|
HC RMVL OF SKIN TAGS 1-15 LESIONS
|
Facility
|
OP
|
$619.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
900501378
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$54.44 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$123.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$258.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$258.05
|
| 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 |
$402.27
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$278.55
|
| Rate for Payer: Cash Price |
$278.55
|
| Rate for Payer: Cash Price |
$278.55
|
| Rate for Payer: Central Health Plan Commercial |
$495.20
|
| Rate for Payer: Cigna of CA HMO |
$396.16
|
| Rate for Payer: Cigna of CA PPO |
$458.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$387.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$258.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$433.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.78
|
| Rate for Payer: EPIC Health Plan Senior |
$283.86
|
| Rate for Payer: Galaxy Health WC |
$526.15
|
| Rate for Payer: Global Benefits Group Commercial |
$371.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$557.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$423.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$54.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$258.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$393.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$60.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$361.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$345.79
|
| Rate for Payer: Multiplan Commercial |
$464.25
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: Networks By Design Commercial |
$402.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$258.05
|
| Rate for Payer: Preferred Health Network WC |
$410.48
|
| Rate for Payer: Prime Health Services Commercial |
$526.15
|
| Rate for Payer: Prime Health Services Medicare |
$273.53
|
| Rate for Payer: Prime Health Services WC |
$398.17
|
| Rate for Payer: Riverside University Health System MISP |
$283.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$371.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$309.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$258.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Vantage Medical Group Senior |
$258.05
|
|
|
HC RMVL OF SKIN TAGS 1-15 LESIONS
|
Facility
|
IP
|
$619.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
900501378
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$123.80 |
| Max. Negotiated Rate |
$557.10 |
| Rate for Payer: Adventist Health Commercial |
$123.80
|
| Rate for Payer: Cash Price |
$278.55
|
| Rate for Payer: Central Health Plan Commercial |
$495.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$433.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$247.60
|
| Rate for Payer: EPIC Health Plan Senior |
$247.60
|
| Rate for Payer: Galaxy Health WC |
$526.15
|
| Rate for Payer: Global Benefits Group Commercial |
$371.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$557.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$393.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$365.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.80
|
| Rate for Payer: Multiplan Commercial |
$464.25
|
| Rate for Payer: Networks By Design Commercial |
$402.35
|
| Rate for Payer: Prime Health Services Commercial |
$526.15
|
|
|
HC RMVL OF SKIN TAGS 1-15 LESIONS
|
Facility
|
IP
|
$619.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
900501378
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$123.80 |
| Max. Negotiated Rate |
$557.10 |
| Rate for Payer: Adventist Health Commercial |
$123.80
|
| Rate for Payer: Cash Price |
$278.55
|
| Rate for Payer: Central Health Plan Commercial |
$495.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$433.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$247.60
|
| Rate for Payer: EPIC Health Plan Senior |
$247.60
|
| Rate for Payer: Galaxy Health WC |
$526.15
|
| Rate for Payer: Global Benefits Group Commercial |
$371.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$557.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$393.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$365.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.80
|
| Rate for Payer: Multiplan Commercial |
$464.25
|
| Rate for Payer: Networks By Design Commercial |
$402.35
|
| Rate for Payer: Prime Health Services Commercial |
$526.15
|
|
|
HC RMVL OF SKIN TAGS 1-15 LESIONS
|
Facility
|
IP
|
$619.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
900501378
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$123.80 |
| Max. Negotiated Rate |
$557.10 |
| Rate for Payer: Adventist Health Commercial |
$123.80
|
| Rate for Payer: Cash Price |
$278.55
|
| Rate for Payer: Central Health Plan Commercial |
$495.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$433.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$247.60
|
| Rate for Payer: EPIC Health Plan Senior |
$247.60
|
| Rate for Payer: Galaxy Health WC |
$526.15
|
| Rate for Payer: Global Benefits Group Commercial |
$371.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$557.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$393.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$365.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.80
|
| Rate for Payer: Multiplan Commercial |
$464.25
|
| Rate for Payer: Networks By Design Commercial |
$402.35
|
| Rate for Payer: Prime Health Services Commercial |
$526.15
|
|
|
HC RMVL OF SKIN TAGS 1-15 LESIONS
|
Facility
|
OP
|
$619.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
900501378
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$60.13 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$253.79
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$401.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$258.05
|
| 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 |
$402.27
|
| Rate for Payer: Cash Price |
$278.55
|
| Rate for Payer: Cash Price |
$278.55
|
| Rate for Payer: Cash Price |
$278.55
|
| Rate for Payer: Cash Price |
$278.55
|
| Rate for Payer: Central Health Plan Commercial |
$495.20
|
| Rate for Payer: Cigna of CA HMO |
