|
HC PLATELET NEUTRALIZATION
|
Facility
|
IP
|
$65.00
|
|
|
Service Code
|
CPT 85597
|
| Hospital Charge Code |
900912007
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.00 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Adventist Health Commercial |
$13.00
|
| Rate for Payer: Cash Price |
$35.75
|
| Rate for Payer: Central Health Plan Commercial |
$52.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.00
|
| Rate for Payer: EPIC Health Plan Senior |
$26.00
|
| Rate for Payer: Galaxy Health WC |
$55.25
|
| Rate for Payer: Global Benefits Group Commercial |
$39.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$58.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.00
|
| Rate for Payer: Multiplan Commercial |
$48.75
|
| Rate for Payer: Networks By Design Commercial |
$42.25
|
| Rate for Payer: Prime Health Services Commercial |
$55.25
|
|
|
HC PLATELET PED PAK ALIQUOT
|
Facility
|
OP
|
$914.00
|
|
|
Service Code
|
CPT P9011
|
| Hospital Charge Code |
900904532
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$180.17 |
| Max. Negotiated Rate |
$822.60 |
| Rate for Payer: Adventist Health Commercial |
$182.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$180.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$555.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$270.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$198.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$180.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$442.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$536.79
|
| Rate for Payer: Blue Shield of California Commercial |
$558.45
|
| Rate for Payer: Blue Shield of California EPN |
$364.69
|
| Rate for Payer: Cash Price |
$502.70
|
| Rate for Payer: Cash Price |
$502.70
|
| Rate for Payer: Cash Price |
$502.70
|
| Rate for Payer: Central Health Plan Commercial |
$731.20
|
| Rate for Payer: Cigna of CA HMO |
$584.96
|
| Rate for Payer: Cigna of CA PPO |
$676.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$270.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$198.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$180.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$243.23
|
| Rate for Payer: EPIC Health Plan Senior |
$180.17
|
| Rate for Payer: Galaxy Health WC |
$776.90
|
| Rate for Payer: Global Benefits Group Commercial |
$548.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$822.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$295.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$256.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$180.17
|
| Rate for Payer: InnovAge PACE Commercial |
$270.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$609.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$283.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$180.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$182.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$241.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$241.43
|
| Rate for Payer: Multiplan Commercial |
$685.50
|
| Rate for Payer: Networks By Design Commercial |
$594.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$180.17
|
| Rate for Payer: Prime Health Services Commercial |
$776.90
|
| Rate for Payer: Prime Health Services Medicare |
$190.98
|
| Rate for Payer: Riverside University Health System MISP |
$198.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$548.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$548.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$676.00
|
| Rate for Payer: United Healthcare All Other HMO |
$663.00
|
| Rate for Payer: United Healthcare HMO Rider |
$662.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$605.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$180.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$270.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$198.19
|
| Rate for Payer: Vantage Medical Group Senior |
$180.17
|
|
|
HC PLATELET PED PAK ALIQUOT
|
Facility
|
IP
|
$914.00
|
|
|
Service Code
|
CPT P9011
|
| Hospital Charge Code |
900904532
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$182.80 |
| Max. Negotiated Rate |
$822.60 |
| Rate for Payer: Adventist Health Commercial |
$182.80
|
| Rate for Payer: Cash Price |
$502.70
|
| Rate for Payer: Central Health Plan Commercial |
$731.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$365.60
|
| Rate for Payer: EPIC Health Plan Senior |
$365.60
|
| Rate for Payer: Galaxy Health WC |
$776.90
|
| Rate for Payer: Global Benefits Group Commercial |
$548.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$822.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$609.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$348.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$565.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$182.80
|
| Rate for Payer: Multiplan Commercial |
$685.50
|
| Rate for Payer: Networks By Design Commercial |
$594.10
|
| Rate for Payer: Prime Health Services Commercial |
$776.90
|
|
|
HC PLATELET SURVIVAL
|
Facility
|
OP
|
$766.00
|
|
|
Service Code
|
CPT 78191
|
| Hospital Charge Code |
909301642
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$153.20 |
| Max. Negotiated Rate |
$1,526.91 |
| Rate for Payer: Adventist Health Commercial |
$153.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$510.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$465.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$765.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$561.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$510.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,526.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$449.87
