|
HC PARTIAL RMVL DIST PHALANX FNGR
|
Facility
OP
|
$8,089.00
|
|
|
Service Code
|
CPT 26236
|
| Hospital Charge Code |
900501314
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$8,114.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,853.40
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$3,640.05
|
| Rate for Payer: Cash Price |
$3,640.05
|
| Rate for Payer: Cash Price |
$3,640.05
|
| Rate for Payer: Cash Price |
$3,640.05
|
| Rate for Payer: Central Health Plan Commercial |
$6,471.20
|
| Rate for Payer: Cigna of CA PPO |
$5,985.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,710.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,008.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,008.09
|
| Rate for Payer: Galaxy Health WC |
$6,875.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,853.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,280.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6,066.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,293.27
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$2,008.09
|
| Rate for Payer: Innovage PACE Commercial |
$3,012.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,395.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,617.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,690.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,690.84
|
| Rate for Payer: Multiplan Commercial |
$6,066.75
|
| Rate for Payer: Networks By Design Commercial |
$5,257.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,875.65
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,853.40
|
| Rate for Payer: Riverside University Health MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,853.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,044.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,044.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,044.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,044.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Vantage Medical Group Senior |
$2,008.09
|
|
|
HC PARTIAL RMVL OF EYE FLUID
|
Facility
IP
|
$9,867.00
|
|
|
Service Code
|
CPT 67005
|
| Hospital Charge Code |
900501540
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,973.40 |
| Max. Negotiated Rate |
$8,880.30 |
| Rate for Payer: Cash Price |
$4,440.15
|
| Rate for Payer: Central Health Plan Commercial |
$7,893.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,946.80
|
| Rate for Payer: Galaxy Health WC |
$8,386.95
|
| Rate for Payer: Global Benefits Group Commercial |
$5,920.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,880.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,581.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,973.40
|
| Rate for Payer: Multiplan Commercial |
$7,400.25
|
| Rate for Payer: Networks By Design Commercial |
$6,413.55
|
| Rate for Payer: Prime Health Services Commercial |
$8,386.95
|
|
|
HC PARTIAL RMVL OF EYE FLUID
|
Facility
OP
|
$9,867.00
|
|
|
Service Code
|
CPT 67005
|
| Hospital Charge Code |
900501540
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$10,567.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,367.44
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,202.79
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,911.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: BCBS Transplant Transplant |
$5,920.20
|
| Rate for Payer: Caremore Medicare Advantage |
$2,911.63
|
| Rate for Payer: Cash Price |
$4,440.15
|
| Rate for Payer: Cash Price |
$4,440.15
|
| Rate for Payer: Cash Price |
$4,440.15
|
| Rate for Payer: Cash Price |
$4,440.15
|
| Rate for Payer: Central Health Plan Commercial |
$7,893.60
|
| Rate for Payer: Cigna of CA PPO |
$7,301.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,367.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,930.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,911.63
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,911.63
|
| Rate for Payer: Galaxy Health WC |
$8,386.95
|
| Rate for Payer: Global Benefits Group Commercial |
$5,920.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,880.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7,400.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,775.07
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$2,911.63
|
| Rate for Payer: Innovage PACE Commercial |
$4,367.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,581.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,911.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,973.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,901.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,901.58
|
| Rate for Payer: Multiplan Commercial |
$7,400.25
|
| Rate for Payer: Networks By Design Commercial |
$6,413.55
|
| Rate for Payer: Prime Health Services Commercial |
$8,386.95
|
| Rate for Payer: Prime Health Services Medicare |
$3,086.33
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,920.20
|
| Rate for Payer: Riverside University Health MISP |
$3,202.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,920.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,933.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,933.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,933.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,933.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,367.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,202.79
|
| Rate for Payer: Vantage Medical Group Senior |
$2,911.63
|
|
|
HC PARTL HAND EXT POWRD SELF-SUSP
|
Facility
OP
|
$12,600.00
|
|
|
Service Code
|
CPT L6025
|
| Hospital Charge Code |
