|
HC RMVL FB CORNEA W SLIT LAMP
|
Facility
|
OP
|
$1,438.00
|
|
|
Service Code
|
CPT 65222
|
| Hospital Charge Code |
900501179
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$38.40 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$589.58
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$307.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| 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 |
$260.96
|
| Rate for Payer: Cash Price |
$647.10
|
| Rate for Payer: Cash Price |
$647.10
|
| Rate for Payer: Cash Price |
$647.10
|
| Rate for Payer: Cash Price |
$647.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,150.40
|
| Rate for Payer: Cigna of CA HMO |
$920.32
|
| Rate for Payer: Cigna of CA PPO |
$1,064.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,006.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$1,222.30
|
| Rate for Payer: Global Benefits Group Commercial |
$862.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,294.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$913.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$38.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$183.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$287.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$1,078.50
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$934.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$171.12
|
| Rate for Payer: Preferred Health Network WC |
$266.29
|
| Rate for Payer: Prime Health Services Commercial |
$1,222.30
|
| Rate for Payer: Prime Health Services Medicare |
$181.39
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Riverside University Health System MISP |
$188.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$862.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$862.80
|
| 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 |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
|
HC RMVL FB CORNEA W SLIT LAMP
|
Facility
|
IP
|
$1,438.00
|
|
|
Service Code
|
CPT 65222
|
| Hospital Charge Code |
900501179
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$287.60 |
| Max. Negotiated Rate |
$1,294.20 |
| Rate for Payer: Adventist Health Commercial |
$287.60
|
| Rate for Payer: Cash Price |
$647.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,150.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,006.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$575.20
|
| Rate for Payer: EPIC Health Plan Senior |
$575.20
|
| Rate for Payer: Galaxy Health WC |
$1,222.30
|
| Rate for Payer: Global Benefits Group Commercial |
$862.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,294.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$913.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$848.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$287.60
|
| Rate for Payer: Multiplan Commercial |
$1,078.50
|
| Rate for Payer: Networks By Design Commercial |
$934.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,222.30
|
|
|
HC RMVL FB CORNEA W SLIT LAMP
|
Facility
|
OP
|
$1,438.00
|
|
|
Service Code
|
CPT 65222
|
| Hospital Charge Code |
900501179
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$38.40 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$287.60
|
| 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 |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| 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 |
$260.96
|
| Rate for Payer: Cash Price |
$647.10
|
| Rate for Payer: Cash Price |
$647.10
|
| Rate for Payer: Cash Price |
$647.10
|
| Rate for Payer: Cash Price |
$647.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,150.40
|
| Rate for Payer: Cigna of CA HMO |
$920.32
|
| Rate for Payer: Cigna of CA PPO |
$1,064.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,006.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$1,222.30
|
| Rate for Payer: Global Benefits Group Commercial |
$862.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,294.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$913.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$38.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$183.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$287.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$1,078.50
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$934.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$171.12
|
| Rate for Payer: Preferred Health Network WC |
$266.29
|
| Rate for Payer: Prime Health Services Commercial |
$1,222.30
|
| Rate for Payer: Prime Health Services Medicare |
$181.39
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Riverside University Health System MISP |
$188.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$862.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$719.00
|
| Rate for Payer: United Healthcare All Other HMO |
$719.00
|
| Rate for Payer: United Healthcare HMO Rider |
$719.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$719.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
|
HC RMVL F.B. DEEP,THIGH/KNEE AREA
|
Facility
|
OP
|
$10,401.00
|
|
|
Service Code
|
CPT 27372
|
| Hospital Charge Code |
900501311
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$9,360.90 |
| Rate for Payer: Adventist Health Commercial |
$2,080.20
|
| 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 |
$5,603.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,735.95
|
| 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 |
$5,794.14
|
| Rate for Payer: Cash Price |
$4,680.45
|
| Rate for Payer: Cash Price |
$4,680.45
|
| Rate for Payer: Cash Price |
$4,680.45
|
| Rate for Payer: Cash Price |
$4,680.45
|
| Rate for Payer: Central Health Plan Commercial |
$8,320.80
|
| Rate for Payer: Cigna of CA HMO |
$6,656.64
|
| Rate for Payer: Cigna of CA PPO |
$7,696.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,109.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,735.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,280.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,164.32
|
| Rate for Payer: EPIC Health Plan Senior |
$4,109.55
|
| Rate for Payer: Galaxy Health WC |
$8,840.85
|
| Rate for Payer: Global Benefits Group Commercial |
$6,240.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,360.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,126.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,604.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$453.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,016.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,080.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,006.17
