|
HC RMVL FB OUTER EAR CANAL W/ANES
|
Facility
|
OP
|
$11,583.00
|
|
|
Service Code
|
CPT 69205
|
| Hospital Charge Code |
900501755
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$152.80 |
| Max. Negotiated Rate |
$10,424.70 |
| Rate for Payer: Adventist Health Commercial |
$2,316.60
|
| 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 |
$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 |
$5,212.35
|
| Rate for Payer: Cash Price |
$5,212.35
|
| Rate for Payer: Cash Price |
$5,212.35
|
| Rate for Payer: Cash Price |
$5,212.35
|
| Rate for Payer: Central Health Plan Commercial |
$9,266.40
|
| Rate for Payer: Cigna of CA HMO |
$7,413.12
|
| Rate for Payer: Cigna of CA PPO |
$8,571.42
|
| 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 |
$8,108.10
|
| 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 |
$9,845.55
|
| Rate for Payer: Global Benefits Group Commercial |
$6,949.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,424.70
|
| 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 |
$7,355.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$152.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,283.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,316.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$8,687.25
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$7,528.95
|
| 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 |
$9,845.55
|
| 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 |
$6,949.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,791.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,791.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,791.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,791.50
|
| 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 FB OUTER EAR CANAL W/ANES
|
Facility
|
IP
|
$11,583.00
|
|
|
Service Code
|
CPT 69205
|
| Hospital Charge Code |
900501755
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,316.60 |
| Max. Negotiated Rate |
$10,424.70 |
| Rate for Payer: Adventist Health Commercial |
$2,316.60
|
| Rate for Payer: Cash Price |
$5,212.35
|
| Rate for Payer: Central Health Plan Commercial |
$9,266.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,108.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,633.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4,633.20
|
| Rate for Payer: Galaxy Health WC |
$9,845.55
|
| Rate for Payer: Global Benefits Group Commercial |
$6,949.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,424.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,355.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,833.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,316.60
|
| Rate for Payer: Multiplan Commercial |
$8,687.25
|
| Rate for Payer: Networks By Design Commercial |
$7,528.95
|
| Rate for Payer: Prime Health Services Commercial |
$9,845.55
|
|
|
HC RMVL FB PHARYNGEAL
|
Facility
|
IP
|
$889.00
|
|
|
Service Code
|
CPT 42809
|
| Hospital Charge Code |
900501152
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$177.80 |
| Max. Negotiated Rate |
$800.10 |
| Rate for Payer: Adventist Health Commercial |
$177.80
|
| Rate for Payer: Cash Price |
$400.05
|
| Rate for Payer: Central Health Plan Commercial |
$711.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$622.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$355.60
|
| Rate for Payer: EPIC Health Plan Senior |
$355.60
|
| Rate for Payer: Galaxy Health WC |
$755.65
|
| Rate for Payer: Global Benefits Group Commercial |
$533.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$800.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$564.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$524.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$177.80
|
| Rate for Payer: Multiplan Commercial |
$666.75
|
| Rate for Payer: Networks By Design Commercial |
$577.85
|
| Rate for Payer: Prime Health Services Commercial |
$755.65
|
|
|
HC RMVL FB PHARYNGEAL
|
Facility
|
OP
|
$889.00
|
|
|
Service Code
|
CPT 42809
|
| Hospital Charge Code |
900501152
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$177.80 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$364.49
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$768.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$861.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$632.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$574.56
|
| 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 |
$807.84
|
| Rate for Payer: Cash Price |
$400.05
|
| Rate for Payer: Cash Price |
$400.05
|
| Rate for Payer: Cash Price |
$400.05
|
| Rate for Payer: Cash Price |
$400.05
|
| Rate for Payer: Central Health Plan Commercial |
$711.20
|
| Rate for Payer: Cigna of CA HMO |
$568.96
|
| Rate for Payer: Cigna of CA PPO |
$657.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$861.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$632.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$574.56
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$622.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$948.02
|
| Rate for Payer: EPIC Health Plan Senior |
$632.02
|
| Rate for Payer: Galaxy Health WC |
$755.65
|
| Rate for Payer: Global Benefits Group Commercial |
$533.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$800.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$942.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$574.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$564.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$282.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$617.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$177.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$769.91
|
| Rate for Payer: Multiplan Commercial |
$666.75
|
| Rate for Payer: Multiplan WC |
$807.84
|
| Rate for Payer: Networks By Design Commercial |
$577.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$574.56
