|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
|
OP
|
$1,447.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$228.21 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$593.27
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$531.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$808.84
|
| Rate for Payer: Cash Price |
$651.15
|
| Rate for Payer: Cash Price |
$651.15
|
| Rate for Payer: Cash Price |
$651.15
|
| Rate for Payer: Cash Price |
$651.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,157.60
|
| Rate for Payer: Cigna of CA HMO |
$926.08
|
| Rate for Payer: Cigna of CA PPO |
$1,070.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,012.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Galaxy Health WC |
$1,229.95
|
| Rate for Payer: Global Benefits Group Commercial |
$868.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,302.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$918.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$228.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$562.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$1,085.25
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$940.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$522.85
|
| Rate for Payer: Preferred Health Network WC |
$825.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,229.95
|
| Rate for Payer: Prime Health Services Medicare |
$554.22
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Riverside University Health System MISP |
$575.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$868.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$868.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$522.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
|
IP
|
$1,447.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$289.40 |
| Max. Negotiated Rate |
$1,302.30 |
| Rate for Payer: Adventist Health Commercial |
$289.40
|
| Rate for Payer: Cash Price |
$651.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,157.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,012.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$578.80
|
| Rate for Payer: EPIC Health Plan Senior |
$578.80
|
| Rate for Payer: Galaxy Health WC |
$1,229.95
|
| Rate for Payer: Global Benefits Group Commercial |
$868.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,302.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$918.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$853.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.40
|
| Rate for Payer: Multiplan Commercial |
$1,085.25
|
| Rate for Payer: Networks By Design Commercial |
$940.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,229.95
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
|
OP
|
$1,447.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$206.59 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$289.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$522.85
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$808.84
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$651.15
|
| Rate for Payer: Cash Price |
$651.15
|
| Rate for Payer: Cash Price |
$651.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,157.60
|
| Rate for Payer: Cigna of CA HMO |
$926.08
|
| Rate for Payer: Cigna of CA PPO |
$1,070.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,012.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Galaxy Health WC |
$1,229.95
|
| Rate for Payer: Global Benefits Group Commercial |
$868.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,302.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$206.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$918.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$228.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$731.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$1,085.25
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$940.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$522.85
|
| Rate for Payer: Preferred Health Network WC |
$825.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,229.95
|
| Rate for Payer: Prime Health Services Medicare |
$554.22
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Riverside University Health System MISP |
$575.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$868.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$723.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$522.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
|
IP
|
$1,447.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$289.40 |
| Max. Negotiated Rate |
$1,302.30 |
| Rate for Payer: Adventist Health Commercial |
$289.40
|
| Rate for Payer: Cash Price |
$651.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,157.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,012.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$578.80
|
| Rate for Payer: EPIC Health Plan Senior |
$578.80
|
| Rate for Payer: Galaxy Health WC |
$1,229.95
|
| Rate for Payer: Global Benefits Group Commercial |
$868.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,302.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$918.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$853.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.40
|
| Rate for Payer: Multiplan Commercial |
$1,085.25
|
| Rate for Payer: Networks By Design Commercial |
$940.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,229.95
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
|
IP
|
$1,447.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$289.40 |
| Max. Negotiated Rate |
$1,302.30 |
| Rate for Payer: Adventist Health Commercial |
$289.40
|
| Rate for Payer: Cash Price |
$651.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,157.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,012.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$578.80
|
