|
HC REMOVE TUNNEL PLEURAL CATH
|
Facility
|
IP
|
$3,802.00
|
|
|
Service Code
|
CPT 32552
|
| Hospital Charge Code |
902100152
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$760.40 |
| Max. Negotiated Rate |
$3,421.80 |
| Rate for Payer: Adventist Health Commercial |
$760.40
|
| Rate for Payer: Cash Price |
$1,710.90
|
| Rate for Payer: Central Health Plan Commercial |
$3,041.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,661.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,520.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,520.80
|
| 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: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,414.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,243.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$760.40
|
| Rate for Payer: Multiplan Commercial |
$2,851.50
|
| Rate for Payer: Networks By Design Commercial |
$2,471.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,231.70
|
|
|
HC REMOVE URETER STENT, PERCUT
|
Facility
|
IP
|
$9,770.00
|
|
|
Service Code
|
CPT 50384
|
| Hospital Charge Code |
909081851
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,954.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Adventist Health Commercial |
$1,954.00
|
| Rate for Payer: Cash Price |
$4,396.50
|
| Rate for Payer: Central Health Plan Commercial |
$7,816.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,839.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,908.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,908.00
|
| Rate for Payer: Galaxy Health WC |
$8,304.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,862.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,793.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,203.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,764.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,954.00
|
| Rate for Payer: Multiplan Commercial |
$7,327.50
|
| Rate for Payer: Networks By Design Commercial |
$6,350.50
|
| Rate for Payer: Prime Health Services Commercial |
$8,304.50
|
|
|
HC REMOVE URETER STENT, PERCUT
|
Facility
|
OP
|
$9,770.00
|
|
|
Service Code
|
CPT 50384
|
| Hospital Charge Code |
909081851
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,954.00 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,954.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,688.58
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,032.87
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,957.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,688.58
|
| 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 |
$4,147.14
|
| 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 |
$4,396.50
|
| Rate for Payer: Cash Price |
$4,396.50
|
| Rate for Payer: Cash Price |
$4,396.50
|
| Rate for Payer: Central Health Plan Commercial |
$7,816.00
|
| Rate for Payer: Cigna of CA HMO |
$6,252.80
|
| Rate for Payer: Cigna of CA PPO |
$7,229.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,032.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,957.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,688.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,839.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,436.16
|
| Rate for Payer: EPIC Health Plan Senior |
$2,957.44
|
| Rate for Payer: Galaxy Health WC |
$8,304.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,862.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,793.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,409.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,266.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,688.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,203.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,503.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,764.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,954.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,602.70
|
| Rate for Payer: Multiplan Commercial |
$7,327.50
|
| Rate for Payer: Multiplan WC |
$4,147.14
|
| Rate for Payer: Networks By Design Commercial |
$6,350.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,688.58
|
| Rate for Payer: Preferred Health Network WC |
$4,231.78
|
| Rate for Payer: Prime Health Services Commercial |
$8,304.50
|
| Rate for Payer: Prime Health Services Medicare |
$2,849.89
|
| Rate for Payer: Prime Health Services WC |
$4,104.83
|
| Rate for Payer: Riverside University Health System MISP |
$2,957.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,862.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,885.00
|
| 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 |
$2,688.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,032.87
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,957.44
|
| Rate for Payer: Vantage Medical Group Senior |
$2,688.58
|
|
|
HC REMOVE VAD DIFF SESSION
|
Facility
|
IP
|
$6,134.00
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
906811430
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,226.80 |
| Max. Negotiated Rate |
$5,520.60 |
| Rate for Payer: Adventist Health Commercial |
$1,226.80
|
| Rate for Payer: Cash Price |
$2,760.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,907.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,293.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,453.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,453.60
|
| Rate for Payer: Galaxy Health WC |
$5,213.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,680.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,520.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,895.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,619.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,226.80
|
| Rate for Payer: Multiplan Commercial |
$4,600.50
|
| Rate for Payer: Networks By Design Commercial |
$3,987.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,213.90
|
|
|
HC REMOVE VAD DIFF SESSION
|
Facility
|
OP
|
$6,134.00
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
