|
HC RMVL IMPACTED CERUMEN
|
Facility
|
OP
|
$1,475.00
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
900501186
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$58.01 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$295.00
|
| 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 |
$113.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.87
|
| 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 |
$120.25
|
| Rate for Payer: Cash Price |
$663.75
|
| Rate for Payer: Cash Price |
$663.75
|
| Rate for Payer: Cash Price |
$663.75
|
| Rate for Payer: Cash Price |
$663.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,180.00
|
| Rate for Payer: Cigna of CA HMO |
$944.00
|
| Rate for Payer: Cigna of CA PPO |
$1,091.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,032.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.19
|
| Rate for Payer: EPIC Health Plan Senior |
$83.46
|
| 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: Heritage Provider Network Commercial/Senior |
$124.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$936.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$58.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$81.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$295.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$101.67
|
| Rate for Payer: Multiplan Commercial |
$1,106.25
|
| Rate for Payer: Multiplan WC |
$120.25
|
| Rate for Payer: Networks By Design Commercial |
$958.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.87
|
| Rate for Payer: Preferred Health Network WC |
$122.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,253.75
|
| Rate for Payer: Prime Health Services Medicare |
$80.42
|
| Rate for Payer: Prime Health Services WC |
$119.02
|
| Rate for Payer: Riverside University Health System MISP |
$83.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$885.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$737.50
|
| Rate for Payer: United Healthcare All Other HMO |
$737.50
|
| Rate for Payer: United Healthcare HMO Rider |
$737.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$737.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.46
|
| Rate for Payer: Vantage Medical Group Senior |
$75.87
|
|
|
HC RMVL IMPACTED CERUMEN
|
Facility
|
IP
|
$1,475.00
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
900501186
|
|
Hospital Revenue Code
|
450
|
| 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
|
|
|
HC RMVL IMPACTED CERUMEN
|
Facility
|
OP
|
$1,475.00
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
900501186
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$58.01 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$604.75
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$179.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.87
|
| 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 |
$120.25
|
| Rate for Payer: Cash Price |
$663.75
|
| Rate for Payer: Cash Price |
$663.75
|
| Rate for Payer: Cash Price |
$663.75
|
| Rate for Payer: Cash Price |
$663.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,180.00
|
| Rate for Payer: Cigna of CA HMO |
$944.00
|
| Rate for Payer: Cigna of CA PPO |
$1,091.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,032.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.19
|
| Rate for Payer: EPIC Health Plan Senior |
$83.46
|
| 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: Heritage Provider Network Commercial/Senior |
$124.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$936.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$58.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$81.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$295.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$101.67
|
| Rate for Payer: Multiplan Commercial |
$1,106.25
|
| Rate for Payer: Multiplan WC |
$120.25
|
| Rate for Payer: Networks By Design Commercial |
$958.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.87
|
| Rate for Payer: Preferred Health Network WC |
$122.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,253.75
|
| Rate for Payer: Prime Health Services Medicare |
$80.42
|
| Rate for Payer: Prime Health Services WC |
$119.02
|
| Rate for Payer: Riverside University Health System MISP |
$83.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$885.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$885.00
|
| 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 |
$75.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.46
|
| Rate for Payer: Vantage Medical Group Senior |
$75.87
|
|
|
HC RMVL IMPACTED VAGINAL FB
|
Facility
|
OP
|
$7,383.00
|
|
|
Service Code
|
CPT 57415
|
| Hospital Charge Code |
900501347
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$301.51 |
| Max. Negotiated Rate |
$6,869.74 |
| Rate for Payer: Adventist Health Commercial |
$3,027.03
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$998.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,579.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,163.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,436.87
|
| Rate for Payer: Cash Price |
$3,322.35
|
| Rate for Payer: Cash Price |
$3,322.35
|
| Rate for Payer: Cash Price |
$3,322.35
|
| Rate for Payer: Cash Price |
$3,322.35
|
| Rate for Payer: Central Health Plan Commercial |
$5,906.40
|
| Rate for Payer: Cigna of CA HMO |
$4,725.12
|
| Rate for Payer: Cigna of CA PPO |
$5,463.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,579.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,163.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,168.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,869.74
|
| Rate for Payer: EPIC Health Plan Senior |
$4,579.83
|
| Rate for Payer: Galaxy Health WC |
$6,275.55
|
| Rate for Payer: Global Benefits Group Commercial |
$4,429.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,644.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,828.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,163.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,688.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$301.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,475.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,476.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,579.06