905356025
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$4,410.00 |
| Max. Negotiated Rate |
$11,340.00 |
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,710.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6,930.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6,930.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,100.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,444.08
|
| Rate for Payer: BCBS Transplant Transplant |
$7,560.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,450.00
|
| Rate for Payer: Blue Shield of California EPN |
$6,854.40
|
| Rate for Payer: Cash Price |
$5,670.00
|
| Rate for Payer: Cash Price |
$5,670.00
|
| Rate for Payer: Central Health Plan Commercial |
$10,080.00
|
| Rate for Payer: Cigna of CA HMO |
$8,820.00
|
| Rate for Payer: Cigna of CA PPO |
$8,820.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,710.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,040.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$5,040.00
|
| Rate for Payer: Galaxy Health WC |
$10,710.00
|
| Rate for Payer: Global Benefits Group Commercial |
$7,560.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,340.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9,450.00
|
| Rate for Payer: IEHP medi-cal |
$4,410.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,404.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,166.00
|
| Rate for Payer: Multiplan Commercial |
$9,450.00
|
| Rate for Payer: Networks By Design Commercial |
$6,300.00
|
| Rate for Payer: Prime Health Services Commercial |
$10,710.00
|
| Rate for Payer: Riverside University Health MISP |
$5,040.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,560.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,560.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,300.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6,300.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6,300.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,300.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,710.00
|
| Rate for Payer: Vantage Medical Group Senior |
$10,710.00
|
|
|
HC PARTL HAND EXT POWRD SELF-SUSP
|
Facility
IP
|
$12,600.00
|
|
|
Service Code
|
CPT L6025
|
| Hospital Charge Code |
905356025
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$2,520.00 |
| Max. Negotiated Rate |
$11,340.00 |
| Rate for Payer: Blue Shield of California EPN |
$6,728.40
|
| Rate for Payer: Cash Price |
$5,670.00
|
| Rate for Payer: Central Health Plan Commercial |
$10,080.00
|
| Rate for Payer: Cigna of CA HMO |
$8,820.00
|
| Rate for Payer: Cigna of CA PPO |
$8,820.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,040.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$5,040.00
|
| Rate for Payer: Galaxy Health WC |
$10,710.00
|
| Rate for Payer: Global Benefits Group Commercial |
$7,560.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,340.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,404.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,520.00
|
| Rate for Payer: Multiplan Commercial |
$9,450.00
|
| Rate for Payer: Networks By Design Commercial |
$6,300.00
|
| Rate for Payer: Prime Health Services Commercial |
$10,710.00
|
|
|
HC PASSY MUIR VALVE FOR VENTS
|
Facility
OP
|
$288.00
|
|
| Hospital Charge Code |
900800705
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$259.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$174.90
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$244.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$158.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$158.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$139.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.15
|
| Rate for Payer: BCBS Transplant Transplant |
$172.80
|
| Rate for Payer: Blue Shield of California Commercial |
$181.15
|
| Rate for Payer: Blue Shield of California EPN |
$140.83
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Central Health Plan Commercial |
$230.40
|
| Rate for Payer: Cigna of CA HMO |
$184.32
|
| Rate for Payer: Cigna of CA PPO |
$213.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$244.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$259.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$216.00
|
| Rate for Payer: IEHP medi-cal |
$100.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$192.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.60
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$172.80
|
| Rate for Payer: Riverside University Health MISP |
$115.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$144.00
|
| Rate for Payer: United Healthcare All Other HMO |
$144.00
|
| Rate for Payer: United Healthcare HMO Rider |
$144.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$144.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$244.80
|
| Rate for Payer: Vantage Medical Group Senior |
$244.80
|
|
|
HC PASSY MUIR VALVE FOR VENTS
|
Facility
IP
|
$288.00
|
|
| Hospital Charge Code |
900800705
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$259.20 |
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Central Health Plan Commercial |
$230.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$259.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$192.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.60
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
|
|
HC PASSY MUIR VALVE SPEAKING
|
Facility
OP
|
$288.00
|
|
|
Service Code
|
CPT L8501
|
| Hospital Charge Code |
900800700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$534.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$534.30