|
| Rate for Payer: Blue Shield of California Commercial |
$464.96
|
| Rate for Payer: Blue Shield of California EPN |
$304.10
|
| Rate for Payer: Cash Price |
$421.30
|
| Rate for Payer: Cash Price |
$421.30
|
| Rate for Payer: Central Health Plan Commercial |
$612.80
|
| Rate for Payer: Cigna of CA HMO |
$490.24
|
| Rate for Payer: Cigna of CA PPO |
$566.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$765.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$561.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$510.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$689.27
|
| Rate for Payer: EPIC Health Plan Senior |
$510.57
|
| Rate for Payer: Galaxy Health WC |
$651.10
|
| Rate for Payer: Global Benefits Group Commercial |
$459.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$689.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$837.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$198.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$510.57
|
| Rate for Payer: InnovAge PACE Commercial |
$765.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$510.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$219.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$510.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$153.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$684.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$684.16
|
| Rate for Payer: Multiplan Commercial |
$574.50
|
| Rate for Payer: Networks By Design Commercial |
$497.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$510.57
|
| Rate for Payer: Prime Health Services Commercial |
$651.10
|
| Rate for Payer: Prime Health Services Medicare |
$541.20
|
| Rate for Payer: Riverside University Health System MISP |
$561.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$459.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$459.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$409.89
|
| Rate for Payer: United Healthcare All Other HMO |
$409.89
|
| Rate for Payer: United Healthcare HMO Rider |
$409.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$409.89
|
| Rate for Payer: Upland Medical Group Pediatric |
$510.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$765.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$561.63
|
| Rate for Payer: Vantage Medical Group Senior |
$510.57
|
|
|
HC PLATELET SURVIVAL
|
Facility
|
IP
|
$766.00
|
|
|
Service Code
|
CPT 78191
|
| Hospital Charge Code |
909301642
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$153.20 |
| Max. Negotiated Rate |
$689.40 |
| Rate for Payer: Adventist Health Commercial |
$153.20
|
| Rate for Payer: Cash Price |
$421.30
|
| Rate for Payer: Central Health Plan Commercial |
$612.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$306.40
|
| Rate for Payer: EPIC Health Plan Senior |
$306.40
|
| Rate for Payer: Galaxy Health WC |
$651.10
|
| Rate for Payer: Global Benefits Group Commercial |
$459.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$689.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$510.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$291.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$474.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$153.20
|
| Rate for Payer: Multiplan Commercial |
$574.50
|
| Rate for Payer: Networks By Design Commercial |
$497.90
|
| Rate for Payer: Prime Health Services Commercial |
$651.10
|
|
|
HC PLCMNT ACC BILIARY TREE PERCU
|
Facility
|
OP
|
$14,725.00
|
|
|
Service Code
|
CPT 47541
|
| Hospital Charge Code |
909047541
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,860.23 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$2,945.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,928.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,892.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,721.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,928.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,764.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$12,632.22
|
| Rate for Payer: Blue Shield of California Commercial |
$4,851.77
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$8,098.75
|
| Rate for Payer: Cash Price |
$8,098.75
|
| Rate for Payer: Cash Price |
$8,098.75
|
| Rate for Payer: Central Health Plan Commercial |
$11,780.00
|
| Rate for Payer: Cigna of CA HMO |
$9,424.00
|
| Rate for Payer: Cigna of CA PPO |
$10,896.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,892.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,721.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,928.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,703.11
|
| Rate for Payer: EPIC Health Plan Senior |
$7,928.23
|
| Rate for Payer: Galaxy Health WC |
$12,516.25
|
| Rate for Payer: Global Benefits Group Commercial |
$8,835.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,252.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13,002.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,860.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,928.23
|
| Rate for Payer: InnovAge PACE Commercial |
$11,892.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,821.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,054.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,928.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,945.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,623.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,623.83
