|
HC PACKING WEIMERT EPISTAXIS
|
Facility
|
OP
|
$171.50
|
|
| Hospital Charge Code |
901603221
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.30 |
| Max. Negotiated Rate |
$154.35 |
| Rate for Payer: Adventist Health Commercial |
$34.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$104.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$145.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$94.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$128.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$83.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$100.72
|
| Rate for Payer: Blue Shield of California Commercial |
$104.79
|
| Rate for Payer: Blue Shield of California EPN |
$68.43
|
| Rate for Payer: Cash Price |
$77.17
|
| Rate for Payer: Central Health Plan Commercial |
$137.20
|
| Rate for Payer: Cigna of CA HMO |
$109.76
|
| Rate for Payer: Cigna of CA PPO |
$126.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$145.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$145.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$145.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.60
|
| Rate for Payer: EPIC Health Plan Senior |
$68.60
|
| Rate for Payer: Galaxy Health WC |
$145.78
|
| Rate for Payer: Global Benefits Group Commercial |
$102.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$154.35
|
| Rate for Payer: InnovAge PACE Commercial |
$85.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$114.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$106.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$120.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$120.05
|
| Rate for Payer: Multiplan Commercial |
$128.62
|
| Rate for Payer: Networks By Design Commercial |
$111.47
|
| Rate for Payer: Prime Health Services Commercial |
$145.78
|
| Rate for Payer: Riverside University Health System MISP |
$68.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$102.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$102.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$85.75
|
| Rate for Payer: United Healthcare All Other HMO |
$85.75
|
| Rate for Payer: United Healthcare HMO Rider |
$85.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$85.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$145.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$145.78
|
| Rate for Payer: Vantage Medical Group Senior |
$145.78
|
|
|
HC PACKING WOUND STRIP 1/4" PLAIN
|
Facility
|
IP
|
$18.20
|
|
| Hospital Charge Code |
901600270
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.64 |
| Max. Negotiated Rate |
$16.38 |
| Rate for Payer: Adventist Health Commercial |
$3.64
|
| Rate for Payer: Cash Price |
$8.19
|
| Rate for Payer: Central Health Plan Commercial |
$14.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.28
|
| Rate for Payer: EPIC Health Plan Senior |
$7.28
|
| Rate for Payer: Galaxy Health WC |
$15.47
|
| Rate for Payer: Global Benefits Group Commercial |
$10.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.64
|
| Rate for Payer: Multiplan Commercial |
$13.65
|
| Rate for Payer: Networks By Design Commercial |
$11.83
|
| Rate for Payer: Prime Health Services Commercial |
$15.47
|
|
|
HC PACKING WOUND STRIP 1/4" PLAIN
|
Facility
|
OP
|
$18.20
|
|
| Hospital Charge Code |
901600270
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.64 |
| Max. Negotiated Rate |
$16.38 |
| Rate for Payer: Adventist Health Commercial |
$3.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.69
|
| Rate for Payer: Blue Shield of California Commercial |
$11.12
|
| Rate for Payer: Blue Shield of California EPN |
$7.26
|
| Rate for Payer: Cash Price |
$8.19
|
| Rate for Payer: Central Health Plan Commercial |
$14.56
|
| Rate for Payer: Cigna of CA HMO |
$11.65
|
| Rate for Payer: Cigna of CA PPO |
$13.47
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.28
|
| Rate for Payer: EPIC Health Plan Senior |
$7.28
|
| Rate for Payer: Galaxy Health WC |
$15.47
|
| Rate for Payer: Global Benefits Group Commercial |
$10.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.38
|
| Rate for Payer: InnovAge PACE Commercial |
$9.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.74
|
| Rate for Payer: Multiplan Commercial |
$13.65
|
| Rate for Payer: Networks By Design Commercial |
$11.83
|
| Rate for Payer: Prime Health Services Commercial |
$15.47
|
| Rate for Payer: Riverside University Health System MISP |
$7.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.10
|
| Rate for Payer: United Healthcare All Other HMO |
$9.10
|
| Rate for Payer: United Healthcare HMO Rider |
$9.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.47
|
| Rate for Payer: Vantage Medical Group Senior |
$15.47
|
|
|
HC PACKING WOUND STRIPS 1/2"X 5YD
|
Facility
|
OP
|
$18.12
|
|
| Hospital Charge Code |
901698472
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.62 |
| Max. Negotiated Rate |
$16.31 |
| Rate for Payer: Adventist Health Commercial |
$3.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.64
|
| Rate for Payer: Blue Shield of California Commercial |
$11.07
|
| Rate for Payer: Blue Shield of California EPN |
$7.23
|
| Rate for Payer: Cash Price |
$8.15
|
| Rate for Payer: Central Health Plan Commercial |
$14.50
|
| Rate for Payer: Cigna of CA HMO |
$11.60
|
| Rate for Payer: Cigna of CA PPO |
$13.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.25