|
| Rate for Payer: Multiplan Commercial |
$5,537.25
|
| Rate for Payer: Multiplan WC |
$6,436.87
|
| Rate for Payer: Networks By Design Commercial |
$4,798.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,163.48
|
| Rate for Payer: Preferred Health Network WC |
$6,568.23
|
| Rate for Payer: Prime Health Services Commercial |
$6,275.55
|
| Rate for Payer: Prime Health Services Medicare |
$4,413.29
|
| Rate for Payer: Prime Health Services WC |
$6,371.18
|
| Rate for Payer: Riverside University Health System MISP |
$4,579.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,429.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,429.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,163.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,579.83
|
| Rate for Payer: Vantage Medical Group Senior |
$4,163.48
|
|
|
HC RMVL IMPACTED VAGINAL FB
|
Facility
|
IP
|
$7,383.00
|
|
|
Service Code
|
CPT 57415
|
| Hospital Charge Code |
900501347
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,476.60 |
| Max. Negotiated Rate |
$6,644.70 |
| Rate for Payer: Adventist Health Commercial |
$1,476.60
|
| Rate for Payer: Cash Price |
$3,322.35
|
| Rate for Payer: Central Health Plan Commercial |
$5,906.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,168.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,953.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,953.20
|
| Rate for Payer: Galaxy Health WC |
$6,275.55
|
| Rate for Payer: Global Benefits Group Commercial |
$4,429.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,644.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,688.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,355.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,476.60
|
| Rate for Payer: Multiplan Commercial |
$5,537.25
|
| Rate for Payer: Networks By Design Commercial |
$4,798.95
|
| Rate for Payer: Prime Health Services Commercial |
$6,275.55
|
|
|
HC RMVL IMPACTED VAGINAL FB
|
Facility
|
IP
|
$7,383.00
|
|
|
Service Code
|
CPT 57415
|
| Hospital Charge Code |
900501347
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,476.60 |
| Max. Negotiated Rate |
$6,644.70 |
| Rate for Payer: Adventist Health Commercial |
$1,476.60
|
| Rate for Payer: Cash Price |
$3,322.35
|
| Rate for Payer: Central Health Plan Commercial |
$5,906.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,168.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,953.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,953.20
|
| Rate for Payer: Galaxy Health WC |
$6,275.55
|
| Rate for Payer: Global Benefits Group Commercial |
$4,429.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,644.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,688.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,355.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,476.60
|
| Rate for Payer: Multiplan Commercial |
$5,537.25
|
| Rate for Payer: Networks By Design Commercial |
$4,798.95
|
| Rate for Payer: Prime Health Services Commercial |
$6,275.55
|
|
|
HC RMVL IMPACTED VAGINAL FB
|
Facility
|
OP
|
$7,383.00
|
|
|
Service Code
|
CPT 57415
|
| Hospital Charge Code |
900501347
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$301.51 |
| Max. Negotiated Rate |
$6,869.74 |
| Rate for Payer: Adventist Health Commercial |
$1,476.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,579.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,163.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,436.87
|
| Rate for Payer: Cash Price |
$3,322.35
|
| Rate for Payer: Cash Price |
$3,322.35
|
| Rate for Payer: Cash Price |
$3,322.35
|
| Rate for Payer: Cash Price |
$3,322.35
|
| Rate for Payer: Central Health Plan Commercial |
$5,906.40
|
| Rate for Payer: Cigna of CA HMO |
$4,725.12
|
| Rate for Payer: Cigna of CA PPO |
$5,463.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,579.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,163.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,168.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,869.74
|
| Rate for Payer: EPIC Health Plan Senior |
$4,579.83
|
| Rate for Payer: Galaxy Health WC |
$6,275.55
|
| Rate for Payer: Global Benefits Group Commercial |
$4,429.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,644.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,828.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,163.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,688.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$301.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,475.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,476.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,579.06
|
| Rate for Payer: Multiplan Commercial |
$5,537.25
|
| Rate for Payer: Multiplan WC |
$6,436.87
|
| Rate for Payer: Networks By Design Commercial |
$4,798.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,163.48
|
| Rate for Payer: Preferred Health Network WC |
$6,568.23
|
| Rate for Payer: Prime Health Services Commercial |
$6,275.55
|
| Rate for Payer: Prime Health Services Medicare |
$4,413.29
|
| Rate for Payer: Prime Health Services WC |
$6,371.18
|
| Rate for Payer: Riverside University Health System MISP |
$4,579.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,429.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,691.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,691.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,691.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,691.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,163.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,579.83
|
| Rate for Payer: Vantage Medical Group Senior |
$4,163.48
|
|
|
HC RMVL INTRA AORTIC BLLN AST DVC
|
Facility
|
IP
|
$8,737.00
|
|
|
Service Code
|
CPT 33968
|
| Hospital Charge Code |
906803968
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,747.40 |
| Max. Negotiated Rate |
$7,863.30 |
| Rate for Payer: Adventist Health Commercial |
$1,747.40
|
| Rate for Payer: Cash Price |
