|
HC MSI
|
Facility
|
IP
|
$540.00
|
|
|
Service Code
|
CPT 81301
|
| Hospital Charge Code |
903800318
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$108.00 |
| Max. Negotiated Rate |
$486.00 |
| Rate for Payer: Cash Price |
$243.00
|
| Rate for Payer: Central Health Plan Commercial |
$432.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$216.00
|
| Rate for Payer: Galaxy Health WC |
$459.00
|
| Rate for Payer: Global Benefits Group Commercial |
$324.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$486.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$360.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$205.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$108.00
|
| Rate for Payer: Multiplan Commercial |
$405.00
|
| Rate for Payer: Networks By Design Commercial |
$351.00
|
| Rate for Payer: Prime Health Services Commercial |
$459.00
|
|
|
HC MSLT OR MWT REDUCED SVC
|
Facility
|
IP
|
$3,199.00
|
|
|
Service Code
|
CPT 95805
|
| Hospital Charge Code |
903600033
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$639.80 |
| Max. Negotiated Rate |
$2,879.10 |
| Rate for Payer: Cash Price |
$1,439.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,559.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,279.60
|
| Rate for Payer: Galaxy Health WC |
$2,719.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,919.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,879.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,133.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,218.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$639.80
|
| Rate for Payer: Multiplan Commercial |
$2,399.25
|
| Rate for Payer: Networks By Design Commercial |
$2,079.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,719.15
|
|
|
HC MSLT OR MWT REDUCED SVC
|
Facility
|
OP
|
$3,199.00
|
|
|
Service Code
|
CPT 95805
|
| Hospital Charge Code |
903600033
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$371.87 |
| Max. Negotiated Rate |
$6,702.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$669.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,117.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,004.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$736.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$669.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,145.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,889.97
|
| Rate for Payer: Blue Distinction Transplant |
$1,919.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,976.98
|
| Rate for Payer: Blue Shield of California EPN |
$1,554.71
|
| Rate for Payer: Caremore Medicare Advantage |
$669.68
|
| Rate for Payer: Cash Price |
$1,439.55
|
| Rate for Payer: Cash Price |
$1,439.55
|
| Rate for Payer: Cash Price |
$1,439.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,559.20
|
| Rate for Payer: Cigna of CA HMO |
$2,047.36
|
| Rate for Payer: Cigna of CA PPO |
$2,367.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,004.52
|
| Rate for Payer: Dignity Health Media |
$669.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$736.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$904.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$669.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$669.68
|
| Rate for Payer: Galaxy Health WC |
$2,719.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,919.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,879.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,399.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,098.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,104.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$669.68
|
| Rate for Payer: InnovAge PACE Commercial |
$1,004.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,133.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$371.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$669.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$639.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$897.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$897.37
|
| Rate for Payer: Multiplan Commercial |
$2,399.25
|
| Rate for Payer: Networks By Design Commercial |
$2,079.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,719.15
|
| Rate for Payer: Prime Health Services Medicare |
$709.86
|
| Rate for Payer: Riverside University Health System MISP |
$736.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,919.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,919.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,702.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6,698.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,497.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,113.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,004.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$736.65
|
| Rate for Payer: Vantage Medical Group Senior |
$669.68
|
|
|
HC MTR URN 400ML DRAIN BAG L/F LL
|
Facility
|
OP
|
$54.28
|
|
| Hospital Charge Code |
901607518
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.86 |
| Max. Negotiated Rate |
$48.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$46.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32.07
|
| Rate for Payer: Blue Distinction Transplant |
$32.57
|
| Rate for Payer: Blue Shield of California Commercial |
$34.14
|
| Rate for Payer: Blue Shield of California EPN |
$26.54
|
| Rate for Payer: Cash Price |
$24.43
|
| Rate for Payer: Central Health Plan Commercial |
$43.42
|
| Rate for Payer: Cigna of CA HMO |
$34.74
|
| Rate for Payer: Cigna of CA PPO |
$40.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$46.14
|
| Rate for Payer: Dignity Health Media |