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$244.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$158.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$158.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$139.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.15
|
| Rate for Payer: BCBS Transplant Transplant |
$172.80
|
| Rate for Payer: Blue Shield of California Commercial |
$181.15
|
| Rate for Payer: Blue Shield of California EPN |
$140.83
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Central Health Plan Commercial |
$230.40
|
| Rate for Payer: Cigna of CA HMO |
$184.32
|
| Rate for Payer: Cigna of CA PPO |
$213.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$244.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$259.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$216.00
|
| Rate for Payer: IEHP medi-cal |
$100.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$192.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.60
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$172.80
|
| Rate for Payer: Riverside University Health MISP |
$115.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$144.00
|
| Rate for Payer: United Healthcare All Other HMO |
$144.00
|
| Rate for Payer: United Healthcare HMO Rider |
$144.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$144.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$244.80
|
| Rate for Payer: Vantage Medical Group Senior |
$244.80
|
|
|
HC PASSY MUIR VALVE SPEAKING
|
Facility
IP
|
$288.00
|
|
|
Service Code
|
CPT L8501
|
| Hospital Charge Code |
900800700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$259.20 |
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Central Health Plan Commercial |
$230.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$259.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$192.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.60
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
|
|
HC PASTE MEDIHONEY TUBE .5FL OZ
|
Facility
OP
|
$38.95
|
|
|
Service Code
|
CPT A6240
|
| Hospital Charge Code |
901698328
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.79 |
| Max. Negotiated Rate |
$35.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32.15
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$33.11
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$21.42
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.01
|
| Rate for Payer: BCBS Transplant Transplant |
$23.37
|
| Rate for Payer: Blue Shield of California Commercial |
$24.50
|
| Rate for Payer: Blue Shield of California EPN |
$19.05
|
| Rate for Payer: Cash Price |
$17.53
|
| Rate for Payer: Cash Price |
$17.53
|
| Rate for Payer: Central Health Plan Commercial |
$31.16
|
| Rate for Payer: Cigna of CA HMO |
$24.93
|
| Rate for Payer: Cigna of CA PPO |
$28.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$15.58
|
| Rate for Payer: Galaxy Health WC |
$33.11
|
| Rate for Payer: Global Benefits Group Commercial |
$23.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.06
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$29.21
|
| Rate for Payer: IEHP medi-cal |
$13.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.79
|
| Rate for Payer: Multiplan Commercial |
$29.21
|
| Rate for Payer: Networks By Design Commercial |
$25.32
|
| Rate for Payer: Prime Health Services Commercial |
$33.11
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23.37
|
| Rate for Payer: Riverside University Health MISP |
$15.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.48
|
| Rate for Payer: United Healthcare All Other HMO |
$19.48
|
| Rate for Payer: United Healthcare HMO Rider |
$19.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$33.11
|
| Rate for Payer: Vantage Medical Group Senior |
$33.11
|
|
|
HC PASTE MEDIHONEY TUBE .5FL OZ
|
Facility
IP
|
$38.95
|
|
|
Service Code
|
CPT A6240
|
| Hospital Charge Code |
901698328
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.79 |
| Max. Negotiated Rate |
$35.06 |
| Rate for Payer: Cash Price |
$17.53
|
| Rate for Payer: Central Health Plan Commercial |
$31.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.58
|
| Rate for Payer: Galaxy Health WC |
$33.11
|
| Rate for Payer: Global Benefits Group Commercial |
$23.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.79
|
| Rate for Payer: Multiplan Commercial |
$29.21
|
| Rate for Payer: Networks By Design Commercial |
$25.32
|
| Rate for Payer: Prime Health Services Commercial |
$33.11
|
|
|
HC PATH CONSULT SURG ADDL BLOCK P
|
Facility
OP
|
$25.00
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
903800220
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$1,989.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$62.09
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$60.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$74.02
|
| Rate for Payer: BCBS Transplant Transplant |
$15.00
|
| Rate for Payer: Blue Shield of California Commercial |
$15.45
|
| Rate for Payer: Blue Shield of California EPN |
$12.15
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: Cigna of CA HMO |
$16.00
|
| Rate for Payer: Cigna of CA PPO |
$18.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$18.75
|
| Rate for Payer: IEHP medi-cal |
$8.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: Riverside University Health MISP |
$10.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.90
|
| Rate for Payer: United Healthcare All Other HMO |
$19.90
|
| Rate for Payer: United Healthcare HMO Rider |