$396.16
|
| Rate for Payer: Cigna of CA PPO |
$458.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$387.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$258.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$433.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.78
|
| Rate for Payer: EPIC Health Plan Senior |
$283.86
|
| Rate for Payer: Galaxy Health WC |
$526.15
|
| Rate for Payer: Global Benefits Group Commercial |
$371.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$557.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$423.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$258.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$393.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$60.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$277.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$345.79
|
| Rate for Payer: Multiplan Commercial |
$464.25
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: Networks By Design Commercial |
$402.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$258.05
|
| Rate for Payer: Preferred Health Network WC |
$410.48
|
| Rate for Payer: Prime Health Services Commercial |
$526.15
|
| Rate for Payer: Prime Health Services Medicare |
$273.53
|
| Rate for Payer: Prime Health Services WC |
$398.17
|
| Rate for Payer: Riverside University Health System MISP |
$283.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$371.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$371.40
|
| 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 |
$258.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Vantage Medical Group Senior |
$258.05
|
|
|
HC RMVL OF SKIN TAGS 1-15 LESIONS
|
Facility
|
OP
|
$619.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
900501378
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$60.13 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$123.80
|
| 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 |
$387.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$258.05
|
| 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 |
$402.27
|
| Rate for Payer: Cash Price |
$278.55
|
| Rate for Payer: Cash Price |
$278.55
|
| Rate for Payer: Cash Price |
$278.55
|
| Rate for Payer: Cash Price |
$278.55
|
| Rate for Payer: Central Health Plan Commercial |
$495.20
|
| Rate for Payer: Cigna of CA HMO |
$396.16
|
| Rate for Payer: Cigna of CA PPO |
$458.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$387.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$258.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$433.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.78
|
| Rate for Payer: EPIC Health Plan Senior |
$283.86
|
| Rate for Payer: Galaxy Health WC |
$526.15
|
| Rate for Payer: Global Benefits Group Commercial |
$371.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$557.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$423.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$258.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$393.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$60.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$277.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$345.79
|
| Rate for Payer: Multiplan Commercial |
$464.25
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: Networks By Design Commercial |
$402.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$258.05
|
| Rate for Payer: Preferred Health Network WC |
$410.48
|
| Rate for Payer: Prime Health Services Commercial |
$526.15
|
| Rate for Payer: Prime Health Services Medicare |
$273.53
|
| Rate for Payer: Prime Health Services WC |
$398.17
|
| Rate for Payer: Riverside University Health System MISP |
$283.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$371.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$309.50
|
| Rate for Payer: United Healthcare All Other HMO |
$309.50
|
| Rate for Payer: United Healthcare HMO Rider |
$309.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$309.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$258.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Vantage Medical Group Senior |
$258.05
|
|
|
HC RMVL OR BIVALVING GAUNTLET BOOT OR BODY CAST
|
Facility
|
OP
|
$1,013.00
|
|
|
Service Code
|
CPT 29700
|
| Hospital Charge Code |
900101506
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$39.06 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$202.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$359.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$191.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$539.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$395.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$359.73
|
| 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: Blue Shield of California Commercial |
$642.24
|
| Rate for Payer: Blue Shield of California EPN |
$404.19
|
| Rate for Payer: Cash Price |
$455.85
|
| Rate for Payer: Cash Price |
$455.85
|
| Rate for Payer: Cash Price |
$455.85
|
| Rate for Payer: Central Health Plan Commercial |
$810.40
|
| Rate for Payer: Cigna of CA HMO |
$648.32
|
| Rate for Payer: Cigna of CA PPO |
$749.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$539.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$395.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$359.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$709.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$593.55
|
| Rate for Payer: EPIC Health Plan Senior |
$395.70
|
| Rate for Payer: Galaxy Health WC |
$861.05
|
| Rate for Payer: Global Benefits Group Commercial |
$607.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$911.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$589.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$39.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$359.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$643.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$503.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$482.04
|
| Rate for Payer: Multiplan Commercial |
$759.75
|
| Rate for Payer: Networks By Design Commercial |
$658.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$359.73
|
| Rate for Payer: Prime Health Services Commercial |
