|
HC REPAIR FLEXOR TENDON EA
|
Facility
|
OP
|
$12,763.00
|
|
|
Service Code
|
CPT 26350
|
| Hospital Charge Code |
900501285
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$11,486.70 |
| Rate for Payer: Adventist Health Commercial |
$2,552.60
|
| 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 |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,568.63
|
| Rate for Payer: Cash Price |
$5,743.35
|
| Rate for Payer: Cash Price |
$5,743.35
|
| Rate for Payer: Cash Price |
$5,743.35
|
| Rate for Payer: Cash Price |
$5,743.35
|
| Rate for Payer: Central Health Plan Commercial |
$10,210.40
|
| Rate for Payer: Cigna of CA HMO |
$8,168.32
|
| Rate for Payer: Cigna of CA PPO |
$9,444.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,934.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,943.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4,629.17
|
| Rate for Payer: Galaxy Health WC |
$10,848.55
|
| Rate for Payer: Global Benefits Group Commercial |
$7,657.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,486.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,901.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,104.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$715.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,523.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,552.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,639.18
|
| Rate for Payer: Multiplan Commercial |
$9,572.25
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$8,295.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Preferred Health Network WC |
$6,702.68
|
| Rate for Payer: Prime Health Services Commercial |
$10,848.55
|
| Rate for Payer: Prime Health Services Medicare |
$4,460.84
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Riverside University Health System MISP |
$4,629.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,657.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,381.50
|
| Rate for Payer: United Healthcare All Other HMO |
$6,381.50
|
| Rate for Payer: United Healthcare HMO Rider |
$6,381.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,381.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,208.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
HC REPAIR FLEXOR TENDON,ZONE 2,EA
|
Facility
|
OP
|
$16,792.00
|
|
|
Service Code
|
CPT 26356
|
| Hospital Charge Code |
900501551
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$15,112.80 |
| Rate for Payer: Adventist Health Commercial |
$3,358.40
|
| 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 |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,568.63
|
| Rate for Payer: Cash Price |
$7,556.40
|
| Rate for Payer: Cash Price |
$7,556.40
|
| Rate for Payer: Cash Price |
$7,556.40
|
| Rate for Payer: Cash Price |
$7,556.40
|
| Rate for Payer: Central Health Plan Commercial |
$13,433.60
|
| Rate for Payer: Cigna of CA HMO |
$10,746.88
|
| Rate for Payer: Cigna of CA PPO |
$12,426.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,754.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,943.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4,629.17
|
| Rate for Payer: Galaxy Health WC |
$14,273.20
|
| Rate for Payer: Global Benefits Group Commercial |
$10,075.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,112.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,901.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,662.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$823.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,523.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,358.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,639.18
|
| Rate for Payer: Multiplan Commercial |
$12,594.00
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$10,914.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Preferred Health Network WC |
$6,702.68
|
| Rate for Payer: Prime Health Services Commercial |
$14,273.20
|
| Rate for Payer: Prime Health Services Medicare |
$4,460.84
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Riverside University Health System MISP |
$4,629.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,075.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,396.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,396.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,396.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,208.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
HC REPAIR FLEXOR TENDON,ZONE 2,EA
|
Facility
|
IP
|
$16,792.00
|
|
|
Service Code
|
CPT 26356
|
| Hospital Charge Code |
900501551
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,358.40 |
| Max. Negotiated Rate |
$15,112.80 |
| Rate for Payer: Adventist Health Commercial |
$3,358.40
|
| Rate for Payer: Cash Price |
$7,556.40
|
| Rate for Payer: Central Health Plan Commercial |
$13,433.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,754.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,716.80
|
| Rate for Payer: EPIC Health Plan Senior |
$6,716.80
|
| Rate for Payer: Galaxy Health WC |
$14,273.20
|
| Rate for Payer: Global Benefits Group Commercial |
$10,075.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,112.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,662.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,907.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,358.40
|
| Rate for Payer: Multiplan Commercial |
$12,594.00
|
| Rate for Payer: Networks By Design Commercial |
$10,914.80
|
| Rate for Payer: Prime Health Services Commercial |
$14,273.20
|
|
|
HC REPAIR FOOT TENDON
|
Facility
|
IP
|
$11,119.00
|
|
|
Service Code
|
CPT 28200
|
| Hospital Charge Code |
900501722