|
| Rate for Payer: EPIC Health Plan Senior |
$7.25
|
| Rate for Payer: Galaxy Health WC |
$15.40
|
| Rate for Payer: Global Benefits Group Commercial |
$10.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.31
|
| Rate for Payer: InnovAge PACE Commercial |
$9.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.68
|
| Rate for Payer: Multiplan Commercial |
$13.59
|
| Rate for Payer: Networks By Design Commercial |
$11.78
|
| Rate for Payer: Prime Health Services Commercial |
$15.40
|
| Rate for Payer: Riverside University Health System MISP |
$7.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.06
|
| Rate for Payer: United Healthcare All Other HMO |
$9.06
|
| Rate for Payer: United Healthcare HMO Rider |
$9.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.40
|
| Rate for Payer: Vantage Medical Group Senior |
$15.40
|
|
|
HC PACKING WOUND STRIPS 1/2"X 5YD
|
Facility
|
IP
|
$18.12
|
|
| Hospital Charge Code |
901698472
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.62 |
| Max. Negotiated Rate |
$16.31 |
| Rate for Payer: Adventist Health Commercial |
$3.62
|
| Rate for Payer: Cash Price |
$8.15
|
| Rate for Payer: Central Health Plan Commercial |
$14.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.25
|
| Rate for Payer: EPIC Health Plan Senior |
$7.25
|
| Rate for Payer: Galaxy Health WC |
$15.40
|
| Rate for Payer: Global Benefits Group Commercial |
$10.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.62
|
| Rate for Payer: Multiplan Commercial |
$13.59
|
| Rate for Payer: Networks By Design Commercial |
$11.78
|
| Rate for Payer: Prime Health Services Commercial |
$15.40
|
|
|
HC PACKING WOUND STRIPS 1"X 5YD
|
Facility
|
IP
|
$20.58
|
|
| Hospital Charge Code |
901698473
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.12 |
| Max. Negotiated Rate |
$18.52 |
| Rate for Payer: Adventist Health Commercial |
$4.12
|
| Rate for Payer: Cash Price |
$9.26
|
| Rate for Payer: Central Health Plan Commercial |
$16.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.23
|
| Rate for Payer: EPIC Health Plan Senior |
$8.23
|
| Rate for Payer: Galaxy Health WC |
$17.49
|
| Rate for Payer: Global Benefits Group Commercial |
$12.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.12
|
| Rate for Payer: Multiplan Commercial |
$15.44
|
| Rate for Payer: Networks By Design Commercial |
$13.38
|
| Rate for Payer: Prime Health Services Commercial |
$17.49
|
|
|
HC PACKING WOUND STRIPS 1"X 5YD
|
Facility
|
OP
|
$20.58
|
|
| Hospital Charge Code |
901698473
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.12 |
| Max. Negotiated Rate |
$18.52 |
| Rate for Payer: Adventist Health Commercial |
$4.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.09
|
| Rate for Payer: Blue Shield of California Commercial |
$12.57
|
| Rate for Payer: Blue Shield of California EPN |
$8.21
|
| Rate for Payer: Cash Price |
$9.26
|
| Rate for Payer: Central Health Plan Commercial |
$16.46
|
| Rate for Payer: Cigna of CA HMO |
$13.17
|
| Rate for Payer: Cigna of CA PPO |
$15.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.23
|
| Rate for Payer: EPIC Health Plan Senior |
$8.23
|
| Rate for Payer: Galaxy Health WC |
$17.49
|
| Rate for Payer: Global Benefits Group Commercial |
$12.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.52
|
| Rate for Payer: InnovAge PACE Commercial |
$10.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.41
|
| Rate for Payer: Multiplan Commercial |
$15.44
|
| Rate for Payer: Networks By Design Commercial |
$13.38
|
| Rate for Payer: Prime Health Services Commercial |
$17.49
|
| Rate for Payer: Riverside University Health System MISP |
$8.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.29
|
| Rate for Payer: United Healthcare All Other HMO |
$10.29
|
| Rate for Payer: United Healthcare HMO Rider |
$10.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.49
|
| Rate for Payer: Vantage Medical Group Senior |
$17.49
|
|
|
HC PAD REHAB PER SESSION
|
Facility
|
OP
|
$209.00
|
|
|
Service Code
|
CPT 93668
|
| Hospital Charge Code |
900203668
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$41.80 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$41.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$75.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$126.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$101.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$122.75
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$94.05
|
| Rate for Payer: Cash Price |
$94.05
|
| Rate for Payer: Cash Price |
$94.05
|
| Rate for Payer: Central Health Plan Commercial |
$167.20
|
| Rate for Payer: Cigna of CA HMO |
$133.76
|
| Rate for Payer: Cigna of CA PPO |
$154.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.88
|
| Rate for Payer: EPIC Health Plan Senior |
$75.47
|
| Rate for Payer: Galaxy Health WC |
$177.65
|
| Rate for Payer: Global Benefits Group Commercial |
$125.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$188.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$123.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: InnovAge PACE Commercial |
$113.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$139.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$79.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$101.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.13