$861.05
|
| Rate for Payer: Prime Health Services Medicare |
$381.31
|
| Rate for Payer: Riverside University Health System MISP |
$395.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$607.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$607.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$506.50
|
| Rate for Payer: United Healthcare All Other HMO |
$506.50
|
| Rate for Payer: United Healthcare HMO Rider |
$506.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$506.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$359.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$539.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$395.70
|
| Rate for Payer: Vantage Medical Group Senior |
$359.73
|
|
|
HC RMVL OR BIVALVING GAUNTLET BOOT OR BODY CAST
|
Facility
|
IP
|
$1,013.00
|
|
|
Service Code
|
CPT 29700
|
| Hospital Charge Code |
900101506
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$202.60 |
| Max. Negotiated Rate |
$911.70 |
| Rate for Payer: Adventist Health Commercial |
$202.60
|
| Rate for Payer: Cash Price |
$455.85
|
| Rate for Payer: Central Health Plan Commercial |
$810.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$709.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$405.20
|
| Rate for Payer: EPIC Health Plan Senior |
$405.20
|
| Rate for Payer: Galaxy Health WC |
$861.05
|
| Rate for Payer: Global Benefits Group Commercial |
$607.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$911.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$643.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$597.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.60
|
| Rate for Payer: Multiplan Commercial |
$759.75
|
| Rate for Payer: Networks By Design Commercial |
$658.45
|
| Rate for Payer: Prime Health Services Commercial |
$861.05
|
|
|
HC RMVL PERM CCM DFIB SYS DUAL LEADS
|
Facility
|
OP
|
$9,938.00
|
|
|
Service Code
|
CPT 0922T
|
| Hospital Charge Code |
906811510
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$8,944.20 |
| Rate for Payer: Adventist Health Commercial |
$1,987.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,806.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,035.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,806.35
|
| 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 |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Central Health Plan Commercial |
$7,950.40
|
| Rate for Payer: Cigna of CA HMO |
$6,360.32
|
| Rate for Payer: Cigna of CA PPO |
$7,354.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,286.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,806.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,956.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,930.48
|
| Rate for Payer: EPIC Health Plan Senior |
$5,286.98
|
| Rate for Payer: Galaxy Health WC |
$8,447.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,962.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,944.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,882.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,806.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,310.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,607.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,728.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,987.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,440.51
|
| Rate for Payer: Multiplan Commercial |
$7,453.50
|
| Rate for Payer: Networks By Design Commercial |
$6,459.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,806.35
|
| Rate for Payer: Prime Health Services Commercial |
$8,447.30
|
| Rate for Payer: Prime Health Services Medicare |
$5,094.73
|
| Rate for Payer: Riverside University Health System MISP |
$5,286.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,962.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,962.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,806.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Vantage Medical Group Senior |
$4,806.35
|
|
|
HC RMVL PERM CCM DFIB SYS DUAL LEADS
|
Facility
|
IP
|
$9,938.00
|
|
|
Service Code
|
CPT 0922T
|
| Hospital Charge Code |
906811510
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,987.60 |
| Max. Negotiated Rate |
$8,944.20 |
| Rate for Payer: Adventist Health Commercial |
$1,987.60
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Central Health Plan Commercial |
$7,950.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,956.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,975.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,975.20
|
| Rate for Payer: Galaxy Health WC |
$8,447.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,962.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,944.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,310.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,863.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,987.60
|
| Rate for Payer: Multiplan Commercial |
$7,453.50
|
| Rate for Payer: Networks By Design Commercial |
$6,459.70
|
| Rate for Payer: Prime Health Services Commercial |
$8,447.30
|
|
|
HC RMVL PERM CCM DFIB SYS PG ONLY
|
Facility
|
OP
|
$9,938.00
|
|
|
Service Code
|
CPT 0919T
|
| Hospital Charge Code |
906811507
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$8,944.20 |
| Rate for Payer: Adventist Health Commercial |
$1,987.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,806.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,035.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,806.35
|
| 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 |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Central Health Plan Commercial |
$7,950.40
|
| Rate for Payer: Cigna of CA HMO |
$6,360.32
|
| Rate for Payer: Cigna of CA PPO |
$7,354.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,286.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,806.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,956.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,930.48
|
| Rate for Payer: EPIC Health Plan Senior |
$5,286.98
|
| Rate for Payer: Galaxy Health WC |