$46.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$46.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$21.71
|
| Rate for Payer: Galaxy Health WC |
$46.14
|
| Rate for Payer: Global Benefits Group Commercial |
$32.57
|
| Rate for Payer: Health Management Network EPO/PPO |
$48.85
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$40.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.86
|
| Rate for Payer: Multiplan Commercial |
$40.71
|
| Rate for Payer: Networks By Design Commercial |
$35.28
|
| Rate for Payer: Prime Health Services Commercial |
$46.14
|
| Rate for Payer: Riverside University Health System MISP |
$21.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.57
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$32.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.14
|
| Rate for Payer: United Healthcare All Other HMO |
$27.14
|
| Rate for Payer: United Healthcare HMO Rider |
$27.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$46.14
|
| Rate for Payer: Vantage Medical Group Senior |
$46.14
|
|
|
HC MTR URN 400ML DRAIN BAG L/F LL
|
Facility
|
IP
|
$54.28
|
|
| Hospital Charge Code |
901607518
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.86 |
| Max. Negotiated Rate |
$48.85 |
| Rate for Payer: Cash Price |
$24.43
|
| Rate for Payer: Central Health Plan Commercial |
$43.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.71
|
| Rate for Payer: Galaxy Health WC |
$46.14
|
| Rate for Payer: Global Benefits Group Commercial |
$32.57
|
| Rate for Payer: Health Management Network EPO/PPO |
$48.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.86
|
| Rate for Payer: Multiplan Commercial |
$40.71
|
| Rate for Payer: Networks By Design Commercial |
$35.28
|
| Rate for Payer: Prime Health Services Commercial |
$46.14
|
|
|
HC MULTIAXIAL ANKLE W DORSIFLEX
|
Facility
|
OP
|
$5,722.00
|
|
|
Service Code
|
CPT L5968
|
| Hospital Charge Code |
905355968
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$2,002.70 |
| Max. Negotiated Rate |
$5,149.80 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,863.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,147.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,147.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,770.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,380.56
|
| Rate for Payer: Blue Distinction Transplant |
$3,433.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4,291.50
|
| Rate for Payer: Blue Shield of California EPN |
$3,112.77
|
| Rate for Payer: Cash Price |
$2,574.90
|
| Rate for Payer: Cash Price |
$2,574.90
|
| Rate for Payer: Central Health Plan Commercial |
$4,577.60
|
| Rate for Payer: Cigna of CA HMO |
$4,005.40
|
| Rate for Payer: Cigna of CA PPO |
$4,005.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,863.70
|
| Rate for Payer: Dignity Health Media |
$4,863.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,863.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,288.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,288.80
|
| Rate for Payer: Galaxy Health WC |
$4,863.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,433.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,149.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,291.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,002.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,816.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,085.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,346.02
|
| Rate for Payer: Multiplan Commercial |
$4,291.50
|
| Rate for Payer: Networks By Design Commercial |
$2,861.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,863.70
|
| Rate for Payer: Riverside University Health System MISP |
$2,288.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,433.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,433.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,861.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,861.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,861.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,861.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,863.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4,863.70
|
|
|
HC MULTIAXIAL ANKLE W DORSIFLEX
|
Facility
|
IP
|
$5,722.00
|
|
|
Service Code
|
CPT L5968
|
| Hospital Charge Code |
905355968
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,144.40 |
| Max. Negotiated Rate |
$5,149.80 |
| Rate for Payer: Blue Shield of California EPN |
$3,055.55
|
| Rate for Payer: Cash Price |
$2,574.90
|
| Rate for Payer: Central Health Plan Commercial |
$4,577.60
|
| Rate for Payer: Cigna of CA HMO |
$4,005.40
|
| Rate for Payer: Cigna of CA PPO |
$4,005.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,288.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,288.80
|
| Rate for Payer: Galaxy Health WC |
$4,863.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,433.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,149.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,816.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,180.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,144.40
|
| Rate for Payer: Multiplan Commercial |
$4,291.50
|
| Rate for Payer: Networks By Design Commercial |
$2,861.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,863.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,160.63
|
| Rate for Payer: United Healthcare All Other HMO |
$2,110.27
|
| Rate for Payer: United Healthcare HMO Rider |
$2,064.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,888.26
|
|
|
HC MULTI FAMILY GROUP PSYCH
|
Facility
|
OP
|
$401.00
|
|
|
Service Code
|
CPT 90849
|
| Hospital Charge Code |
