|
HC RNPIGG
|
Facility
|
IP
|
$22.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
900913709
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$19.80 |
| Rate for Payer: Adventist Health Commercial |
$4.40
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Central Health Plan Commercial |
$17.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.80
|
| Rate for Payer: EPIC Health Plan Senior |
$8.80
|
| Rate for Payer: Galaxy Health WC |
$18.70
|
| Rate for Payer: Global Benefits Group Commercial |
$13.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.40
|
| Rate for Payer: Multiplan Commercial |
$16.50
|
| Rate for Payer: Networks By Design Commercial |
$14.30
|
| Rate for Payer: Prime Health Services Commercial |
$18.70
|
|
|
HC RN SUPERVISORY VISIT EPSDT
|
Facility
|
OP
|
$70.00
|
|
|
Service Code
|
CPT 99347
|
| Hospital Charge Code |
903400606
|
|
Hospital Revenue Code
|
552
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$300.40 |
| Rate for Payer: Adventist Health Commercial |
$14.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$300.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$59.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$52.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$33.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40.72
|
| Rate for Payer: Blue Shield of California Commercial |
$44.38
|
| Rate for Payer: Blue Shield of California EPN |
$27.93
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Central Health Plan Commercial |
$56.00
|
| Rate for Payer: Cigna of CA HMO |
$44.80
|
| Rate for Payer: Cigna of CA PPO |
$51.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$59.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$59.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$59.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$49.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.00
|
| Rate for Payer: EPIC Health Plan Senior |
$28.00
|
| Rate for Payer: Galaxy Health WC |
$59.50
|
| Rate for Payer: Global Benefits Group Commercial |
$42.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$63.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$68.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$44.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$76.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$41.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$49.00
|
| Rate for Payer: Multiplan Commercial |
$52.50
|
| Rate for Payer: Networks By Design Commercial |
$45.50
|
| Rate for Payer: Prime Health Services Commercial |
$59.50
|
| Rate for Payer: Riverside University Health System MISP |
$28.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$42.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$42.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$59.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$59.50
|
| Rate for Payer: Vantage Medical Group Senior |
$59.50
|
|
|
HC RN SUPERVISORY VISIT EPSDT
|
Facility
|
IP
|
$70.00
|
|
|
Service Code
|
CPT 99347
|
| Hospital Charge Code |
903400606
|
|
Hospital Revenue Code
|
552
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Adventist Health Commercial |
$14.00
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Central Health Plan Commercial |
$56.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$49.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.00
|
| Rate for Payer: EPIC Health Plan Senior |
$28.00
|
| Rate for Payer: Galaxy Health WC |
$59.50
|
| Rate for Payer: Global Benefits Group Commercial |
$42.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$63.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$44.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$41.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.00
|
| Rate for Payer: Multiplan Commercial |
$52.50
|
| Rate for Payer: Networks By Design Commercial |
$45.50
|
| Rate for Payer: Prime Health Services Commercial |
$59.50
|
|
|
HC ROBOTIC SURGERY LEVEL I 1ST ADDL 30 MIN
|
Facility
|
IP
|
$3,184.00
|
|
| Hospital Charge Code |
900700495
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$636.80 |
| Max. Negotiated Rate |
$2,865.60 |
| Rate for Payer: Adventist Health Commercial |
$636.80
|
| Rate for Payer: Cash Price |
$1,432.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,547.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,228.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,273.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,273.60
|
| Rate for Payer: Galaxy Health WC |
$2,706.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,910.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,865.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,021.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,878.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$636.80
|
| Rate for Payer: Multiplan Commercial |
$2,388.00
|
| Rate for Payer: Networks By Design Commercial |
$2,069.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,706.40
|
|
|
HC ROBOTIC SURGERY LEVEL I 1ST ADDL 30 MIN
|
Facility
|
OP
|
$3,184.00
|
|
| Hospital Charge Code |
900700495
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$636.80 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$636.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,706.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,751.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,388.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,541.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,852.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$1,432.80
|
| Rate for Payer: Cash Price |
$1,432.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,547.20
|
| Rate for Payer: Cigna of CA HMO |
$2,037.76
|
| Rate for Payer: Cigna of CA PPO |