|
| Rate for Payer: Multiplan Commercial |
$156.75
|
| Rate for Payer: Networks By Design Commercial |
$135.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.47
|
| Rate for Payer: Prime Health Services Commercial |
$177.65
|
| Rate for Payer: Prime Health Services Medicare |
$80.00
|
| Rate for Payer: Riverside University Health System MISP |
$83.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$125.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$125.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC PAD REHAB PER SESSION
|
Facility
|
IP
|
$209.00
|
|
|
Service Code
|
CPT 93668
|
| Hospital Charge Code |
900203668
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$41.80 |
| Max. Negotiated Rate |
$188.10 |
| Rate for Payer: Adventist Health Commercial |
$41.80
|
| Rate for Payer: Cash Price |
$94.05
|
| Rate for Payer: Central Health Plan Commercial |
$167.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$83.60
|
| Rate for Payer: EPIC Health Plan Senior |
$83.60
|
| Rate for Payer: Galaxy Health WC |
$177.65
|
| Rate for Payer: Global Benefits Group Commercial |
$125.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$188.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$139.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$79.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$129.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.80
|
| Rate for Payer: Multiplan Commercial |
$156.75
|
| Rate for Payer: Networks By Design Commercial |
$135.85
|
| Rate for Payer: Prime Health Services Commercial |
$177.65
|
|
|
HC PAIN MANAGEMENT SERVICES
|
Facility
|
OP
|
$12,891.00
|
|
| Hospital Charge Code |
900700075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,578.20 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,578.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,957.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,090.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,668.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,241.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,570.88
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$5,800.95
|
| Rate for Payer: Cash Price |
$5,800.95
|
| Rate for Payer: Central Health Plan Commercial |
$10,312.80
|
| Rate for Payer: Cigna of CA HMO |
$8,250.24
|
| Rate for Payer: Cigna of CA PPO |
$9,539.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,957.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,957.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,957.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,156.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,156.40
|
| Rate for Payer: Galaxy Health WC |
$10,957.35
|
| Rate for Payer: Global Benefits Group Commercial |
$7,734.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,601.90
|
| Rate for Payer: InnovAge PACE Commercial |
$6,445.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,598.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,911.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,979.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,578.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,023.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,023.70
|
| Rate for Payer: Multiplan Commercial |
$9,668.25
|
| Rate for Payer: Networks By Design Commercial |
$8,379.15
|
| Rate for Payer: Prime Health Services Commercial |
$10,957.35
|
| Rate for Payer: Riverside University Health System MISP |
$5,156.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,734.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,445.50
|
| Rate for Payer: United Healthcare All Other HMO |
$6,445.50
|
| Rate for Payer: United Healthcare HMO Rider |
$6,445.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,445.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,957.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,957.35
|
| Rate for Payer: Vantage Medical Group Senior |
$10,957.35
|
|
|
HC PAIN MANAGEMENT SERVICES
|
Facility
|
IP
|
$12,891.00
|
|
| Hospital Charge Code |
900700075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,578.20 |
| Max. Negotiated Rate |
$11,601.90 |
| Rate for Payer: Adventist Health Commercial |
$2,578.20
|
| Rate for Payer: Cash Price |
$5,800.95
|
| Rate for Payer: Central Health Plan Commercial |
$10,312.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,156.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,156.40
|
| Rate for Payer: Galaxy Health WC |
$10,957.35
|
| Rate for Payer: Global Benefits Group Commercial |
$7,734.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,601.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,598.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,911.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,979.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,578.20
|
| Rate for Payer: Multiplan Commercial |
$9,668.25
|
| Rate for Payer: Networks By Design Commercial |
$8,379.15
|
| Rate for Payer: Prime Health Services Commercial |
$10,957.35
|
|
|
HC PALINDROME DIALYS 19CM
|
Facility
|
IP
|
$1,959.78
|
|
|
Service Code
|
CPT C1750
|
| Hospital Charge Code |
901698140
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$391.96 |
| Max. Negotiated Rate |
$1,763.80 |
| Rate for Payer: Adventist Health Commercial |
$391.96
|
| Rate for Payer: Cash Price |