900100710
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$60.52 |
| Max. Negotiated Rate |
$360.90 |
| Rate for Payer: Adventist Health Medi-Cal |
$199.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$251.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$298.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$219.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$199.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$194.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$236.91
|
| Rate for Payer: Blue Distinction Transplant |
$240.60
|
| Rate for Payer: Blue Shield of California Commercial |
$252.23
|
| Rate for Payer: Blue Shield of California EPN |
$196.09
|
| Rate for Payer: Caremore Medicare Advantage |
$199.21
|
| Rate for Payer: Cash Price |
$180.45
|
| Rate for Payer: Cash Price |
$180.45
|
| Rate for Payer: Central Health Plan Commercial |
$320.80
|
| Rate for Payer: Cigna of CA HMO |
$256.64
|
| Rate for Payer: Cigna of CA PPO |
$296.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$298.82
|
| Rate for Payer: Dignity Health Media |
$199.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$219.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$268.93
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$199.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$199.21
|
| Rate for Payer: Galaxy Health WC |
$340.85
|
| Rate for Payer: Global Benefits Group Commercial |
$240.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$360.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$300.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$326.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$328.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$199.21
|
| Rate for Payer: InnovAge PACE Commercial |
$298.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$267.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$60.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$199.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$266.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$266.94
|
| Rate for Payer: Multiplan Commercial |
$300.75
|
| Rate for Payer: Networks By Design Commercial |
$260.65
|
| Rate for Payer: Prime Health Services Commercial |
$340.85
|
| Rate for Payer: Prime Health Services Medicare |
$211.16
|
| Rate for Payer: Riverside University Health System MISP |
$219.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$240.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$240.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$200.50
|
| Rate for Payer: United Healthcare All Other HMO |
$200.50
|
| Rate for Payer: United Healthcare HMO Rider |
$200.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$200.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$298.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$219.13
|
| Rate for Payer: Vantage Medical Group Senior |
$199.21
|
|
|
HC MULTI FAMILY GROUP PSYCH
|
Facility
|
IP
|
$401.00
|
|
|
Service Code
|
CPT 90849
|
| Hospital Charge Code |
900100710
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$80.20 |
| Max. Negotiated Rate |
$360.90 |
| Rate for Payer: Cash Price |
$180.45
|
| Rate for Payer: Central Health Plan Commercial |
$320.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.40
|
| Rate for Payer: Galaxy Health WC |
$340.85
|
| Rate for Payer: Global Benefits Group Commercial |
$240.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$360.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$267.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$152.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.20
|
| Rate for Payer: Multiplan Commercial |
$300.75
|
| Rate for Payer: Networks By Design Commercial |
$260.65
|
| Rate for Payer: Prime Health Services Commercial |
$340.85
|
|
|
HC MULTI FAMILY GROUP PSYCH
|
Facility
|
IP
|
$401.00
|
|
|
Service Code
|
CPT 90849
|
| Hospital Charge Code |
900100710
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$80.20 |
| Max. Negotiated Rate |
$360.90 |
| Rate for Payer: Cash Price |
$180.45
|
| Rate for Payer: Central Health Plan Commercial |
$320.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.40
|
| Rate for Payer: Galaxy Health WC |
$340.85
|
| Rate for Payer: Global Benefits Group Commercial |
$240.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$360.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$267.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$152.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.20
|
| Rate for Payer: Multiplan Commercial |
$300.75
|
| Rate for Payer: Networks By Design Commercial |
$260.65
|
| Rate for Payer: Prime Health Services Commercial |
$340.85
|
|
|
HC MULTI FAMILY GROUP PSYCH
|
Facility
|
OP
|
$401.00
|
|
|
Service Code
|
CPT 90849
|
| Hospital Charge Code |
900100710
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$60.52 |
| Max. Negotiated Rate |
$360.90 |
| Rate for Payer: Adventist Health Medi-Cal |
$199.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$251.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$298.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$219.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$199.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$194.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$236.91
|
| Rate for Payer: Blue Distinction Transplant |
$240.60
|
| Rate for Payer: Blue Shield of California Commercial |
$252.23
|
| Rate for Payer: Blue Shield of California EPN |
$196.09
|
| Rate for Payer: Caremore Medicare Advantage |
$199.21
|
| Rate for Payer: Cash Price |
$180.45
|
| Rate for Payer: Cash Price |
$180.45
|
| Rate for Payer: Central Health Plan Commercial |