$3,931.65
|
| Rate for Payer: Central Health Plan Commercial |
$6,989.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,115.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,494.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,494.80
|
| Rate for Payer: Galaxy Health WC |
$7,426.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,242.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,863.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,547.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,154.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,747.40
|
| Rate for Payer: Multiplan Commercial |
$6,552.75
|
| Rate for Payer: Networks By Design Commercial |
$5,679.05
|
| Rate for Payer: Prime Health Services Commercial |
$7,426.45
|
|
|
HC RMVL INTRA AORTIC BLLN AST DVC
|
Facility
|
OP
|
$8,737.00
|
|
|
Service Code
|
CPT 33968
|
| Hospital Charge Code |
906803968
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$46.11 |
| Max. Negotiated Rate |
$71,375.00 |
| Rate for Payer: Adventist Health Commercial |
$1,747.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,426.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,805.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,552.75
|
| 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: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,931.65
|
| Rate for Payer: Cash Price |
$3,931.65
|
| Rate for Payer: Cash Price |
$3,931.65
|
| Rate for Payer: Central Health Plan Commercial |
$6,989.60
|
| Rate for Payer: Cigna of CA HMO |
$5,591.68
|
| Rate for Payer: Cigna of CA PPO |
$6,465.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,426.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,426.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,426.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,115.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,494.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,494.80
|
| Rate for Payer: Galaxy Health WC |
$7,426.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,242.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,863.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$46.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,547.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$50.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,154.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,747.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,115.90
|
| Rate for Payer: Multiplan Commercial |
$6,552.75
|
| Rate for Payer: Networks By Design Commercial |
$5,679.05
|
| Rate for Payer: Prime Health Services Commercial |
$7,426.45
|
| Rate for Payer: Riverside University Health System MISP |
$3,494.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,242.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,368.50
|
| Rate for Payer: United Healthcare All Other HMO |
$71,375.00
|
| Rate for Payer: United Healthcare HMO Rider |
$57,385.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52,575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,426.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,426.45
|
| Rate for Payer: Vantage Medical Group Senior |
$7,426.45
|
|
|
HC RMVL INTRANASAL FB
|
Facility
|
IP
|
$1,916.00
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
900501113
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$383.20 |
| Max. Negotiated Rate |
$1,724.40 |
| Rate for Payer: Adventist Health Commercial |
$383.20
|
| Rate for Payer: Cash Price |
$862.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,532.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,341.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$766.40
|
| Rate for Payer: EPIC Health Plan Senior |
$766.40
|
| Rate for Payer: Galaxy Health WC |
$1,628.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,149.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,724.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,216.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,130.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$383.20
|
| Rate for Payer: Multiplan Commercial |
$1,437.00
|
| Rate for Payer: Networks By Design Commercial |
$1,245.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,628.60
|
|
|
HC RMVL INTRANASAL FB
|
Facility
|
OP
|
$1,916.00
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
900501113
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$106.82 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$383.20
|
| 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 |
$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 |
$862.20
|
| Rate for Payer: Cash Price |
$862.20
|
| Rate for Payer: Cash Price |
$862.20
|
| Rate for Payer: Cash Price |
$862.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,532.80
|
| Rate for Payer: Cigna of CA HMO |
$1,226.24
|
| Rate for Payer: Cigna of CA PPO |
$1,417.84
|
| 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 |
$1,341.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$1,628.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,149.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,724.40
|
| 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 |
$1,216.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$106.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$183.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$383.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$1,437.00
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$1,245.40
|
| 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 |
$1,628.60
|
| 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 |
$1,149.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$958.00
|
| Rate for Payer: United Healthcare All Other HMO |
$958.00
|
| Rate for Payer: United Healthcare HMO Rider |
$958.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$958.00
|
| 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 INTRANASAL FB
|
Facility
|
OP
|
$1,916.00
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
900501113
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$106.82 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$785.56