906811430
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$285.61 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,226.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,213.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,373.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,600.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,138.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,579.41
|
| Rate for Payer: Blue Shield of California EPN |
$6,020.76
|
| Rate for Payer: Cash Price |
$2,760.30
|
| Rate for Payer: Cash Price |
$2,760.30
|
| Rate for Payer: Cash Price |
$2,760.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,907.20
|
| Rate for Payer: Cigna of CA HMO |
$3,987.10
|
| Rate for Payer: Cigna of CA PPO |
$4,539.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,213.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,213.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,213.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,293.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,453.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,453.60
|
| Rate for Payer: Galaxy Health WC |
$5,213.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,680.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,520.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$285.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,895.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$315.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,619.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,226.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,293.80
|
| Rate for Payer: Multiplan Commercial |
$4,600.50
|
| Rate for Payer: Networks By Design Commercial |
$3,987.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,213.90
|
| Rate for Payer: Riverside University Health System MISP |
$2,453.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,680.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,680.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,067.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,213.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,213.90
|
| Rate for Payer: Vantage Medical Group Senior |
$5,213.90
|
|
|
HC REMOVE VENTILATING TUBE
|
Facility
|
OP
|
$7,823.00
|
|
|
Service Code
|
CPT 69424
|
| Hospital Charge Code |
900501512
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$120.25 |
| Max. Negotiated Rate |
$7,040.70 |
| Rate for Payer: Adventist Health Commercial |
$1,564.60
|
| 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 |
$6,396.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,690.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,264.23
|
| 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 |
$6,565.51
|
| Rate for Payer: Cash Price |
$3,520.35
|
| Rate for Payer: Cash Price |
$3,520.35
|
| Rate for Payer: Cash Price |
$3,520.35
|
| Rate for Payer: Cash Price |
$3,520.35
|
| Rate for Payer: Central Health Plan Commercial |
$6,258.40
|
| Rate for Payer: Cigna of CA HMO |
$5,006.72
|
| Rate for Payer: Cigna of CA PPO |
$5,789.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,690.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,264.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,476.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,035.98
|
| Rate for Payer: EPIC Health Plan Senior |
$4,690.65
|
| Rate for Payer: Galaxy Health WC |
$6,649.55
|
| Rate for Payer: Global Benefits Group Commercial |
$4,693.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,040.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,993.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,264.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,967.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$120.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,584.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,564.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,714.07
|
| Rate for Payer: Multiplan Commercial |
$5,867.25
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: Networks By Design Commercial |
$5,084.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,264.23
|
| Rate for Payer: Preferred Health Network WC |
$6,699.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,649.55
|
| Rate for Payer: Prime Health Services Medicare |
$4,520.08
|
| Rate for Payer: Prime Health Services WC |
$6,498.52
|
| Rate for Payer: Riverside University Health System MISP |
$4,690.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,693.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,911.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,911.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,911.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,911.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,264.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,690.65
|
| Rate for Payer: Vantage Medical Group Senior |
$4,264.23
|
|
|
HC REMOVE VENTILATING TUBE
|
Facility
|
IP
|
$7,823.00
|
|
|
Service Code
|
CPT 69424
|
| Hospital Charge Code |
900501512
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,564.60 |
| Max. Negotiated Rate |
$7,040.70 |
| Rate for Payer: Adventist Health Commercial |
$1,564.60
|
| Rate for Payer: Cash Price |
$3,520.35
|
| Rate for Payer: Central Health Plan Commercial |
$6,258.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,476.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,129.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,129.20
|
| Rate for Payer: Galaxy Health WC |
$6,649.55
|
| Rate for Payer: Global Benefits Group Commercial |
$4,693.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,040.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,967.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,615.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,564.60
|
| Rate for Payer: Multiplan Commercial |
$5,867.25
|
| Rate for Payer: Networks By Design Commercial |
$5,084.95
|