$8,447.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,962.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,944.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,882.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,806.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,310.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,607.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,728.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,987.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,440.51
|
| Rate for Payer: Multiplan Commercial |
$7,453.50
|
| Rate for Payer: Networks By Design Commercial |
$6,459.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,806.35
|
| Rate for Payer: Prime Health Services Commercial |
$8,447.30
|
| Rate for Payer: Prime Health Services Medicare |
$5,094.73
|
| Rate for Payer: Riverside University Health System MISP |
$5,286.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,962.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,962.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,806.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Vantage Medical Group Senior |
$4,806.35
|
|
|
HC RMVL PERM CCM DFIB SYS PG ONLY
|
Facility
|
IP
|
$9,938.00
|
|
|
Service Code
|
CPT 0919T
|
| Hospital Charge Code |
906811507
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,987.60 |
| Max. Negotiated Rate |
$8,944.20 |
| Rate for Payer: Adventist Health Commercial |
$1,987.60
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Central Health Plan Commercial |
$7,950.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,956.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,975.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,975.20
|
| Rate for Payer: Galaxy Health WC |
$8,447.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,962.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,944.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,310.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,863.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,987.60
|
| Rate for Payer: Multiplan Commercial |
$7,453.50
|
| Rate for Payer: Networks By Design Commercial |
$6,459.70
|
| Rate for Payer: Prime Health Services Commercial |
$8,447.30
|
|
|
HC RMVL PERM CCM DFIB SYS SINGLE DFB LEAD
|
Facility
|
IP
|
$9,938.00
|
|
|
Service Code
|
CPT 0921T
|
| Hospital Charge Code |
906811509
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,987.60 |
| Max. Negotiated Rate |
$8,944.20 |
| Rate for Payer: Adventist Health Commercial |
$1,987.60
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Central Health Plan Commercial |
$7,950.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,956.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,975.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,975.20
|
| Rate for Payer: Galaxy Health WC |
$8,447.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,962.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,944.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,310.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,863.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,987.60
|
| Rate for Payer: Multiplan Commercial |
$7,453.50
|
| Rate for Payer: Networks By Design Commercial |
$6,459.70
|
| Rate for Payer: Prime Health Services Commercial |
$8,447.30
|
|
|
HC RMVL PERM CCM DFIB SYS SINGLE DFB LEAD
|
Facility
|
OP
|
$9,938.00
|
|
|
Service Code
|
CPT 0921T
|
| Hospital Charge Code |
906811509
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$8,944.20 |
| Rate for Payer: Adventist Health Commercial |
$1,987.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,806.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,035.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,806.35
|
| 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 |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Central Health Plan Commercial |
$7,950.40
|
| Rate for Payer: Cigna of CA HMO |
$6,360.32
|
| Rate for Payer: Cigna of CA PPO |
$7,354.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,286.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,806.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,956.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,930.48
|
| Rate for Payer: EPIC Health Plan Senior |
$5,286.98
|
| Rate for Payer: Galaxy Health WC |
$8,447.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,962.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,944.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,882.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,806.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,310.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,607.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,728.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,987.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,440.51
|
| Rate for Payer: Multiplan Commercial |
$7,453.50
|
| Rate for Payer: Networks By Design Commercial |
$6,459.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,806.35
|
| Rate for Payer: Prime Health Services Commercial |
$8,447.30
|
| Rate for Payer: Prime Health Services Medicare |
$5,094.73
|
| Rate for Payer: Riverside University Health System MISP |
$5,286.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,962.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,962.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,806.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Vantage Medical Group Senior |
$4,806.35
|
|
|
HC RMVL PERM CCM DFIB SYS SINGLE PAC LEAD
|
Facility
|
OP
|
$9,938.00
|
|
|
Service Code
|
CPT 0920T
|
| Hospital Charge Code |
906811508
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$8,944.20 |
| Rate for Payer: Adventist Health Commercial |
$1,987.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,806.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,035.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,806.35
|
| 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 |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Central Health Plan Commercial |
$7,950.40
|
| Rate for Payer: Cigna of CA HMO |
$6,360.32
|
| Rate for Payer: Cigna of CA PPO |
$7,354.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,286.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,806.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,956.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,930.48