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$720.09
|
| 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 |
$862.20
|
| Rate for Payer: Cash Price |
$862.20
|
| Rate for Payer: Cash Price |
$862.20
|
| Rate for Payer: Cash Price |
$862.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,532.80
|
| Rate for Payer: Cigna of CA HMO |
$1,226.24
|
| Rate for Payer: Cigna of CA PPO |
$1,417.84
|
| 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 |
$1,341.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$1,628.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,149.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,724.40
|
| 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 |
$1,216.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$106.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$183.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$383.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$1,437.00
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$1,245.40
|
| 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 |
$1,628.60
|
| 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 |
$1,149.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,149.60
|
| 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 |
$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 INTRANASAL FB
|
Facility
|
IP
|
$1,916.00
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
900501113
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$383.20 |
| Max. Negotiated Rate |
$1,724.40 |
| Rate for Payer: Adventist Health Commercial |
$383.20
|
| Rate for Payer: Cash Price |
$862.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,532.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,341.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$766.40
|
| Rate for Payer: EPIC Health Plan Senior |
$766.40
|
| Rate for Payer: Galaxy Health WC |
$1,628.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,149.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,724.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,216.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,130.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$383.20
|
| Rate for Payer: Multiplan Commercial |
$1,437.00
|
| Rate for Payer: Networks By Design Commercial |
$1,245.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,628.60
|
|
|
HC RMVL INTRANASAL LESION
|
Facility
|
IP
|
$7,633.00
|
|
|
Service Code
|
CPT 30117
|
| Hospital Charge Code |
900501734
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,526.60 |
| Max. Negotiated Rate |
$6,869.70 |
| Rate for Payer: Adventist Health Commercial |
$1,526.60
|
| Rate for Payer: Cash Price |
$3,434.85
|
| Rate for Payer: Central Health Plan Commercial |
$6,106.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,343.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,053.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,053.20
|
| Rate for Payer: Galaxy Health WC |
$6,488.05
|
| Rate for Payer: Global Benefits Group Commercial |
$4,579.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,869.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,846.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,503.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,526.60
|
| Rate for Payer: Multiplan Commercial |
$5,724.75
|
| Rate for Payer: Networks By Design Commercial |
$4,961.45
|
| Rate for Payer: Prime Health Services Commercial |
$6,488.05
|
|
|
HC RMVL INTRANASAL LESION
|
Facility
|
OP
|
$7,633.00
|
|
|
Service Code
|
CPT 30117
|
| Hospital Charge Code |
900501734
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$7,035.98 |
| Rate for Payer: Adventist Health Commercial |
$1,526.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,690.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,264.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,565.51
|
| Rate for Payer: Cash Price |
$3,434.85
|
| Rate for Payer: Cash Price |
$3,434.85
|
| Rate for Payer: Cash Price |
$3,434.85
|
| Rate for Payer: Cash Price |
$3,434.85
|
| Rate for Payer: Central Health Plan Commercial |
$6,106.40
|
| Rate for Payer: Cigna of CA HMO |
$4,885.12
|
| Rate for Payer: Cigna of CA PPO |
$5,648.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,690.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,264.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,343.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,035.98
|
| Rate for Payer: EPIC Health Plan Senior |
$4,690.65
|
| Rate for Payer: Galaxy Health WC |
$6,488.05
|
| Rate for Payer: Global Benefits Group Commercial |
$4,579.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,869.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,993.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,264.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,846.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$431.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,584.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,526.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,714.07
|
| Rate for Payer: Multiplan Commercial |
$5,724.75
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: Networks By Design Commercial |
$4,961.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,264.23
|
| Rate for Payer: Preferred Health Network WC |
$6,699.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,488.05
|
| Rate for Payer: Prime Health Services Medicare |
$4,520.08
|
| Rate for Payer: Prime Health Services WC |
$6,498.52
|
| Rate for Payer: Riverside University Health System MISP |
$4,690.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,579.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,816.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,816.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,816.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,816.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,264.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,690.65
|
| Rate for Payer: Vantage Medical Group Senior |
$4,264.23
|
|
|
HC RMVL NASAL F.B.