$2,356.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,706.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,706.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,706.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,228.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,273.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,273.60
|
| Rate for Payer: Galaxy Health WC |
$2,706.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,910.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,865.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,021.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,155.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,878.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$636.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,228.80
|
| Rate for Payer: Multiplan Commercial |
$2,388.00
|
| Rate for Payer: Networks By Design Commercial |
$2,069.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,706.40
|
| Rate for Payer: Riverside University Health System MISP |
$1,273.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,910.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,592.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,592.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,592.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,592.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,706.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,706.40
|
| Rate for Payer: Vantage Medical Group Senior |
$2,706.40
|
|
|
HC ROBOTIC SURGERY LEVEL I 1ST HR
|
Facility
|
OP
|
$26,251.00
|
|
| Hospital Charge Code |
900700496
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,113.68 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$5,250.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,313.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,438.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19,688.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,710.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,270.21
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$11,812.95
|
| Rate for Payer: Cash Price |
$11,812.95
|
| Rate for Payer: Central Health Plan Commercial |
$21,000.80
|
| Rate for Payer: Cigna of CA HMO |
$16,800.64
|
| Rate for Payer: Cigna of CA PPO |
$19,425.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,313.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$22,313.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,313.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18,375.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,500.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10,500.40
|
| Rate for Payer: Galaxy Health WC |
$22,313.35
|
| Rate for Payer: Global Benefits Group Commercial |
$15,750.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$23,625.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16,669.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9,529.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15,488.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,250.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18,375.70
|
| Rate for Payer: Multiplan Commercial |
$19,688.25
|
| Rate for Payer: Networks By Design Commercial |
$17,063.15
|
| Rate for Payer: Prime Health Services Commercial |
$22,313.35
|
| Rate for Payer: Riverside University Health System MISP |
$10,500.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,750.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,125.50
|
| Rate for Payer: United Healthcare All Other HMO |
$13,125.50
|
| Rate for Payer: United Healthcare HMO Rider |
$13,125.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13,125.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,313.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22,313.35
|
| Rate for Payer: Vantage Medical Group Senior |
$22,313.35
|
|
|
HC ROBOTIC SURGERY LEVEL I 1ST HR
|
Facility
|
IP
|
$26,251.00
|
|
| Hospital Charge Code |
900700496
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,250.20 |
| Max. Negotiated Rate |
$23,625.90 |
| Rate for Payer: Adventist Health Commercial |
$5,250.20
|
| Rate for Payer: Cash Price |
$11,812.95
|
| Rate for Payer: Central Health Plan Commercial |
$21,000.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18,375.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,500.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10,500.40
|
| Rate for Payer: Galaxy Health WC |
$22,313.35
|
| Rate for Payer: Global Benefits Group Commercial |
$15,750.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$23,625.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16,669.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15,488.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,250.20
|
| Rate for Payer: Multiplan Commercial |
$19,688.25
|
| Rate for Payer: Networks By Design Commercial |
$17,063.15
|
| Rate for Payer: Prime Health Services Commercial |
$22,313.35
|
|
|
HC ROBOTIC SURGERY LEVEL I EA SUBS 30 MIN
|
Facility
|
IP
|
$3,184.00
|
|
| Hospital Charge Code |
900700497
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$636.80 |
| Max. Negotiated Rate |
$2,865.60 |
| Rate for Payer: Adventist Health Commercial |
$636.80
|
| Rate for Payer: Cash Price |
$1,432.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,547.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,228.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,273.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,273.60
|
| Rate for Payer: Galaxy Health WC |
$2,706.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,910.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,865.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,021.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,878.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$636.80
|
| Rate for Payer: Multiplan Commercial |
$2,388.00
|
| Rate for Payer: Networks By Design Commercial |
$2,069.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,706.40
|
|
|
HC ROBOTIC SURGERY LEVEL I EA SUBS 30 MIN
|
Facility
|
OP