|
| Rate for Payer: EPIC Health Plan Senior |
$5,286.98
|
| Rate for Payer: Galaxy Health WC |
$8,447.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,962.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,944.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,882.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,806.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,310.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,607.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,728.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,987.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,440.51
|
| Rate for Payer: Multiplan Commercial |
$7,453.50
|
| Rate for Payer: Networks By Design Commercial |
$6,459.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,806.35
|
| Rate for Payer: Prime Health Services Commercial |
$8,447.30
|
| Rate for Payer: Prime Health Services Medicare |
$5,094.73
|
| Rate for Payer: Riverside University Health System MISP |
$5,286.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,962.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,962.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,806.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Vantage Medical Group Senior |
$4,806.35
|
|
|
HC RMVL PERM CCM DFIB SYS SINGLE PAC LEAD
|
Facility
|
IP
|
$9,938.00
|
|
|
Service Code
|
CPT 0920T
|
| Hospital Charge Code |
906811508
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,987.60 |
| Max. Negotiated Rate |
$8,944.20 |
| Rate for Payer: Adventist Health Commercial |
$1,987.60
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Central Health Plan Commercial |
$7,950.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,956.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,975.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,975.20
|
| Rate for Payer: Galaxy Health WC |
$8,447.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,962.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,944.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,310.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,863.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,987.60
|
| Rate for Payer: Multiplan Commercial |
$7,453.50
|
| Rate for Payer: Networks By Design Commercial |
$6,459.70
|
| Rate for Payer: Prime Health Services Commercial |
$8,447.30
|
|
|
HC RMVL REPAIR FULL ARM/LEG CAST
|
Facility
|
IP
|
$1,540.00
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
900501111
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$308.00 |
| Max. Negotiated Rate |
$1,386.00 |
| Rate for Payer: Adventist Health Commercial |
$308.00
|
| Rate for Payer: Cash Price |
$693.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,232.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,078.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$616.00
|
| Rate for Payer: EPIC Health Plan Senior |
$616.00
|
| Rate for Payer: Galaxy Health WC |
$1,309.00
|
| Rate for Payer: Global Benefits Group Commercial |
$924.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,386.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$977.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$908.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$308.00
|
| Rate for Payer: Multiplan Commercial |
$1,155.00
|
| Rate for Payer: Networks By Design Commercial |
$1,001.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,309.00
|
|
|
HC RMVL REPAIR FULL ARM/LEG CAST
|
Facility
|
OP
|
$1,540.00
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
900501111
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$55.18 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$308.00
|
| 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 |
$539.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$395.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$359.73
|
| 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 |
$537.66
|
| Rate for Payer: Cash Price |
$693.00
|
| Rate for Payer: Cash Price |
$693.00
|
| Rate for Payer: Cash Price |
$693.00
|
| Rate for Payer: Cash Price |
$693.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,232.00
|
| Rate for Payer: Cigna of CA HMO |
$985.60
|
| Rate for Payer: Cigna of CA PPO |
$1,139.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$539.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$395.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$359.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,078.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$593.55
|
| Rate for Payer: EPIC Health Plan Senior |
$395.70
|
| Rate for Payer: Galaxy Health WC |
$1,309.00
|
| Rate for Payer: Global Benefits Group Commercial |
$924.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,386.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$589.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$359.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$977.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$55.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$386.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$308.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$482.04
|
| Rate for Payer: Multiplan Commercial |
$1,155.00
|
| Rate for Payer: Multiplan WC |
$537.66
|
| Rate for Payer: Networks By Design Commercial |
$1,001.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$359.73
|
| Rate for Payer: Preferred Health Network WC |
$548.63
|
| Rate for Payer: Prime Health Services Commercial |
$1,309.00
|
| Rate for Payer: Prime Health Services Medicare |
$381.31
|
| Rate for Payer: Prime Health Services WC |
$532.17
|
| Rate for Payer: Riverside University Health System MISP |
$395.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$924.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$770.00
|
| Rate for Payer: United Healthcare All Other HMO |
$770.00
|
| Rate for Payer: United Healthcare HMO Rider |
$770.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$770.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$359.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$539.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$395.70
|