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,223.80 |
| Max. Negotiated Rate |
$10,007.10 |
| Rate for Payer: Adventist Health Commercial |
$2,223.80
|
| Rate for Payer: Cash Price |
$5,003.55
|
| Rate for Payer: Central Health Plan Commercial |
$8,895.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,783.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,447.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,447.60
|
| Rate for Payer: Galaxy Health WC |
$9,451.15
|
| Rate for Payer: Global Benefits Group Commercial |
$6,671.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,007.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,060.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,560.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,223.80
|
| Rate for Payer: Multiplan Commercial |
$8,339.25
|
| Rate for Payer: Networks By Design Commercial |
$7,227.35
|
| Rate for Payer: Prime Health Services Commercial |
$9,451.15
|
|
|
HC REPAIR FOOT TENDON
|
Facility
|
OP
|
$11,119.00
|
|
|
Service Code
|
CPT 28200
|
| Hospital Charge Code |
900501722
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$10,007.10 |
| Rate for Payer: Adventist Health Commercial |
$2,223.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| 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 |
$6,568.63
|
| Rate for Payer: Cash Price |
$5,003.55
|
| Rate for Payer: Cash Price |
$5,003.55
|
| Rate for Payer: Cash Price |
$5,003.55
|
| Rate for Payer: Cash Price |
$5,003.55
|
| Rate for Payer: Central Health Plan Commercial |
$8,895.20
|
| Rate for Payer: Cigna of CA HMO |
$7,116.16
|
| Rate for Payer: Cigna of CA PPO |
$8,228.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,783.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,943.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4,629.17
|
| Rate for Payer: Galaxy Health WC |
$9,451.15
|
| Rate for Payer: Global Benefits Group Commercial |
$6,671.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,007.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,901.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,060.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$481.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,523.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,223.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,639.18
|
| Rate for Payer: Multiplan Commercial |
$8,339.25
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$7,227.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Preferred Health Network WC |
$6,702.68
|
| Rate for Payer: Prime Health Services Commercial |
$9,451.15
|
| Rate for Payer: Prime Health Services Medicare |
$4,460.84
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Riverside University Health System MISP |
$4,629.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,671.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,559.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,559.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,559.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,559.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,208.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
HC REPAIR HAND JOINT
|
Facility
|
OP
|
$10,508.00
|
|
|
Service Code
|
CPT 26540
|
| Hospital Charge Code |
900501397
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$160.57 |
| Max. Negotiated Rate |
$9,457.20 |
| Rate for Payer: Adventist Health Commercial |
$4,308.28
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,776.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,568.63
|
| Rate for Payer: Cash Price |
$4,728.60
|
| Rate for Payer: Cash Price |
$4,728.60
|
| Rate for Payer: Cash Price |
$4,728.60
|
| Rate for Payer: Cash Price |
$4,728.60
|
| Rate for Payer: Central Health Plan Commercial |
$8,406.40
|
| Rate for Payer: Cigna of CA HMO |
$6,725.12
|
| Rate for Payer: Cigna of CA PPO |
$7,775.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,355.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,943.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4,629.17
|
| Rate for Payer: Galaxy Health WC |
$8,931.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,304.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,457.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,901.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,672.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$160.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,523.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,101.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,639.18
|
| Rate for Payer: Multiplan Commercial |
$7,881.00
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$6,830.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Preferred Health Network WC |
$6,702.68
|
| Rate for Payer: Prime Health Services Commercial |
$8,931.80
|
| Rate for Payer: Prime Health Services Medicare |
$4,460.84
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Riverside University Health System MISP |
$4,629.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,304.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,304.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,208.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
HC REPAIR HAND JOINT
|
Facility
|
IP
|
$10,508.00
|
|
|
Service Code
|
CPT 26540
|
| Hospital Charge Code |
900501397
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,101.60 |
| Max. Negotiated Rate |
$9,457.20 |
| Rate for Payer: Adventist Health Commercial |
$2,101.60
|
| Rate for Payer: Cash Price |
$4,728.60
|
| Rate for Payer: Central Health Plan Commercial |