|
Facility
|
IP
|
$8,101.00
|
|
|
Service Code
|
CPT 30310
|
| Hospital Charge Code |
900501618
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,620.20 |
| Max. Negotiated Rate |
$7,290.90 |
| Rate for Payer: Adventist Health Commercial |
$1,620.20
|
| Rate for Payer: Cash Price |
$3,645.45
|
| Rate for Payer: Central Health Plan Commercial |
$6,480.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,670.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,240.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,240.40
|
| Rate for Payer: Galaxy Health WC |
$6,885.85
|
| Rate for Payer: Global Benefits Group Commercial |
$4,860.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,290.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,144.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,779.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,620.20
|
| Rate for Payer: Multiplan Commercial |
$6,075.75
|
| Rate for Payer: Networks By Design Commercial |
$5,265.65
|
| Rate for Payer: Prime Health Services Commercial |
$6,885.85
|
|
|
HC RMVL NASAL F.B.
|
Facility
|
OP
|
$8,101.00
|
|
|
Service Code
|
CPT 30310
|
| Hospital Charge Code |
900501618
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$160.57 |
| Max. Negotiated Rate |
$7,290.90 |
| Rate for Payer: Adventist Health Commercial |
$1,620.20
|
| 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 |
$6,396.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,690.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,264.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,565.51
|
| Rate for Payer: Cash Price |
$3,645.45
|
| Rate for Payer: Cash Price |
$3,645.45
|
| Rate for Payer: Cash Price |
$3,645.45
|
| Rate for Payer: Cash Price |
$3,645.45
|
| Rate for Payer: Central Health Plan Commercial |
$6,480.80
|
| Rate for Payer: Cigna of CA HMO |
$5,184.64
|
| Rate for Payer: Cigna of CA PPO |
$5,994.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,690.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,264.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,670.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,035.98
|
| Rate for Payer: EPIC Health Plan Senior |
$4,690.65
|
| Rate for Payer: Galaxy Health WC |
$6,885.85
|
| Rate for Payer: Global Benefits Group Commercial |
$4,860.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,290.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,993.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,264.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,144.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$160.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,584.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,620.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,714.07
|
| Rate for Payer: Multiplan Commercial |
$6,075.75
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: Networks By Design Commercial |
$5,265.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,264.23
|
| Rate for Payer: Preferred Health Network WC |
$6,699.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,885.85
|
| Rate for Payer: Prime Health Services Medicare |
$4,520.08
|
| Rate for Payer: Prime Health Services WC |
$6,498.52
|
| Rate for Payer: Riverside University Health System MISP |
$4,690.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,860.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,050.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,050.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,050.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,050.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,264.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,690.65
|
| Rate for Payer: Vantage Medical Group Senior |
$4,264.23
|
|
|
HC RMVL OF CORNEAL EPITELIUM
|
Facility
|
OP
|
$4,231.00
|
|
|
Service Code
|
CPT 65435
|
| Hospital Charge Code |
900501182
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$79.93 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,734.71
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$374.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,923.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,410.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,282.15
|
| 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 |
$1,960.77
|
| Rate for Payer: Cash Price |
$1,903.95
|
| Rate for Payer: Cash Price |
$1,903.95
|
| Rate for Payer: Cash Price |
$1,903.95
|
| Rate for Payer: Cash Price |
$1,903.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,384.80
|
| Rate for Payer: Cigna of CA HMO |
$2,707.84
|
| Rate for Payer: Cigna of CA PPO |
$3,130.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,923.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,410.37
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,282.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,961.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,115.55
|
| Rate for Payer: EPIC Health Plan Senior |
$1,410.37
|
| Rate for Payer: Galaxy Health WC |
$3,596.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,538.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,807.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,102.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,282.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,686.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$79.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,378.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$846.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,718.08
|
| Rate for Payer: Multiplan Commercial |
$3,173.25
|
| Rate for Payer: Multiplan WC |
$1,960.77
|
