|
HC REMOVE CERCLAGE SUTURE
|
Facility
|
OP
|
$10,704.00
|
|
|
Service Code
|
CPT 59871
|
| Hospital Charge Code |
902400749
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$231.82 |
| Max. Negotiated Rate |
$9,633.60 |
| Rate for Payer: Adventist Health Commercial |
$2,140.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,163.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$817.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,579.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,163.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,786.34
|
| Rate for Payer: Blue Shield of California EPN |
$4,270.90
|
| Rate for Payer: Cash Price |
$4,816.80
|
| Rate for Payer: Cash Price |
$4,816.80
|
| Rate for Payer: Cash Price |
$4,816.80
|
| Rate for Payer: Cash Price |
$4,816.80
|
| Rate for Payer: Central Health Plan Commercial |
$8,563.20
|
| Rate for Payer: Cigna of CA HMO |
$6,850.56
|
| Rate for Payer: Cigna of CA PPO |
$7,920.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,579.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,163.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,492.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,869.74
|
| Rate for Payer: EPIC Health Plan Senior |
$4,579.83
|
| Rate for Payer: Galaxy Health WC |
$9,098.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,422.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,633.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,828.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$231.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,163.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,797.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$256.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,828.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,140.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,579.06
|
| Rate for Payer: Multiplan Commercial |
$8,028.00
|
| Rate for Payer: Networks By Design Commercial |
$6,957.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,163.48
|
| Rate for Payer: Prime Health Services Commercial |
$9,098.40
|
| Rate for Payer: Prime Health Services Medicare |
$4,413.29
|
| Rate for Payer: Riverside University Health System MISP |
$4,579.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,422.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,422.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,091.00
|
| Rate for Payer: United Healthcare All Other HMO |
$839.00
|
| Rate for Payer: United Healthcare HMO Rider |
$635.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$581.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,163.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,579.83
|
| Rate for Payer: Vantage Medical Group Senior |
$4,163.48
|
|
|
HC REMOVE CERCLAGE SUTURE
|
Facility
|
IP
|
$10,704.00
|
|
|
Service Code
|
CPT 59871
|
| Hospital Charge Code |
902400749
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$2,140.80 |
| Max. Negotiated Rate |
$9,633.60 |
| Rate for Payer: Adventist Health Commercial |
$2,140.80
|
| Rate for Payer: Cash Price |
$4,816.80
|
| Rate for Payer: Central Health Plan Commercial |
$8,563.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,492.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,281.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,281.60
|
| Rate for Payer: Galaxy Health WC |
$9,098.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,422.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,633.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,797.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,315.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,140.80
|
| Rate for Payer: Multiplan Commercial |
$8,028.00
|
| Rate for Payer: Networks By Design Commercial |
$6,957.60
|
| Rate for Payer: Prime Health Services Commercial |
$9,098.40
|
|
|
HC REMOVE FIBRIN SHEATH
|
Facility
|
IP
|
$6,668.00
|
|
|
Service Code
|
CPT 36595
|
| Hospital Charge Code |
909020014
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,333.60 |
| Max. Negotiated Rate |
$6,001.20 |
| Rate for Payer: Adventist Health Commercial |
$1,333.60
|
| Rate for Payer: Cash Price |
$3,000.60
|
| Rate for Payer: Central Health Plan Commercial |
$5,334.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,667.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,667.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,667.20
|
| Rate for Payer: Galaxy Health WC |
$5,667.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,000.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,001.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,234.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,934.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,333.60
|
| Rate for Payer: Multiplan Commercial |
$5,001.00
|
| Rate for Payer: Networks By Design Commercial |
$4,334.20
|
| Rate for Payer: Prime Health Services Commercial |
$5,667.80
|
|
|
HC REMOVE FIBRIN SHEATH
|
Facility
|
OP
|
$6,668.00
|
|
|
Service Code
|
CPT 36595
|
| Hospital Charge Code |
909020014
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,251.90 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,333.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,061.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$3,000.60
|
| Rate for Payer: Cash Price |
$3,000.60
|
| Rate for Payer: Cash Price |
$3,000.60
|
| Rate for Payer: Central Health Plan Commercial |
$5,334.40
|
| Rate for Payer: Cigna of CA HMO |
$4,267.52
|
| Rate for Payer: Cigna of CA PPO |
$4,934.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,667.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$5,667.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,000.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,001.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,251.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,234.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,382.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,333.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$5,001.00
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$4,334.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$5,667.80
|
| Rate for Payer: Prime Health Services Medicare |