|
| Rate for Payer: Multiplan Commercial |
$11,043.75
|
| Rate for Payer: Multiplan WC |
$12,632.22
|
| Rate for Payer: Networks By Design Commercial |
$9,571.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,928.23
|
| Rate for Payer: Preferred Health Network WC |
$12,890.02
|
| Rate for Payer: Prime Health Services Commercial |
$12,516.25
|
| Rate for Payer: Prime Health Services Medicare |
$8,403.92
|
| Rate for Payer: Prime Health Services WC |
$12,503.32
|
| Rate for Payer: Riverside University Health System MISP |
$8,721.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,835.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,928.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,892.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,721.05
|
| Rate for Payer: Vantage Medical Group Senior |
$7,928.23
|
|
|
HC PLCMNT ACC BILIARY TREE PERCU
|
Facility
|
IP
|
$14,725.00
|
|
|
Service Code
|
CPT 47541
|
| Hospital Charge Code |
909047541
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,945.00 |
| Max. Negotiated Rate |
$13,252.50 |
| Rate for Payer: Adventist Health Commercial |
$2,945.00
|
| Rate for Payer: Cash Price |
$8,098.75
|
| Rate for Payer: Central Health Plan Commercial |
$11,780.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,890.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,890.00
|
| Rate for Payer: Galaxy Health WC |
$12,516.25
|
| Rate for Payer: Global Benefits Group Commercial |
$8,835.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,252.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,821.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,610.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,114.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,945.00
|
| Rate for Payer: Multiplan Commercial |
$11,043.75
|
| Rate for Payer: Networks By Design Commercial |
$9,571.25
|
| Rate for Payer: Prime Health Services Commercial |
$12,516.25
|
|
|
HC PLCMNT LCL DVC PERC 1ST LESION
|
Facility
|
IP
|
$1,755.00
|
|
|
Service Code
|
CPT 10035
|
| Hospital Charge Code |
909010035
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$351.00 |
| Max. Negotiated Rate |
$1,579.50 |
| Rate for Payer: Adventist Health Commercial |
$351.00
|
| Rate for Payer: Cash Price |
$965.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,404.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$702.00
|
| Rate for Payer: EPIC Health Plan Senior |
$702.00
|
| Rate for Payer: Galaxy Health WC |
$1,491.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,053.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,579.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,170.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$668.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,086.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$351.00
|
| Rate for Payer: Multiplan Commercial |
$1,316.25
|
| Rate for Payer: Networks By Design Commercial |
$1,140.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,491.75
|
|
|
HC PLCMNT LCL DVC PERC 1ST LESION
|
Facility
|
OP
|
$1,755.00
|
|
|
Service Code
|
CPT 10035
|
| Hospital Charge Code |
909010035
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$351.00 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Commercial |
$351.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$893.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$893.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,065.29
|
| Rate for Payer: Blue Shield of California EPN |
$696.74
|
| Rate for Payer: Cash Price |
$965.25
|
| Rate for Payer: Cash Price |
$965.25
|
| Rate for Payer: Cash Price |
$965.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,404.00
|
| Rate for Payer: Cigna of CA HMO |
$1,123.20
|
| Rate for Payer: Cigna of CA PPO |
$1,298.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$983.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$893.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,206.87
|
| Rate for Payer: EPIC Health Plan Senior |
$893.98
|
| Rate for Payer: Galaxy Health WC |
$1,491.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,053.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,579.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,466.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$847.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$893.98
|
| Rate for Payer: InnovAge PACE Commercial |
$1,340.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,170.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$935.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$893.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$351.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,197.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,197.93
|
| Rate for Payer: Multiplan Commercial |
$1,316.25
|
| Rate for Payer: Networks By Design Commercial |
$1,140.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$893.98
|
| Rate for Payer: Prime Health Services Commercial |
$1,491.75
|
| Rate for Payer: Prime Health Services Medicare |
$947.62
|
| Rate for Payer: Riverside University Health System MISP |
$983.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,053.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,053.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$877.50
|
| Rate for Payer: United Healthcare All Other HMO |
$877.50
|