| Rate for Payer: Networks By Design Commercial |
$2,750.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,282.15
|
| Rate for Payer: Preferred Health Network WC |
$2,000.79
|
| Rate for Payer: Prime Health Services Commercial |
$3,596.35
|
| Rate for Payer: Prime Health Services Medicare |
$1,359.08
|
| Rate for Payer: Prime Health Services WC |
$1,940.77
|
| Rate for Payer: Riverside University Health System MISP |
$1,410.37
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,538.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,538.60
|
| 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 |
$1,282.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,923.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,410.37
|
| Rate for Payer: Vantage Medical Group Senior |
$1,282.15
|
|
|
HC RMVL OF CORNEAL EPITELIUM
|
Facility
|
IP
|
$4,231.00
|
|
|
Service Code
|
CPT 65435
|
| Hospital Charge Code |
900501182
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$846.20 |
| Max. Negotiated Rate |
$3,807.90 |
| Rate for Payer: Adventist Health Commercial |
$846.20
|
| Rate for Payer: Cash Price |
$1,903.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,384.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,961.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,692.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.40
|
| Rate for Payer: Galaxy Health WC |
$3,596.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,538.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,807.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,686.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,496.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$846.20
|
| Rate for Payer: Multiplan Commercial |
$3,173.25
|
| Rate for Payer: Networks By Design Commercial |
$2,750.15
|
| Rate for Payer: Prime Health Services Commercial |
$3,596.35
|
|
|
HC RMVL OF CORNEAL EPITELIUM
|
Facility
|
OP
|
$4,231.00
|
|
|
Service Code
|
CPT 65435
|
| Hospital Charge Code |
900501182
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$79.93 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$846.20
|
| 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 |
$1,923.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,410.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,282.15
|
| 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 |
$1,960.77
|
| Rate for Payer: Cash Price |
$1,903.95
|
| Rate for Payer: Cash Price |
$1,903.95
|
| Rate for Payer: Cash Price |
$1,903.95
|
| Rate for Payer: Cash Price |
$1,903.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,384.80
|
| Rate for Payer: Cigna of CA HMO |
$2,707.84
|
| Rate for Payer: Cigna of CA PPO |
$3,130.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,923.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,410.37
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,282.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,961.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,115.55
|
| Rate for Payer: EPIC Health Plan Senior |
$1,410.37
|
| Rate for Payer: Galaxy Health WC |
$3,596.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,538.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,807.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,102.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,282.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,686.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$79.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,378.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$846.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,718.08
|
| Rate for Payer: Multiplan Commercial |
$3,173.25
|
| Rate for Payer: Multiplan WC |
$1,960.77
|
| Rate for Payer: Networks By Design Commercial |
$2,750.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,282.15
|
| Rate for Payer: Preferred Health Network WC |
$2,000.79
|
| Rate for Payer: Prime Health Services Commercial |
$3,596.35
|
| Rate for Payer: Prime Health Services Medicare |
$1,359.08
|
| Rate for Payer: Prime Health Services WC |
$1,940.77
|
| Rate for Payer: Riverside University Health System MISP |
$1,410.37
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,538.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,115.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,115.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,115.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,115.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,282.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,923.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,410.37
|
| Rate for Payer: Vantage Medical Group Senior |
$1,282.15
|
|
|
HC RMVL OF CORNEAL EPITELIUM
|
Facility
|
IP
|
$4,231.00
|
|
|
Service Code
|
CPT 65435
|
| Hospital Charge Code |
900501182
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$846.20 |
| Max. Negotiated Rate |
$3,807.90 |
| Rate for Payer: Adventist Health Commercial |
$846.20
|
| Rate for Payer: Cash Price |
$1,903.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,384.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,961.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,692.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.40
|
| Rate for Payer: Galaxy Health WC |
$3,596.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,538.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,807.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,686.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,496.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$846.20
|
| Rate for Payer: Multiplan Commercial |
$3,173.25
|
| Rate for Payer: Networks By Design Commercial |