| Rate for Payer: EPIC Health Plan Senior |
$578.80
|
| Rate for Payer: Galaxy Health WC |
$1,229.95
|
| Rate for Payer: Global Benefits Group Commercial |
$868.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,302.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$918.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$853.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.40
|
| Rate for Payer: Multiplan Commercial |
$1,085.25
|
| Rate for Payer: Networks By Design Commercial |
$940.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,229.95
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
|
IP
|
$1,447.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$289.40 |
| Max. Negotiated Rate |
$1,302.30 |
| Rate for Payer: Adventist Health Commercial |
$289.40
|
| Rate for Payer: Cash Price |
$651.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,157.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,012.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$578.80
|
| Rate for Payer: EPIC Health Plan Senior |
$578.80
|
| Rate for Payer: Galaxy Health WC |
$1,229.95
|
| Rate for Payer: Global Benefits Group Commercial |
$868.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,302.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$918.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$853.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.40
|
| Rate for Payer: Multiplan Commercial |
$1,085.25
|
| Rate for Payer: Networks By Design Commercial |
$940.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,229.95
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
|
OP
|
$1,447.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$206.59 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$289.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$522.85
|
| Rate for Payer: Aetna of CA HMO/PPO |
$531.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$917.40
|
| Rate for Payer: Blue Shield of California EPN |
$577.35
|
| Rate for Payer: Cash Price |
$651.15
|
| Rate for Payer: Cash Price |
$651.15
|
| Rate for Payer: Cash Price |
$651.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,157.60
|
| Rate for Payer: Cigna of CA HMO |
$926.08
|
| Rate for Payer: Cigna of CA PPO |
$1,070.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,012.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Galaxy Health WC |
$1,229.95
|
| Rate for Payer: Global Benefits Group Commercial |
$868.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,302.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$206.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$918.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$228.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$731.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$1,085.25
|
| Rate for Payer: Networks By Design Commercial |
$940.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$522.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,229.95
|
| Rate for Payer: Prime Health Services Medicare |
$554.22
|
| Rate for Payer: Riverside University Health System MISP |
$575.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$868.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$868.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$723.50
|
| Rate for Payer: United Healthcare All Other HMO |
$723.50
|
| Rate for Payer: United Healthcare HMO Rider |
$723.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$723.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$522.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
|
OP
|
$1,447.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$206.59 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$289.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$522.85
|
| Rate for Payer: Aetna of CA HMO/PPO |
$531.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$917.40
|
| Rate for Payer: Blue Shield of California EPN |
$577.35
|
| Rate for Payer: Cash Price |
$651.15
|
| Rate for Payer: Cash Price |
$651.15
|
| Rate for Payer: Cash Price |
$651.15
|
| Rate for Payer: Cash Price |
$651.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,157.60
|
| Rate for Payer: Cigna of CA HMO |
$926.08
|
| Rate for Payer: Cigna of CA PPO |
$1,070.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,012.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Galaxy Health WC |
$1,229.95
|
| Rate for Payer: Global Benefits Group Commercial |
$868.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,302.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$206.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$918.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$228.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$731.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$1,085.25
|
| Rate for Payer: Networks By Design Commercial |
$940.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$522.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,229.95
|
| Rate for Payer: Prime Health Services Medicare |
$554.22
|
| Rate for Payer: Riverside University Health System MISP |
$575.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$868.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$868.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,091.00
|
| Rate for Payer: United Healthcare All Other HMO |
$839.00
|
| Rate for Payer: United Healthcare HMO Rider |
$635.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$581.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$522.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
|
OP
|
$1,447.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$228.21 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$289.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$808.84
|
| Rate for Payer: Cash Price |
$651.15
|
| Rate for Payer: Cash Price |
$651.15
|
| Rate for Payer: Cash Price |
$651.15