$4,304.71
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,467.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,000.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,334.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC REMOVE FOREIGN BODY (RENAL)
|
Facility
|
OP
|
$11,347.00
|
|
|
Service Code
|
CPT 50561
|
| Hospital Charge Code |
909081362
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$726.17 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,269.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$6,896.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,344.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,585.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,896.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$10,291.67
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$5,106.15
|
| Rate for Payer: Cash Price |
$5,106.15
|
| Rate for Payer: Cash Price |
$5,106.15
|
| Rate for Payer: Central Health Plan Commercial |
$9,077.60
|
| Rate for Payer: Cigna of CA HMO |
$7,262.08
|
| Rate for Payer: Cigna of CA PPO |
$8,396.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,344.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,585.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,896.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,942.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,378.68
|
| Rate for Payer: EPIC Health Plan Senior |
$7,585.79
|
| Rate for Payer: Galaxy Health WC |
$9,644.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,808.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,212.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,309.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$726.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,896.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,205.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$802.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,654.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,269.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,240.87
|
| Rate for Payer: Multiplan Commercial |
$8,510.25
|
| Rate for Payer: Multiplan WC |
$10,291.67
|
| Rate for Payer: Networks By Design Commercial |
$7,375.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6,896.17
|
| Rate for Payer: Preferred Health Network WC |
$10,501.70
|
| Rate for Payer: Prime Health Services Commercial |
$9,644.95
|
| Rate for Payer: Prime Health Services Medicare |
$7,309.94
|
| Rate for Payer: Prime Health Services WC |
$10,186.65
|
| Rate for Payer: Riverside University Health System MISP |
$7,585.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,808.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,673.50
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$6,896.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,344.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,585.79
|
| Rate for Payer: Vantage Medical Group Senior |
$6,896.17
|
|
|
HC REMOVE FOREIGN BODY (RENAL)
|
Facility
|
IP
|
$11,347.00
|
|
|
Service Code
|
CPT 50561
|
| Hospital Charge Code |
909081362
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,269.40 |
| Max. Negotiated Rate |
$10,212.30 |
| Rate for Payer: Adventist Health Commercial |
$2,269.40
|
| Rate for Payer: Cash Price |
$5,106.15
|
| Rate for Payer: Central Health Plan Commercial |
$9,077.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,942.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,538.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,538.80
|
| Rate for Payer: Galaxy Health WC |
$9,644.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,808.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,212.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,205.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,694.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,269.40
|
| Rate for Payer: Multiplan Commercial |
$8,510.25
|
| Rate for Payer: Networks By Design Commercial |
$7,375.55
|
| Rate for Payer: Prime Health Services Commercial |
$9,644.95
|
|
|
HC REMOVE FOREIGN BODY (URETER
|
Facility
|
OP
|
$11,347.00
|
|
|
Service Code
|
CPT 50961
|
| Hospital Charge Code |
909081363
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$858.71 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,269.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$6,896.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,344.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,585.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,896.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$10,291.67
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$5,106.15
|
| Rate for Payer: Cash Price |
$5,106.15
|
| Rate for Payer: Cash Price |
$5,106.15
|
| Rate for Payer: Central Health Plan Commercial |
$9,077.60
|
| Rate for Payer: Cigna of CA HMO |
$7,262.08
|
| Rate for Payer: Cigna of CA PPO |
$8,396.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,344.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,585.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,896.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,942.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,378.68
|
| Rate for Payer: EPIC Health Plan Senior |
$7,585.79
|
| Rate for Payer: Galaxy Health WC |
$9,644.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,808.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,212.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,309.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$858.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,896.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,205.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$948.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,654.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,269.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,240.87
|
| Rate for Payer: Multiplan Commercial |
$8,510.25
|
| Rate for Payer: Multiplan WC |
$10,291.67
|
| Rate for Payer: Networks By Design Commercial |
$7,375.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6,896.17
|
| Rate for Payer: Preferred Health Network WC |
$10,501.70
|
| Rate for Payer: Prime Health Services Commercial |
$9,644.95
|