|
$3,184.00
|
|
| Hospital Charge Code |
900700497
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$636.80 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$636.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,706.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,751.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,388.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,541.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,852.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$1,432.80
|
| Rate for Payer: Cash Price |
$1,432.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,547.20
|
| Rate for Payer: Cigna of CA HMO |
$2,037.76
|
| Rate for Payer: Cigna of CA PPO |
$2,356.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,706.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,706.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,706.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,228.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,273.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,273.60
|
| Rate for Payer: Galaxy Health WC |
$2,706.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,910.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,865.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,021.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,155.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,878.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$636.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,228.80
|
| Rate for Payer: Multiplan Commercial |
$2,388.00
|
| Rate for Payer: Networks By Design Commercial |
$2,069.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,706.40
|
| Rate for Payer: Riverside University Health System MISP |
$1,273.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,910.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,592.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,592.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,592.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,592.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,706.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,706.40
|
| Rate for Payer: Vantage Medical Group Senior |
$2,706.40
|
|
|
HC ROBOTIC SURGERY LEVEL II 1ST ADDL 30 MIN
|
Facility
|
IP
|
$4,303.00
|
|
| Hospital Charge Code |
900700498
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$860.60 |
| Max. Negotiated Rate |
$3,872.70 |
| Rate for Payer: Adventist Health Commercial |
$860.60
|
| Rate for Payer: Cash Price |
$1,936.35
|
| Rate for Payer: Central Health Plan Commercial |
$3,442.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,012.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,721.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,721.20
|
| Rate for Payer: Galaxy Health WC |
$3,657.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,581.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,872.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,732.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,538.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$860.60
|
| Rate for Payer: Multiplan Commercial |
$3,227.25
|
| Rate for Payer: Networks By Design Commercial |
$2,796.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,657.55
|
|
|
HC ROBOTIC SURGERY LEVEL II 1ST ADDL 30 MIN
|
Facility
|
OP
|
$4,303.00
|
|
| Hospital Charge Code |
900700498
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$860.60 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$860.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,657.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,366.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,227.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,083.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,503.06
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$1,936.35
|
| Rate for Payer: Cash Price |
$1,936.35
|
| Rate for Payer: Central Health Plan Commercial |
$3,442.40
|
| Rate for Payer: Cigna of CA HMO |
$2,753.92
|
| Rate for Payer: Cigna of CA PPO |
$3,184.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,657.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,657.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,657.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,012.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,721.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,721.20
|
| Rate for Payer: Galaxy Health WC |
$3,657.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,581.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,872.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,732.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,561.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,538.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$860.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,012.10
|
| Rate for Payer: Multiplan Commercial |
$3,227.25
|
| Rate for Payer: Networks By Design Commercial |
$2,796.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,657.55
|
| Rate for Payer: Riverside University Health System MISP |
$1,721.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,581.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,151.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,151.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,151.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,151.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,657.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,657.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,657.55
|
|
|
HC ROBOTIC SURGERY LEVEL II 1ST HR
|
Facility
|
OP
|
$35,444.00
|
|
| Hospital Charge Code |
900700499
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,113.68 |
| Max. Negotiated Rate |
$31,899.60 |
| Rate for Payer: Adventist Health Commercial |