| Rate for Payer: United Healthcare HMO Rider |
$877.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$877.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$893.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Vantage Medical Group Senior |
$893.98
|
|
|
HC PLCMNT LCL DVC PERC ADD LESION
|
Facility
|
IP
|
$878.00
|
|
|
Service Code
|
CPT 10036
|
| Hospital Charge Code |
909010036
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$175.60 |
| Max. Negotiated Rate |
$790.20 |
| Rate for Payer: Adventist Health Commercial |
$175.60
|
| Rate for Payer: Cash Price |
$482.90
|
| Rate for Payer: Central Health Plan Commercial |
$702.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$351.20
|
| Rate for Payer: EPIC Health Plan Senior |
$351.20
|
| Rate for Payer: Galaxy Health WC |
$746.30
|
| Rate for Payer: Global Benefits Group Commercial |
$526.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$790.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$585.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$334.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$543.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$175.60
|
| Rate for Payer: Multiplan Commercial |
$658.50
|
| Rate for Payer: Networks By Design Commercial |
$570.70
|
| Rate for Payer: Prime Health Services Commercial |
$746.30
|
|
|
HC PLCMNT LCL DVC PERC ADD LESION
|
Facility
|
OP
|
$878.00
|
|
|
Service Code
|
CPT 10036
|
| Hospital Charge Code |
909010036
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$175.60 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$175.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$746.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$482.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$658.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$425.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$515.65
|
| Rate for Payer: Blue Shield of California Commercial |
$532.95
|
| Rate for Payer: Blue Shield of California EPN |
$348.57
|
| Rate for Payer: Cash Price |
$482.90
|
| Rate for Payer: Cash Price |
$482.90
|
| Rate for Payer: Cash Price |
$482.90
|
| Rate for Payer: Central Health Plan Commercial |
$702.40
|
| Rate for Payer: Cigna of CA HMO |
$561.92
|
| Rate for Payer: Cigna of CA PPO |
$649.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$746.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$746.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$746.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$351.20
|
| Rate for Payer: EPIC Health Plan Senior |
$351.20
|
| Rate for Payer: Galaxy Health WC |
$746.30
|
| Rate for Payer: Global Benefits Group Commercial |
$526.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$790.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$740.89
|
| Rate for Payer: InnovAge PACE Commercial |
$439.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$585.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$818.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$543.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$175.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$614.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$614.60
|
| Rate for Payer: Multiplan Commercial |
$658.50
|
| Rate for Payer: Networks By Design Commercial |
$570.70
|
| Rate for Payer: Prime Health Services Commercial |
$746.30
|
| Rate for Payer: Riverside University Health System MISP |
$351.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$526.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$526.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$439.00
|
| Rate for Payer: United Healthcare All Other HMO |
$439.00
|
| Rate for Payer: United Healthcare HMO Rider |
$439.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$439.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$746.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$746.30
|
| Rate for Payer: Vantage Medical Group Senior |
$746.30
|
|
|
HC PLCMNT NEPH CATH PERCU
|
Facility
|
OP
|
$17,730.00
|
|
|
Service Code
|
CPT 50432
|
| Hospital Charge Code |
909050432
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,330.66 |
| Max. Negotiated Rate |
$16,122.00 |
| Rate for Payer: Adventist Health Commercial |
$3,546.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,602.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,904.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,863.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,602.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$4,147.14
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$9,751.50
|
| Rate for Payer: Cash Price |
$9,751.50
|
| Rate for Payer: Cash Price |
$9,751.50
|
| Rate for Payer: Central Health Plan Commercial |
$14,184.00
|
| Rate for Payer: Cigna of CA HMO |
$11,347.20
|
| Rate for Payer: Cigna of CA PPO |
$13,120.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,904.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,863.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,602.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,513.83
|
| Rate for Payer: EPIC Health Plan Senior |
$2,602.84
|
| Rate for Payer: Galaxy Health WC |
$15,070.50
|
| Rate for Payer: Global Benefits Group Commercial |
$10,638.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,957.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,268.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,330.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,602.84
|