$320.80
|
| Rate for Payer: Cigna of CA HMO |
$256.64
|
| Rate for Payer: Cigna of CA PPO |
$296.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$298.82
|
| Rate for Payer: Dignity Health Media |
$199.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$219.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$268.93
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$199.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$199.21
|
| Rate for Payer: Galaxy Health WC |
$340.85
|
| Rate for Payer: Global Benefits Group Commercial |
$240.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$360.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$300.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$326.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$328.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$199.21
|
| Rate for Payer: InnovAge PACE Commercial |
$298.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$267.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$60.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$199.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$266.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$266.94
|
| Rate for Payer: Multiplan Commercial |
$300.75
|
| Rate for Payer: Networks By Design Commercial |
$260.65
|
| Rate for Payer: Prime Health Services Commercial |
$340.85
|
| Rate for Payer: Prime Health Services Medicare |
$211.16
|
| Rate for Payer: Riverside University Health System MISP |
$219.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$240.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$240.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$200.50
|
| Rate for Payer: United Healthcare All Other HMO |
$200.50
|
| Rate for Payer: United Healthcare HMO Rider |
$200.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$200.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$298.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$219.13
|
| Rate for Payer: Vantage Medical Group Senior |
$199.21
|
|
|
HC MULTIHANCE PER ML
|
Facility
|
IP
|
$18.00
|
|
|
Service Code
|
CPT A9577
|
| Hospital Charge Code |
900009577
|
|
Hospital Revenue Code
|
255
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$16.20 |
| Rate for Payer: Blue Shield of California Commercial |
$13.50
|
| Rate for Payer: Blue Shield of California EPN |
$9.61
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Central Health Plan Commercial |
$14.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.20
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Multiplan Commercial |
$13.50
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
|
|
HC MULTIHANCE PER ML
|
Facility
|
OP
|
$18.00
|
|
|
Service Code
|
CPT A9577
|
| Hospital Charge Code |
900009577
|
|
Hospital Revenue Code
|
255
|
| Min. Negotiated Rate |
$1.83 |
| Max. Negotiated Rate |
$16.20 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.86
|
| Rate for Payer: Blue Distinction Transplant |
$10.80
|
| Rate for Payer: Blue Shield of California Commercial |
$11.32
|
| Rate for Payer: Blue Shield of California EPN |
$8.80
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Central Health Plan Commercial |
$14.40
|
| Rate for Payer: Cigna of CA HMO |
$11.52
|
| Rate for Payer: Cigna of CA PPO |
$13.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.30
|
| Rate for Payer: Dignity Health Media |
$15.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.20
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$13.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Multiplan Commercial |
$13.50
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
| Rate for Payer: Riverside University Health System MISP |
$7.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.00
|
| Rate for Payer: United Healthcare All Other HMO |
$9.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.30
|
| Rate for Payer: Vantage Medical Group Senior |
$15.30
|
|
|
HC MULTI-PLANAR RECON
|
Facility
|
OP
|
$2,175.00
|
|
|
Service Code
|
CPT 76376
|
| Hospital Charge Code |
909201350
|
|
Hospital Revenue Code
|
359
|
| Min. Negotiated Rate |
$435.00 |
| Max. Negotiated Rate |
$2,364.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,848.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,196.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$701.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,284.99
|
| Rate for Payer: Blue Distinction Transplant |
$1,305.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,368.08
|
| Rate for Payer: Blue Shield of California EPN |
$1,063.58
|
| Rate for Payer: Cash Price |
$978.75
|
| Rate for Payer: Cash Price |
$978.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,740.00
|
| Rate for Payer: Cigna of CA HMO |
$1,392.00
|
| Rate for Payer: Cigna of CA PPO |
$1,609.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,848.75
|
| Rate for Payer: Dignity Health Media |
$1,848.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,848.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$870.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$870.00
|
| Rate for Payer: Galaxy Health WC |
$1,848.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,305.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,957.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,631.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$761.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,450.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$828.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$435.00
|
| Rate for Payer: Multiplan Commercial |
$1,631.25
|
| Rate for Payer: Networks By Design Commercial |