$7,088.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30,127.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19,494.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26,583.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,161.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20,617.77
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$15,949.80
|
| Rate for Payer: Cash Price |
$15,949.80
|
| Rate for Payer: Central Health Plan Commercial |
$28,355.20
|
| Rate for Payer: Cigna of CA HMO |
$22,684.16
|
| Rate for Payer: Cigna of CA PPO |
$26,228.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30,127.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$30,127.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30,127.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$24,810.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,177.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,177.60
|
| Rate for Payer: Galaxy Health WC |
$30,127.40
|
| Rate for Payer: Global Benefits Group Commercial |
$21,266.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$31,899.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22,506.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12,866.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,911.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,088.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24,810.80
|
| Rate for Payer: Multiplan Commercial |
$26,583.00
|
| Rate for Payer: Networks By Design Commercial |
$23,038.60
|
| Rate for Payer: Prime Health Services Commercial |
$30,127.40
|
| Rate for Payer: Riverside University Health System MISP |
$14,177.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21,266.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,722.00
|
| Rate for Payer: United Healthcare All Other HMO |
$17,722.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,722.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17,722.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30,127.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30,127.40
|
| Rate for Payer: Vantage Medical Group Senior |
$30,127.40
|
|
|
HC ROBOTIC SURGERY LEVEL II 1ST HR
|
Facility
|
IP
|
$35,444.00
|
|
| Hospital Charge Code |
900700499
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,088.80 |
| Max. Negotiated Rate |
$31,899.60 |
| Rate for Payer: Adventist Health Commercial |
$7,088.80
|
| Rate for Payer: Cash Price |
$15,949.80
|
| Rate for Payer: Central Health Plan Commercial |
$28,355.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$24,810.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,177.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,177.60
|
| Rate for Payer: Galaxy Health WC |
$30,127.40
|
| Rate for Payer: Global Benefits Group Commercial |
$21,266.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$31,899.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22,506.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,911.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,088.80
|
| Rate for Payer: Multiplan Commercial |
$26,583.00
|
| Rate for Payer: Networks By Design Commercial |
$23,038.60
|
| Rate for Payer: Prime Health Services Commercial |
$30,127.40
|
|
|
HC ROBOTIC SURGERY LEVEL II EA SUBS 30 MIN
|
Facility
|
IP
|
$4,303.00
|
|
| Hospital Charge Code |
900700500
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$860.60 |
| Max. Negotiated Rate |
$3,872.70 |
| Rate for Payer: Adventist Health Commercial |
$860.60
|
| Rate for Payer: Cash Price |
$1,936.35
|
| Rate for Payer: Central Health Plan Commercial |
$3,442.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,012.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,721.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,721.20
|
| Rate for Payer: Galaxy Health WC |
$3,657.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,581.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,872.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,732.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,538.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$860.60
|
| Rate for Payer: Multiplan Commercial |
$3,227.25
|
| Rate for Payer: Networks By Design Commercial |
$2,796.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,657.55
|
|
|
HC ROBOTIC SURGERY LEVEL II EA SUBS 30 MIN
|
Facility
|
OP
|
$4,303.00
|
|
| Hospital Charge Code |
900700500
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$860.60 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$860.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,657.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,366.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,227.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,083.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,503.06
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$1,936.35
|
| Rate for Payer: Cash Price |
$1,936.35
|
| Rate for Payer: Central Health Plan Commercial |
$3,442.40
|
| Rate for Payer: Cigna of CA HMO |
$2,753.92
|
| Rate for Payer: Cigna of CA PPO |
$3,184.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,657.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,657.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,657.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,012.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,721.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,721.20
|
| Rate for Payer: Galaxy Health WC |
$3,657.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,581.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,872.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,732.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,561.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,538.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$860.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,012.10
|
| Rate for Payer: Multiplan Commercial |
$3,227.25
|
| Rate for Payer: Networks By Design Commercial |