| Rate for Payer: Prime Health Services Commercial |
$6,649.55
|
|
|
HC REMVL TUN CVP ACCESS W SUBCU
|
Facility
|
OP
|
$8,597.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
909081361
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$275.35 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,719.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,024.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,227.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,024.63
|
| 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 |
$3,144.90
|
| 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 |
$3,868.65
|
| Rate for Payer: Cash Price |
$3,868.65
|
| Rate for Payer: Cash Price |
$3,868.65
|
| Rate for Payer: Central Health Plan Commercial |
$6,877.60
|
| Rate for Payer: Cigna of CA HMO |
$5,502.08
|
| Rate for Payer: Cigna of CA PPO |
$6,361.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,227.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,024.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,017.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,340.64
|
| Rate for Payer: EPIC Health Plan Senior |
$2,227.09
|
| Rate for Payer: Galaxy Health WC |
$7,307.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,158.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,737.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,320.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$275.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,024.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,459.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$304.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,834.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,719.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,713.00
|
| Rate for Payer: Multiplan Commercial |
$6,447.75
|
| Rate for Payer: Multiplan WC |
$3,144.90
|
| Rate for Payer: Networks By Design Commercial |
$5,588.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,024.63
|
| Rate for Payer: Preferred Health Network WC |
$3,209.08
|
| Rate for Payer: Prime Health Services Commercial |
$7,307.45
|
| Rate for Payer: Prime Health Services Medicare |
$2,146.11
|
| Rate for Payer: Prime Health Services WC |
$3,112.81
|
| Rate for Payer: Riverside University Health System MISP |
$2,227.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,158.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,298.50
|
| 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 |
$2,024.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,227.09
|
| Rate for Payer: Vantage Medical Group Senior |
$2,024.63
|
|
|
HC REMVL TUN CVP ACCESS W SUBCU
|
Facility
|
IP
|
$8,597.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
900501752
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,719.40 |
| Max. Negotiated Rate |
$7,737.30 |
| Rate for Payer: Adventist Health Commercial |
$1,719.40
|
| Rate for Payer: Cash Price |
$3,868.65
|
| Rate for Payer: Central Health Plan Commercial |
$6,877.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,017.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,438.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,438.80
|
| Rate for Payer: Galaxy Health WC |
$7,307.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,158.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,737.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,459.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,072.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,719.40
|
| Rate for Payer: Multiplan Commercial |
$6,447.75
|
| Rate for Payer: Networks By Design Commercial |
$5,588.05
|
| Rate for Payer: Prime Health Services Commercial |
$7,307.45
|
|
|
HC REMVL TUN CVP ACCESS W SUBCU
|
Facility
|
IP
|
$8,597.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
909081361
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,719.40 |
| Max. Negotiated Rate |
$7,737.30 |
| Rate for Payer: Adventist Health Commercial |
$1,719.40
|
| Rate for Payer: Cash Price |
$3,868.65
|
| Rate for Payer: Central Health Plan Commercial |
$6,877.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,017.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,438.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,438.80
|
| Rate for Payer: Galaxy Health WC |
$7,307.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,158.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,737.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,459.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,072.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,719.40
|
| Rate for Payer: Multiplan Commercial |
$6,447.75
|
| Rate for Payer: Networks By Design Commercial |
$5,588.05
|
| Rate for Payer: Prime Health Services Commercial |
$7,307.45
|
|
|
HC REMVL TUN CVP ACCESS W SUBCU
|
Facility
|
OP
|
$8,597.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
900501752
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$304.17 |
| Max. Negotiated Rate |
$7,737.30 |
| Rate for Payer: Adventist Health Commercial |
$1,719.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,227.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,024.63
|
| 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 |
$3,144.90
|
| Rate for Payer: Cash Price |
$3,868.65
|
| Rate for Payer: Cash Price |
$3,868.65
|
| Rate for Payer: Cash Price |
$3,868.65
|
| Rate for Payer: Cash Price |
$3,868.65
|
| Rate for Payer: Central Health Plan Commercial |
$6,877.60
|
| Rate for Payer: Cigna of CA HMO |
$5,502.08
|
| Rate for Payer: Cigna of CA PPO |
$6,361.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,227.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,024.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,017.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,340.64
|
| Rate for Payer: EPIC Health Plan Senior |
$2,227.09
|
| Rate for Payer: Galaxy Health WC |