| Rate for Payer: Prime Health Services Medicare |
$7,309.94
|
| Rate for Payer: Prime Health Services WC |
$10,186.65
|
| Rate for Payer: Riverside University Health System MISP |
$7,585.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,808.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,673.50
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$6,896.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,344.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,585.79
|
| Rate for Payer: Vantage Medical Group Senior |
$6,896.17
|
|
|
HC REMOVE FOREIGN BODY (URETER
|
Facility
|
IP
|
$11,347.00
|
|
|
Service Code
|
CPT 50961
|
| Hospital Charge Code |
909081363
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,269.40 |
| Max. Negotiated Rate |
$10,212.30 |
| Rate for Payer: Adventist Health Commercial |
$2,269.40
|
| Rate for Payer: Cash Price |
$5,106.15
|
| Rate for Payer: Central Health Plan Commercial |
$9,077.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,942.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,538.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,538.80
|
| Rate for Payer: Galaxy Health WC |
$9,644.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,808.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,212.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,205.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,694.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,269.40
|
| Rate for Payer: Multiplan Commercial |
$8,510.25
|
| Rate for Payer: Networks By Design Commercial |
$7,375.55
|
| Rate for Payer: Prime Health Services Commercial |
$9,644.95
|
|
|
HC REMOVE OBSTRUCT GAST/JEJ/CEC T
|
Facility
|
OP
|
$3,801.00
|
|
|
Service Code
|
CPT 49460
|
| Hospital Charge Code |
909020008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$760.20 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$760.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,166.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,898.06
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,710.45
|
| Rate for Payer: Cash Price |
$1,710.45
|
| Rate for Payer: Cash Price |
$1,710.45
|
| Rate for Payer: Central Health Plan Commercial |
$3,040.80
|
| Rate for Payer: Cigna of CA HMO |
$2,432.64
|
| Rate for Payer: Cigna of CA PPO |
$2,812.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,660.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.77
|
| Rate for Payer: EPIC Health Plan Senior |
$1,283.18
|
| Rate for Payer: Galaxy Health WC |
$3,230.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,280.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,420.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,913.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,169.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,413.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,291.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,633.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$760.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,563.15
|
| Rate for Payer: Multiplan Commercial |
$2,850.75
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: Networks By Design Commercial |
$2,470.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Preferred Health Network WC |
$1,936.80
|
| Rate for Payer: Prime Health Services Commercial |
$3,230.85
|
| Rate for Payer: Prime Health Services Medicare |
$1,236.52
|
| Rate for Payer: Prime Health Services WC |
$1,878.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,283.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,280.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,900.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
|
|
HC REMOVE OBSTRUCT GAST/JEJ/CEC T
|
Facility
|
IP
|
$3,801.00
|
|
|
Service Code
|
CPT 49460
|
| Hospital Charge Code |
909020008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$760.20 |
| Max. Negotiated Rate |
$3,420.90 |
| Rate for Payer: Adventist Health Commercial |
$760.20
|
| Rate for Payer: Cash Price |
$1,710.45
|
| Rate for Payer: Central Health Plan Commercial |
$3,040.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,660.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,520.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,520.40
|
| Rate for Payer: Galaxy Health WC |
$3,230.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,280.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,420.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,413.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,242.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$760.20
|
| Rate for Payer: Multiplan Commercial |
$2,850.75
|
| Rate for Payer: Networks By Design Commercial |
$2,470.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,230.85
|
|
|
HC REMOVE PERICATH OBSTRUCTION
|
Facility
|
OP
|
$3,582.00
|
|
|
Service Code
|
CPT 75901
|
| Hospital Charge Code |
909020013
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$170.90 |
| Max. Negotiated Rate |
$3,223.80 |
| Rate for Payer: Adventist Health Commercial |
$716.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$911.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,044.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,970.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,686.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$380.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$529.13
|
| Rate for Payer: Blue Shield of California Commercial |
$2,256.66
|
| Rate for Payer: Blue Shield of California EPN |
$1,422.05
|
| Rate for Payer: Cash Price |
$1,611.90
|
| Rate for Payer: Cash Price |
$1,611.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,865.60
|
| Rate for Payer: Cigna of CA HMO |
$2,292.48
|
| Rate for Payer: Cigna of CA PPO |
$2,650.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,044.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,044.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,044.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,507.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,432.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,432.80
|
| Rate for Payer: Galaxy Health WC |