| Rate for Payer: InnovAge PACE Commercial |
$3,904.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,825.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,469.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,602.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,546.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,487.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,487.81
|
| Rate for Payer: Multiplan Commercial |
$13,297.50
|
| Rate for Payer: Multiplan WC |
$4,147.14
|
| Rate for Payer: Networks By Design Commercial |
$11,524.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,602.84
|
| Rate for Payer: Preferred Health Network WC |
$4,231.78
|
| Rate for Payer: Prime Health Services Commercial |
$15,070.50
|
| Rate for Payer: Prime Health Services Medicare |
$2,759.01
|
| Rate for Payer: Prime Health Services WC |
$4,104.83
|
| Rate for Payer: Riverside University Health System MISP |
$2,863.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,638.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,984.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,602.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,904.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,863.12
|
| Rate for Payer: Vantage Medical Group Senior |
$2,602.84
|
|
|
HC PLCMNT NEPH CATH PERCU
|
Facility
|
IP
|
$17,730.00
|
|
|
Service Code
|
CPT 50432
|
| Hospital Charge Code |
909050432
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,546.00 |
| Max. Negotiated Rate |
$15,957.00 |
| Rate for Payer: Adventist Health Commercial |
$3,546.00
|
| Rate for Payer: Cash Price |
$9,751.50
|
| Rate for Payer: Central Health Plan Commercial |
$14,184.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,092.00
|
| Rate for Payer: EPIC Health Plan Senior |
$7,092.00
|
| Rate for Payer: Galaxy Health WC |
$15,070.50
|
| Rate for Payer: Global Benefits Group Commercial |
$10,638.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,957.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,825.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,755.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,974.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,546.00
|
| Rate for Payer: Multiplan Commercial |
$13,297.50
|
| Rate for Payer: Networks By Design Commercial |
$11,524.50
|
| Rate for Payer: Prime Health Services Commercial |
$15,070.50
|
|
|
HC PLCMNT NEPHU CATH PERCU
|
Facility
|
OP
|
$10,190.00
|
|
|
Service Code
|
CPT 50433
|
| Hospital Charge Code |
909050433
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,794.27 |
| Max. Negotiated Rate |
$16,122.00 |
| Rate for Payer: Adventist Health Commercial |
$2,038.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,382.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,573.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,820.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,382.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,982.34
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$5,604.50
|
| Rate for Payer: Cash Price |
$5,604.50
|
| Rate for Payer: Cash Price |
$5,604.50
|
| Rate for Payer: Central Health Plan Commercial |
$8,152.00
|
| Rate for Payer: Cigna of CA HMO |
$6,521.60
|
| Rate for Payer: Cigna of CA PPO |
$7,540.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,573.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,820.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,382.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,916.05
|
| Rate for Payer: EPIC Health Plan Senior |
$4,382.26
|
| Rate for Payer: Galaxy Health WC |
$8,661.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6,114.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,171.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,186.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,794.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,382.26
|
| Rate for Payer: InnovAge PACE Commercial |
$6,573.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,796.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,982.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,382.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,038.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,872.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,872.23
|
| Rate for Payer: Multiplan Commercial |
$7,642.50
|
| Rate for Payer: Multiplan WC |
$6,982.34
|
| Rate for Payer: Networks By Design Commercial |
$6,623.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,382.26
|
| Rate for Payer: Preferred Health Network WC |
$7,124.84
|
| Rate for Payer: Prime Health Services Commercial |
$8,661.50
|
| Rate for Payer: Prime Health Services Medicare |
$4,645.20
|
| Rate for Payer: Prime Health Services WC |
$6,911.09
|
| Rate for Payer: Riverside University Health System MISP |
$4,820.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,114.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,984.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,382.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,573.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,820.49
|
| Rate for Payer: Vantage Medical Group Senior |
$4,382.26
|
|
|
HC PLCMNT NEPHU CATH PERCU
|
Facility
|
IP
|
$10,190.00
|
|
|
Service Code
|
CPT 50433
|
| Hospital Charge Code |
909050433
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,038.00 |
| Max. Negotiated Rate |
$9,171.00 |
| Rate for Payer: Adventist Health Commercial |
$2,038.00
|
| Rate for Payer: Cash Price |