$2,796.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,657.55
|
| Rate for Payer: Riverside University Health System MISP |
$1,721.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,581.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,151.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,151.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,151.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,151.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,657.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,657.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,657.55
|
|
|
HC ROBOTIC SURGERY LEVEL III 1ST ADDL 30 MIN
|
Facility
|
IP
|
$8,196.00
|
|
| Hospital Charge Code |
900700501
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,639.20 |
| Max. Negotiated Rate |
$7,376.40 |
| Rate for Payer: Adventist Health Commercial |
$1,639.20
|
| Rate for Payer: Cash Price |
$3,688.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,556.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,737.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,278.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,278.40
|
| Rate for Payer: Galaxy Health WC |
$6,966.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,917.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,376.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,204.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,835.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,639.20
|
| Rate for Payer: Multiplan Commercial |
$6,147.00
|
| Rate for Payer: Networks By Design Commercial |
$5,327.40
|
| Rate for Payer: Prime Health Services Commercial |
$6,966.60
|
|
|
HC ROBOTIC SURGERY LEVEL III 1ST ADDL 30 MIN
|
Facility
|
OP
|
$8,196.00
|
|
| Hospital Charge Code |
900700501
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,639.20 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,639.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,966.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,507.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,147.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,968.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,767.61
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,688.20
|
| Rate for Payer: Cash Price |
$3,688.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,556.80
|
| Rate for Payer: Cigna of CA HMO |
$5,245.44
|
| Rate for Payer: Cigna of CA PPO |
$6,065.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,966.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,966.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,966.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,737.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,278.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,278.40
|
| Rate for Payer: Galaxy Health WC |
$6,966.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,917.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,376.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,204.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,975.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,835.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,639.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,737.20
|
| Rate for Payer: Multiplan Commercial |
$6,147.00
|
| Rate for Payer: Networks By Design Commercial |
$5,327.40
|
| Rate for Payer: Prime Health Services Commercial |
$6,966.60
|
| Rate for Payer: Riverside University Health System MISP |
$3,278.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,917.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,098.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,098.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,098.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,098.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,966.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,966.60
|
| Rate for Payer: Vantage Medical Group Senior |
$6,966.60
|
|
|
HC ROBOTIC SURGERY LEVEL III 1ST HR
|
Facility
|
OP
|
$56,771.00
|
|
| Hospital Charge Code |
900700502
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,113.68 |
| Max. Negotiated Rate |
$51,093.90 |
| Rate for Payer: Adventist Health Commercial |
$11,354.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$48,255.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31,224.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42,578.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27,488.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33,023.69
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$25,546.95
|
| Rate for Payer: Cash Price |
$25,546.95
|
| Rate for Payer: Central Health Plan Commercial |
$45,416.80
|
| Rate for Payer: Cigna of CA HMO |
$36,333.44
|
| Rate for Payer: Cigna of CA PPO |
$42,010.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$48,255.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$48,255.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$48,255.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$39,739.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,708.40
|
| Rate for Payer: EPIC Health Plan Senior |
$22,708.40
|
| Rate for Payer: Galaxy Health WC |
$48,255.35
|
| Rate for Payer: Global Benefits Group Commercial |
$34,062.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$51,093.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$36,049.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20,607.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33,494.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,354.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$39,739.70
|
| Rate for Payer: Multiplan Commercial |
$42,578.25
|
| Rate for Payer: Networks By Design Commercial |
$36,901.15
|
| Rate for Payer: Prime Health Services Commercial |
$48,255.35
|
| Rate for Payer: Riverside University Health System MISP |