|
| Rate for Payer: Preferred Health Network WC |
$824.33
|
| Rate for Payer: Prime Health Services Commercial |
$755.65
|
| Rate for Payer: Prime Health Services Medicare |
$609.03
|
| Rate for Payer: Prime Health Services WC |
$799.60
|
| Rate for Payer: Riverside University Health System MISP |
$632.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$533.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$533.40
|
| 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 |
$574.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$861.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$632.02
|
| Rate for Payer: Vantage Medical Group Senior |
$574.56
|
|
|
HC RMVL FB PHARYNGEAL
|
Facility
|
OP
|
$889.00
|
|
|
Service Code
|
CPT 42809
|
| Hospital Charge Code |
900501152
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$177.80 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$177.80
|
| 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 |
$861.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$632.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$574.56
|
| 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 |
$807.84
|
| Rate for Payer: Cash Price |
$400.05
|
| Rate for Payer: Cash Price |
$400.05
|
| Rate for Payer: Cash Price |
$400.05
|
| Rate for Payer: Cash Price |
$400.05
|
| Rate for Payer: Central Health Plan Commercial |
$711.20
|
| Rate for Payer: Cigna of CA HMO |
$568.96
|
| Rate for Payer: Cigna of CA PPO |
$657.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$861.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$632.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$574.56
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$622.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$948.02
|
| Rate for Payer: EPIC Health Plan Senior |
$632.02
|
| Rate for Payer: Galaxy Health WC |
$755.65
|
| Rate for Payer: Global Benefits Group Commercial |
$533.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$800.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$942.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$574.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$564.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$282.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$617.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$177.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$769.91
|
| Rate for Payer: Multiplan Commercial |
$666.75
|
| Rate for Payer: Multiplan WC |
$807.84
|
| Rate for Payer: Networks By Design Commercial |
$577.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$574.56
|
| Rate for Payer: Preferred Health Network WC |
$824.33
|
| Rate for Payer: Prime Health Services Commercial |
$755.65
|
| Rate for Payer: Prime Health Services Medicare |
$609.03
|
| Rate for Payer: Prime Health Services WC |
$799.60
|
| Rate for Payer: Riverside University Health System MISP |
$632.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$533.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$444.50
|
| Rate for Payer: United Healthcare All Other HMO |
$444.50
|
| Rate for Payer: United Healthcare HMO Rider |
$444.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$444.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$574.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$861.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$632.02
|
| Rate for Payer: Vantage Medical Group Senior |
$574.56
|
|
|
HC RMVL FB PHARYNGEAL
|
Facility
|
IP
|
$889.00
|
|
|
Service Code
|
CPT 42809
|
| Hospital Charge Code |
900501152
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$177.80 |
| Max. Negotiated Rate |
$800.10 |
| Rate for Payer: Adventist Health Commercial |
$177.80
|
| Rate for Payer: Cash Price |
$400.05
|
| Rate for Payer: Central Health Plan Commercial |
$711.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$622.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$355.60
|
| Rate for Payer: EPIC Health Plan Senior |
$355.60
|
| Rate for Payer: Galaxy Health WC |
$755.65
|
| Rate for Payer: Global Benefits Group Commercial |
$533.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$800.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$564.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$524.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$177.80
|
| Rate for Payer: Multiplan Commercial |
$666.75
|
| Rate for Payer: Networks By Design Commercial |
$577.85
|
| Rate for Payer: Prime Health Services Commercial |
$755.65
|
|
|
HC RMVL F.B. UPPER ARM/ELBOW,SUBC
|
Facility
|
OP
|
$2,559.00
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
900501468
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$210.08 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,049.19
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$779.30
|
| 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 |
$210.08
|
| 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: TriValley Medical Group Commercial/Senior |
$1,535.40
|
| 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 |
$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. UPPER ARM/ELBOW,SUBC
|
Facility
|
OP
|
$2,559.00
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
900501468
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$210.08 |
| 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 |
$210.08
|
| 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
|
|
|
HC RMVL F.B. UPPER ARM/ELBOW,SUBC
|
Facility
|
IP
|
$2,559.00
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
900501468
|
|
Hospital Revenue Code
|
456
|
| 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 F.B. UPPER ARM/ELBOW,SUBC
|
Facility
|
IP
|
$2,559.00
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
900501468
|
|
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 FECAL IMPACTION W/ANESTHE
|