$8,406.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,355.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,203.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4,203.20
|
| Rate for Payer: Galaxy Health WC |
$8,931.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,304.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,457.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,672.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,199.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,101.60
|
| Rate for Payer: Multiplan Commercial |
$7,881.00
|
| Rate for Payer: Networks By Design Commercial |
$6,830.20
|
| Rate for Payer: Prime Health Services Commercial |
$8,931.80
|
|
|
HC REPAIR HAND JOINT
|
Facility
|
IP
|
$10,508.00
|
|
|
Service Code
|
CPT 26540
|
| Hospital Charge Code |
900501397
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$2,101.60 |
| Max. Negotiated Rate |
$9,457.20 |
| Rate for Payer: Adventist Health Commercial |
$2,101.60
|
| Rate for Payer: Cash Price |
$4,728.60
|
| Rate for Payer: Central Health Plan Commercial |
$8,406.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,355.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,203.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4,203.20
|
| Rate for Payer: Galaxy Health WC |
$8,931.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,304.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,457.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,672.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,199.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,101.60
|
| Rate for Payer: Multiplan Commercial |
$7,881.00
|
| Rate for Payer: Networks By Design Commercial |
$6,830.20
|
| Rate for Payer: Prime Health Services Commercial |
$8,931.80
|
|
|
HC REPAIR HAND JOINT
|
Facility
|
OP
|
$10,508.00
|
|
|
Service Code
|
CPT 26540
|
| Hospital Charge Code |
900501397
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$160.57 |
| Max. Negotiated Rate |
$9,457.20 |
| Rate for Payer: Adventist Health Commercial |
$2,101.60
|
| 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 |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,568.63
|
| Rate for Payer: Cash Price |
$4,728.60
|
| Rate for Payer: Cash Price |
$4,728.60
|
| Rate for Payer: Cash Price |
$4,728.60
|
| Rate for Payer: Cash Price |
$4,728.60
|
| Rate for Payer: Central Health Plan Commercial |
$8,406.40
|
| Rate for Payer: Cigna of CA HMO |
$6,725.12
|
| Rate for Payer: Cigna of CA PPO |
$7,775.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,355.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,943.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4,629.17
|
| Rate for Payer: Galaxy Health WC |
$8,931.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,304.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,457.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,901.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,672.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$160.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,523.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,101.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,639.18
|
| Rate for Payer: Multiplan Commercial |
$7,881.00
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$6,830.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Preferred Health Network WC |
$6,702.68
|
| Rate for Payer: Prime Health Services Commercial |
$8,931.80
|
| Rate for Payer: Prime Health Services Medicare |
$4,460.84
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Riverside University Health System MISP |
$4,629.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,304.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,254.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,254.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,254.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,254.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,208.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
HC REPAIR INTL INGUINAL HERNIA
|
Facility
|
OP
|
$14,442.00
|
|
|
Service Code
|
CPT 49501
|
| Hospital Charge Code |
900501740
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$145.01 |
| Max. Negotiated Rate |
$12,997.80 |
| Rate for Payer: Adventist Health Commercial |
$2,888.40
|
| 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 |
$6,907.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,065.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,604.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$7,144.49
|
| Rate for Payer: Cash Price |
$6,498.90
|
| Rate for Payer: Cash Price |
$6,498.90
|
| Rate for Payer: Cash Price |
$6,498.90
|
| Rate for Payer: Cash Price |
$6,498.90
|
| Rate for Payer: Central Health Plan Commercial |
$11,553.60
|
| Rate for Payer: Cigna of CA HMO |
$9,242.88
|
| Rate for Payer: Cigna of CA PPO |
$10,687.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,065.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,604.99
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,109.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,598.23
|
| Rate for Payer: EPIC Health Plan Senior |
$5,065.49
|
| Rate for Payer: Galaxy Health WC |
$12,275.70
|
| Rate for Payer: Global Benefits Group Commercial |
$8,665.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,997.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,552.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,604.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,170.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$145.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,950.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,888.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,170.69