$22,708.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34,062.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$28,385.50
|
| Rate for Payer: United Healthcare All Other HMO |
$28,385.50
|
| Rate for Payer: United Healthcare HMO Rider |
$28,385.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,385.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$48,255.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$48,255.35
|
| Rate for Payer: Vantage Medical Group Senior |
$48,255.35
|
|
|
HC ROBOTIC SURGERY LEVEL III 1ST HR
|
Facility
|
IP
|
$56,771.00
|
|
| Hospital Charge Code |
900700502
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$11,354.20 |
| Max. Negotiated Rate |
$51,093.90 |
| Rate for Payer: Adventist Health Commercial |
$11,354.20
|
| Rate for Payer: Cash Price |
$25,546.95
|
| Rate for Payer: Central Health Plan Commercial |
$45,416.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$39,739.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,708.40
|
| Rate for Payer: EPIC Health Plan Senior |
$22,708.40
|
| Rate for Payer: Galaxy Health WC |
$48,255.35
|
| Rate for Payer: Global Benefits Group Commercial |
$34,062.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$51,093.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$36,049.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33,494.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,354.20
|
| Rate for Payer: Multiplan Commercial |
$42,578.25
|
| Rate for Payer: Networks By Design Commercial |
$36,901.15
|
| Rate for Payer: Prime Health Services Commercial |
$48,255.35
|
|
|
HC ROBOTIC SURGERY LEVEL III EA SUBS 30 MIN
|
Facility
|
IP
|
$8,196.00
|
|
| Hospital Charge Code |
900700503
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,639.20 |
| Max. Negotiated Rate |
$7,376.40 |
| Rate for Payer: Adventist Health Commercial |
$1,639.20
|
| Rate for Payer: Cash Price |
$3,688.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,556.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,737.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,278.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,278.40
|
| Rate for Payer: Galaxy Health WC |
$6,966.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,917.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,376.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,204.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,835.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,639.20
|
| Rate for Payer: Multiplan Commercial |
$6,147.00
|
| Rate for Payer: Networks By Design Commercial |
$5,327.40
|
| Rate for Payer: Prime Health Services Commercial |
$6,966.60
|
|
|
HC ROBOTIC SURGERY LEVEL III EA SUBS 30 MIN
|
Facility
|
OP
|
$8,196.00
|
|
| Hospital Charge Code |
900700503
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,639.20 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,639.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,966.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,507.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,147.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,968.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,767.61
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,688.20
|
| Rate for Payer: Cash Price |
$3,688.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,556.80
|
| Rate for Payer: Cigna of CA HMO |
$5,245.44
|
| Rate for Payer: Cigna of CA PPO |
$6,065.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,966.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,966.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,966.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,737.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,278.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,278.40
|
| Rate for Payer: Galaxy Health WC |
$6,966.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,917.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,376.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,204.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,975.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,835.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,639.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,737.20
|
| Rate for Payer: Multiplan Commercial |
$6,147.00
|
| Rate for Payer: Networks By Design Commercial |
$5,327.40
|
| Rate for Payer: Prime Health Services Commercial |
$6,966.60
|
| Rate for Payer: Riverside University Health System MISP |
$3,278.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,917.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,098.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,098.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,098.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,098.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,966.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,966.60
|
| Rate for Payer: Vantage Medical Group Senior |
$6,966.60
|
|
|
HC ROBOTIC SURGERY LEVEL IV 1ST ADDL 30 MIN
|
Facility
|
IP
|
$11,775.00
|
|
| Hospital Charge Code |
900700504
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,355.00 |
| Max. Negotiated Rate |
$10,597.50 |
| Rate for Payer: Adventist Health Commercial |
$2,355.00
|
| Rate for Payer: Cash Price |
$5,298.75
|
| Rate for Payer: Central Health Plan Commercial |
$9,420.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,242.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,710.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,710.00
|
| Rate for Payer: Galaxy Health WC |
$10,008.75
|
| Rate for Payer: Global Benefits Group Commercial |
$7,065.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,597.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,477.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,947.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,355.00
|
| Rate for Payer: Multiplan Commercial |
$8,831.25
|
| Rate for Payer: Networks By Design Commercial |