|
| Rate for Payer: Cash Price |
$651.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,157.60
|
| Rate for Payer: Cigna of CA HMO |
$926.08
|
| Rate for Payer: Cigna of CA PPO |
$1,070.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,012.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Galaxy Health WC |
$1,229.95
|
| Rate for Payer: Global Benefits Group Commercial |
$868.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,302.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$918.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$228.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$562.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$1,085.25
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$940.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$522.85
|
| Rate for Payer: Preferred Health Network WC |
$825.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,229.95
|
| Rate for Payer: Prime Health Services Medicare |
$554.22
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Riverside University Health System MISP |
$575.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$868.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$723.50
|
| Rate for Payer: United Healthcare All Other HMO |
$723.50
|
| Rate for Payer: United Healthcare HMO Rider |
$723.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$723.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$522.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
|
IP
|
$1,447.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$289.40 |
| Max. Negotiated Rate |
$1,302.30 |
| Rate for Payer: Adventist Health Commercial |
$289.40
|
| Rate for Payer: Cash Price |
$651.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,157.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,012.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$578.80
|
| Rate for Payer: EPIC Health Plan Senior |
$578.80
|
| Rate for Payer: Galaxy Health WC |
$1,229.95
|
| Rate for Payer: Global Benefits Group Commercial |
$868.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,302.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$918.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$853.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.40
|
| Rate for Payer: Multiplan Commercial |
$1,085.25
|
| Rate for Payer: Networks By Design Commercial |
$940.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,229.95
|
|
|
HC PUNCTURE PERITONEAL CAVITY W IMAGING GUIDANCE
|
Facility
|
OP
|
$2,790.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
904000016
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$476.25 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$558.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,166.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,898.06
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,232.00
|
| Rate for Payer: Cigna of CA HMO |
$1,785.60
|
| Rate for Payer: Cigna of CA PPO |
$2,064.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,953.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.77
|
| Rate for Payer: EPIC Health Plan Senior |
$1,283.18
|
| Rate for Payer: Galaxy Health WC |
$2,371.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,674.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,511.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,913.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$476.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,771.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$526.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,633.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$558.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,563.15
|
| Rate for Payer: Multiplan Commercial |
$2,092.50
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: Networks By Design Commercial |
$1,813.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Preferred Health Network WC |
$1,936.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,371.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,236.52
|
| Rate for Payer: Prime Health Services WC |
$1,878.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,283.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,674.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,395.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
|
|
HC PUNCTURE PERITONEAL CAVITY W IMAGING GUIDANCE
|
Facility
|
IP
|
$2,790.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
904000016
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$558.00 |
| Max. Negotiated Rate |
$2,511.00 |
| Rate for Payer: Adventist Health Commercial |
$558.00
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,232.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,953.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,116.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,116.00
|
| Rate for Payer: Galaxy Health WC |
$2,371.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,674.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,511.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,771.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,646.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$558.00
|
| Rate for Payer: Multiplan Commercial |
$2,092.50
|
| Rate for Payer: Networks By Design Commercial |
$1,813.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,371.50
|
|
|
HC PUNCTURE SHUNT TUBE
|
Facility
|
OP
|
$1,965.00
|
|
|
Service Code
|
CPT 61070
|
| Hospital Charge Code |
909000198
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$224.77 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$393.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$907.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$998.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$907.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,402.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$884.25