|
| Rate for Payer: Multiplan Commercial |
$7,800.75
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: Networks By Design Commercial |
$6,760.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Preferred Health Network WC |
$5,912.39
|
| Rate for Payer: Prime Health Services Commercial |
$8,840.85
|
| Rate for Payer: Prime Health Services Medicare |
$3,960.11
|
| Rate for Payer: Prime Health Services WC |
$5,735.02
|
| Rate for Payer: Riverside University Health System MISP |
$4,109.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,240.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,200.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,200.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,200.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,200.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,735.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,735.95
|
|
|
HC RMVL F.B. DEEP,THIGH/KNEE AREA
|
Facility
|
IP
|
$10,401.00
|
|
|
Service Code
|
CPT 27372
|
| Hospital Charge Code |
900501311
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,080.20 |
| Max. Negotiated Rate |
$9,360.90 |
| Rate for Payer: Adventist Health Commercial |
$2,080.20
|
| Rate for Payer: Cash Price |
$4,680.45
|
| Rate for Payer: Central Health Plan Commercial |
$8,320.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,280.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,160.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,160.40
|
| Rate for Payer: Galaxy Health WC |
$8,840.85
|
| Rate for Payer: Global Benefits Group Commercial |
$6,240.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,360.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,604.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,136.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,080.20
|
| Rate for Payer: Multiplan Commercial |
$7,800.75
|
| Rate for Payer: Networks By Design Commercial |
$6,760.65
|
| Rate for Payer: Prime Health Services Commercial |
$8,840.85
|
|
|
HC RMVL FB EXT AUDITORY CANAL
|
Facility
|
IP
|
$1,107.00
|
|
|
Service Code
|
CPT 69200
|
| Hospital Charge Code |
900501185
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$221.40 |
| Max. Negotiated Rate |
$996.30 |
| Rate for Payer: Adventist Health Commercial |
$221.40
|
| Rate for Payer: Cash Price |
$498.15
|
| Rate for Payer: Central Health Plan Commercial |
$885.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$774.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$442.80
|
| Rate for Payer: EPIC Health Plan Senior |
$442.80
|
| Rate for Payer: Galaxy Health WC |
$940.95
|
| Rate for Payer: Global Benefits Group Commercial |
$664.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$996.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$702.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$653.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.40
|
| Rate for Payer: Multiplan Commercial |
$830.25
|
| Rate for Payer: Networks By Design Commercial |
$719.55
|
| Rate for Payer: Prime Health Services Commercial |
$940.95
|
|
|
HC RMVL FB EXT AUDITORY CANAL
|
Facility
|
OP
|
$1,107.00
|
|
|
Service Code
|
CPT 69200
|
| Hospital Charge Code |
900501185
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$140.88 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$453.87
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$325.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| 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 |
$260.96
|
| Rate for Payer: Cash Price |
$498.15
|
| Rate for Payer: Cash Price |
$498.15
|
| Rate for Payer: Cash Price |
$498.15
|
| Rate for Payer: Cash Price |
$498.15
|
| Rate for Payer: Central Health Plan Commercial |
$885.60
|
| Rate for Payer: Cigna of CA HMO |
$708.48
|
| Rate for Payer: Cigna of CA PPO |
$819.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$774.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$940.95
|
| Rate for Payer: Global Benefits Group Commercial |
$664.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$996.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$702.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$140.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$183.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$830.25
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$719.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$171.12
|
| Rate for Payer: Preferred Health Network WC |
$266.29
|
| Rate for Payer: Prime Health Services Commercial |
$940.95
|
| Rate for Payer: Prime Health Services Medicare |
$181.39
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Riverside University Health System MISP |
$188.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$664.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$664.20
|
| 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 |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
|
HC RMVL FB EXT AUDITORY CANAL
|
Facility
|
IP
|
$1,107.00
|
|
|
Service Code
|
CPT 69200
|
| Hospital Charge Code |
900501185
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$221.40 |
| Max. Negotiated Rate |
$996.30 |
| Rate for Payer: Adventist Health Commercial |
$221.40
|
| Rate for Payer: Cash Price |
$498.15
|
| Rate for Payer: Central Health Plan Commercial |
$885.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$774.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$442.80
|
| Rate for Payer: EPIC Health Plan Senior |
$442.80
|
| Rate for Payer: Galaxy Health WC |
$940.95
|
| Rate for Payer: Global Benefits Group Commercial |
$664.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$996.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$702.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$653.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.40
|
| Rate for Payer: Multiplan Commercial |
$830.25
|
| Rate for Payer: Networks By Design Commercial |
$719.55
|
| Rate for Payer: Prime Health Services Commercial |
$940.95
|
|
|
HC RMVL FB EXT AUDITORY CANAL
|
Facility
|
OP
|
$1,107.00
|
|
|
Service Code
|
CPT 69200
|
| Hospital Charge Code |
900501185
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.88 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$221.40