$7,307.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,158.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,737.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,320.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,024.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,459.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$304.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,176.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,719.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,713.00
|
| Rate for Payer: Multiplan Commercial |
$6,447.75
|
| Rate for Payer: Multiplan WC |
$3,144.90
|
| Rate for Payer: Networks By Design Commercial |
$5,588.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,024.63
|
| Rate for Payer: Preferred Health Network WC |
$3,209.08
|
| Rate for Payer: Prime Health Services Commercial |
$7,307.45
|
| Rate for Payer: Prime Health Services Medicare |
$2,146.11
|
| Rate for Payer: Prime Health Services WC |
$3,112.81
|
| Rate for Payer: Riverside University Health System MISP |
$2,227.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,158.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,298.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,298.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,298.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,298.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,024.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,227.09
|
| Rate for Payer: Vantage Medical Group Senior |
$2,024.63
|
|
|
HC RENAL ANGIO CARDIAC CATH
|
Facility
|
IP
|
$2,788.00
|
|
|
Service Code
|
CPT G0278
|
| Hospital Charge Code |
906811386
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$557.60 |
| Max. Negotiated Rate |
$2,509.20 |
| Rate for Payer: Adventist Health Commercial |
$557.60
|
| Rate for Payer: Cash Price |
$1,254.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,230.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,951.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,115.20
|
| Rate for Payer: Galaxy Health WC |
$2,369.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,672.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,509.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,770.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,644.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.60
|
| Rate for Payer: Multiplan Commercial |
$2,091.00
|
| Rate for Payer: Networks By Design Commercial |
$1,812.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,369.80
|
|
|
HC RENAL ANGIO CARDIAC CATH
|
Facility
|
OP
|
$2,788.00
|
|
|
Service Code
|
CPT G0278
|
| Hospital Charge Code |
906811386
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$68.42 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$557.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,369.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,533.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,091.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$68.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,621.78
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$1,254.60
|
| Rate for Payer: Cash Price |
$1,254.60
|
| Rate for Payer: Cash Price |
$1,254.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,230.40
|
| Rate for Payer: Cigna of CA HMO |
$1,784.32
|
| Rate for Payer: Cigna of CA PPO |
$2,063.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,369.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,369.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,369.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,951.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,115.20
|
| Rate for Payer: Galaxy Health WC |
$2,369.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,672.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,509.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,770.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,012.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,644.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,951.60
|
| Rate for Payer: Multiplan Commercial |
$2,091.00
|
| Rate for Payer: Networks By Design Commercial |
$1,812.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,369.80
|
| Rate for Payer: Riverside University Health System MISP |
$1,115.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,672.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,394.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,394.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,394.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,394.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,369.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,369.80
|
| Rate for Payer: Vantage Medical Group Senior |
$2,369.80
|
|
|
HC RENAL BILAT 2ND ORDER
|
Facility
|
IP
|
$8,446.00
|
|
|
Service Code
|
CPT 36254
|
| Hospital Charge Code |
909036254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,689.20 |
| Max. Negotiated Rate |
$7,601.40 |
| Rate for Payer: Adventist Health Commercial |
$1,689.20
|
| Rate for Payer: Cash Price |
$3,800.70
|
| Rate for Payer: Central Health Plan Commercial |
$6,756.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,912.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,378.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,378.40
|
| Rate for Payer: Galaxy Health WC |
$7,179.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,067.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,601.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,363.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,983.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,689.20
|
| Rate for Payer: Multiplan Commercial |
$6,334.50
|
| Rate for Payer: Networks By Design Commercial |
$5,489.90
|
| Rate for Payer: Prime Health Services Commercial |
$7,179.10
|
|
|
HC RENAL BILAT 2ND ORDER
|
Facility
|
OP
|
$8,446.00
|
|
|
Service Code
|
CPT 36254
|
| Hospital Charge Code |
909036254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$586.57 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,689.20