Facility
|
IP
|
$6,116.00
|
|
|
Service Code
|
CPT 45915
|
| Hospital Charge Code |
900501608
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,223.20 |
| Max. Negotiated Rate |
$5,504.40 |
| Rate for Payer: Adventist Health Commercial |
$1,223.20
|
| Rate for Payer: Cash Price |
$2,752.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,892.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,281.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,446.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,446.40
|
| Rate for Payer: Galaxy Health WC |
$5,198.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,669.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,504.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,883.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,608.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,223.20
|
| Rate for Payer: Multiplan Commercial |
$4,587.00
|
| Rate for Payer: Networks By Design Commercial |
$3,975.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,198.60
|
|
|
HC RMVL FECAL IMPACTION W/ANESTHE
|
Facility
|
IP
|
$6,116.00
|
|
|
Service Code
|
CPT 45915
|
| Hospital Charge Code |
900501608
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,223.20 |
| Max. Negotiated Rate |
$5,504.40 |
| Rate for Payer: Adventist Health Commercial |
$1,223.20
|
| Rate for Payer: Cash Price |
$2,752.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,892.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,281.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,446.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,446.40
|
| Rate for Payer: Galaxy Health WC |
$5,198.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,669.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,504.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,883.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,608.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,223.20
|
| Rate for Payer: Multiplan Commercial |
$4,587.00
|
| Rate for Payer: Networks By Design Commercial |
$3,975.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,198.60
|
|
|
HC RMVL FECAL IMPACTION W/ANESTHE
|
Facility
|
OP
|
$6,116.00
|
|
|
Service Code
|
CPT 45915
|
| Hospital Charge Code |
900501608
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$391.17 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,223.20
|
| 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 |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| 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 |
$2,387.03
|
| Rate for Payer: Cash Price |
$2,752.20
|
| Rate for Payer: Cash Price |
$2,752.20
|
| Rate for Payer: Cash Price |
$2,752.20
|
| Rate for Payer: Cash Price |
$2,752.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,892.80
|
| Rate for Payer: Cigna of CA HMO |
$3,914.24
|
| Rate for Payer: Cigna of CA PPO |
$4,525.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,281.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$5,198.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,669.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,504.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,883.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$391.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,654.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,223.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$4,587.00
|
| Rate for Payer: Multiplan WC |
$2,387.03
|
| Rate for Payer: Networks By Design Commercial |
$3,975.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Preferred Health Network WC |
$2,435.74
|
| Rate for Payer: Prime Health Services Commercial |
$5,198.60
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Prime Health Services WC |
$2,362.67
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,669.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,058.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,058.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,058.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,058.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC RMVL FECAL IMPACTION W/ANESTHE
|
Facility
|
OP
|
$6,116.00
|
|
|
Service Code
|
CPT 45915
|
| Hospital Charge Code |
900501608
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$354.11 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,223.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$2,387.03
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$2,752.20
|
| Rate for Payer: Cash Price |
$2,752.20
|
| Rate for Payer: Cash Price |
$2,752.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,892.80
|
| Rate for Payer: Cigna of CA HMO |
$3,914.24
|
| Rate for Payer: Cigna of CA PPO |
$4,525.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,281.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$5,198.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,669.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,504.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$354.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,883.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$391.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,223.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$4,587.00
|
| Rate for Payer: Multiplan WC |
$2,387.03
|
| Rate for Payer: Networks By Design Commercial |
$3,975.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Preferred Health Network WC |
$2,435.74
|
| Rate for Payer: Prime Health Services Commercial |
$5,198.60
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Prime Health Services WC |
$2,362.67
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,669.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,058.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC RMVL FOREARM LESION SUBCU
|
Facility
|
OP
|
$11,144.00
|
|
|
Service Code
|
CPT 25075
|
| Hospital Charge Code |
902890327