$881.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,567.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$783.91
|
| Rate for Payer: EPIC Health Plan Senior |
$783.91
|
| Rate for Payer: Galaxy Health WC |
$1,665.81
|
| Rate for Payer: Global Benefits Group Commercial |
$1,175.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,763.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,307.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$746.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,213.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$391.96
|
| Rate for Payer: Multiplan Commercial |
$1,469.84
|
| Rate for Payer: Networks By Design Commercial |
$1,273.86
|
| Rate for Payer: Prime Health Services Commercial |
$1,665.81
|
|
|
HC PALINDROME DIALYS 19CM
|
Facility
|
OP
|
$1,959.78
|
|
|
Service Code
|
CPT C1750
|
| Hospital Charge Code |
901698140
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$391.96 |
| Max. Negotiated Rate |
$1,763.80 |
| Rate for Payer: Adventist Health Commercial |
$391.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,190.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,665.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,077.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,469.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$948.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,150.98
|
| Rate for Payer: Blue Shield of California Commercial |
$1,197.43
|
| Rate for Payer: Blue Shield of California EPN |
$781.95
|
| Rate for Payer: Cash Price |
$881.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,567.82
|
| Rate for Payer: Cigna of CA HMO |
$1,254.26
|
| Rate for Payer: Cigna of CA PPO |
$1,450.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,665.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,665.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,665.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$783.91
|
| Rate for Payer: EPIC Health Plan Senior |
$783.91
|
| Rate for Payer: Galaxy Health WC |
$1,665.81
|
| Rate for Payer: Global Benefits Group Commercial |
$1,175.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,763.80
|
| Rate for Payer: InnovAge PACE Commercial |
$979.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,307.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$746.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,213.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$391.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,371.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,371.85
|
| Rate for Payer: Multiplan Commercial |
$1,469.84
|
| Rate for Payer: Networks By Design Commercial |
$1,273.86
|
| Rate for Payer: Prime Health Services Commercial |
$1,665.81
|
| Rate for Payer: Riverside University Health System MISP |
$783.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,175.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,175.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$979.89
|
| Rate for Payer: United Healthcare All Other HMO |
$979.89
|
| Rate for Payer: United Healthcare HMO Rider |
$979.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$979.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,665.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,665.81
|
| Rate for Payer: Vantage Medical Group Senior |
$1,665.81
|
|
|
HC PANCREAS BIOPSY PERCUTANEOUS
|
Facility
|
OP
|
$4,661.00
|
|
|
Service Code
|
CPT 48102
|
| Hospital Charge Code |
909000153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$651.24 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$932.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,058.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$2,097.45
|
| Rate for Payer: Cash Price |
$2,097.45
|
| Rate for Payer: Cash Price |
$2,097.45
|
| Rate for Payer: Central Health Plan Commercial |
$3,728.80
|
| Rate for Payer: Cigna of CA HMO |
$2,983.04
|
| Rate for Payer: Cigna of CA PPO |
$3,449.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,779.22
|
| Rate for Payer: EPIC Health Plan Senior |
$2,058.68
|
| Rate for Payer: Galaxy Health WC |
$3,961.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,796.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,194.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$651.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: InnovAge PACE Commercial |
$3,088.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,108.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$719.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$932.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,758.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,758.63
|
| Rate for Payer: Multiplan Commercial |
$3,495.75
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$3,029.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$3,961.85
|
| Rate for Payer: Prime Health Services Medicare |
$2,182.20
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,264.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,796.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| 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 |
$2,058.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
HC PANCREAS BIOPSY PERCUTANEOUS
|
Facility
|
IP
|
$4,661.00
|
|
|
Service Code
|
CPT 48102
|
| Hospital Charge Code |
909000153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$932.20 |