$7,653.75
|
| Rate for Payer: Prime Health Services Commercial |
$10,008.75
|
|
|
HC ROBOTIC SURGERY LEVEL IV 1ST ADDL 30 MIN
|
Facility
|
OP
|
$11,775.00
|
|
| Hospital Charge Code |
900700504
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,355.00 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,355.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,008.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,476.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,831.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,701.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,849.52
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$5,298.75
|
| Rate for Payer: Cash Price |
$5,298.75
|
| Rate for Payer: Central Health Plan Commercial |
$9,420.00
|
| Rate for Payer: Cigna of CA HMO |
$7,536.00
|
| Rate for Payer: Cigna of CA PPO |
$8,713.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,008.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,008.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,008.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,242.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,710.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,710.00
|
| Rate for Payer: Galaxy Health WC |
$10,008.75
|
| Rate for Payer: Global Benefits Group Commercial |
$7,065.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,597.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,477.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,274.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,947.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,355.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8,242.50
|
| Rate for Payer: Multiplan Commercial |
$8,831.25
|
| Rate for Payer: Networks By Design Commercial |
$7,653.75
|
| Rate for Payer: Prime Health Services Commercial |
$10,008.75
|
| Rate for Payer: Riverside University Health System MISP |
$4,710.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,065.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,887.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,887.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,887.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,887.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,008.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,008.75
|
| Rate for Payer: Vantage Medical Group Senior |
$10,008.75
|
|
|
HC ROBOTIC SURGERY LEVEL IV 1ST HR
|
Facility
|
IP
|
$75,655.00
|
|
| Hospital Charge Code |
900700505
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$15,131.00 |
| Max. Negotiated Rate |
$68,089.50 |
| Rate for Payer: Adventist Health Commercial |
$15,131.00
|
| Rate for Payer: Cash Price |
$34,044.75
|
| Rate for Payer: Central Health Plan Commercial |
$60,524.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$52,958.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,262.00
|
| Rate for Payer: EPIC Health Plan Senior |
$30,262.00
|
| Rate for Payer: Galaxy Health WC |
$64,306.75
|
| Rate for Payer: Global Benefits Group Commercial |
$45,393.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$68,089.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48,040.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$44,636.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,131.00
|
| Rate for Payer: Multiplan Commercial |
$56,741.25
|
| Rate for Payer: Networks By Design Commercial |
$49,175.75
|
| Rate for Payer: Prime Health Services Commercial |
$64,306.75
|
|
|
HC ROBOTIC SURGERY LEVEL IV 1ST HR
|
Facility
|
OP
|
$75,655.00
|
|
| Hospital Charge Code |
900700505
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,113.68 |
| Max. Negotiated Rate |
$68,089.50 |
| Rate for Payer: Adventist Health Commercial |
$15,131.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$64,306.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$41,610.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$56,741.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36,632.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,008.51
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$34,044.75
|
| Rate for Payer: Cash Price |
$34,044.75
|
| Rate for Payer: Central Health Plan Commercial |
$60,524.00
|
| Rate for Payer: Cigna of CA HMO |
$48,419.20
|
| Rate for Payer: Cigna of CA PPO |
$55,984.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64,306.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$64,306.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$64,306.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$52,958.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,262.00
|
| Rate for Payer: EPIC Health Plan Senior |
$30,262.00
|
| Rate for Payer: Galaxy Health WC |
$64,306.75
|
| Rate for Payer: Global Benefits Group Commercial |
$45,393.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$68,089.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48,040.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27,462.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$44,636.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,131.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$52,958.50
|
| Rate for Payer: Multiplan Commercial |
$56,741.25
|
| Rate for Payer: Networks By Design Commercial |
$49,175.75
|
| Rate for Payer: Prime Health Services Commercial |
$64,306.75
|
| Rate for Payer: Riverside University Health System MISP |
$30,262.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45,393.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$37,827.50
|
| Rate for Payer: United Healthcare All Other HMO |
$37,827.50
|
| Rate for Payer: United Healthcare HMO Rider |
$37,827.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$37,827.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$64,306.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$64,306.75
|
| Rate for Payer: Vantage Medical Group Senior |
$64,306.75
|
|