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$124.49 |
| Max. Negotiated Rate |
$10,029.60 |
| Rate for Payer: Adventist Health Commercial |
$4,569.04
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,853.17
|
| 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 |
$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 |
$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 |
$7,800.80
|
| 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 |
$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 |
$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 |
$7,076.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$124.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,283.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,228.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$8,358.00
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$7,243.60
|
| 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 |
$9,472.40
|
| 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 |
$6,686.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,686.40
|
| 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 |
$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 FOREARM LESION SUBCU
|
Facility
|
IP
|
$11,144.00
|
|
|
Service Code
|
CPT 25075
|
| Hospital Charge Code |
902890327
|
|
Hospital Revenue Code
|
456
|
| 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 FOREIGN BODY EYELID
|
Facility
|
IP
|
$1,538.00
|
|
|
Service Code
|
CPT 67938
|
| Hospital Charge Code |
900501599
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$307.60 |
| Max. Negotiated Rate |
$1,384.20 |
| Rate for Payer: Adventist Health Commercial |
$307.60
|
| Rate for Payer: Cash Price |
$692.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,230.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,076.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$615.20
|
| Rate for Payer: EPIC Health Plan Senior |
$615.20
|
| Rate for Payer: Galaxy Health WC |
$1,307.30
|
| Rate for Payer: Global Benefits Group Commercial |
$922.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,384.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$976.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$907.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$307.60
|
| Rate for Payer: Multiplan Commercial |
$1,153.50
|
| Rate for Payer: Networks By Design Commercial |
$999.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,307.30
|
|
|
HC RMVL FOREIGN BODY EYELID
|
Facility
|
OP
|
$1,538.00
|
|
|
Service Code
|
CPT 67938
|
| Hospital Charge Code |
900501599
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$103.99 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$307.60
|
| 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 |
$612.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$449.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$408.24
|
| 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 |
$605.18
|
| Rate for Payer: Cash Price |
$692.10
|
| Rate for Payer: Cash Price |
$692.10
|
| Rate for Payer: Cash Price |
$692.10
|
| Rate for Payer: Cash Price |
$692.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,230.40
|
| Rate for Payer: Cigna of CA HMO |
$984.32
|
| Rate for Payer: Cigna of CA PPO |
$1,138.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$612.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$449.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$408.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,076.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$673.60
|
| Rate for Payer: EPIC Health Plan Senior |
$449.06
|
| Rate for Payer: Galaxy Health WC |
$1,307.30
|
| Rate for Payer: Global Benefits Group Commercial |
$922.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,384.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$669.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$408.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$976.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$103.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$438.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$307.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$547.04
|
| Rate for Payer: Multiplan Commercial |
$1,153.50
|
| Rate for Payer: Multiplan WC |
$605.18
|
| Rate for Payer: Networks By Design Commercial |
$999.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$408.24
|
| Rate for Payer: Preferred Health Network WC |
$617.53
|
| Rate for Payer: Prime Health Services Commercial |
$1,307.30
|
| Rate for Payer: Prime Health Services Medicare |
$432.73
|
| Rate for Payer: Prime Health Services WC |
$599.00
|
| Rate for Payer: Riverside University Health System MISP |
$449.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$922.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$769.00
|
| Rate for Payer: United Healthcare All Other HMO |
$769.00
|
| Rate for Payer: United Healthcare HMO Rider |
$769.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$769.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$408.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$612.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$449.06
|
| Rate for Payer: Vantage Medical Group Senior |
$408.24
|
|
|
HC RMVL FOREIGN BODY EYELID
|
Facility
|
OP
|
$1,538.00
|
|
|
Service Code
|
CPT 67938
|
| Hospital Charge Code |
900501599
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$103.99 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$630.58
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$619.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$612.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$449.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$408.24
|
| 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 |
$605.18
|
| Rate for Payer: Cash Price |
$692.10
|
| Rate for Payer: Cash Price |