$19.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,989.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.25
|
| Rate for Payer: Vantage Medical Group Senior |
$21.25
|
|
|
HC PATH CONSULT SURG ADDL BLOCK P
|
Facility
IP
|
$25.00
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
903800220
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
|
|
HC PATH CONSULT SURGERY FRZN PG
|
Facility
IP
|
$75.00
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
903800219
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.00 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Cash Price |
$33.75
|
| Rate for Payer: Central Health Plan Commercial |
$60.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.00
|
| Rate for Payer: Galaxy Health WC |
$63.75
|
| Rate for Payer: Global Benefits Group Commercial |
$45.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$67.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.00
|
| Rate for Payer: Multiplan Commercial |
$56.25
|
| Rate for Payer: Networks By Design Commercial |
$48.75
|
| Rate for Payer: Prime Health Services Commercial |
$63.75
|
|
|
HC PATH CONSULT SURGERY FRZN PG
|
Facility
OP
|
$75.00
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
903800219
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.00 |
| Max. Negotiated Rate |
$12,338.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$213.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$178.61
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$320.12
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$234.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$213.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$141.29
|
| Rate for Payer: BCBS Transplant Transplant |
$45.00
|
| Rate for Payer: Blue Shield of California Commercial |
$46.35
|
| Rate for Payer: Blue Shield of California EPN |
$36.45
|
| Rate for Payer: Caremore Medicare Advantage |
$213.41
|
| Rate for Payer: Cash Price |
$33.75
|
| Rate for Payer: Cash Price |
$33.75
|
| Rate for Payer: Central Health Plan Commercial |
$60.00
|
| Rate for Payer: Cigna of CA HMO |
$48.00
|
| Rate for Payer: Cigna of CA PPO |
$55.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$320.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$288.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$213.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$213.41
|
| Rate for Payer: Galaxy Health WC |
$63.75
|
| Rate for Payer: Global Benefits Group Commercial |
$45.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$67.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$56.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$349.99
|
| Rate for Payer: IEHP medi-cal |
$352.13
|
| Rate for Payer: IEHP Medicare Advantage |
$213.41
|
| Rate for Payer: Innovage PACE Commercial |
$320.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$213.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$285.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$285.97
|
| Rate for Payer: Multiplan Commercial |
$56.25
|
| Rate for Payer: Networks By Design Commercial |
$48.75
|
| Rate for Payer: Prime Health Services Commercial |
$63.75
|
| Rate for Payer: Prime Health Services Medicare |
$226.21
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$45.00
|
| Rate for Payer: Riverside University Health MISP |
$234.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$45.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12,338.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$320.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$234.75
|
| Rate for Payer: Vantage Medical Group Senior |
$213.41
|
|
|
HC PATTEN BOTTOM ADDITION LE
|
Facility
OP
|
$754.00
|
|
|
Service Code
|
CPT L2370
|
| Hospital Charge Code |
905352370
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$263.90 |
| Max. Negotiated Rate |
$1,065.77 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,065.77
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$640.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$414.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$414.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$365.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$445.46
|
| Rate for Payer: BCBS Transplant Transplant |
$452.40
|
| Rate for Payer: Blue Shield of California Commercial |
$565.50
|
| Rate for Payer: Blue Shield of California EPN |
$410.18
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Central Health Plan Commercial |
$603.20
|
| Rate for Payer: Cigna of CA HMO |
$527.80
|
| Rate for Payer: Cigna of CA PPO |
$527.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$640.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$301.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$301.60
|
| Rate for Payer: Galaxy Health WC |
$640.90
|
| Rate for Payer: Global Benefits Group Commercial |
$452.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$678.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$565.50
|
| Rate for Payer: IEHP medi-cal |
$263.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$502.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$309.14
|
| Rate for Payer: Multiplan Commercial |
$565.50
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$640.90
|
| Rate for Payer: Riverside University Health MISP |
$301.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$452.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$452.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$377.00
|
| Rate for Payer: United Healthcare All Other HMO |
$377.00
|
| Rate for Payer: United Healthcare HMO Rider |