|
| Rate for Payer: Multiplan Commercial |
$10,831.50
|
| Rate for Payer: Multiplan WC |
$7,144.49
|
| Rate for Payer: Networks By Design Commercial |
$9,387.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,604.99
|
| Rate for Payer: Preferred Health Network WC |
$7,290.30
|
| Rate for Payer: Prime Health Services Commercial |
$12,275.70
|
| Rate for Payer: Prime Health Services Medicare |
$4,881.29
|
| Rate for Payer: Prime Health Services WC |
$7,071.59
|
| Rate for Payer: Riverside University Health System MISP |
$5,065.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,665.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,221.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,221.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,221.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,221.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,604.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,065.49
|
| Rate for Payer: Vantage Medical Group Senior |
$4,604.99
|
|
|
HC REPAIR INTL INGUINAL HERNIA
|
Facility
|
IP
|
$14,442.00
|
|
|
Service Code
|
CPT 49501
|
| Hospital Charge Code |
900501740
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,888.40 |
| Max. Negotiated Rate |
$12,997.80 |
| Rate for Payer: Adventist Health Commercial |
$2,888.40
|
| Rate for Payer: Cash Price |
$6,498.90
|
| Rate for Payer: Central Health Plan Commercial |
$11,553.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,109.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,776.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,776.80
|
| Rate for Payer: Galaxy Health WC |
$12,275.70
|
| Rate for Payer: Global Benefits Group Commercial |
$8,665.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,997.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,170.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,520.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,888.40
|
| Rate for Payer: Multiplan Commercial |
$10,831.50
|
| Rate for Payer: Networks By Design Commercial |
$9,387.30
|
| Rate for Payer: Prime Health Services Commercial |
$12,275.70
|
|
|
HC REPAIR LACERATION CORNEA/SCLER
|
Facility
|
IP
|
$16,707.00
|
|
|
Service Code
|
CPT 65285
|
| Hospital Charge Code |
900501628
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,341.40 |
| Max. Negotiated Rate |
$15,036.30 |
| Rate for Payer: Adventist Health Commercial |
$3,341.40
|
| Rate for Payer: Cash Price |
$7,518.15
|
| Rate for Payer: Central Health Plan Commercial |
$13,365.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,694.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,682.80
|
| Rate for Payer: EPIC Health Plan Senior |
$6,682.80
|
| Rate for Payer: Galaxy Health WC |
$14,200.95
|
| Rate for Payer: Global Benefits Group Commercial |
$10,024.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,036.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,608.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,857.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,341.40
|
| Rate for Payer: Multiplan Commercial |
$12,530.25
|
| Rate for Payer: Networks By Design Commercial |
$10,859.55
|
| Rate for Payer: Prime Health Services Commercial |
$14,200.95
|
|
|
HC REPAIR LACERATION CORNEA/SCLER
|
Facility
|
OP
|
$16,707.00
|
|
|
Service Code
|
CPT 65285
|
| Hospital Charge Code |
900501628
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$15,036.30 |
| Rate for Payer: Adventist Health Commercial |
$3,341.40
|
| 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 |
$10,266.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,528.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,844.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$10,445.70
|
| Rate for Payer: Cash Price |
$7,518.15
|
| Rate for Payer: Cash Price |
$7,518.15
|
| Rate for Payer: Cash Price |
$7,518.15
|
| Rate for Payer: Cash Price |
$7,518.15
|
| Rate for Payer: Central Health Plan Commercial |
$13,365.60
|
| Rate for Payer: Cigna of CA HMO |
$10,692.48
|
| Rate for Payer: Cigna of CA PPO |
$12,363.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,266.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,528.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,844.09
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,694.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,292.75
|
| Rate for Payer: EPIC Health Plan Senior |
$7,528.50
|
| Rate for Payer: Galaxy Health WC |
$14,200.95
|
| Rate for Payer: Global Benefits Group Commercial |
$10,024.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,036.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,224.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,844.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,608.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,609.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,357.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,341.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,171.08
|
| Rate for Payer: Multiplan Commercial |
$12,530.25
|
| Rate for Payer: Multiplan WC |
$10,445.70
|
| Rate for Payer: Networks By Design Commercial |
$10,859.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6,844.09
|
| Rate for Payer: Preferred Health Network WC |
$10,658.88
|
| Rate for Payer: Prime Health Services Commercial |
$14,200.95
|
| Rate for Payer: Prime Health Services Medicare |
$7,254.74
|
| Rate for Payer: Prime Health Services WC |
$10,339.11
|
| Rate for Payer: Riverside University Health System MISP |
$7,528.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,024.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,353.50
|