|
| 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 |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| 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 |
$260.96
|
| Rate for Payer: Cash Price |
$498.15
|
| Rate for Payer: Cash Price |
$498.15
|
| Rate for Payer: Cash Price |
$498.15
|
| Rate for Payer: Cash Price |
$498.15
|
| Rate for Payer: Central Health Plan Commercial |
$885.60
|
| Rate for Payer: Cigna of CA HMO |
$708.48
|
| Rate for Payer: Cigna of CA PPO |
$819.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$774.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$940.95
|
| Rate for Payer: Global Benefits Group Commercial |
$664.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$996.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$702.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$140.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$183.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$830.25
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$719.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$171.12
|
| Rate for Payer: Preferred Health Network WC |
$266.29
|
| Rate for Payer: Prime Health Services Commercial |
$940.95
|
| Rate for Payer: Prime Health Services Medicare |
$181.39
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Riverside University Health System MISP |
$188.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$664.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$553.50
|
| Rate for Payer: United Healthcare All Other HMO |
$553.50
|
| Rate for Payer: United Healthcare HMO Rider |
$553.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$553.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
|
HC RMVL F.B. FOOT, COMPLICATED
|
Facility
|
OP
|
$4,277.00
|
|
|
Service Code
|
CPT 28193
|
| Hospital Charge Code |
900501715
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$855.40
|
| 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 |
$3,186.34
|
| 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 |
$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 |
$3,280.13
|
| Rate for Payer: Cash Price |
$1,924.65
|
| Rate for Payer: Cash Price |
$1,924.65
|
| Rate for Payer: Cash Price |
$1,924.65
|
| Rate for Payer: Cash Price |
$1,924.65
|
| Rate for Payer: Central Health Plan Commercial |
$3,421.60
|
| Rate for Payer: Cigna of CA HMO |
$2,737.28
|
| Rate for Payer: Cigna of CA PPO |
$3,164.98
|
| 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 |
$2,993.90
|
| 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 |
$3,635.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,566.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,849.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,715.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$415.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,283.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$855.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$3,207.75
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$2,780.05
|
| 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 |
$3,635.45
|
| 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 |
$2,566.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,138.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,138.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,138.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,138.50
|
| 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 RMVL F.B. FOOT, COMPLICATED
|
Facility
|
IP
|
$4,277.00
|
|
|
Service Code
|
CPT 28193
|
| Hospital Charge Code |
900501715
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$855.40 |
| Max. Negotiated Rate |
$3,849.30 |
| Rate for Payer: Adventist Health Commercial |
$855.40
|
| Rate for Payer: Cash Price |
$1,924.65
|
| Rate for Payer: Central Health Plan Commercial |
$3,421.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,993.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,710.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,710.80
|
| Rate for Payer: Galaxy Health WC |
$3,635.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,566.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,849.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,715.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,523.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$855.40
|
| Rate for Payer: Multiplan Commercial |
$3,207.75
|
| Rate for Payer: Networks By Design Commercial |
$2,780.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,635.45
|
|
|
HC RMVL F B FOOT, DEEP
|
Facility
|
IP
|
$10,508.00
|
|
|
Service Code
|
CPT 28192
|
| Hospital Charge Code |
900501460
|
|
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 RMVL F B FOOT, DEEP
|
Facility
|
OP
|
$10,508.00
|
|
|
Service Code
|
CPT 28192
|
| Hospital Charge Code |
900501460
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| 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 |
$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 |
$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 |
$3,280.13
|
| 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 |
$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 |
$7,355.60
|
| 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 |
$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 |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,672.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$696.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,283.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,101.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$7,881.00
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$6,830.20
|
| 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 |
$8,931.80
|
| 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 |
$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 |
$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 RMVL F.B. FOOT SUBCUTANEOUS
|
Facility
|
IP
|
$3,256.00
|
|
|
Service Code
|
CPT 28190
|
| Hospital Charge Code |
900501097
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$651.20 |
| Max. Negotiated Rate |
$2,930.40 |
| Rate for Payer: Adventist Health Commercial |
$651.20
|
| Rate for Payer: Cash Price |