|
| 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 |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,800.70
|
| Rate for Payer: Cash Price |
$3,800.70
|
| Rate for Payer: Cash Price |
$3,800.70
|
| Rate for Payer: Central Health Plan Commercial |
$6,756.80
|
| Rate for Payer: Cigna of CA HMO |
$5,405.44
|
| Rate for Payer: Cigna of CA PPO |
$6,250.04
|
| 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 |
$5,912.20
|
| 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 |
$7,179.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,067.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,601.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$586.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,363.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$647.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,689.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$6,334.50
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$5,489.90
|
| 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 |
$7,179.10
|
| 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 |
$5,067.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,223.00
|
| 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 RENAL BILAT SELECTIVE INC AO
|
Facility
|
OP
|
$8,871.00
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
909036252
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$510.36 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,774.20
|
| 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 |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,991.95
|
| Rate for Payer: Cash Price |
$3,991.95
|
| Rate for Payer: Cash Price |
$3,991.95
|
| Rate for Payer: Central Health Plan Commercial |
$7,096.80
|
| Rate for Payer: Cigna of CA HMO |
$5,677.44
|
| Rate for Payer: Cigna of CA PPO |
$6,564.54
|
| 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 |
$6,209.70
|
| 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 |
$7,540.35
|
| Rate for Payer: Global Benefits Group Commercial |
$5,322.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,983.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$510.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,633.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$563.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,774.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$6,653.25
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$5,766.15
|
| 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 |
$7,540.35
|
| 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 |
$5,322.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,435.50
|
| 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 RENAL BILAT SELECTIVE INC AO
|
Facility
|
IP
|
$8,871.00
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
909036252
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,774.20 |
| Max. Negotiated Rate |
$7,983.90 |
| Rate for Payer: Adventist Health Commercial |
$1,774.20
|
| Rate for Payer: Cash Price |
$3,991.95
|
| Rate for Payer: Central Health Plan Commercial |
$7,096.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,209.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,548.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,548.40
|
| Rate for Payer: Galaxy Health WC |
$7,540.35
|
| Rate for Payer: Global Benefits Group Commercial |
$5,322.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,983.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,633.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,233.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,774.20
|
| Rate for Payer: Multiplan Commercial |
$6,653.25
|
| Rate for Payer: Networks By Design Commercial |
$5,766.15
|
| Rate for Payer: Prime Health Services Commercial |
$7,540.35
|
|
|
HC RENAL BIOP PERCUT BY NEEDLE
|
Facility
|
OP
|
$6,469.00
|
|
|
Service Code
|
CPT 50200
|
| Hospital Charge Code |
903800069
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$121.67 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,293.80
|
| Rate for Payer: Adventist Health Commercial |
$87.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,124.23
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,124.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| 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 HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| 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: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$196.65
|
| Rate for Payer: Cash Price |
$196.65
|
| Rate for Payer: Cash Price |
$196.65
|
| Rate for Payer: Cash Price |
$2,911.05
|
| Rate for Payer: Cash Price |
$2,911.05
|
| Rate for Payer: Cash Price |
$2,911.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,175.20
|
| Rate for Payer: Central Health Plan Commercial |
$349.60
|
| Rate for Payer: Cigna of CA HMO |
$279.68
|
| Rate for Payer: Cigna of CA HMO |
$4,140.16
|
| Rate for Payer: Cigna of CA PPO |
$4,787.06
|
| Rate for Payer: Cigna of CA PPO |
$323.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$305.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,528.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Galaxy Health WC |
$5,498.65
|
| Rate for Payer: Galaxy Health WC |
$371.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,881.40
|
| Rate for Payer: Global Benefits Group Commercial |
$262.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$393.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,822.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$121.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$121.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,107.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$277.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$134.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$134.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,973.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,973.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,293.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$4,851.75