| Rate for Payer: United Healthcare All Other HMO |
$8,353.50
|
| Rate for Payer: United Healthcare HMO Rider |
$8,353.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,353.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$6,844.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,266.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,528.50
|
| Rate for Payer: Vantage Medical Group Senior |
$6,844.09
|
|
|
HC REPAIR LIP, FULL THICKNESS
|
Facility
|
IP
|
$4,513.00
|
|
|
Service Code
|
CPT 40650
|
| Hospital Charge Code |
900501495
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$902.60 |
| Max. Negotiated Rate |
$4,061.70 |
| Rate for Payer: Adventist Health Commercial |
$902.60
|
| Rate for Payer: Cash Price |
$2,030.85
|
| Rate for Payer: Central Health Plan Commercial |
$3,610.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,159.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,805.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,805.20
|
| Rate for Payer: Galaxy Health WC |
$3,836.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,707.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,061.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,865.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,662.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$902.60
|
| Rate for Payer: Multiplan Commercial |
$3,384.75
|
| Rate for Payer: Networks By Design Commercial |
$2,933.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,836.05
|
|
|
HC REPAIR LIP, FULL THICKNESS
|
Facility
|
OP
|
$4,513.00
|
|
|
Service Code
|
CPT 40650
|
| Hospital Charge Code |
900501495
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$8,074.00 |
| Rate for Payer: Adventist Health Commercial |
$902.60
|
| 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 |
$1,040.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$763.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$693.67
|
| 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 |
$1,030.97
|
| Rate for Payer: Cash Price |
$2,030.85
|
| Rate for Payer: Cash Price |
$2,030.85
|
| Rate for Payer: Cash Price |
$2,030.85
|
| Rate for Payer: Cash Price |
$2,030.85
|
| Rate for Payer: Central Health Plan Commercial |
$3,610.40
|
| Rate for Payer: Cigna of CA HMO |
$2,888.32
|
| Rate for Payer: Cigna of CA PPO |
$3,339.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,040.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$763.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$693.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,159.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,144.56
|
| Rate for Payer: EPIC Health Plan Senior |
$763.04
|
| Rate for Payer: Galaxy Health WC |
$3,836.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,707.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,061.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,137.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$693.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,865.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$505.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$745.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$902.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$929.52
|
| Rate for Payer: Multiplan Commercial |
$3,384.75
|
| Rate for Payer: Multiplan WC |
$1,030.97
|
| Rate for Payer: Networks By Design Commercial |
$2,933.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$693.67
|
| Rate for Payer: Preferred Health Network WC |
$1,052.01
|
| Rate for Payer: Prime Health Services Commercial |
$3,836.05
|
| Rate for Payer: Prime Health Services Medicare |
$735.29
|
| Rate for Payer: Prime Health Services WC |
$1,020.45
|
| Rate for Payer: Riverside University Health System MISP |
$763.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,707.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,256.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,256.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,256.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,256.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$693.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,040.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$763.04
|
| Rate for Payer: Vantage Medical Group Senior |
$693.67
|
|
|
HC REPAIR MOUTH LACERATION GT 2.5 C
|
Facility
|
OP
|
$6,611.00
|
|
|
Service Code
|
CPT 40831
|
| Hospital Charge Code |
900501471
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$290.74 |
| Max. Negotiated Rate |
$5,949.90 |
| Rate for Payer: Adventist Health Commercial |
$1,322.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,040.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$763.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$693.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,030.97
|
| Rate for Payer: Cash Price |
$2,974.95
|
| Rate for Payer: Cash Price |
$2,974.95
|
| Rate for Payer: Cash Price |
$2,974.95
|
| Rate for Payer: Cash Price |
$2,974.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,288.80
|
| Rate for Payer: Cigna of CA HMO |
$4,231.04
|
| Rate for Payer: Cigna of CA PPO |
$4,892.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,040.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$763.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$693.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,627.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,144.56
|
| Rate for Payer: EPIC Health Plan Senior |
$763.04
|
| Rate for Payer: Galaxy Health WC |
$5,619.35
|
| Rate for Payer: Global Benefits Group Commercial |