|
| Rate for Payer: Cash Price |
$884.25
|
| Rate for Payer: Cash Price |
$884.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,572.00
|
| Rate for Payer: Cigna of CA HMO |
$1,257.60
|
| Rate for Payer: Cigna of CA PPO |
$1,454.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$998.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$907.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,375.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,498.00
|
| Rate for Payer: EPIC Health Plan Senior |
$998.67
|
| Rate for Payer: Galaxy Health WC |
$1,670.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,179.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,768.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,488.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$224.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$907.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,247.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$248.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,271.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$393.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,216.56
|
| Rate for Payer: Multiplan Commercial |
$1,473.75
|
| Rate for Payer: Multiplan WC |
$1,402.00
|
| Rate for Payer: Networks By Design Commercial |
$1,277.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$907.88
|
| Rate for Payer: Preferred Health Network WC |
$1,430.61
|
| Rate for Payer: Prime Health Services Commercial |
$1,670.25
|
| Rate for Payer: Prime Health Services Medicare |
$962.35
|
| Rate for Payer: Prime Health Services WC |
$1,387.69
|
| Rate for Payer: Riverside University Health System MISP |
$998.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,179.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$982.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$907.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$998.67
|
| Rate for Payer: Vantage Medical Group Senior |
$907.88
|
|
|
HC PUNCTURE SHUNT TUBE
|
Facility
|
OP
|
$1,965.00
|
|
|
Service Code
|
CPT 61070
|
| Hospital Charge Code |
909000198
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$248.29 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$393.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$998.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$907.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,402.00
|
| Rate for Payer: Cash Price |
$884.25
|
| Rate for Payer: Cash Price |
$884.25
|
| Rate for Payer: Cash Price |
$884.25
|
| Rate for Payer: Cash Price |
$884.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,572.00
|
| Rate for Payer: Cigna of CA HMO |
$1,257.60
|
| Rate for Payer: Cigna of CA PPO |
$1,454.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$998.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$907.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,375.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,498.00
|
| Rate for Payer: EPIC Health Plan Senior |
$998.67
|
| Rate for Payer: Galaxy Health WC |
$1,670.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,179.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,768.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,488.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$907.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,247.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$248.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$975.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$393.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,216.56
|
| Rate for Payer: Multiplan Commercial |
$1,473.75
|
| Rate for Payer: Multiplan WC |
$1,402.00
|
| Rate for Payer: Networks By Design Commercial |
$1,277.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$907.88
|
| Rate for Payer: Preferred Health Network WC |
$1,430.61
|
| Rate for Payer: Prime Health Services Commercial |
$1,670.25
|
| Rate for Payer: Prime Health Services Medicare |
$962.35
|
| Rate for Payer: Prime Health Services WC |
$1,387.69
|
| Rate for Payer: Riverside University Health System MISP |
$998.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,179.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$982.50
|
| Rate for Payer: United Healthcare All Other HMO |
$982.50
|
| Rate for Payer: United Healthcare HMO Rider |
$982.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$982.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$907.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$998.67
|
| Rate for Payer: Vantage Medical Group Senior |
$907.88
|
|
|
HC PUNCTURE SHUNT TUBE
|
Facility
|
IP
|
$1,965.00
|
|
|
Service Code
|
CPT 61070
|
| Hospital Charge Code |
909000198
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$393.00 |
| Max. Negotiated Rate |
$1,768.50 |
| Rate for Payer: Adventist Health Commercial |
$393.00
|
| Rate for Payer: Cash Price |
$884.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,572.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,375.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$786.00
|
| Rate for Payer: EPIC Health Plan Senior |
$786.00
|
| Rate for Payer: Galaxy Health WC |
$1,670.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,179.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,768.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,247.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,159.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$393.00
|
| Rate for Payer: Multiplan Commercial |
$1,473.75
|
| Rate for Payer: Networks By Design Commercial |
$1,277.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,670.25
|
|
|
HC PUNCTURE SHUNT TUBE
|
Facility
|
IP
|
$1,965.00
|
|
|
Service Code
|
CPT 61070
|
| Hospital Charge Code |
909000198
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$393.00 |