|
| Rate for Payer: Multiplan Commercial |
$327.75
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$284.05
|
| Rate for Payer: Networks By Design Commercial |
$4,204.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,124.23
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$5,498.65
|
| Rate for Payer: Prime Health Services Commercial |
$371.45
|
| Rate for Payer: Prime Health Services Medicare |
$2,251.68
|
| Rate for Payer: Prime Health Services Medicare |
$2,251.68
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,336.65
|
| Rate for Payer: Riverside University Health System MISP |
$2,336.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,881.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$262.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$218.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,234.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,124.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
|
HC RENAL BIOP PERCUT BY NEEDLE
|
Facility
|
IP
|
$6,469.00
|
|
|
Service Code
|
CPT 50200
|
| Hospital Charge Code |
903800069
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,293.80 |
| Max. Negotiated Rate |
$5,822.10 |
| Rate for Payer: Adventist Health Commercial |
$1,293.80
|
| Rate for Payer: Cash Price |
$2,911.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,175.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,528.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,587.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,587.60
|
| Rate for Payer: Galaxy Health WC |
$5,498.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,881.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,822.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,107.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,816.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,293.80
|
| Rate for Payer: Multiplan Commercial |
$4,851.75
|
| Rate for Payer: Networks By Design Commercial |
$4,204.85
|
| Rate for Payer: Prime Health Services Commercial |
$5,498.65
|
|
|
HC RENAL BIOPSY,PERCUTANEOUS
|
Facility
|
IP
|
$6,469.00
|
|
|
Service Code
|
CPT 50200
|
| Hospital Charge Code |
909000163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,293.80 |
| Max. Negotiated Rate |
$5,822.10 |
| Rate for Payer: Adventist Health Commercial |
$1,293.80
|
| Rate for Payer: Cash Price |
$2,911.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,175.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,528.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,587.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,587.60
|
| Rate for Payer: Galaxy Health WC |
$5,498.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,881.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,822.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,107.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,816.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,293.80
|
| Rate for Payer: Multiplan Commercial |
$4,851.75
|
| Rate for Payer: Networks By Design Commercial |
$4,204.85
|
| Rate for Payer: Prime Health Services Commercial |
$5,498.65
|
|
|
HC RENAL BIOPSY,PERCUTANEOUS
|
Facility
|
OP
|
$6,469.00
|
|
|
Service Code
|
CPT 50200
|
| Hospital Charge Code |
909000163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$121.67 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,293.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,124.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| 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 |
$3,280.13
|
| 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 |
$2,911.05
|
| Rate for Payer: Cash Price |
$2,911.05
|
| Rate for Payer: Cash Price |
$2,911.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,175.20
|
| Rate for Payer: Cigna of CA HMO |
$4,140.16
|
| Rate for Payer: Cigna of CA PPO |
$4,787.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,528.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Galaxy Health WC |
$5,498.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,881.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,822.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$121.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,107.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$134.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,973.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,293.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$4,851.75
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$4,204.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$5,498.65
|
| Rate for Payer: Prime Health Services Medicare |
$2,251.68
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,336.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,881.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,234.50
|
| 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 |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
|
HC RENAL CYST ASPIRATION
|
Facility
|
OP
|
$3,650.00
|
|
|
Service Code
|
CPT 50390
|
| Hospital Charge Code |
909000164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$121.67 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$730.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$910.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| 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 |
$1,424.40
|
| 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 |
$1,642.50
|
| Rate for Payer: Cash Price |
$1,642.50
|
| Rate for Payer: Cash Price |
$1,642.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,920.00
|
| Rate for Payer: Cigna of CA HMO |
$2,336.00
|
| Rate for Payer: Cigna of CA PPO |