$5,604.50
|
| Rate for Payer: Central Health Plan Commercial |
$8,152.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,076.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,076.00
|
| Rate for Payer: Galaxy Health WC |
$8,661.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6,114.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,171.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,796.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,882.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,307.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,038.00
|
| Rate for Payer: Multiplan Commercial |
$7,642.50
|
| Rate for Payer: Networks By Design Commercial |
$6,623.50
|
| Rate for Payer: Prime Health Services Commercial |
$8,661.50
|
|
|
HC PLCMNT TRANSESOPHEAGEAL PROBE
|
Facility
|
OP
|
$1,953.00
|
|
|
Service Code
|
CPT 93316
|
| Hospital Charge Code |
900501593
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$390.60 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Commercial |
$390.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,045.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$766.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$696.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,110.02
|
| Rate for Payer: Cash Price |
$1,074.15
|
| Rate for Payer: Cash Price |
$1,074.15
|
| Rate for Payer: Cash Price |
$1,074.15
|
| Rate for Payer: Cash Price |
$1,074.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,562.40
|
| Rate for Payer: Cigna of CA HMO |
$1,249.92
|
| Rate for Payer: Cigna of CA PPO |
$1,445.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,045.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$766.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$696.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$940.50
|
| Rate for Payer: EPIC Health Plan Senior |
$696.67
|
| Rate for Payer: Galaxy Health WC |
$1,660.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,171.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,757.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,142.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$696.67
|
| Rate for Payer: InnovAge PACE Commercial |
$1,045.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,302.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$744.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$696.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$390.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$933.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$933.54
|
| Rate for Payer: Multiplan Commercial |
$1,464.75
|
| Rate for Payer: Multiplan WC |
$1,110.02
|
| Rate for Payer: Networks By Design Commercial |
$1,269.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$696.67
|
| Rate for Payer: Preferred Health Network WC |
$1,132.67
|
| Rate for Payer: Prime Health Services Commercial |
$1,660.05
|
| Rate for Payer: Prime Health Services Medicare |
$738.47
|
| Rate for Payer: Prime Health Services WC |
$1,098.69
|
| Rate for Payer: Riverside University Health System MISP |
$766.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,171.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$976.50
|
| Rate for Payer: United Healthcare All Other HMO |
$976.50
|
| Rate for Payer: United Healthcare HMO Rider |
$976.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$976.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$696.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,045.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$766.34
|
| Rate for Payer: Vantage Medical Group Senior |
$696.67
|
|
|
HC PLCMNT TRANSESOPHEAGEAL PROBE
|
Facility
|
IP
|
$1,953.00
|
|
|
Service Code
|
CPT 93316
|
| Hospital Charge Code |
900501593
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$390.60 |
| Max. Negotiated Rate |
$1,757.70 |
| Rate for Payer: Adventist Health Commercial |
$390.60
|
| Rate for Payer: Cash Price |
$1,074.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,562.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$781.20
|
| Rate for Payer: EPIC Health Plan Senior |
$781.20
|
| Rate for Payer: Galaxy Health WC |
$1,660.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,171.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,757.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,302.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$744.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,208.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$390.60
|
| Rate for Payer: Multiplan Commercial |
$1,464.75
|
| Rate for Payer: Networks By Design Commercial |
$1,269.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,660.05
|
|
|
HC PLCMT CENTRLY INSERT TUN CVP GT 5YR
|
Facility
|
OP
|
$16,638.00
|
|
|
Service Code
|
CPT 36558
|
| Hospital Charge Code |
909080010
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$233.09 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$3,327.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$9,150.90
|
| Rate for Payer: Cash Price |
$9,150.90
|
| Rate for Payer: Cash Price |
$9,150.90
|
| Rate for Payer: Central Health Plan Commercial |
$13,310.40
|
| Rate for Payer: Cigna of CA HMO |
$10,648.32
|
| Rate for Payer: Cigna of CA PPO |
$12,312.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$14,142.30
|
| Rate for Payer: Global Benefits Group Commercial |
$9,982.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,974.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$233.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: InnovAge PACE Commercial |