$1,465.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,604.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,279.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,302.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,302.40
|
| Rate for Payer: Galaxy Health WC |
$2,767.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,953.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,930.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,067.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,921.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$651.20
|
| Rate for Payer: Multiplan Commercial |
$2,442.00
|
| Rate for Payer: Networks By Design Commercial |
$2,116.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,767.60
|
|
|
HC RMVL F.B. FOOT SUBCUTANEOUS
|
Facility
|
IP
|
$3,256.00
|
|
|
Service Code
|
CPT 28190
|
| Hospital Charge Code |
900501097
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$651.20 |
| Max. Negotiated Rate |
$2,930.40 |
| Rate for Payer: Adventist Health Commercial |
$651.20
|
| Rate for Payer: Cash Price |
$1,465.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,604.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,279.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,302.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,302.40
|
| Rate for Payer: Galaxy Health WC |
$2,767.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,953.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,930.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,067.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,921.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$651.20
|
| Rate for Payer: Multiplan Commercial |
$2,442.00
|
| Rate for Payer: Networks By Design Commercial |
$2,116.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,767.60
|
|
|
HC RMVL F.B. FOOT SUBCUTANEOUS
|
Facility
|
OP
|
$3,256.00
|
|
|
Service Code
|
CPT 28190
|
| Hospital Charge Code |
900501097
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$235.56 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,334.96
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$765.31
|
| 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 |
$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 |
$1,424.40
|
| Rate for Payer: Cash Price |
$1,465.20
|
| Rate for Payer: Cash Price |
$1,465.20
|
| Rate for Payer: Cash Price |
$1,465.20
|
| Rate for Payer: Cash Price |
$1,465.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,604.80
|
| Rate for Payer: Cigna of CA HMO |
$2,083.84
|
| Rate for Payer: Cigna of CA PPO |
$2,409.44
|
| 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 |
$2,279.20
|
| 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 |
$2,767.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,953.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,930.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,067.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$235.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$979.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$651.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$2,442.00
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$2,116.40
|
| 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 |
$2,767.60
|
| 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 |
$1,953.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,953.60
|
| 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 |
$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 RMVL F.B. FOOT SUBCUTANEOUS
|
Facility
|
OP
|
$3,256.00
|
|
|
Service Code
|
CPT 28190
|
| Hospital Charge Code |
900501097
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$235.56 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$651.20
|
| 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 |
$1,366.17
|
| 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 |
$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 |
$1,424.40
|
| Rate for Payer: Cash Price |
$1,465.20
|
| Rate for Payer: Cash Price |
$1,465.20
|
| Rate for Payer: Cash Price |
$1,465.20
|
| Rate for Payer: Cash Price |
$1,465.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,604.80
|
| Rate for Payer: Cigna of CA HMO |
$2,083.84
|
| Rate for Payer: Cigna of CA PPO |
$2,409.44
|
| 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 |
$2,279.20
|
| 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 |
$2,767.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,953.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,930.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,067.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$235.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$979.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$651.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$2,442.00
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$2,116.40
|
| 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 |
$2,767.60
|
| 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 |
$1,953.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,628.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,628.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,628.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,628.00
|
| 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 RMVL FB INTRAOCULAR
|
Facility
|
OP
|
$6,445.00
|
|
|
Service Code
|
CPT 65235
|
| Hospital Charge Code |
900501180
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$1,289.00
|
| 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 |
$4,452.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,265.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,968.25
|
| 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 |
$4,617.28
|
| Rate for Payer: Cash Price |
$2,900.25
|
| Rate for Payer: Cash Price |
$2,900.25
|
| Rate for Payer: Cash Price |
$2,900.25
|
| Rate for Payer: Cash Price |
$2,900.25
|
| Rate for Payer: Central Health Plan Commercial |
$5,156.00
|
| Rate for Payer: Cigna of CA HMO |
$4,124.80
|
| Rate for Payer: Cigna of CA PPO |
$4,769.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,452.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,265.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,968.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,511.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,897.61
|
| Rate for Payer: EPIC Health Plan Senior |
$3,265.07
|
| Rate for Payer: Galaxy Health WC |
