|
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 |
$11.32
|
| 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 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 |
$11.32
|
| 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 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 |
$114.95
|
| Rate for Payer: Cash Price |
$114.95
|
| Rate for Payer: Cash Price |
$114.95
|
| 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 |
$114.95
|
| 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
|
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 |
$7,090.05
|
| 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 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 |
$7,090.05
|
| Rate for Payer: Cash Price |
$7,090.05
|
| 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 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 |
$1,077.88
|
| 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 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 |
$1,077.88
|
| 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 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 |
$2,563.55
|
| 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 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 |
$2,563.55
|
| Rate for Payer: Cash Price |
$2,563.55
|
| Rate for Payer: Cash Price |
$2,563.55
|
| 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 CELLVIZIO
|
Facility
|
IP
|
$1,250.00
|
|
|
Service Code
|
CPT 48999
|
| Hospital Charge Code |
906748999
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$250.00 |
| Max. Negotiated Rate |
$1,125.00 |
| Rate for Payer: Adventist Health Commercial |
$250.00
|
| Rate for Payer: Cash Price |
$687.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$500.00
|
| Rate for Payer: EPIC Health Plan Senior |
$500.00
|
| 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: Kaiser Permanente of CA Commercial/Self Funded |
$833.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$476.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$773.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$250.00
|
| Rate for Payer: Multiplan Commercial |
$937.50
|
| Rate for Payer: Networks By Design Commercial |
$812.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,062.50
|
|
|
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 |
$687.50
|
| Rate for Payer: Cash Price |
$687.50
|
| Rate for Payer: Cash Price |
$687.50
|
| 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 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 |
$553.30
|
| 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 |
$553.30
|
| Rate for Payer: Cash Price |
$553.30
|
| Rate for Payer: Cash Price |
$553.30
|
| 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 |
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 |
$18.70
|
| 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 |
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 |
$18.70
|
| 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 |
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 |
$18.70
|
| 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
|
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 |
$18.70
|
| 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 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 |
$706.12
|
| 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
|
|
|
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 |
$706.12
|
| Rate for Payer: Cash Price |
$706.12
|
| 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 PAP S EAR-THIN PREP PG
|
Facility
|
OP
|
$59.00
|
|
|
Service Code
|
CPT 88142
|
| Hospital Charge Code |
903800211
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$11.80 |
| Max. Negotiated Rate |
$102.85 |
| Rate for Payer: Adventist Health Commercial |
$11.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$20.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$35.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$102.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.87
|
| Rate for Payer: Blue Shield of California Commercial |
$35.81
|
| Rate for Payer: Blue Shield of California EPN |
$23.42
|
| Rate for Payer: Cash Price |
$32.45
|
| Rate for Payer: Cash Price |
$32.45
|
| Rate for Payer: Central Health Plan Commercial |
$47.20
|
| Rate for Payer: Cigna of CA HMO |
$37.76
|
| Rate for Payer: Cigna of CA PPO |
$43.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.35
|
| Rate for Payer: EPIC Health Plan Senior |
$20.26
|
| Rate for Payer: Galaxy Health WC |
$50.15
|
| Rate for Payer: Global Benefits Group Commercial |
$35.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$53.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$33.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$30.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.26
|
| Rate for Payer: InnovAge PACE Commercial |
$30.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.15
|
| Rate for Payer: Multiplan Commercial |
$44.25
|
| Rate for Payer: Networks By Design Commercial |
$38.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$20.26
|
| Rate for Payer: Prime Health Services Commercial |
$50.15
|
| Rate for Payer: Prime Health Services Medicare |
$21.48
|
| Rate for Payer: Riverside University Health System MISP |
$22.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$35.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$35.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.41
|
| Rate for Payer: United Healthcare All Other HMO |
$16.41
|
| Rate for Payer: United Healthcare HMO Rider |
$16.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.41
|
| Rate for Payer: Upland Medical Group Pediatric |
$20.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.29
|
| Rate for Payer: Vantage Medical Group Senior |
$20.26
|
|
|
HC PAP S EAR-THIN PREP PG
|
Facility
|
IP
|
$59.00
|
|
|
Service Code
|
CPT 88142
|
| Hospital Charge Code |
903800211
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$11.80 |
| Max. Negotiated Rate |
$53.10 |
| Rate for Payer: Adventist Health Commercial |
$11.80
|
| Rate for Payer: Cash Price |
$32.45
|
| Rate for Payer: Central Health Plan Commercial |
$47.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.60
|
| Rate for Payer: EPIC Health Plan Senior |
$23.60
|
| Rate for Payer: Galaxy Health WC |
$50.15
|
| Rate for Payer: Global Benefits Group Commercial |
$35.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$53.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.80
|
| Rate for Payer: Multiplan Commercial |
$44.25
|
| Rate for Payer: Networks By Design Commercial |
$38.35
|
| Rate for Payer: Prime Health Services Commercial |
$50.15
|
|
|
HC PAP SMEAR-CONVENTIONAL PG
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
CPT 88164
|
| Hospital Charge Code |
903800212
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$37.61 |
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$18.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.63
|
| Rate for Payer: Blue Shield of California Commercial |
$15.18
|
| Rate for Payer: Blue Shield of California EPN |
$9.93
|
| Rate for Payer: Cash Price |
$13.75
|
| Rate for Payer: Cash Price |
$13.75
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: Cigna of CA HMO |
$16.00
|
| Rate for Payer: Cigna of CA PPO |
$18.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.56
|
| Rate for Payer: EPIC Health Plan Senior |
$18.19
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$16.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.19
|
| Rate for Payer: InnovAge PACE Commercial |
$27.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.37
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$18.19
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
| Rate for Payer: Prime Health Services Medicare |
$19.28
|
| Rate for Payer: Riverside University Health System MISP |
$20.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.90
|
| Rate for Payer: United Healthcare All Other HMO |
$12.90
|
| Rate for Payer: United Healthcare HMO Rider |
$12.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.90
|
| Rate for Payer: Upland Medical Group Pediatric |
$18.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.01
|
| Rate for Payer: Vantage Medical Group Senior |
$18.19
|
|
|
HC PAP SMEAR-CONVENTIONAL PG
|
Facility
|
IP
|
$25.00
|
|
|
Service Code
|
CPT 88164
|
| Hospital Charge Code |
903800212
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Cash Price |
$13.75
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
|
|
HC PARACENTESIS EYE RML BLOOD
|
Facility
|
IP
|
$9,345.00
|
|
|
Service Code
|
CPT 65815
|
| Hospital Charge Code |
950442303
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,869.00 |
| Max. Negotiated Rate |
$8,410.50 |
| Rate for Payer: Adventist Health Commercial |
$1,869.00
|
| Rate for Payer: Cash Price |
$5,139.75
|
| Rate for Payer: Central Health Plan Commercial |
$7,476.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,738.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,738.00
|
| Rate for Payer: Galaxy Health WC |
$7,943.25
|
| Rate for Payer: Global Benefits Group Commercial |
$5,607.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,410.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,233.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,560.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,784.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,869.00
|
| Rate for Payer: Multiplan Commercial |
$7,008.75
|
| Rate for Payer: Networks By Design Commercial |
$6,074.25
|
| Rate for Payer: Prime Health Services Commercial |
$7,943.25
|
|