$3,966.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,949.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,137.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$693.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,197.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$290.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$745.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,322.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$929.52
|
| Rate for Payer: Multiplan Commercial |
$4,958.25
|
| Rate for Payer: Multiplan WC |
$1,030.97
|
| Rate for Payer: Networks By Design Commercial |
$4,297.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$693.67
|
| Rate for Payer: Preferred Health Network WC |
$1,052.01
|
| Rate for Payer: Prime Health Services Commercial |
$5,619.35
|
| Rate for Payer: Prime Health Services Medicare |
$735.29
|
| Rate for Payer: Prime Health Services WC |
$1,020.45
|
| Rate for Payer: Riverside University Health System MISP |
$763.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,966.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,305.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,305.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,305.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,305.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$693.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,040.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$763.04
|
| Rate for Payer: Vantage Medical Group Senior |
$693.67
|
|
|
HC REPAIR MOUTH LACERATION GT 2.5 C
|
Facility
|
IP
|
$6,611.00
|
|
|
Service Code
|
CPT 40831
|
| Hospital Charge Code |
900501471
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,322.20 |
| Max. Negotiated Rate |
$5,949.90 |
| Rate for Payer: Adventist Health Commercial |
$1,322.20
|
| Rate for Payer: Cash Price |
$2,974.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,288.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,627.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,644.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,644.40
|
| Rate for Payer: Galaxy Health WC |
$5,619.35
|
| Rate for Payer: Global Benefits Group Commercial |
$3,966.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,949.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,197.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,900.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,322.20
|
| Rate for Payer: Multiplan Commercial |
$4,958.25
|
| Rate for Payer: Networks By Design Commercial |
$4,297.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,619.35
|
|
|
HC REPAIR MOUTH LACERATION LT 2.5CM
|
Facility
|
OP
|
$1,011.00
|
|
|
Service Code
|
CPT 40830
|
| Hospital Charge Code |
900540830
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$130.15 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$202.20
|
| 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 |
$456.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.63
|
| 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 |
$470.13
|
| Rate for Payer: Cash Price |
$454.95
|
| Rate for Payer: Cash Price |
$454.95
|
| Rate for Payer: Cash Price |
$454.95
|
| Rate for Payer: Cash Price |
$454.95
|
| Rate for Payer: Central Health Plan Commercial |
$808.80
|
| Rate for Payer: Cigna of CA HMO |
$647.04
|
| Rate for Payer: Cigna of CA PPO |
$748.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$456.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$707.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$502.64
|
| Rate for Payer: EPIC Health Plan Senior |
$335.09
|
| Rate for Payer: Galaxy Health WC |
$859.35
|
| Rate for Payer: Global Benefits Group Commercial |
$606.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$909.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$499.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$641.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$130.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$327.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$408.20
|
| Rate for Payer: Multiplan Commercial |
$758.25
|
| Rate for Payer: Multiplan WC |
$470.13
|
| Rate for Payer: Networks By Design Commercial |
$657.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$304.63
|
| Rate for Payer: Preferred Health Network WC |
$479.72
|
| Rate for Payer: Prime Health Services Commercial |
$859.35
|
| Rate for Payer: Prime Health Services Medicare |
$322.91
|
| Rate for Payer: Prime Health Services WC |
$465.33
|
| Rate for Payer: Riverside University Health System MISP |
$335.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$606.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$505.50
|
| Rate for Payer: United Healthcare All Other HMO |
$505.50
|
| Rate for Payer: United Healthcare HMO Rider |
$505.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$505.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$304.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$456.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Vantage Medical Group Senior |
$304.63
|
|
|
HC REPAIR MOUTH LACERATION LT 2.5CM
|
Facility
|
IP
|
$1,011.00
|
|
|
Service Code
|
CPT 40830
|
| Hospital Charge Code |
900540830
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$202.20 |
| Max. Negotiated Rate |
$909.90 |
| Rate for Payer: Adventist Health Commercial |
$202.20
|
| Rate for Payer: Cash Price |
$454.95
|
| Rate for Payer: Central Health Plan Commercial |
$808.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$707.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$404.40
|
| Rate for Payer: EPIC Health Plan Senior |
$404.40
|
| Rate for Payer: Galaxy Health WC |
$859.35
|
| Rate for Payer: Global Benefits Group Commercial |