| Max. Negotiated Rate |
$1,768.50 |
| Rate for Payer: Adventist Health Commercial |
$393.00
|
| Rate for Payer: Cash Price |
$884.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,572.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,375.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$786.00
|
| Rate for Payer: EPIC Health Plan Senior |
$786.00
|
| Rate for Payer: Galaxy Health WC |
$1,670.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,179.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,768.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,247.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,159.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$393.00
|
| Rate for Payer: Multiplan Commercial |
$1,473.75
|
| Rate for Payer: Networks By Design Commercial |
$1,277.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,670.25
|
|
|
HC PVA PARTICLES
|
Facility
|
OP
|
$1,127.00
|
|
| Hospital Charge Code |
909081806
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.40 |
| Max. Negotiated Rate |
$1,014.30 |
| Rate for Payer: Adventist Health Commercial |
$225.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$957.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$619.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$845.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$514.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$618.05
|
| Rate for Payer: Blue Shield of California Commercial |
$903.85
|
| Rate for Payer: Blue Shield of California EPN |
$568.01
|
| Rate for Payer: Cash Price |
$507.15
|
| Rate for Payer: Central Health Plan Commercial |
$901.60
|
| Rate for Payer: Cigna of CA HMO |
$788.90
|
| Rate for Payer: Cigna of CA PPO |
$788.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$957.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$957.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$957.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$788.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$450.80
|
| Rate for Payer: EPIC Health Plan Senior |
$450.80
|
| Rate for Payer: Galaxy Health WC |
$957.95
|
| Rate for Payer: Global Benefits Group Commercial |
$676.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,014.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$715.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$409.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$664.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$788.90
|
| Rate for Payer: Multiplan Commercial |
$845.25
|
| Rate for Payer: Networks By Design Commercial |
$563.50
|
| Rate for Payer: Prime Health Services Commercial |
$957.95
|
| Rate for Payer: Riverside University Health System MISP |
$450.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$676.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$676.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$422.96
|
| Rate for Payer: United Healthcare All Other HMO |
$411.69
|
| Rate for Payer: United Healthcare HMO Rider |
$402.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$369.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$957.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$957.95
|
| Rate for Payer: Vantage Medical Group Senior |
$957.95
|
|
|
HC PVA PARTICLES
|
Facility
|
IP
|
$1,127.00
|
|
| Hospital Charge Code |
909081806
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.40 |
| Max. Negotiated Rate |
$1,014.30 |
| Rate for Payer: Adventist Health Commercial |
$225.40
|
| Rate for Payer: Blue Shield of California Commercial |
$903.85
|
| Rate for Payer: Blue Shield of California EPN |
$568.01
|
| Rate for Payer: Cash Price |
$507.15
|
| Rate for Payer: Central Health Plan Commercial |
$901.60
|
| Rate for Payer: Cigna of CA HMO |
$788.90
|
| Rate for Payer: Cigna of CA PPO |
$788.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$788.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$450.80
|
| Rate for Payer: EPIC Health Plan Senior |
$450.80
|
| Rate for Payer: Galaxy Health WC |
$957.95
|
| Rate for Payer: Global Benefits Group Commercial |
$676.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,014.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$715.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$664.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.40
|
| Rate for Payer: Multiplan Commercial |
$845.25
|
| Rate for Payer: Networks By Design Commercial |
$563.50
|
| Rate for Payer: Prime Health Services Commercial |
$957.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$422.96
|
| Rate for Payer: United Healthcare All Other HMO |
$411.69
|
| Rate for Payer: United Healthcare HMO Rider |
$402.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$369.09
|
|
|
HC PWRWAND CATH ED STERILE 3FR
|
Facility
|
OP
|
$440.97
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698405
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$88.19 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Adventist Health Commercial |
$88.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$374.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$242.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$330.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$213.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$256.51
|
| Rate for Payer: Blue Shield of California Commercial |
$279.57
|
| Rate for Payer: Blue Shield of California EPN |
$175.95
|
| Rate for Payer: Cash Price |
$198.44
|
| Rate for Payer: Cash Price |
$198.44
|
| Rate for Payer: Central Health Plan Commercial |
$352.78
|
| Rate for Payer: Cigna of CA HMO |
$282.22
|
| Rate for Payer: Cigna of CA PPO |
$326.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$374.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$374.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$374.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$308.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$176.39