$3,044.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,149.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,223.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$170.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,274.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$188.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,113.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$716.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,507.40
|
| Rate for Payer: Multiplan Commercial |
$2,686.50
|
| Rate for Payer: Networks By Design Commercial |
$2,328.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,044.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,432.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,149.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,149.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,791.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,791.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,791.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,791.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,044.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,044.70
|
| Rate for Payer: Vantage Medical Group Senior |
$3,044.70
|
|
|
HC REMOVE PERICATH OBSTRUCTION
|
Facility
|
IP
|
$3,582.00
|
|
|
Service Code
|
CPT 75901
|
| Hospital Charge Code |
909020013
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$716.40 |
| Max. Negotiated Rate |
$3,223.80 |
| Rate for Payer: Adventist Health Commercial |
$716.40
|
| Rate for Payer: Cash Price |
$1,611.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,865.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,507.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,432.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,432.80
|
| Rate for Payer: Galaxy Health WC |
$3,044.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,149.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,223.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,274.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,113.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$716.40
|
| Rate for Payer: Multiplan Commercial |
$2,686.50
|
| Rate for Payer: Networks By Design Commercial |
$2,328.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,044.70
|
|
|
HC REMOVE PERM CANNULA/CATHETER
|
Facility
|
IP
|
$11,342.00
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
909001458
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,268.40 |
| Max. Negotiated Rate |
$10,207.80 |
| Rate for Payer: Adventist Health Commercial |
$2,268.40
|
| Rate for Payer: Cash Price |
$5,103.90
|
| Rate for Payer: Central Health Plan Commercial |
$9,073.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,939.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,536.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,536.80
|
| Rate for Payer: Galaxy Health WC |
$9,640.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,805.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,207.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,202.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,691.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,268.40
|
| Rate for Payer: Multiplan Commercial |
$8,506.50
|
| Rate for Payer: Networks By Design Commercial |
$7,372.30
|
| Rate for Payer: Prime Health Services Commercial |
$9,640.70
|
|
|
HC REMOVE PERM CANNULA/CATHETER
|
Facility
|
OP
|
$11,342.00
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
909001458
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$541.09 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,268.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,061.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$5,103.90
|
| Rate for Payer: Cash Price |
$5,103.90
|
| Rate for Payer: Cash Price |
$5,103.90
|
| Rate for Payer: Central Health Plan Commercial |
$9,073.60
|
| Rate for Payer: Cigna of CA HMO |
$7,258.88
|
| Rate for Payer: Cigna of CA PPO |
$8,393.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,939.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$9,640.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,805.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,207.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$541.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,202.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$597.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,268.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$8,506.50
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$7,372.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$9,640.70
|
| Rate for Payer: Prime Health Services Medicare |
$4,304.71
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,467.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,805.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,671.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC REMOVE PERM CANNULA/CATHETER
|
Facility
|
IP
|
$11,342.00
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
909001458
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,268.40 |
| Max. Negotiated Rate |
$10,207.80 |
| Rate for Payer: Adventist Health Commercial |
$2,268.40
|
| Rate for Payer: Cash Price |
$5,103.90
|
| Rate for Payer: Central Health Plan Commercial |
$9,073.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,939.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,536.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,536.80
|
| Rate for Payer: Galaxy Health WC |
$9,640.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,805.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,207.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,202.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,691.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,268.40
|
| Rate for Payer: Multiplan Commercial |
$8,506.50
|
| Rate for Payer: Networks By Design Commercial |
$7,372.30
|
| Rate for Payer: Prime Health Services Commercial |
$9,640.70
|
|
|
HC REMOVE PERM CANNULA/CATHETER
|
Facility
|
OP
|
$11,342.00
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
909001458
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$541.09 |
| Max. Negotiated Rate |
$10,207.80 |
| Rate for Payer: Adventist Health Commercial |