$606.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$909.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$641.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$596.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.20
|
| Rate for Payer: Multiplan Commercial |
$758.25
|
| Rate for Payer: Networks By Design Commercial |
$657.15
|
| Rate for Payer: Prime Health Services Commercial |
$859.35
|
|
|
HC REPAIR MUSCLES OF HAND, EA
|
Facility
|
IP
|
$8,932.00
|
|
|
Service Code
|
CPT 26591
|
| Hospital Charge Code |
900501445
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,786.40 |
| Max. Negotiated Rate |
$8,038.80 |
| Rate for Payer: Adventist Health Commercial |
$1,786.40
|
| Rate for Payer: Cash Price |
$4,019.40
|
| Rate for Payer: Central Health Plan Commercial |
$7,145.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,252.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,572.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,572.80
|
| Rate for Payer: Galaxy Health WC |
$7,592.20
|
| Rate for Payer: Global Benefits Group Commercial |
$5,359.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,038.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,671.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,269.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,786.40
|
| Rate for Payer: Multiplan Commercial |
$6,699.00
|
| Rate for Payer: Networks By Design Commercial |
$5,805.80
|
| Rate for Payer: Prime Health Services Commercial |
$7,592.20
|
|
|
HC REPAIR MUSCLES OF HAND, EA
|
Facility
|
OP
|
$8,932.00
|
|
|
Service Code
|
CPT 26591
|
| Hospital Charge Code |
900501445
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$8,074.00 |
| Rate for Payer: Adventist Health Commercial |
$1,786.40
|
| 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 |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| 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 |
$6,568.63
|
| Rate for Payer: Cash Price |
$4,019.40
|
| Rate for Payer: Cash Price |
$4,019.40
|
| Rate for Payer: Cash Price |
$4,019.40
|
| Rate for Payer: Cash Price |
$4,019.40
|
| Rate for Payer: Central Health Plan Commercial |
$7,145.60
|
| Rate for Payer: Cigna of CA HMO |
$5,716.48
|
| Rate for Payer: Cigna of CA PPO |
$6,609.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,252.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,943.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4,629.17
|
| Rate for Payer: Galaxy Health WC |
$7,592.20
|
| Rate for Payer: Global Benefits Group Commercial |
$5,359.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,038.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,901.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,671.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,523.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,786.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,639.18
|
| Rate for Payer: Multiplan Commercial |
$6,699.00
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$5,805.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Preferred Health Network WC |
$6,702.68
|
| Rate for Payer: Prime Health Services Commercial |
$7,592.20
|
| Rate for Payer: Prime Health Services Medicare |
$4,460.84
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Riverside University Health System MISP |
$4,629.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,359.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,466.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,466.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,466.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,466.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,208.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
HC REPAIR OF CORNEAL LACERATION
|
Facility
|
OP
|
$8,798.00
|
|
|
Service Code
|
CPT 65280
|
| Hospital Charge Code |
900501665
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$182.50 |
| Max. Negotiated Rate |
$11,292.75 |
| Rate for Payer: Adventist Health Commercial |
$1,759.60
|
| 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 |
$10,266.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,528.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,844.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$10,445.70
|
| Rate for Payer: Cash Price |
$3,959.10
|
| Rate for Payer: Cash Price |
$3,959.10
|
| Rate for Payer: Cash Price |
$3,959.10
|
| Rate for Payer: Cash Price |
$3,959.10
|
| Rate for Payer: Central Health Plan Commercial |
$7,038.40
|
| Rate for Payer: Cigna of CA HMO |
$5,630.72
|
| Rate for Payer: Cigna of CA PPO |
$6,510.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,266.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,528.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,844.09
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,158.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,292.75
|
| Rate for Payer: EPIC Health Plan Senior |
$7,528.50
|
| Rate for Payer: Galaxy Health WC |
$7,478.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,278.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,918.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,224.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,844.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,586.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$182.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,357.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,759.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,171.08
|
| Rate for Payer: Multiplan Commercial |
$6,598.50
|
| Rate for Payer: Multiplan WC |
$10,445.70
|
| Rate for Payer: Networks By Design Commercial |