$5,998.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,097.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$257.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,327.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$12,478.50
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$10,814.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$14,142.30
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,982.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC PLCMT CENTRLY INSERT TUN CVP GT 5YR
|
Facility
|
IP
|
$16,638.00
|
|
|
Service Code
|
CPT 36558
|
| Hospital Charge Code |
909080010
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,327.60 |
| Max. Negotiated Rate |
$14,974.20 |
| Rate for Payer: Adventist Health Commercial |
$3,327.60
|
| Rate for Payer: Cash Price |
$9,150.90
|
| Rate for Payer: Central Health Plan Commercial |
$13,310.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,655.20
|
| Rate for Payer: EPIC Health Plan Senior |
$6,655.20
|
| Rate for Payer: Galaxy Health WC |
$14,142.30
|
| Rate for Payer: Global Benefits Group Commercial |
$9,982.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,974.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,097.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,339.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,298.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,327.60
|
| Rate for Payer: Multiplan Commercial |
$12,478.50
|
| Rate for Payer: Networks By Design Commercial |
$10,814.70
|
| Rate for Payer: Prime Health Services Commercial |
$14,142.30
|
|
|
HC PLCMT CENTRLY INSERT TUN CVP LT 5YR
|
Facility
|
OP
|
$10,962.00
|
|
|
Service Code
|
CPT 36557
|
| Hospital Charge Code |
909081359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$238.22 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$2,192.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$6,868.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,868.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$10,943.70
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$6,029.10
|
| Rate for Payer: Cash Price |
$6,029.10
|
| Rate for Payer: Cash Price |
$6,029.10
|
| Rate for Payer: Central Health Plan Commercial |
$8,769.60
|
| Rate for Payer: Cigna of CA HMO |
$7,015.68
|
| Rate for Payer: Cigna of CA PPO |
$8,111.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,555.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,868.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,272.45
|
| Rate for Payer: EPIC Health Plan Senior |
$6,868.48
|
| Rate for Payer: Galaxy Health WC |
$9,317.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,577.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,865.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,264.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$238.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,868.48
|
| Rate for Payer: InnovAge PACE Commercial |
$10,302.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,311.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$263.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,868.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,192.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,203.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,203.76
|
| Rate for Payer: Multiplan Commercial |
$8,221.50
|
| Rate for Payer: Multiplan WC |
$10,943.70
|
| Rate for Payer: Networks By Design Commercial |
$7,125.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6,868.48
|
| Rate for Payer: Preferred Health Network WC |
$11,167.04
|
| Rate for Payer: Prime Health Services Commercial |
$9,317.70
|
| Rate for Payer: Prime Health Services Medicare |
$7,280.59
|
| Rate for Payer: Prime Health Services WC |
$10,832.03
|
| Rate for Payer: Riverside University Health System MISP |
$7,555.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,577.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$6,868.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Vantage Medical Group Senior |
$6,868.48
|
|
|
HC PLCMT CENTRLY INSERT TUN CVP LT 5YR
|
Facility
|
IP
|
$10,962.00
|
|
|
Service Code
|
CPT 36557
|
| Hospital Charge Code |
909081359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,192.40 |
| Max. Negotiated Rate |
$9,865.80 |
| Rate for Payer: Adventist Health Commercial |
$2,192.40
|
| Rate for Payer: Cash Price |
$6,029.10
|
| Rate for Payer: Central Health Plan Commercial |
$8,769.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,384.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,384.80
|
| Rate for Payer: Galaxy Health WC |
$9,317.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,577.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,865.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,311.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,176.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,785.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,192.40
|
| Rate for Payer: Multiplan Commercial |
$8,221.50
|
| Rate for Payer: Networks By Design Commercial |
$7,125.30
|
| Rate for Payer: Prime Health Services Commercial |
$9,317.70
|
|
|
HC PLCMT OF ENTRSTMY OR CECSTMY TUBE
|
Facility
|
OP
|
$5,527.00
|
|
|
Service Code
|
CPT 44300
|
| Hospital Charge Code |
906744300