$692.10
|
| Rate for Payer: Cash Price |
$692.10
|
| Rate for Payer: Cash Price |
$692.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,230.40
|
| Rate for Payer: Cigna of CA HMO |
$984.32
|
| Rate for Payer: Cigna of CA PPO |
$1,138.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$612.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$449.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$408.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,076.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$673.60
|
| Rate for Payer: EPIC Health Plan Senior |
$449.06
|
| Rate for Payer: Galaxy Health WC |
$1,307.30
|
| Rate for Payer: Global Benefits Group Commercial |
$922.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,384.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$669.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$408.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$976.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$103.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$438.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$307.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$547.04
|
| Rate for Payer: Multiplan Commercial |
$1,153.50
|
| Rate for Payer: Multiplan WC |
$605.18
|
| Rate for Payer: Networks By Design Commercial |
$999.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$408.24
|
| Rate for Payer: Preferred Health Network WC |
$617.53
|
| Rate for Payer: Prime Health Services Commercial |
$1,307.30
|
| Rate for Payer: Prime Health Services Medicare |
$432.73
|
| Rate for Payer: Prime Health Services WC |
$599.00
|
| Rate for Payer: Riverside University Health System MISP |
$449.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$922.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$922.80
|
| 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 |
$408.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$612.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$449.06
|
| Rate for Payer: Vantage Medical Group Senior |
$408.24
|
|
|
HC RMVL FOREIGN BODY EYELID
|
Facility
|
IP
|
$1,538.00
|
|
|
Service Code
|
CPT 67938
|
| Hospital Charge Code |
900501599
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$307.60 |
| Max. Negotiated Rate |
$1,384.20 |
| Rate for Payer: Adventist Health Commercial |
$307.60
|
| Rate for Payer: Cash Price |
$692.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,230.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,076.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$615.20
|
| Rate for Payer: EPIC Health Plan Senior |
$615.20
|
| Rate for Payer: Galaxy Health WC |
$1,307.30
|
| Rate for Payer: Global Benefits Group Commercial |
$922.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,384.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$976.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$907.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$307.60
|
| Rate for Payer: Multiplan Commercial |
$1,153.50
|
| Rate for Payer: Networks By Design Commercial |
$999.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,307.30
|
|
|
HC RMVL FOREIGN BODY LARYNX
|
Facility
|
IP
|
$785.00
|
|
|
Service Code
|
CPT 31511
|
| Hospital Charge Code |
900501339
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$157.00 |
| Max. Negotiated Rate |
$706.50 |
| Rate for Payer: Adventist Health Commercial |
$157.00
|
| Rate for Payer: Cash Price |
$353.25
|
| Rate for Payer: Central Health Plan Commercial |
$628.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$549.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$314.00
|
| Rate for Payer: EPIC Health Plan Senior |
$314.00
|
| Rate for Payer: Galaxy Health WC |
$667.25
|
| Rate for Payer: Global Benefits Group Commercial |
$471.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$706.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$498.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$463.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$157.00
|
| Rate for Payer: Multiplan Commercial |
$588.75
|
| Rate for Payer: Networks By Design Commercial |
$510.25
|
| Rate for Payer: Prime Health Services Commercial |
$667.25
|
|
|
HC RMVL FOREIGN BODY LARYNX
|
Facility
|
OP
|
$785.00
|
|
|
Service Code
|
CPT 31511
|
| Hospital Charge Code |
900501339
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$157.00 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$321.85
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$714.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$385.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$282.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$256.73
|
| 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 |
$393.03
|
| Rate for Payer: Cash Price |
$353.25
|
| Rate for Payer: Cash Price |
$353.25
|
| Rate for Payer: Cash Price |
$353.25
|
| Rate for Payer: Cash Price |
$353.25
|
| Rate for Payer: Central Health Plan Commercial |
$628.00
|
| Rate for Payer: Cigna of CA HMO |
$502.40
|
| Rate for Payer: Cigna of CA PPO |
$580.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$385.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$282.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$256.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$549.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$423.60
|
| Rate for Payer: EPIC Health Plan Senior |
$282.40
|
| Rate for Payer: Galaxy Health WC |
$667.25
|
| Rate for Payer: Global Benefits Group Commercial |
$471.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$706.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$421.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$256.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$498.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$157.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$275.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$157.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$344.02