$1,413.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,848.75
|
| Rate for Payer: Riverside University Health System MISP |
$870.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,305.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,305.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,087.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,087.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,087.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,087.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,848.75
|
| Rate for Payer: Vantage Medical Group Senior |
$1,848.75
|
|
|
HC MULTI-PLANAR RECON
|
Facility
|
IP
|
$2,175.00
|
|
|
Service Code
|
CPT 76376
|
| Hospital Charge Code |
909201350
|
|
Hospital Revenue Code
|
359
|
| Min. Negotiated Rate |
$435.00 |
| Max. Negotiated Rate |
$1,957.50 |
| Rate for Payer: Cash Price |
$978.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,740.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$870.00
|
| Rate for Payer: Galaxy Health WC |
$1,848.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,305.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,957.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,450.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$828.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$435.00
|
| Rate for Payer: Multiplan Commercial |
$1,631.25
|
| Rate for Payer: Networks By Design Commercial |
$1,413.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,848.75
|
|
|
HC MULTI-PODUS LINER
|
Facility
|
OP
|
$243.00
|
|
|
Service Code
|
CPT L4392
|
| Hospital Charge Code |
905354320
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$85.05 |
| Max. Negotiated Rate |
$218.70 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$206.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$133.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$133.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$117.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$143.56
|
| Rate for Payer: Blue Distinction Transplant |
$145.80
|
| Rate for Payer: Blue Shield of California Commercial |
$182.25
|
| Rate for Payer: Blue Shield of California EPN |
$132.19
|
| Rate for Payer: Cash Price |
$109.35
|
| Rate for Payer: Central Health Plan Commercial |
$194.40
|
| Rate for Payer: Cigna of CA HMO |
$170.10
|
| Rate for Payer: Cigna of CA PPO |
$170.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.55
|
| Rate for Payer: Dignity Health Media |
$206.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$206.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$97.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$97.20
|
| Rate for Payer: Galaxy Health WC |
$206.55
|
| Rate for Payer: Global Benefits Group Commercial |
$145.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$218.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$182.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$85.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$162.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$92.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.63
|
| Rate for Payer: Multiplan Commercial |
$182.25
|
| Rate for Payer: Networks By Design Commercial |
$121.50
|
| Rate for Payer: Prime Health Services Commercial |
$206.55
|
| Rate for Payer: Riverside University Health System MISP |
$97.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$145.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$145.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.50
|
| Rate for Payer: United Healthcare All Other HMO |
$121.50
|
| Rate for Payer: United Healthcare HMO Rider |
$121.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$121.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$206.55
|
| Rate for Payer: Vantage Medical Group Senior |
$206.55
|
|
|
HC MULTI-PODUS LINER
|
Facility
|
IP
|
$243.00
|
|
|
Service Code
|
CPT L4392
|
| Hospital Charge Code |
905354320
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$48.60 |
| Max. Negotiated Rate |
$218.70 |
| Rate for Payer: Blue Shield of California EPN |
$129.76
|
| Rate for Payer: Cash Price |
$109.35
|
| Rate for Payer: Central Health Plan Commercial |
$194.40
|
| Rate for Payer: Cigna of CA HMO |
$170.10
|
| Rate for Payer: Cigna of CA PPO |
$170.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$97.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$97.20
|
| Rate for Payer: Galaxy Health WC |
$206.55
|
| Rate for Payer: Global Benefits Group Commercial |
$145.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$218.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$162.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$92.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.60
|
| Rate for Payer: Multiplan Commercial |
$182.25
|
| Rate for Payer: Networks By Design Commercial |
$121.50
|
| Rate for Payer: Prime Health Services Commercial |
$206.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$91.76
|
| Rate for Payer: United Healthcare All Other HMO |
$89.62
|
| Rate for Payer: United Healthcare HMO Rider |
$87.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$80.19
|
|
|
HC MULTI-POST COLLAR
|
Facility
|
IP
|
$826.00
|
|
|
Service Code
|
CPT L0180
|
| Hospital Charge Code |
905350180
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$165.20 |
| Max. Negotiated Rate |
$743.40 |
| Rate for Payer: Blue Shield of California EPN |
$441.08
|
| Rate for Payer: Cash Price |
$371.70
|
| Rate for Payer: Central Health Plan Commercial |
$660.80
|
| Rate for Payer: Cigna of CA HMO |
$578.20
|
| Rate for Payer: Cigna of CA PPO |
$578.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$330.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$330.40