$2,268.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,061.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,128.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,190.83
|
| Rate for Payer: Blue Shield of California EPN |
$4,525.46
|
| Rate for Payer: Cash Price |
$5,103.90
|
| Rate for Payer: Cash Price |
$5,103.90
|
| Rate for Payer: Cash Price |
$5,103.90
|
| Rate for Payer: Central Health Plan Commercial |
$9,073.60
|
| Rate for Payer: Cigna of CA HMO |
$7,258.88
|
| Rate for Payer: Cigna of CA PPO |
$8,393.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,939.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$9,640.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,805.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,207.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$541.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,202.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$597.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,268.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$8,506.50
|
| Rate for Payer: Networks By Design Commercial |
$7,372.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Prime Health Services Commercial |
$9,640.70
|
| Rate for Payer: Prime Health Services Medicare |
$4,304.71
|
| Rate for Payer: Riverside University Health System MISP |
$4,467.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,805.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,805.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,671.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,671.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,671.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,671.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC REMOVE RENAL TUBE W/FLUORO
|
Facility
|
IP
|
$2,900.00
|
|
|
Service Code
|
CPT 50389
|
| Hospital Charge Code |
909081853
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$580.00 |
| Max. Negotiated Rate |
$2,610.00 |
| Rate for Payer: Adventist Health Commercial |
$580.00
|
| Rate for Payer: Cash Price |
$1,305.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,320.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,030.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,160.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,160.00
|
| Rate for Payer: Galaxy Health WC |
$2,465.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,740.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,610.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,841.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,711.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$580.00
|
| Rate for Payer: Multiplan Commercial |
$2,175.00
|
| Rate for Payer: Networks By Design Commercial |
$1,885.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,465.00
|
|
|
HC REMOVE RENAL TUBE W/FLUORO
|
Facility
|
OP
|
$2,900.00
|
|
|
Service Code
|
CPT 50389
|
| Hospital Charge Code |
909081853
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$580.00 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$580.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$896.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,345.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$986.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$896.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,351.26
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$1,305.00
|
| Rate for Payer: Cash Price |
$1,305.00
|
| Rate for Payer: Cash Price |
$1,305.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,320.00
|
| Rate for Payer: Cigna of CA HMO |
$1,856.00
|
| Rate for Payer: Cigna of CA PPO |
$2,146.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,345.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$986.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$896.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,030.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,479.79
|
| Rate for Payer: EPIC Health Plan Senior |
$986.52
|
| Rate for Payer: Galaxy Health WC |
$2,465.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,740.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,610.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,470.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$781.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$896.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,841.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$863.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,255.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$580.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,201.77
|
| Rate for Payer: Multiplan Commercial |
$2,175.00
|
| Rate for Payer: Multiplan WC |
$1,351.26
|
| Rate for Payer: Networks By Design Commercial |
$1,885.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$896.84
|
| Rate for Payer: Preferred Health Network WC |
$1,378.84
|
| Rate for Payer: Prime Health Services Commercial |
$2,465.00
|
| Rate for Payer: Prime Health Services Medicare |
$950.65
|
| Rate for Payer: Prime Health Services WC |
$1,337.47
|
| Rate for Payer: Riverside University Health System MISP |
$986.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,740.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,450.00
|
| 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 |
$896.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,345.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$986.52
|
| Rate for Payer: Vantage Medical Group Senior |
$896.84
|
|
|
HC REMOVE TUN CV CATH WO PORT
|
Facility
|
OP
|
$7,704.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
909080021
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$233.73 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,540.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$806.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$887.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$806.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,251.66
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$3,466.80
|
| Rate for Payer: Cash Price |
$3,466.80
|
| Rate for Payer: Cash Price |
$3,466.80
|
| Rate for Payer: Central Health Plan Commercial |
$6,163.20
|
| Rate for Payer: Cigna of CA HMO |
$4,930.56
|
| Rate for Payer: Cigna of CA PPO |