$2,701.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,555.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$3,102.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,190.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,285.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$121.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,317.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$134.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,275.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$730.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$2,737.50
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$2,372.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$910.78
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$3,102.50
|
| Rate for Payer: Prime Health Services Medicare |
$965.43
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$1,001.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,190.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,825.00
|
| 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 |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC RENAL CYST ASPIRATION
|
Facility
|
IP
|
$3,650.00
|
|
|
Service Code
|
CPT 50390
|
| Hospital Charge Code |
909000164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$730.00 |
| Max. Negotiated Rate |
$3,285.00 |
| Rate for Payer: Adventist Health Commercial |
$730.00
|
| Rate for Payer: Cash Price |
$1,642.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,920.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,555.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,460.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,460.00
|
| Rate for Payer: Galaxy Health WC |
$3,102.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,190.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,285.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,317.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,153.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$730.00
|
| Rate for Payer: Multiplan Commercial |
$2,737.50
|
| Rate for Payer: Networks By Design Commercial |
$2,372.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,102.50
|
|
|
HC RENAL CYST PUNCTURE
|
Facility
|
OP
|
$1,282.00
|
|
|
Service Code
|
CPT 74470
|
| Hospital Charge Code |
909001941
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$74.44 |
| Max. Negotiated Rate |
$1,462.69 |
| Rate for Payer: Adventist Health Commercial |
$256.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$702.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,462.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,054.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$773.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$702.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$260.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$362.37
|
| Rate for Payer: Blue Shield of California Commercial |
$807.66
|
| Rate for Payer: Blue Shield of California EPN |
$508.95
|
| Rate for Payer: Cash Price |
$576.90
|
| Rate for Payer: Cash Price |
$576.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,025.60
|
| Rate for Payer: Cigna of CA HMO |
$820.48
|
| Rate for Payer: Cigna of CA PPO |
$948.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,054.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$773.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$702.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$897.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,159.59
|
| Rate for Payer: EPIC Health Plan Senior |
$773.06
|
| Rate for Payer: Galaxy Health WC |
$1,089.70
|
| Rate for Payer: Global Benefits Group Commercial |
$769.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,153.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,152.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$74.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$702.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$814.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$82.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$983.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$941.73
|
| Rate for Payer: Multiplan Commercial |
$961.50
|
| Rate for Payer: Networks By Design Commercial |
$833.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$702.78
|
| Rate for Payer: Prime Health Services Commercial |
$1,089.70
|
| Rate for Payer: Prime Health Services Medicare |
$744.95
|
| Rate for Payer: Riverside University Health System MISP |
$773.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$769.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$769.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$605.23
|
| Rate for Payer: United Healthcare All Other HMO |
$605.23
|
| Rate for Payer: United Healthcare HMO Rider |
$605.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$605.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$702.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,054.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$773.06
|
| Rate for Payer: Vantage Medical Group Senior |
$702.78
|
|
|
HC RENAL CYST PUNCTURE
|
Facility
|
IP
|
$1,282.00
|
|
|
Service Code
|
CPT 74470
|
| Hospital Charge Code |
909001941
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$256.40 |
| Max. Negotiated Rate |
$1,153.80 |
| Rate for Payer: Adventist Health Commercial |
$256.40
|
| Rate for Payer: Cash Price |
$576.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,025.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$897.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$512.80
|
| Rate for Payer: EPIC Health Plan Senior |
$512.80
|
| Rate for Payer: Galaxy Health WC |
$1,089.70
|
| Rate for Payer: Global Benefits Group Commercial |
$769.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,153.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$814.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$756.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.40
|
| Rate for Payer: Multiplan Commercial |
$961.50
|
| Rate for Payer: Networks By Design Commercial |
$833.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,089.70
|
|