|
| Rate for Payer: Galaxy Health WC |
$702.10
|
| Rate for Payer: Global Benefits Group Commercial |
$495.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$743.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$550.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$314.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$165.20
|
| Rate for Payer: Multiplan Commercial |
$619.50
|
| Rate for Payer: Networks By Design Commercial |
$413.00
|
| Rate for Payer: Prime Health Services Commercial |
$702.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$311.90
|
| Rate for Payer: United Healthcare All Other HMO |
$304.63
|
| Rate for Payer: United Healthcare HMO Rider |
$298.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$272.58
|
|
|
HC MULTI-POST COLLAR
|
Facility
|
OP
|
$826.00
|
|
|
Service Code
|
CPT L0180
|
| Hospital Charge Code |
905350180
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$289.10 |
| Max. Negotiated Rate |
$743.40 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$702.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$454.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$454.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$399.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$488.00
|
| Rate for Payer: Blue Distinction Transplant |
$495.60
|
| Rate for Payer: Blue Shield of California Commercial |
$619.50
|
| Rate for Payer: Blue Shield of California EPN |
$449.34
|
| Rate for Payer: Cash Price |
$371.70
|
| Rate for Payer: Cash Price |
$371.70
|
| Rate for Payer: Central Health Plan Commercial |
$660.80
|
| Rate for Payer: Cigna of CA HMO |
$578.20
|
| Rate for Payer: Cigna of CA PPO |
$578.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$702.10
|
| Rate for Payer: Dignity Health Media |
$702.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$702.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$330.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$330.40
|
| Rate for Payer: Galaxy Health WC |
$702.10
|
| Rate for Payer: Global Benefits Group Commercial |
$495.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$743.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$619.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$289.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$550.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$337.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$338.66
|
| Rate for Payer: Multiplan Commercial |
$619.50
|
| Rate for Payer: Networks By Design Commercial |
$413.00
|
| Rate for Payer: Prime Health Services Commercial |
$702.10
|
| Rate for Payer: Riverside University Health System MISP |
$330.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$495.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$495.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$413.00
|
| Rate for Payer: United Healthcare All Other HMO |
$413.00
|
| Rate for Payer: United Healthcare HMO Rider |
$413.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$413.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$702.10
|
| Rate for Payer: Vantage Medical Group Senior |
$702.10
|
|
|
HC MUMPS AB
|
Facility
|
IP
|
$227.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
900913533
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$45.40 |
| Max. Negotiated Rate |
$204.30 |
| Rate for Payer: Cash Price |
$102.15
|
| Rate for Payer: Central Health Plan Commercial |
$181.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$90.80
|
| Rate for Payer: Galaxy Health WC |
$192.95
|
| Rate for Payer: Global Benefits Group Commercial |
$136.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$204.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$151.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$86.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.40
|
| Rate for Payer: Multiplan Commercial |
$170.25
|
| Rate for Payer: Networks By Design Commercial |
$147.55
|
| Rate for Payer: Prime Health Services Commercial |
$192.95
|
|
|
HC MUMPS AB
|
Facility
|
OP
|
$27.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
900913533
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.40 |
| Max. Negotiated Rate |
$117.03 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$95.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$95.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$117.03
|
| Rate for Payer: Blue Distinction Transplant |
$16.20
|
| Rate for Payer: Blue Shield of California Commercial |
$16.69
|
| Rate for Payer: Blue Shield of California EPN |
$13.12
|
| Rate for Payer: Caremore Medicare Advantage |
$13.05
|
| Rate for Payer: Cash Price |
$12.15
|
| Rate for Payer: Cash Price |
$12.15
|
| Rate for Payer: Central Health Plan Commercial |
$21.60
|
| Rate for Payer: Cigna of CA HMO |
$17.28
|
| Rate for Payer: Cigna of CA PPO |
$19.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.58
|
| Rate for Payer: Dignity Health Media |
$13.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.05
|
| Rate for Payer: Galaxy Health WC |
$22.95
|
| Rate for Payer: Global Benefits Group Commercial |
$16.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$20.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$21.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.05
|
| Rate for Payer: InnovAge PACE Commercial |
$19.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.49
|
| Rate for Payer: Multiplan Commercial |
$20.25
|
| Rate for Payer: Networks By Design Commercial |
$17.55
|
| Rate for Payer: Prime Health Services Commercial |
$22.95
|
| Rate for Payer: Prime Health Services Medicare |
$13.83