|
| Rate for Payer: EPIC Health Plan Senior |
$176.39
|
| Rate for Payer: Galaxy Health WC |
$374.82
|
| Rate for Payer: Global Benefits Group Commercial |
$264.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$396.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$280.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$160.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$260.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$308.68
|
| Rate for Payer: Multiplan Commercial |
$330.73
|
| Rate for Payer: Networks By Design Commercial |
$286.63
|
| Rate for Payer: Prime Health Services Commercial |
$374.82
|
| Rate for Payer: Riverside University Health System MISP |
$176.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$264.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$264.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$220.49
|
| Rate for Payer: United Healthcare All Other HMO |
$220.49
|
| Rate for Payer: United Healthcare HMO Rider |
$220.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$220.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$374.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$374.82
|
| Rate for Payer: Vantage Medical Group Senior |
$374.82
|
|
|
HC PWRWAND CATH ED STERILE 3FR
|
Facility
|
IP
|
$440.97
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698405
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$88.19 |
| Max. Negotiated Rate |
$396.87 |
| Rate for Payer: Adventist Health Commercial |
$88.19
|
| Rate for Payer: Cash Price |
$198.44
|
| Rate for Payer: Central Health Plan Commercial |
$352.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$308.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$176.39
|
| Rate for Payer: EPIC Health Plan Senior |
$176.39
|
| Rate for Payer: Galaxy Health WC |
$374.82
|
| Rate for Payer: Global Benefits Group Commercial |
$264.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$396.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$280.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$260.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.19
|
| Rate for Payer: Multiplan Commercial |
$330.73
|
| Rate for Payer: Networks By Design Commercial |
$286.63
|
| Rate for Payer: Prime Health Services Commercial |
$374.82
|
|
|
HC PWRWAND XL 3FR 6CM QUICK KIT
|
Facility
|
OP
|
$123.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698224
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.60 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Adventist Health Commercial |
$24.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$104.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$67.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$92.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$59.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.55
|
| Rate for Payer: Blue Shield of California Commercial |
$77.98
|
| Rate for Payer: Blue Shield of California EPN |
$49.08
|
| Rate for Payer: Cash Price |
$55.35
|
| Rate for Payer: Cash Price |
$55.35
|
| Rate for Payer: Central Health Plan Commercial |
$98.40
|
| Rate for Payer: Cigna of CA HMO |
$78.72
|
| Rate for Payer: Cigna of CA PPO |
$91.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$104.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$104.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$104.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$86.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.20
|
| Rate for Payer: EPIC Health Plan Senior |
$49.20
|
| Rate for Payer: Galaxy Health WC |
$104.55
|
| Rate for Payer: Global Benefits Group Commercial |
$73.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$110.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$78.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$44.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$72.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$86.10
|
| Rate for Payer: Multiplan Commercial |
$92.25
|
| Rate for Payer: Networks By Design Commercial |
$79.95
|
| Rate for Payer: Prime Health Services Commercial |
$104.55
|
| Rate for Payer: Riverside University Health System MISP |
$49.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$73.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$73.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$61.50
|
| Rate for Payer: United Healthcare All Other HMO |
$61.50
|
| Rate for Payer: United Healthcare HMO Rider |
$61.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$61.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$104.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$104.55
|
| Rate for Payer: Vantage Medical Group Senior |
$104.55
|
|
|
HC PWRWAND XL 3FR 6CM QUICK KIT
|
Facility
|
IP
|
$123.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698224
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.60 |
| Max. Negotiated Rate |
$110.70 |
| Rate for Payer: Adventist Health Commercial |
$24.60
|
| Rate for Payer: Cash Price |
$55.35
|
| Rate for Payer: Central Health Plan Commercial |
$98.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$86.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.20
|
| Rate for Payer: EPIC Health Plan Senior |
$49.20
|
| Rate for Payer: Galaxy Health WC |
$104.55
|
| Rate for Payer: Global Benefits Group Commercial |
$73.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$110.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$78.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$72.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.60
|
| Rate for Payer: Multiplan Commercial |
$92.25
|
| Rate for Payer: Networks By Design Commercial |
$79.95
|
| Rate for Payer: Prime Health Services Commercial |
$104.55
|
|
|
HC PWRWAND XL 4FR 8CM QUICK KIT
|
Facility
|
OP
|