$5,478.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,867.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,800.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,867.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,968.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,092.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$867.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,190.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,289.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,977.45
|
| Rate for Payer: Multiplan Commercial |
$4,833.75
|
| Rate for Payer: Multiplan WC |
$4,617.28
|
| Rate for Payer: Networks By Design Commercial |
$4,189.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,968.25
|
| Rate for Payer: Preferred Health Network WC |
$4,711.51
|
| Rate for Payer: Prime Health Services Commercial |
$5,478.25
|
| Rate for Payer: Prime Health Services Medicare |
$3,146.34
|
| Rate for Payer: Prime Health Services WC |
$4,570.16
|
| Rate for Payer: Riverside University Health System MISP |
$3,265.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,867.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,222.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,222.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,222.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,222.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,968.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,452.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,265.07
|
| Rate for Payer: Vantage Medical Group Senior |
$2,968.25
|
|
|
HC RMVL FB INTRAOCULAR
|
Facility
|
OP
|
$6,445.00
|
|
|
Service Code
|
CPT 65235
|
| Hospital Charge Code |
900501180
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$2,642.45
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,738.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,452.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,265.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,968.25
|
| 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 |
$4,617.28
|
| Rate for Payer: Cash Price |
$2,900.25
|
| Rate for Payer: Cash Price |
$2,900.25
|
| Rate for Payer: Cash Price |
$2,900.25
|
| Rate for Payer: Cash Price |
$2,900.25
|
| Rate for Payer: Central Health Plan Commercial |
$5,156.00
|
| Rate for Payer: Cigna of CA HMO |
$4,124.80
|
| Rate for Payer: Cigna of CA PPO |
$4,769.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,452.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,265.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,968.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,511.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,897.61
|
| Rate for Payer: EPIC Health Plan Senior |
$3,265.07
|
| Rate for Payer: Galaxy Health WC |
$5,478.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,867.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,800.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,867.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,968.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,092.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$867.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,190.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,289.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,977.45
|
| Rate for Payer: Multiplan Commercial |
$4,833.75
|
| Rate for Payer: Multiplan WC |
$4,617.28
|
| Rate for Payer: Networks By Design Commercial |
$4,189.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,968.25
|
| Rate for Payer: Preferred Health Network WC |
$4,711.51
|
| Rate for Payer: Prime Health Services Commercial |
$5,478.25
|
| Rate for Payer: Prime Health Services Medicare |
$3,146.34
|
| Rate for Payer: Prime Health Services WC |
$4,570.16
|
| Rate for Payer: Riverside University Health System MISP |
$3,265.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,867.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,867.00
|
| 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 |
$2,968.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,452.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,265.07
|
| Rate for Payer: Vantage Medical Group Senior |
$2,968.25
|
|
|
HC RMVL FB INTRAOCULAR
|
Facility
|
IP
|
$6,445.00
|
|
|
Service Code
|
CPT 65235
|
| Hospital Charge Code |
900501180
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,289.00 |
| Max. Negotiated Rate |
$5,800.50 |
| Rate for Payer: Adventist Health Commercial |
$1,289.00
|
| Rate for Payer: Cash Price |
$2,900.25
|
| Rate for Payer: Central Health Plan Commercial |
$5,156.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,511.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,578.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,578.00
|
| Rate for Payer: Galaxy Health WC |
$5,478.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,867.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,800.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,092.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,802.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,289.00
|
| Rate for Payer: Multiplan Commercial |
$4,833.75
|
| Rate for Payer: Networks By Design Commercial |
$4,189.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,478.25
|
|
|
HC RMVL FB INTRAOCULAR
|
Facility
|
IP
|
$6,445.00
|
|
|
Service Code
|
CPT 65235
|
| Hospital Charge Code |
900501180
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,289.00 |
| Max. Negotiated Rate |
$5,800.50 |
| Rate for Payer: Adventist Health Commercial |
$1,289.00
|
| Rate for Payer: Cash Price |
$2,900.25
|
| Rate for Payer: Central Health Plan Commercial |
$5,156.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,511.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,578.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,578.00
|
| Rate for Payer: Galaxy Health WC |
$5,478.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,867.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,800.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,092.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,802.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,289.00
|
| Rate for Payer: Multiplan Commercial |
$4,833.75
|
| Rate for Payer: Networks By Design Commercial |
$4,189.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,478.25
|
|
|