| Rate for Payer: Vantage Medical Group Senior |
$359.73
|
|
|
HC RMVL REPAIR FULL ARM/LEG CAST
|
Facility
|
OP
|
$1,540.00
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
900501111
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$55.18 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$631.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$263.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$539.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$395.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$359.73
|
| 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 |
$537.66
|
| Rate for Payer: Cash Price |
$693.00
|
| Rate for Payer: Cash Price |
$693.00
|
| Rate for Payer: Cash Price |
$693.00
|
| Rate for Payer: Cash Price |
$693.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,232.00
|
| Rate for Payer: Cigna of CA HMO |
$985.60
|
| Rate for Payer: Cigna of CA PPO |
$1,139.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$539.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$395.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$359.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,078.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$593.55
|
| Rate for Payer: EPIC Health Plan Senior |
$395.70
|
| Rate for Payer: Galaxy Health WC |
$1,309.00
|
| Rate for Payer: Global Benefits Group Commercial |
$924.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,386.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$589.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$359.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$977.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$55.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$386.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$308.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$482.04
|
| Rate for Payer: Multiplan Commercial |
$1,155.00
|
| Rate for Payer: Multiplan WC |
$537.66
|
| Rate for Payer: Networks By Design Commercial |
$1,001.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$359.73
|
| Rate for Payer: Preferred Health Network WC |
$548.63
|
| Rate for Payer: Prime Health Services Commercial |
$1,309.00
|
| Rate for Payer: Prime Health Services Medicare |
$381.31
|
| Rate for Payer: Prime Health Services WC |
$532.17
|
| Rate for Payer: Riverside University Health System MISP |
$395.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$924.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$924.00
|
| 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 |
$359.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$539.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$395.70
|
| Rate for Payer: Vantage Medical Group Senior |
$359.73
|
|
|
HC RMVL REPAIR FULL ARM/LEG CAST
|
Facility
|
IP
|
$1,540.00
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
900501111
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$308.00 |
| Max. Negotiated Rate |
$1,386.00 |
| Rate for Payer: Adventist Health Commercial |
$308.00
|
| Rate for Payer: Cash Price |
$693.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,232.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,078.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$616.00
|
| Rate for Payer: EPIC Health Plan Senior |
$616.00
|
| Rate for Payer: Galaxy Health WC |
$1,309.00
|
| Rate for Payer: Global Benefits Group Commercial |
$924.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,386.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$977.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$908.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$308.00
|
| Rate for Payer: Multiplan Commercial |
$1,155.00
|
| Rate for Payer: Networks By Design Commercial |
$1,001.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,309.00
|
|
|
HC RMVL SUBQ CARDIAC RHYTHM MNTR
|
Facility
|
IP
|
$2,826.00
|
|
|
Service Code
|
CPT 33286
|
| Hospital Charge Code |
906813407
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$565.20 |
| Max. Negotiated Rate |
$2,543.40 |
| Rate for Payer: Adventist Health Commercial |
$565.20
|
| Rate for Payer: Cash Price |
$1,271.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,260.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,978.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,130.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,130.40
|
| Rate for Payer: Galaxy Health WC |
$2,402.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,695.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,543.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,794.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,667.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$565.20
|
| Rate for Payer: Multiplan Commercial |
$2,119.50
|
| Rate for Payer: Networks By Design Commercial |
$1,836.90
|
| Rate for Payer: Prime Health Services Commercial |
$2,402.10
|
|
|
HC RMVL SUBQ CARDIAC RHYTHM MNTR
|
Facility
|
OP
|
$2,826.00
|
|
|
Service Code
|
CPT 33286
|
| Hospital Charge Code |
906813407
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$39.70 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$565.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$910.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$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 |
$1,424.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,228.07
|
| Rate for Payer: Blue Shield of California EPN |
$3,914.40
|
| Rate for Payer: Cash Price |
$1,271.70
|
| Rate for Payer: Cash Price |
$1,271.70
|
| Rate for Payer: Cash Price |
$1,271.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,260.80
|
| Rate for Payer: Cigna of CA HMO |
$1,808.64
|
| Rate for Payer: Cigna of CA PPO |
$2,091.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,978.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$2,402.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,695.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,543.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$39.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,794.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,275.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$565.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$2,119.50