$123.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698225
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.60 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Adventist Health Commercial |
$24.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$104.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$67.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$92.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$59.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.55
|
| Rate for Payer: Blue Shield of California Commercial |
$77.98
|
| Rate for Payer: Blue Shield of California EPN |
$49.08
|
| Rate for Payer: Cash Price |
$55.35
|
| Rate for Payer: Cash Price |
$55.35
|
| Rate for Payer: Central Health Plan Commercial |
$98.40
|
| Rate for Payer: Cigna of CA HMO |
$78.72
|
| Rate for Payer: Cigna of CA PPO |
$91.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$104.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$104.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$104.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$86.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.20
|
| Rate for Payer: EPIC Health Plan Senior |
$49.20
|
| Rate for Payer: Galaxy Health WC |
$104.55
|
| Rate for Payer: Global Benefits Group Commercial |
$73.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$110.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$78.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$44.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$72.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$86.10
|
| Rate for Payer: Multiplan Commercial |
$92.25
|
| Rate for Payer: Networks By Design Commercial |
$79.95
|
| Rate for Payer: Prime Health Services Commercial |
$104.55
|
| Rate for Payer: Riverside University Health System MISP |
$49.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$73.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$73.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$61.50
|
| Rate for Payer: United Healthcare All Other HMO |
$61.50
|
| Rate for Payer: United Healthcare HMO Rider |
$61.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$61.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$104.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$104.55
|
| Rate for Payer: Vantage Medical Group Senior |
$104.55
|
|
|
HC PWRWAND XL 4FR 8CM QUICK KIT
|
Facility
|
IP
|
$123.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698225
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.60 |
| Max. Negotiated Rate |
$110.70 |
| Rate for Payer: Adventist Health Commercial |
$24.60
|
| Rate for Payer: Cash Price |
$55.35
|
| Rate for Payer: Central Health Plan Commercial |
$98.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$86.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.20
|
| Rate for Payer: EPIC Health Plan Senior |
$49.20
|
| Rate for Payer: Galaxy Health WC |
$104.55
|
| Rate for Payer: Global Benefits Group Commercial |
$73.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$110.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$78.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$72.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.60
|
| Rate for Payer: Multiplan Commercial |
$92.25
|
| Rate for Payer: Networks By Design Commercial |
$79.95
|
| Rate for Payer: Prime Health Services Commercial |
$104.55
|
|
|
HC PWRWAND XL SINGLE 3FR, 6CM
|
Facility
|
OP
|
$417.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698242
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$83.52 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Adventist Health Commercial |
$83.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$354.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$229.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$313.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$202.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$242.92
|
| Rate for Payer: Blue Shield of California Commercial |
$264.76
|
| Rate for Payer: Blue Shield of California EPN |
$166.62
|
| Rate for Payer: Cash Price |
$187.92
|
| Rate for Payer: Cash Price |
$187.92
|
| Rate for Payer: Central Health Plan Commercial |
$334.08
|
| Rate for Payer: Cigna of CA HMO |
$267.26
|
| Rate for Payer: Cigna of CA PPO |
$309.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$354.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$354.96
|
| Rate for Payer: Dignity Health Medicare Advantage |
$354.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$292.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$167.04
|
| Rate for Payer: EPIC Health Plan Senior |
$167.04
|
| Rate for Payer: Galaxy Health WC |
$354.96
|
| Rate for Payer: Global Benefits Group Commercial |
$250.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$375.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$265.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$151.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$246.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$83.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$292.32
|
| Rate for Payer: Multiplan Commercial |
$313.20
|
| Rate for Payer: Networks By Design Commercial |
$271.44
|
| Rate for Payer: Prime Health Services Commercial |
$354.96
|
| Rate for Payer: Riverside University Health System MISP |
$167.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$250.56
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$250.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$208.80
|
| Rate for Payer: United Healthcare All Other HMO |
$208.80
|
| Rate for Payer: United Healthcare HMO Rider |
$208.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$208.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$354.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$354.96
|
| Rate for Payer: Vantage Medical Group Senior |
$354.96
|
|