$5,700.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$887.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$806.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,392.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,331.25
|
| Rate for Payer: EPIC Health Plan Senior |
$887.50
|
| Rate for Payer: Galaxy Health WC |
$6,548.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,622.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,933.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,323.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$233.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$806.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,892.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$258.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,129.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,540.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,081.14
|
| Rate for Payer: Multiplan Commercial |
$5,778.00
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$5,007.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$806.82
|
| Rate for Payer: Preferred Health Network WC |
$1,277.20
|
| Rate for Payer: Prime Health Services Commercial |
$6,548.40
|
| Rate for Payer: Prime Health Services Medicare |
$855.23
|
| Rate for Payer: Prime Health Services WC |
$1,238.88
|
| Rate for Payer: Riverside University Health System MISP |
$887.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,622.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,852.00
|
| 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 |
$806.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$887.50
|
| Rate for Payer: Vantage Medical Group Senior |
$806.82
|
|
|
HC REMOVE TUN CV CATH WO PORT
|
Facility
|
IP
|
$7,704.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
909080021
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,540.80 |
| Max. Negotiated Rate |
$6,933.60 |
| Rate for Payer: Adventist Health Commercial |
$1,540.80
|
| Rate for Payer: Cash Price |
$3,466.80
|
| Rate for Payer: Central Health Plan Commercial |
$6,163.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,392.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,081.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,081.60
|
| Rate for Payer: Galaxy Health WC |
$6,548.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,622.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,933.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,892.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,545.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,540.80
|
| Rate for Payer: Multiplan Commercial |
$5,778.00
|
| Rate for Payer: Networks By Design Commercial |
$5,007.60
|
| Rate for Payer: Prime Health Services Commercial |
$6,548.40
|
|
|
HC REMOVE TUN CV CATH WO PORT
|
Facility
|
OP
|
$7,704.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
900501636
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$233.73 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,540.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$806.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$887.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$806.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,251.66
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$3,466.80
|
| Rate for Payer: Cash Price |
$3,466.80
|
| Rate for Payer: Cash Price |
$3,466.80
|
| Rate for Payer: Central Health Plan Commercial |
$6,163.20
|
| Rate for Payer: Cigna of CA HMO |
$4,930.56
|
| Rate for Payer: Cigna of CA PPO |
$5,700.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$887.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$806.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,392.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,331.25
|
| Rate for Payer: EPIC Health Plan Senior |
$887.50
|
| Rate for Payer: Galaxy Health WC |
$6,548.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,622.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,933.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,323.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$233.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$806.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,892.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$258.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,129.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,540.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,081.14
|
| Rate for Payer: Multiplan Commercial |
$5,778.00
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$5,007.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$806.82
|
| Rate for Payer: Preferred Health Network WC |
$1,277.20
|
| Rate for Payer: Prime Health Services Commercial |
$6,548.40
|
| Rate for Payer: Prime Health Services Medicare |
$855.23
|
| Rate for Payer: Prime Health Services WC |
$1,238.88
|
| Rate for Payer: Riverside University Health System MISP |
$887.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,622.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,852.00
|
| 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 |
$806.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$887.50
|
| Rate for Payer: Vantage Medical Group Senior |
$806.82
|
|
|
HC REMOVE TUN CV CATH WO PORT
|
Facility
|
OP
|
$7,704.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
900501636
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$258.19 |
| Max. Negotiated Rate |
$6,933.60 |
| Rate for Payer: Adventist Health Commercial |
$1,540.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$887.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$806.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,251.66
|
| Rate for Payer: Cash Price |
$3,466.80
|
| Rate for Payer: Cash Price |
$3,466.80
|
| Rate for Payer: Cash Price |
$3,466.80
|
| Rate for Payer: Cash Price |
$3,466.80
|
| Rate for Payer: Central Health Plan Commercial |
$6,163.20
|
| Rate for Payer: Cigna of CA HMO |
$4,930.56
|
| Rate for Payer: Cigna of CA PPO |
$5,700.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$887.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$806.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,392.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,331.25