| Max. Negotiated Rate |
$4,194.90 |
| Rate for Payer: Adventist Health Commercial |
$932.20
|
| Rate for Payer: Cash Price |
$2,097.45
|
| Rate for Payer: Central Health Plan Commercial |
$3,728.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,864.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,864.40
|
| Rate for Payer: Galaxy Health WC |
$3,961.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,796.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,194.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,108.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,775.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,885.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$932.20
|
| Rate for Payer: Multiplan Commercial |
$3,495.75
|
| Rate for Payer: Networks By Design Commercial |
$3,029.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,961.85
|
|
|
HC PANCREAS CELLVIZIO
|
Facility
|
OP
|
$1,250.00
|
|
|
Service Code
|
CPT 48999
|
| Hospital Charge Code |
906748999
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$250.00 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$250.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$893.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$893.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,000.00
|
| Rate for Payer: Cigna of CA HMO |
$800.00
|
| Rate for Payer: Cigna of CA PPO |
$925.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$983.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$893.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,206.87
|
| Rate for Payer: EPIC Health Plan Senior |
$893.98
|
| Rate for Payer: Galaxy Health WC |
$1,062.50
|
| Rate for Payer: Global Benefits Group Commercial |
$750.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,125.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,466.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$893.98
|
| Rate for Payer: InnovAge PACE Commercial |
$1,340.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$833.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$893.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$250.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,197.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,197.93
|
| Rate for Payer: Multiplan Commercial |
$937.50
|
| Rate for Payer: Networks By Design Commercial |
$812.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$893.98
|
| Rate for Payer: Prime Health Services Commercial |
$1,062.50
|
| Rate for Payer: Prime Health Services Medicare |
$947.62
|
| Rate for Payer: Riverside University Health System MISP |
$983.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$750.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,072.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$893.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Vantage Medical Group Senior |
$893.98
|
|
|
HC PANCREAS CELLVIZIO
|
Facility
|
IP
|
$2,360.00
|
|
|
Service Code
|
CPT 48999
|
| Hospital Charge Code |
906748999
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$472.00 |
| Max. Negotiated Rate |
$2,124.00 |
| Rate for Payer: Adventist Health Commercial |
$472.00
|
| Rate for Payer: Cash Price |
$1,062.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,888.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$944.00
|
| Rate for Payer: EPIC Health Plan Senior |
$944.00
|
| Rate for Payer: Galaxy Health WC |
$2,006.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,416.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,124.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,574.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$899.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,460.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$472.00
|
| Rate for Payer: Multiplan Commercial |
$1,770.00
|
| Rate for Payer: Networks By Design Commercial |
$1,534.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,006.00
|
|
|
HC PANCREATIC PSDOCYST EXT DRN
|
Facility
|
IP
|
$1,006.00
|
|
|
Service Code
|
CPT 48510
|
| Hospital Charge Code |
909000155
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$201.20 |
| Max. Negotiated Rate |
$905.40 |
| Rate for Payer: Adventist Health Commercial |
$201.20
|
| Rate for Payer: Cash Price |
$452.70
|
| Rate for Payer: Central Health Plan Commercial |
$804.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$402.40
|
| Rate for Payer: EPIC Health Plan Senior |
$402.40
|
| Rate for Payer: Galaxy Health WC |
$855.10
|
| Rate for Payer: Global Benefits Group Commercial |
$603.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$905.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$671.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$383.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$622.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$201.20
|
| Rate for Payer: Multiplan Commercial |
$754.50
|
| Rate for Payer: Networks By Design Commercial |
$653.90
|
| Rate for Payer: Prime Health Services Commercial |
$855.10
|
|
|
HC PANCREATIC PSDOCYST EXT DRN
|
Facility
|
OP
|
$1,006.00
|
|
|
Service Code
|
CPT 48510
|
| Hospital Charge Code |
909000155
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$201.20 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$201.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$855.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$553.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$754.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$452.70
