.00
|
| Rate for Payer: Cash Price |
$15.75
|
| Rate for Payer: Central Health Plan Commercial |
$28.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$24.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.00
|
| Rate for Payer: EPIC Health Plan Senior |
$14.00
|
| Rate for Payer: Galaxy Health WC |
$29.75
|
| Rate for Payer: Global Benefits Group Commercial |
$21.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$31.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.00
|
| Rate for Payer: Multiplan Commercial |
$26.25
|
| Rate for Payer: Networks By Design Commercial |
$22.75
|
| Rate for Payer: Prime Health Services Commercial |
$29.75
|
|
|
HC PROTEIN BODY FLUID
|
Facility
|
OP
|
$30.00
|
|
|
Service Code
|
CPT 84157
|
| Hospital Charge Code |
900910248
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$37.18 |
| Rate for Payer: Adventist Health Commercial |
$6.00
|
| Rate for Payer: Adventist Health Commercial |
$7.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$26.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$26.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37.18
|
| Rate for Payer: Blue Shield of California Commercial |
$22.05
|
| Rate for Payer: Blue Shield of California Commercial |
$18.90
|
| Rate for Payer: Blue Shield of California EPN |
$13.89
|
| Rate for Payer: Blue Shield of California EPN |
$11.91
|
| Rate for Payer: Cash Price |
$15.75
|
| Rate for Payer: Cash Price |
$15.75
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Central Health Plan Commercial |
$24.00
|
| Rate for Payer: Central Health Plan Commercial |
$28.00
|
| Rate for Payer: Cigna of CA HMO |
$22.40
|
| Rate for Payer: Cigna of CA HMO |
$19.20
|
| Rate for Payer: Cigna of CA PPO |
$25.90
|
| Rate for Payer: Cigna of CA PPO |
$22.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$24.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4.40
|
| Rate for Payer: Galaxy Health WC |
$29.75
|
| Rate for Payer: Galaxy Health WC |
$25.50
|
| Rate for Payer: Global Benefits Group Commercial |
$21.00
|
| Rate for Payer: Global Benefits Group Commercial |
$18.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$31.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6.56
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5.36
|
| Rate for Payer: Multiplan Commercial |
$26.25
|
| Rate for Payer: Multiplan Commercial |
$22.50
|
| Rate for Payer: Networks By Design Commercial |
$19.50
|
| Rate for Payer: Networks By Design Commercial |
$22.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4.00
|
| Rate for Payer: Prime Health Services Commercial |
$29.75
|
| Rate for Payer: Prime Health Services Commercial |
$25.50
|
| Rate for Payer: Prime Health Services Medicare |
$4.24
|
| Rate for Payer: Prime Health Services Medicare |
$4.24
|
| Rate for Payer: Riverside University Health System MISP |
$4.40
|
| Rate for Payer: Riverside University Health System MISP |
$4.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.24
|
| Rate for Payer: United Healthcare All Other HMO |
$3.24
|
| Rate for Payer: United Healthcare All Other HMO |
$3.24
|
| Rate for Payer: United Healthcare HMO Rider |
$3.24
|
| Rate for Payer: United Healthcare HMO Rider |
$3.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.24
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.40
|
| Rate for Payer: Vantage Medical Group Senior |
$4.00
|
| Rate for Payer: Vantage Medical Group Senior |
$4.00
|
|
|
HC PROTEIN C ACTIVITY
|
Facility
|
IP
|
$308.00
|
|
|
Service Code
|
CPT 85303
|
| Hospital Charge Code |
900912012
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$61.60 |
| Max. Negotiated Rate |
$277.20 |
| Rate for Payer: Adventist Health Commercial |
$61.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Central Health Plan Commercial |
$246.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$215.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.20
|
| Rate for Payer: EPIC Health Plan Senior |
$123.20
|
| Rate for Payer: Galaxy Health WC |
$261.80
|
| Rate for Payer: Global Benefits Group Commercial |
$184.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$277.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$195.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$181.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.60
|
| Rate for Payer: Multiplan Commercial |
$231.00
|
| Rate for Payer: Networks By Design Commercial |
$200.20
|
| Rate for Payer: Prime Health Services Commercial |
$261.80
|
|
|
HC PROTEIN C ACTIVITY
|
Facility
|
OP
|
$126.00
|
|
|
Service Code