|
| Rate for Payer: EPIC Health Plan Senior |
$887.50
|
| Rate for Payer: Galaxy Health WC |
$6,548.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,622.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,933.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,323.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$806.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,892.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$258.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$867.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,540.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,081.14
|
| Rate for Payer: Multiplan Commercial |
$5,778.00
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$5,007.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$806.82
|
| Rate for Payer: Preferred Health Network WC |
$1,277.20
|
| Rate for Payer: Prime Health Services Commercial |
$6,548.40
|
| Rate for Payer: Prime Health Services Medicare |
$855.23
|
| Rate for Payer: Prime Health Services WC |
$1,238.88
|
| Rate for Payer: Riverside University Health System MISP |
$887.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,622.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,852.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,852.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,852.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,852.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$806.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$887.50
|
| Rate for Payer: Vantage Medical Group Senior |
$806.82
|
|
|
HC REMOVE TUN CV CATH WO PORT
|
Facility
|
IP
|
$7,704.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
900501636
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,540.80 |
| Max. Negotiated Rate |
$6,933.60 |
| Rate for Payer: Adventist Health Commercial |
$1,540.80
|
| Rate for Payer: Cash Price |
$3,466.80
|
| Rate for Payer: Central Health Plan Commercial |
$6,163.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,392.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,081.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,081.60
|
| Rate for Payer: Galaxy Health WC |
$6,548.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,622.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,933.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,892.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,545.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,540.80
|
| Rate for Payer: Multiplan Commercial |
$5,778.00
|
| Rate for Payer: Networks By Design Commercial |
$5,007.60
|
| Rate for Payer: Prime Health Services Commercial |
$6,548.40
|
|
|
HC REMOVE TUN CV CATH WO PORT
|
Facility
|
IP
|
$7,704.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
900501636
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,540.80 |
| Max. Negotiated Rate |
$6,933.60 |
| Rate for Payer: Adventist Health Commercial |
$1,540.80
|
| Rate for Payer: Cash Price |
$3,466.80
|
| Rate for Payer: Central Health Plan Commercial |
$6,163.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,392.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,081.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,081.60
|
| Rate for Payer: Galaxy Health WC |
$6,548.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,622.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,933.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,892.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,545.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,540.80
|
| Rate for Payer: Multiplan Commercial |
$5,778.00
|
| Rate for Payer: Networks By Design Commercial |
$5,007.60
|
| Rate for Payer: Prime Health Services Commercial |
$6,548.40
|
|
|
HC REMOVE TUNNEL PLEURAL CATH
|
Facility
|
OP
|
$3,802.00
|
|
|
Service Code
|
CPT 32552
|
| Hospital Charge Code |
902100152
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$262.54 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$760.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$806.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$887.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$806.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,251.66
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$1,710.90
|
| Rate for Payer: Cash Price |
$1,710.90
|
| Rate for Payer: Cash Price |
$1,710.90
|
| Rate for Payer: Central Health Plan Commercial |
$3,041.60
|
| Rate for Payer: Cigna of CA HMO |
$2,433.28
|
| Rate for Payer: Cigna of CA PPO |
$2,813.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$887.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$806.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,661.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,331.25
|
| Rate for Payer: EPIC Health Plan Senior |
$887.50
|
| Rate for Payer: Galaxy Health WC |
$3,231.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,281.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,421.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,323.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$262.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$806.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,414.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$290.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,129.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$760.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,081.14
|
| Rate for Payer: Multiplan Commercial |
$2,851.50
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$2,471.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$806.82
|
| Rate for Payer: Preferred Health Network WC |
$1,277.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,231.70
|
| Rate for Payer: Prime Health Services Medicare |
$855.23
|
| Rate for Payer: Prime Health Services WC |
$1,238.88
|
| Rate for Payer: Riverside University Health System MISP |
$887.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,281.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,901.00
|
| 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 |
$806.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$887.50
|
| Rate for Payer: Vantage Medical Group Senior |
$806.82
|
|