$2,750.15
|
| Rate for Payer: Prime Health Services Commercial |
$3,596.35
|
|
|
HC RMVL OF IMPLANT,SUPERFICIAL
|
Facility
|
IP
|
$10,697.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
900501283
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,139.40 |
| Max. Negotiated Rate |
$9,627.30 |
| Rate for Payer: Adventist Health Commercial |
$2,139.40
|
| Rate for Payer: Cash Price |
$4,813.65
|
| Rate for Payer: Central Health Plan Commercial |
$8,557.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,487.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,278.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,278.80
|
| Rate for Payer: Galaxy Health WC |
$9,092.45
|
| Rate for Payer: Global Benefits Group Commercial |
$6,418.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,627.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,792.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,311.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,139.40
|
| Rate for Payer: Multiplan Commercial |
$8,022.75
|
| Rate for Payer: Networks By Design Commercial |
$6,953.05
|
| Rate for Payer: Prime Health Services Commercial |
$9,092.45
|
|
|
HC RMVL OF IMPLANT,SUPERFICIAL
|
Facility
|
OP
|
$10,697.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
900501283
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$220.00 |
| Max. Negotiated Rate |
$9,627.30 |
| Rate for Payer: Adventist Health Commercial |
$2,139.40
|
| 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 |
$4,813.65
|
| Rate for Payer: Cash Price |
$4,813.65
|
| Rate for Payer: Cash Price |
$4,813.65
|
| Rate for Payer: Cash Price |
$4,813.65
|
| Rate for Payer: Central Health Plan Commercial |
$8,557.60
|
| Rate for Payer: Cigna of CA HMO |
$6,846.08
|
| Rate for Payer: Cigna of CA PPO |
$7,915.78
|
| 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 |
$7,487.90
|
| 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 |
$9,092.45
|
| Rate for Payer: Global Benefits Group Commercial |
$6,418.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,627.30
|
| 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 |
$6,792.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$220.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,283.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,139.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$8,022.75
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$6,953.05
|
| 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 |
$9,092.45
|
| 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 |
$6,418.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,348.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,348.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,348.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,348.50
|
| 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 OF IMPL FROM HAND
|
Facility
|
IP
|
$12,619.00
|
|
|
Service Code
|
CPT 26320
|
| Hospital Charge Code |
900501699
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,523.80 |
| Max. Negotiated Rate |
$11,357.10 |
| Rate for Payer: Adventist Health Commercial |
$2,523.80
|
| Rate for Payer: Cash Price |
$5,678.55
|
| Rate for Payer: Central Health Plan Commercial |
$10,095.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,833.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,047.60
|
| Rate for Payer: EPIC Health Plan Senior |
$5,047.60
|
| Rate for Payer: Galaxy Health WC |
$10,726.15
|
| Rate for Payer: Global Benefits Group Commercial |
$7,571.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,357.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,013.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,445.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,523.80
|
| Rate for Payer: Multiplan Commercial |
$9,464.25
|
| Rate for Payer: Networks By Design Commercial |
$8,202.35
|
| Rate for Payer: Prime Health Services Commercial |
$10,726.15
|
|
|
HC RMVL OF IMPL FROM HAND
|
Facility
|
OP
|
$12,619.00
|
|
|
Service Code
|
CPT 26320
|
| Hospital Charge Code |
900501699
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$11,357.10 |
| Rate for Payer: Adventist Health Commercial |
$2,523.80
|
| 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 |
$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 |
$5,678.55
|
| Rate for Payer: Cash Price |
$5,678.55
|
| Rate for Payer: Cash Price |
$5,678.55
|
| Rate for Payer: Cash Price |
$5,678.55
|
| Rate for Payer: Central Health Plan Commercial |
$10,095.20
|
| Rate for Payer: Cigna of CA HMO |
$8,076.16
|
| Rate for Payer: Cigna of CA PPO |
$9,338.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,833.30
|
| 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 |
$10,726.15
|
| Rate for Payer: Global Benefits Group Commercial |
$7,571.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,357.10
|
| 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 |
$8,013.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$560.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,283.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,523.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$9,464.25
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$8,202.35
|
| 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 |
$10,726.15
|
| 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 |
$7,571.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,309.50
|
| Rate for Payer: United Healthcare All Other HMO |
$6,309.50
|
| Rate for Payer: United Healthcare HMO Rider |
$6,309.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,309.50
|
| 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
|
|