|
CPT 85303
|
| Hospital Charge Code |
900912012
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.21 |
| Max. Negotiated Rate |
$139.99 |
| Rate for Payer: Adventist Health Commercial |
$25.20
|
| Rate for Payer: Adventist Health Commercial |
$61.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$13.84
|
| Rate for Payer: Adventist Health Medi-Cal |
$13.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$101.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$101.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$100.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$100.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$139.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$139.99
|
| Rate for Payer: Blue Shield of California Commercial |
$194.04
|
| Rate for Payer: Blue Shield of California Commercial |
$79.38
|
| Rate for Payer: Blue Shield of California EPN |
$122.28
|
| Rate for Payer: Blue Shield of California EPN |
$50.02
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$56.70
|
| Rate for Payer: Cash Price |
$56.70
|
| Rate for Payer: Central Health Plan Commercial |
$100.80
|
| Rate for Payer: Central Health Plan Commercial |
$246.40
|
| Rate for Payer: Cigna of CA HMO |
$197.12
|
| Rate for Payer: Cigna of CA HMO |
$80.64
|
| Rate for Payer: Cigna of CA PPO |
$227.92
|
| Rate for Payer: Cigna of CA PPO |
$93.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$88.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$215.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.84
|
| Rate for Payer: EPIC Health Plan Senior |
$15.22
|
| Rate for Payer: EPIC Health Plan Senior |
$15.22
|
| Rate for Payer: Galaxy Health WC |
$261.80
|
| Rate for Payer: Galaxy Health WC |
$107.10
|
| Rate for Payer: Global Benefits Group Commercial |
$184.80
|
| Rate for Payer: Global Benefits Group Commercial |
$75.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$277.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$113.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$21.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$21.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$80.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$195.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18.55
|
| Rate for Payer: Multiplan Commercial |
$231.00
|
| Rate for Payer: Multiplan Commercial |
$94.50
|
| Rate for Payer: Networks By Design Commercial |
$81.90
|
| Rate for Payer: Networks By Design Commercial |
$200.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13.84
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13.84
|
| Rate for Payer: Prime Health Services Commercial |
$261.80
|
| Rate for Payer: Prime Health Services Commercial |
$107.10
|
| Rate for Payer: Prime Health Services Medicare |
$14.67
|
| Rate for Payer: Prime Health Services Medicare |
$14.67
|
| Rate for Payer: Riverside University Health System MISP |
$15.22
|
| Rate for Payer: Riverside University Health System MISP |
$15.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$75.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$184.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$184.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$75.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.21
|
| Rate for Payer: United Healthcare All Other HMO |
$11.21
|
| Rate for Payer: United Healthcare All Other HMO |
$11.21
|
| Rate for Payer: United Healthcare HMO Rider |
$11.21
|
| Rate for Payer: United Healthcare HMO Rider |
$11.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.21
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.84
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.22
|
| Rate for Payer: Vantage Medical Group Senior |
$13.84
|
| Rate for Payer: Vantage Medical Group Senior |
$13.84
|
|
|
HC PROTEIN CSF
|
Facility
|
IP
|
$39.00
|
|
|
Service Code
|
CPT 84157
|
| Hospital Charge Code |
900912250
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$35.10 |
| Rate for Payer: Adventist Health Commercial |
$7.80
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Central Health Plan Commercial |
$31.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.60
|
| Rate for Payer: EPIC Health Plan Senior |
$15.60
|
| Rate for Payer: Galaxy Health WC |
$33.15
|
| Rate for Payer: Global Benefits Group Commercial |
$23.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.80
|
| Rate for Payer: Multiplan Commercial |
$29.25
|
| Rate for Payer: Networks By Design Commercial |
$25.35
|
| Rate for Payer: Prime Health Services Commercial |
$33.15
|
|