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$1,836.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$910.78
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$2,402.10
|
| Rate for Payer: Prime Health Services Medicare |
$965.43
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$1,001.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,695.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,413.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC RMV SELF-CONTD PENIS PROS
|
Facility
|
OP
|
$13,731.00
|
|
|
Service Code
|
CPT 54415
|
| Hospital Charge Code |
900501733
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$12,357.90 |
| Rate for Payer: Adventist Health Commercial |
$2,746.20
|
| 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 |
$6,800.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,987.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,533.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,982.34
|
| Rate for Payer: Cash Price |
$6,178.95
|
| Rate for Payer: Cash Price |
$6,178.95
|
| Rate for Payer: Cash Price |
$6,178.95
|
| Rate for Payer: Cash Price |
$6,178.95
|
| Rate for Payer: Central Health Plan Commercial |
$10,984.80
|
| Rate for Payer: Cigna of CA HMO |
$8,787.84
|
| Rate for Payer: Cigna of CA PPO |
$10,160.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,800.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,987.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,533.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,611.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,480.62
|
| Rate for Payer: EPIC Health Plan Senior |
$4,987.08
|
| Rate for Payer: Galaxy Health WC |
$11,671.35
|
| Rate for Payer: Global Benefits Group Commercial |
$8,238.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,357.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,435.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,533.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,719.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$821.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,873.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,746.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,075.17
|
| Rate for Payer: Multiplan Commercial |
$10,298.25
|
| Rate for Payer: Multiplan WC |
$6,982.34
|
| Rate for Payer: Networks By Design Commercial |
$8,925.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,533.71
|
| Rate for Payer: Preferred Health Network WC |
$7,124.84
|
| Rate for Payer: Prime Health Services Commercial |
$11,671.35
|
| Rate for Payer: Prime Health Services Medicare |
$4,805.73
|
| Rate for Payer: Prime Health Services WC |
$6,911.09
|
| Rate for Payer: Riverside University Health System MISP |
$4,987.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,238.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,865.50
|
| Rate for Payer: United Healthcare All Other HMO |
$6,865.50
|
| Rate for Payer: United Healthcare HMO Rider |
$6,865.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,865.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,533.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,800.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,987.08
|
| Rate for Payer: Vantage Medical Group Senior |
$4,533.71
|
|
|
HC RMV SELF-CONTD PENIS PROS
|
Facility
|
IP
|
$13,731.00
|
|
|
Service Code
|
CPT 54415
|
| Hospital Charge Code |
900501733
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,746.20 |
| Max. Negotiated Rate |
$12,357.90 |
| Rate for Payer: Adventist Health Commercial |
$2,746.20
|
| Rate for Payer: Cash Price |
$6,178.95
|
| Rate for Payer: Central Health Plan Commercial |
$10,984.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,611.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,492.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,492.40
|
| Rate for Payer: Galaxy Health WC |
$11,671.35
|
| Rate for Payer: Global Benefits Group Commercial |
$8,238.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,357.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,719.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,101.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,746.20
|
| Rate for Payer: Multiplan Commercial |
$10,298.25
|
| Rate for Payer: Networks By Design Commercial |
$8,925.15
|
| Rate for Payer: Prime Health Services Commercial |
$11,671.35
|
|
|
HC RNPIGG
|
Facility
|
OP
|
$18.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
900913709
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$154.02 |
| Rate for Payer: Adventist Health Commercial |
$3.60
|
| Rate for Payer: Adventist Health Commercial |
$4.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$120.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$120.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$110.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$110.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$154.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$154.02
|
| Rate for Payer: Blue Shield of California Commercial |
$13.86
|
| Rate for Payer: Blue Shield of California Commercial |
$11.34
|
| Rate for Payer: Blue Shield of California EPN |
$8.73
|
| Rate for Payer: Blue Shield of California EPN |
$7.15
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Central Health Plan Commercial |
$14.40
|
| Rate for Payer: Central Health Plan Commercial |
$17.60
|
| Rate for Payer: Cigna of CA HMO |
$14.08
|
| Rate for Payer: Cigna of CA HMO |
$11.52
|
| Rate for Payer: Cigna of CA PPO |
$16.28
|
| Rate for Payer: Cigna of CA PPO |
$13.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: Galaxy Health WC |
$18.70
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Global Benefits Group Commercial |
$13.20
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$25.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$25.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$16.50
|
| Rate for Payer: Multiplan Commercial |
$13.50
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Networks By Design Commercial |
$14.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: Prime Health Services Commercial |
$18.70
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