HC RMVL FB MSCLE/TNDN SHEATH DEEP
|
Facility
|
IP
|
$11,144.00
|
|
|
Service Code
|
CPT 20525
|
| Hospital Charge Code |
900501534
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,228.80 |
| Max. Negotiated Rate |
$10,029.60 |
| Rate for Payer: Adventist Health Commercial |
$2,228.80
|
| Rate for Payer: Cash Price |
$5,014.80
|
| Rate for Payer: Central Health Plan Commercial |
$8,915.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,800.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,457.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,457.60
|
| Rate for Payer: Galaxy Health WC |
$9,472.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,686.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,029.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,076.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,574.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,228.80
|
| Rate for Payer: Multiplan Commercial |
$8,358.00
|
| Rate for Payer: Networks By Design Commercial |
$7,243.60
|
| Rate for Payer: Prime Health Services Commercial |
$9,472.40
|
|
|
HC RMVL FB MSCLE/TNDN SHEATH DEEP
|
Facility
|
OP
|
$11,144.00
|
|
|
Service Code
|
CPT 20525
|
| Hospital Charge Code |
900501534
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$10,029.60 |
| Rate for Payer: Adventist Health Commercial |
$2,228.80
|
| 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 |
$5,603.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,735.95
|
| 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 |
$5,794.14
|
| Rate for Payer: Cash Price |
$5,014.80
|
| Rate for Payer: Cash Price |
$5,014.80
|
| Rate for Payer: Cash Price |
$5,014.80
|
| Rate for Payer: Cash Price |
$5,014.80
|
| Rate for Payer: Central Health Plan Commercial |
$8,915.20
|
| Rate for Payer: Cigna of CA HMO |
$7,132.16
|
| Rate for Payer: Cigna of CA PPO |
$8,246.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,109.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,735.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,800.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,164.32
|
| Rate for Payer: EPIC Health Plan Senior |
$4,109.55
|
| Rate for Payer: Galaxy Health WC |
$9,472.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,686.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,029.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,126.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,076.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$551.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,016.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,228.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,006.17
|
| Rate for Payer: Multiplan Commercial |
$8,358.00
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: Networks By Design Commercial |
$7,243.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Preferred Health Network WC |
$5,912.39
|
| Rate for Payer: Prime Health Services Commercial |
$9,472.40
|
| Rate for Payer: Prime Health Services Medicare |
$3,960.11
|
| Rate for Payer: Prime Health Services WC |
$5,735.02
|
| Rate for Payer: Riverside University Health System MISP |
$4,109.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,686.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,572.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,572.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,572.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,735.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,735.95
|
|
|
HC RMVL FB MSCLE/TNDN SHEATH SMPL
|
Facility
|
IP
|
$2,559.00
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
900501492
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$511.80 |
| Max. Negotiated Rate |
$2,303.10 |
| Rate for Payer: Adventist Health Commercial |
$511.80
|
| Rate for Payer: Cash Price |
$1,151.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,047.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,791.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,023.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,023.60
|
| Rate for Payer: Galaxy Health WC |
$2,175.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,535.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,303.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,624.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,509.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$511.80
|
| Rate for Payer: Multiplan Commercial |
$1,919.25
|
| Rate for Payer: Networks By Design Commercial |
$1,663.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,175.15
|
|
|
HC RMVL FB MSCLE/TNDN SHEATH SMPL
|
Facility
|
OP
|
$2,559.00
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
900501492
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$213.62 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$511.80
|
| 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 |
$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 |
$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 |
$3,280.13
|
| Rate for Payer: Cash Price |
$1,151.55
|
| Rate for Payer: Cash Price |
$1,151.55
|
| Rate for Payer: Cash Price |
$1,151.55
|
| Rate for Payer: Cash Price |
$1,151.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,047.20
|
| Rate for Payer: Cigna of CA HMO |
$1,637.76
|
| Rate for Payer: Cigna of CA PPO |
$1,893.66
|
| 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 |
$1,791.30
|
| 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 |
$2,175.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,535.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,303.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,624.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$213.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,283.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$511.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$1,919.25
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$1,663.35
|
| 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 |
$2,175.15
|
| 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 |
$1,535.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,279.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,279.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,279.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,279.50
|
| 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
|
|