|
| Rate for Payer: Cash Price |
$452.70
|
| Rate for Payer: Cash Price |
$452.70
|
| Rate for Payer: Central Health Plan Commercial |
$804.80
|
| Rate for Payer: Cigna of CA HMO |
$643.84
|
| Rate for Payer: Cigna of CA PPO |
$744.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$855.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$855.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$855.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$402.40
|
| Rate for Payer: EPIC Health Plan Senior |
$402.40
|
| Rate for Payer: Galaxy Health WC |
$855.10
|
| Rate for Payer: Global Benefits Group Commercial |
$603.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$905.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$219.01
|
| Rate for Payer: InnovAge PACE Commercial |
$503.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$671.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$241.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$622.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$201.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$704.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$704.20
|
| Rate for Payer: Multiplan Commercial |
$754.50
|
| Rate for Payer: Networks By Design Commercial |
$653.90
|
| Rate for Payer: Prime Health Services Commercial |
$855.10
|
| Rate for Payer: Riverside University Health System MISP |
$402.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$603.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$855.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$855.10
|
| Rate for Payer: Vantage Medical Group Senior |
$855.10
|
|
|
HC PANTIES
|
Facility
|
IP
|
$34.00
|
|
|
Service Code
|
CPT L8499
|
| Hospital Charge Code |
915380015
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Adventist Health Commercial |
$6.80
|
| Rate for Payer: Blue Shield of California Commercial |
$26.28
|
| Rate for Payer: Blue Shield of California EPN |
$17.14
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Central Health Plan Commercial |
$27.20
|
| Rate for Payer: Cigna of CA HMO |
$23.80
|
| Rate for Payer: Cigna of CA PPO |
$23.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.60
|
| Rate for Payer: EPIC Health Plan Senior |
$13.60
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.80
|
| Rate for Payer: Multiplan Commercial |
$25.50
|
| Rate for Payer: Networks By Design Commercial |
$22.10
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.76
|
| Rate for Payer: United Healthcare All Other HMO |
$12.42
|
| Rate for Payer: United Healthcare HMO Rider |
$12.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.13
|
|
|
HC PANTIES
|
Facility
|
IP
|
$34.00
|
|
|
Service Code
|
CPT L8499
|
| Hospital Charge Code |
905380015
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Adventist Health Commercial |
$6.80
|
| Rate for Payer: Blue Shield of California Commercial |
$26.28
|
| Rate for Payer: Blue Shield of California EPN |
$17.14
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Central Health Plan Commercial |
$27.20
|
| Rate for Payer: Cigna of CA HMO |
$23.80
|
| Rate for Payer: Cigna of CA PPO |
$23.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.60
|
| Rate for Payer: EPIC Health Plan Senior |
$13.60
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.80
|
| Rate for Payer: Multiplan Commercial |
$25.50
|
| Rate for Payer: Networks By Design Commercial |
$22.10
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.76
|
| Rate for Payer: United Healthcare All Other HMO |
$12.42
|
| Rate for Payer: United Healthcare HMO Rider |
$12.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.13
|
|
|
HC PANTIES
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT L8499
|
| Hospital Charge Code |
915380015
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$11.13 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Adventist Health Commercial |
$13.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.97
|
| Rate for Payer: Blue Shield of California Commercial |
$26.28
|
| Rate for Payer: Blue Shield of California EPN |
$17.14
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Central Health Plan Commercial |
$27.20
|
| Rate for Payer: Cigna of CA HMO |
$23.80
|
| Rate for Payer: Cigna of CA PPO |
$23.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.60
|
| Rate for Payer: EPIC Health Plan Senior |
$13.60
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.60
|
| Rate for Payer: InnovAge PACE Commercial |
$17.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.80
|
| Rate for Payer: Multiplan Commercial |
$25.50
|
| Rate for Payer: Networks By Design Commercial |
$17.00
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: Riverside University Health System MISP |
$13.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.76
|
| Rate for Payer: United Healthcare All Other HMO |
$12.42
|
| Rate for Payer: United Healthcare HMO Rider |
$12.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.90
|
| Rate for Payer: Vantage Medical Group Senior |
$28.90
|
|
|
HC PANTIES
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT L8499
|
| Hospital Charge Code |
905380015