|
| Rate for Payer: Riverside University Health System MISP |
$14.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.58
|
| Rate for Payer: United Healthcare All Other HMO |
$10.58
|
| Rate for Payer: United Healthcare HMO Rider |
$10.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Vantage Medical Group Senior |
$13.05
|
|
|
HC MUMPS ANTIBODY
|
Facility
|
IP
|
$58.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
900913663
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.60 |
| Max. Negotiated Rate |
$52.20 |
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Central Health Plan Commercial |
$46.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.20
|
| Rate for Payer: Galaxy Health WC |
$49.30
|
| Rate for Payer: Global Benefits Group Commercial |
$34.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$52.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.60
|
| Rate for Payer: Multiplan Commercial |
$43.50
|
| Rate for Payer: Networks By Design Commercial |
$37.70
|
| Rate for Payer: Prime Health Services Commercial |
$49.30
|
|
|
HC MUMPS ANTIBODY
|
Facility
|
OP
|
$39.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
900913663
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$117.03 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$95.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$95.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$117.03
|
| Rate for Payer: Blue Distinction Transplant |
$23.40
|
| Rate for Payer: Blue Shield of California Commercial |
$24.10
|
| Rate for Payer: Blue Shield of California EPN |
$18.95
|
| Rate for Payer: Caremore Medicare Advantage |
$13.05
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Central Health Plan Commercial |
$31.20
|
| Rate for Payer: Cigna of CA HMO |
$24.96
|
| Rate for Payer: Cigna of CA PPO |
$28.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.58
|
| Rate for Payer: Dignity Health Media |
$13.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.05
|
| Rate for Payer: Galaxy Health WC |
$33.15
|
| Rate for Payer: Global Benefits Group Commercial |
$23.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$29.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$21.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.05
|
| Rate for Payer: InnovAge PACE Commercial |
$19.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.49
|
| Rate for Payer: Multiplan Commercial |
$29.25
|
| Rate for Payer: Networks By Design Commercial |
$25.35
|
| Rate for Payer: Prime Health Services Commercial |
$33.15
|
| Rate for Payer: Prime Health Services Medicare |
$13.83
|
| Rate for Payer: Riverside University Health System MISP |
$14.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.58
|
| Rate for Payer: United Healthcare All Other HMO |
$10.58
|
| Rate for Payer: United Healthcare HMO Rider |
$10.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Vantage Medical Group Senior |
$13.05
|
|
|
HC MUSCLE BIOPSY, PERCUTANEOUS
|
Facility
|
OP
|
$2,857.00
|
|
|
Service Code
|
CPT 20206
|
| Hospital Charge Code |
909000105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$125.21 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,025.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,714.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$2,025.69
|
| Rate for Payer: Cash Price |
$1,285.65
|
| Rate for Payer: Cash Price |
$1,285.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,285.60
|
| Rate for Payer: Cigna of CA PPO |
$2,114.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Dignity Health Media |
$2,025.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
| Rate for Payer: Galaxy Health WC |
$2,428.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,714.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,571.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,142.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,322.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,342.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
| Rate for Payer: InnovAge PACE Commercial |
$3,038.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,905.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$125.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$571.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,714.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
| Rate for Payer: Multiplan Commercial |
$2,142.75
|
| Rate for Payer: Networks By Design Commercial |
$1,857.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,428.45
|
| Rate for Payer: Prime Health Services Medicare |
$2,147.23
|
| Rate for Payer: Riverside University Health System MISP |
$2,228.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,714.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC MUSCLE BIOPSY, PERCUTANEOUS
|
Facility
|
IP
|
$2,857.00
|
|
|
Service Code
|
CPT 20206
|
| Hospital Charge Code |
909000105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$571.40 |
| Max. Negotiated Rate |
$2,571.30 |
| Rate for Payer: Cash Price |
$1,285.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,285.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,142.80
|
| Rate for Payer: Galaxy Health WC |
$2,428.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,714.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,571.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,905.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,088.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$571.40
|
| Rate for Payer: Multiplan Commercial |
$2,142.75
|
| Rate for Payer: Networks By Design Commercial |
$1,857.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,428.45
|
|