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$616.65 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$1,105.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,697.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,039.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,145.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$3,039.85
|
| Rate for Payer: Cash Price |
$3,039.85
|
| Rate for Payer: Cash Price |
$3,039.85
|
| Rate for Payer: Central Health Plan Commercial |
$4,421.60
|
| Rate for Payer: Cigna of CA HMO |
$3,537.28
|
| Rate for Payer: Cigna of CA PPO |
$4,089.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,697.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,697.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,697.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,210.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,210.80
|
| Rate for Payer: Galaxy Health WC |
$4,697.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,316.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,974.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$616.65
|
| Rate for Payer: InnovAge PACE Commercial |
$2,763.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,686.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$681.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,421.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,105.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,868.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,868.90
|
| Rate for Payer: Multiplan Commercial |
$4,145.25
|
| Rate for Payer: Networks By Design Commercial |
$3,592.55
|
| Rate for Payer: Prime Health Services Commercial |
$4,697.95
|
| Rate for Payer: Riverside University Health System MISP |
$2,210.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,316.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,316.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,697.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,697.95
|
| Rate for Payer: Vantage Medical Group Senior |
$4,697.95
|
|
|
HC PLCMT OF ENTRSTMY OR CECSTMY TUBE
|
Facility
|
IP
|
$5,527.00
|
|
|
Service Code
|
CPT 44300
|
| Hospital Charge Code |
906744300
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,105.40 |
| Max. Negotiated Rate |
$4,974.30 |
| Rate for Payer: Adventist Health Commercial |
$1,105.40
|
| Rate for Payer: Cash Price |
$3,039.85
|
| Rate for Payer: Central Health Plan Commercial |
$4,421.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,210.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,210.80
|
| Rate for Payer: Galaxy Health WC |
$4,697.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,316.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,974.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,686.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,105.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,421.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,105.40
|
| Rate for Payer: Multiplan Commercial |
$4,145.25
|
| Rate for Payer: Networks By Design Commercial |
$3,592.55
|
| Rate for Payer: Prime Health Services Commercial |
$4,697.95
|
|
|
HC PLCMT PERIPH INSRT CV DEVC W/P
|
Facility
|
OP
|
$14,091.00
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
909080016
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$522.54 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$2,818.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$7,750.05
|
| Rate for Payer: Cash Price |
$7,750.05
|
| Rate for Payer: Cash Price |
$7,750.05
|
| Rate for Payer: Central Health Plan Commercial |
$11,272.80
|
| Rate for Payer: Cigna of CA HMO |
$9,018.24
|
| Rate for Payer: Cigna of CA PPO |
$10,427.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$11,977.35
|
| Rate for Payer: Global Benefits Group Commercial |
$8,454.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,681.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$522.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: InnovAge PACE Commercial |
$5,998.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,398.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$577.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,818.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$10,568.25
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$9,159.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$11,977.35
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,454.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC PLCMT PERIPH INSRT CV DEVC W/P
|
Facility
|
IP
|
$14,091.00
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
909080016
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,818.20 |
| Max. Negotiated Rate |
$12,681.90 |
| Rate for Payer: Adventist Health Commercial |
$2,818.20
|
| Rate for Payer: Cash Price |
$7,750.05
|
| Rate for Payer: Central Health Plan Commercial |
$11,272.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,636.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,636.40
|
| Rate for Payer: Galaxy Health WC |
$11,977.35
|
| Rate for Payer: Global Benefits Group Commercial |
$8,454.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,681.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,398.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,368.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,722.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,818.20
|
| Rate for Payer: Multiplan Commercial |
$10,568.25
|
| Rate for Payer: Networks By Design Commercial |
$9,159.15
|
| Rate for Payer: Prime Health Services Commercial |
$11,977.35
|
|