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$11.13 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Adventist Health Commercial |
$13.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.97
|
| Rate for Payer: Blue Shield of California Commercial |
$26.28
|
| Rate for Payer: Blue Shield of California EPN |
$17.14
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Central Health Plan Commercial |
$27.20
|
| Rate for Payer: Cigna of CA HMO |
$23.80
|
| Rate for Payer: Cigna of CA PPO |
$23.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.60
|
| Rate for Payer: EPIC Health Plan Senior |
$13.60
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.60
|
| Rate for Payer: InnovAge PACE Commercial |
$17.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.80
|
| Rate for Payer: Multiplan Commercial |
$25.50
|
| Rate for Payer: Networks By Design Commercial |
$17.00
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: Riverside University Health System MISP |
$13.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.76
|
| Rate for Payer: United Healthcare All Other HMO |
$12.42
|
| Rate for Payer: United Healthcare HMO Rider |
$12.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.90
|
| Rate for Payer: Vantage Medical Group Senior |
$28.90
|
|
|
HC PAPOOSE INFANT SPINAL IMOBLIZR
|
Facility
|
OP
|
$1,283.86
|
|
|
Service Code
|
CPT L0174
|
| Hospital Charge Code |
901606308
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$314.64 |
| Max. Negotiated Rate |
$1,155.47 |
| Rate for Payer: Adventist Health Commercial |
$526.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,091.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$706.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$962.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$754.01
|
| Rate for Payer: Blue Shield of California Commercial |
$992.42
|
| Rate for Payer: Blue Shield of California EPN |
$647.07
|
| Rate for Payer: Cash Price |
$577.74
|
| Rate for Payer: Cash Price |
$577.74
|
| Rate for Payer: Central Health Plan Commercial |
$1,027.09
|
| Rate for Payer: Cigna of CA HMO |
$898.70
|
| Rate for Payer: Cigna of CA PPO |
$898.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,091.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,091.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,091.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$513.54
|
| Rate for Payer: EPIC Health Plan Senior |
$513.54
|
| Rate for Payer: Galaxy Health WC |
$1,091.28
|
| Rate for Payer: Global Benefits Group Commercial |
$770.32
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,155.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$314.64
|
| Rate for Payer: InnovAge PACE Commercial |
$641.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$856.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$347.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$794.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$526.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$898.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$898.70
|
| Rate for Payer: Multiplan Commercial |
$962.89
|
| Rate for Payer: Networks By Design Commercial |
$641.93
|
| Rate for Payer: Prime Health Services Commercial |
$1,091.28
|
| Rate for Payer: Riverside University Health System MISP |
$513.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$770.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$770.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$481.83
|
| Rate for Payer: United Healthcare All Other HMO |
$468.99
|
| Rate for Payer: United Healthcare HMO Rider |
$458.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$420.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,091.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,091.28
|
| Rate for Payer: Vantage Medical Group Senior |
$1,091.28
|
|
|
HC PAPOOSE INFANT SPINAL IMOBLIZR
|
Facility
|
IP
|
$1,283.86
|
|
|
Service Code
|
CPT L0174
|
| Hospital Charge Code |
901606308
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$256.77 |
| Max. Negotiated Rate |
$1,155.47 |
| Rate for Payer: Adventist Health Commercial |
$256.77
|
| Rate for Payer: Blue Shield of California Commercial |
$992.42
|
| Rate for Payer: Blue Shield of California EPN |
$647.07
|
| Rate for Payer: Cash Price |
$577.74
|
| Rate for Payer: Central Health Plan Commercial |
$1,027.09
|
| Rate for Payer: Cigna of CA HMO |
$898.70
|
| Rate for Payer: Cigna of CA PPO |
$898.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$513.54
|
| Rate for Payer: EPIC Health Plan Senior |
$513.54
|
| Rate for Payer: Galaxy Health WC |
$1,091.28
|
| Rate for Payer: Global Benefits Group Commercial |
$770.32
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,155.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$856.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$489.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$794.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.77
|
| Rate for Payer: Multiplan Commercial |
$962.89
|
| Rate for Payer: Networks By Design Commercial |
$834.51
|
| Rate for Payer: Prime Health Services Commercial |
$1,091.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$481.83
|
| Rate for Payer: United Healthcare All Other HMO |
$468.99
|
| Rate for Payer: United Healthcare HMO Rider |
$458.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$420.46
|
|