|
| Rate for Payer: Multiplan Commercial |
$588.75
|
| Rate for Payer: Multiplan WC |
$393.03
|
| Rate for Payer: Networks By Design Commercial |
$510.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$256.73
|
| Rate for Payer: Preferred Health Network WC |
$401.05
|
| Rate for Payer: Prime Health Services Commercial |
$667.25
|
| Rate for Payer: Prime Health Services Medicare |
$272.13
|
| Rate for Payer: Prime Health Services WC |
$389.02
|
| Rate for Payer: Riverside University Health System MISP |
$282.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$471.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$471.00
|
| 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 |
$256.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$385.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$282.40
|
| Rate for Payer: Vantage Medical Group Senior |
$256.73
|
|
|
HC RMVL FOREIGN BODY LARYNX
|
Facility
|
IP
|
$785.00
|
|
|
Service Code
|
CPT 31511
|
| Hospital Charge Code |
900501339
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$157.00 |
| Max. Negotiated Rate |
$706.50 |
| Rate for Payer: Adventist Health Commercial |
$157.00
|
| Rate for Payer: Cash Price |
$353.25
|
| Rate for Payer: Central Health Plan Commercial |
$628.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$549.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$314.00
|
| Rate for Payer: EPIC Health Plan Senior |
$314.00
|
| Rate for Payer: Galaxy Health WC |
$667.25
|
| Rate for Payer: Global Benefits Group Commercial |
$471.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$706.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$498.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$463.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$157.00
|
| Rate for Payer: Multiplan Commercial |
$588.75
|
| Rate for Payer: Networks By Design Commercial |
$510.25
|
| Rate for Payer: Prime Health Services Commercial |
$667.25
|
|
|
HC RMVL FOREIGN BODY LARYNX
|
Facility
|
OP
|
$785.00
|
|
|
Service Code
|
CPT 31511
|
| Hospital Charge Code |
900501339
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$157.00 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$157.00
|
| 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 |
$385.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$282.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$256.73
|
| 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 |
$393.03
|
| Rate for Payer: Cash Price |
$353.25
|
| Rate for Payer: Cash Price |
$353.25
|
| Rate for Payer: Cash Price |
$353.25
|
| Rate for Payer: Cash Price |
$353.25
|
| Rate for Payer: Central Health Plan Commercial |
$628.00
|
| Rate for Payer: Cigna of CA HMO |
$502.40
|
| Rate for Payer: Cigna of CA PPO |
$580.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$385.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$282.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$256.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$549.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$423.60
|
| Rate for Payer: EPIC Health Plan Senior |
$282.40
|
| Rate for Payer: Galaxy Health WC |
$667.25
|
| Rate for Payer: Global Benefits Group Commercial |
$471.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$706.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$421.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$256.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$498.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$157.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$275.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$157.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$344.02
|
| Rate for Payer: Multiplan Commercial |
$588.75
|
| Rate for Payer: Multiplan WC |
$393.03
|
| Rate for Payer: Networks By Design Commercial |
$510.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$256.73
|
| Rate for Payer: Preferred Health Network WC |
$401.05
|
| Rate for Payer: Prime Health Services Commercial |
$667.25
|
| Rate for Payer: Prime Health Services Medicare |
$272.13
|
| Rate for Payer: Prime Health Services WC |
$389.02
|
| Rate for Payer: Riverside University Health System MISP |
$282.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$471.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$392.50
|
| Rate for Payer: United Healthcare All Other HMO |
$392.50
|
| Rate for Payer: United Healthcare HMO Rider |
$392.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$392.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$256.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$385.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$282.40
|
| Rate for Payer: Vantage Medical Group Senior |
$256.73
|
|
|
HC RMVL IMPACTED CERUMEN
|
Facility
|
IP
|
$1,475.00
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
900501186
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$295.00 |
| Max. Negotiated Rate |
$1,327.50 |
| Rate for Payer: Adventist Health Commercial |
$295.00
|
| Rate for Payer: Cash Price |
$663.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,180.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,032.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$590.00
|
| Rate for Payer: EPIC Health Plan Senior |
$590.00
|
| Rate for Payer: Galaxy Health WC |
$1,253.75
|
| Rate for Payer: Global Benefits Group Commercial |
$885.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,327.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$936.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$870.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$295.00
|
| Rate for Payer: Multiplan Commercial |
$1,106.25
|
| Rate for Payer: Networks By Design Commercial |
$958.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,253.75
|
|