$5,718.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6,844.09
|
| Rate for Payer: Preferred Health Network WC |
$10,658.88
|
| Rate for Payer: Prime Health Services Commercial |
$7,478.30
|
| Rate for Payer: Prime Health Services Medicare |
$7,254.74
|
| Rate for Payer: Prime Health Services WC |
$10,339.11
|
| Rate for Payer: Riverside University Health System MISP |
$7,528.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,278.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,399.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,399.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,399.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,399.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$6,844.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,266.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,528.50
|
| Rate for Payer: Vantage Medical Group Senior |
$6,844.09
|
|
|
HC REPAIR OF CORNEAL LACERATION
|
Facility
|
IP
|
$8,798.00
|
|
|
Service Code
|
CPT 65280
|
| Hospital Charge Code |
900501665
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,759.60 |
| Max. Negotiated Rate |
$7,918.20 |
| Rate for Payer: Adventist Health Commercial |
$1,759.60
|
| Rate for Payer: Cash Price |
$3,959.10
|
| Rate for Payer: Central Health Plan Commercial |
$7,038.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,158.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,519.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,519.20
|
| Rate for Payer: Galaxy Health WC |
$7,478.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,278.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,918.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,586.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,190.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,759.60
|
| Rate for Payer: Multiplan Commercial |
$6,598.50
|
| Rate for Payer: Networks By Design Commercial |
$5,718.70
|
| Rate for Payer: Prime Health Services Commercial |
$7,478.30
|
|
|
HC REPAIR OF EYE/LID WOUND
|
Facility
|
IP
|
$8,009.00
|
|
|
Service Code
|
CPT 65270
|
| Hospital Charge Code |
900501396
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,601.80 |
| Max. Negotiated Rate |
$7,208.10 |
| Rate for Payer: Adventist Health Commercial |
$1,601.80
|
| Rate for Payer: Cash Price |
$3,604.05
|
| Rate for Payer: Central Health Plan Commercial |
$6,407.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,606.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,203.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,203.60
|
| Rate for Payer: Galaxy Health WC |
$6,807.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,805.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,208.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,085.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,725.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,601.80
|
| Rate for Payer: Multiplan Commercial |
$6,006.75
|
| Rate for Payer: Networks By Design Commercial |
$5,205.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,807.65
|
|
|
HC REPAIR OF EYE/LID WOUND
|
Facility
|
OP
|
$8,009.00
|
|
|
Service Code
|
CPT 65270
|
| Hospital Charge Code |
900501396
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$7,208.10 |
| Rate for Payer: Adventist Health Commercial |
$3,283.69
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$741.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,586.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,363.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,057.84
|
| 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 |
$4,723.01
|
| Rate for Payer: Cash Price |
$3,604.05
|
| Rate for Payer: Cash Price |
$3,604.05
|
| Rate for Payer: Cash Price |
$3,604.05
|
| Rate for Payer: Cash Price |
$3,604.05
|
| Rate for Payer: Central Health Plan Commercial |
$6,407.20
|
| Rate for Payer: Cigna of CA HMO |
$5,125.76
|
| Rate for Payer: Cigna of CA PPO |
$5,926.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,586.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,363.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,057.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,606.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,045.44
|
| Rate for Payer: EPIC Health Plan Senior |
$3,363.62
|
| Rate for Payer: Galaxy Health WC |
$6,807.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,805.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,208.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,014.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,057.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,085.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,287.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,601.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,097.51
|
| Rate for Payer: Multiplan Commercial |
$6,006.75
|
| Rate for Payer: Multiplan WC |
$4,723.01
|
| Rate for Payer: Networks By Design Commercial |
$5,205.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,057.84
|
| Rate for Payer: Preferred Health Network WC |
$4,819.40
|
| Rate for Payer: Prime Health Services Commercial |
$6,807.65
|
| Rate for Payer: Prime Health Services Medicare |
$3,241.31
|
| Rate for Payer: Prime Health Services WC |
$4,674.82
|
| Rate for Payer: Riverside University Health System MISP |
$3,363.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,805.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,805.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,057.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,586.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,363.62
|
| Rate for Payer: Vantage Medical Group Senior |
$3,057.84
|
|