$377.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$377.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$640.90
|
| Rate for Payer: Vantage Medical Group Senior |
$640.90
|
|
|
HC PATTEN BOTTOM ADDITION LE
|
Facility
IP
|
$754.00
|
|
|
Service Code
|
CPT L2370
|
| Hospital Charge Code |
905352370
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$150.80 |
| Max. Negotiated Rate |
$678.60 |
| Rate for Payer: Blue Shield of California EPN |
$402.64
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Central Health Plan Commercial |
$603.20
|
| Rate for Payer: Cigna of CA HMO |
$527.80
|
| Rate for Payer: Cigna of CA PPO |
$527.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$301.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$301.60
|
| Rate for Payer: Galaxy Health WC |
$640.90
|
| Rate for Payer: Global Benefits Group Commercial |
$452.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$678.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$502.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.80
|
| Rate for Payer: Multiplan Commercial |
$565.50
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$640.90
|
|
|
HC PCI BYPASS GRAFT
|
Facility
OP
|
$15,662.00
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
906820243
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,132.40 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,312.30
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: BCBS Transplant Transplant |
$9,397.20
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$7,047.90
|
| Rate for Payer: Cash Price |
$7,047.90
|
| Rate for Payer: Central Health Plan Commercial |
$12,529.60
|
| Rate for Payer: Cigna of CA PPO |
$11,589.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,556.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,745.22
|
| Rate for Payer: Galaxy Health WC |
$13,312.70
|
| Rate for Payer: Global Benefits Group Commercial |
$9,397.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,095.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$11,746.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: IEHP medi-cal |
$22,679.61
|
| Rate for Payer: IEHP Medicare Advantage |
$13,745.22
|
| Rate for Payer: Innovage PACE Commercial |
$20,617.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,446.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,132.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,418.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,418.59
|
| Rate for Payer: Multiplan Commercial |
$11,746.50
|
| Rate for Payer: Networks By Design Commercial |
$10,180.30
|
| Rate for Payer: Prime Health Services Commercial |
$13,312.70
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$9,397.20
|
| Rate for Payer: Riverside University Health MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,397.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,397.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC PCI BYPASS GRAFT
|
Facility
IP
|
$15,662.00
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
906811440
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,132.40 |
| Max. Negotiated Rate |
$14,095.80 |
| Rate for Payer: Cash Price |
$7,047.90
|
| Rate for Payer: Central Health Plan Commercial |
$12,529.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,264.80
|
| Rate for Payer: Galaxy Health WC |
$13,312.70
|
| Rate for Payer: Global Benefits Group Commercial |
$9,397.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,095.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,446.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,132.40
|
| Rate for Payer: Multiplan Commercial |
$11,746.50
|
| Rate for Payer: Networks By Design Commercial |
$10,180.30
|
| Rate for Payer: Prime Health Services Commercial |
$13,312.70
|
|
|
HC PCI BYPASS GRAFT
|
Facility
IP
|
$15,662.00
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
906820243
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,132.40 |
| Max. Negotiated Rate |
$14,095.80 |
| Rate for Payer: Cash Price |
$7,047.90
|
| Rate for Payer: Central Health Plan Commercial |
$12,529.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,264.80
|
| Rate for Payer: Galaxy Health WC |
$13,312.70
|
| Rate for Payer: Global Benefits Group Commercial |
$9,397.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,095.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,446.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,132.40
|
| Rate for Payer: Multiplan Commercial |
$11,746.50
|
| Rate for Payer: Networks By Design Commercial |
$10,180.30
|
| Rate for Payer: Prime Health Services Commercial |
$13,312.70
|
|
|
HC PCI BYPASS GRAFT
|
Facility
OP
|
$15,662.00
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
906811440
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,132.40 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,312.30
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: BCBS Transplant Transplant |
$9,397.20
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$7,047.90
|
| Rate for Payer: Cash Price |
$7,047.90
|
| Rate for Payer: Central Health Plan Commercial |
$12,529.60
|
| Rate for Payer: Cigna of CA PPO |
$11,589.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,556.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,745.22
|
| Rate for Payer: Galaxy Health WC |
$13,312.70
|
| Rate for Payer: Global Benefits Group Commercial |
$9,397.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,095.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$11,746.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: IEHP medi-cal |
$22,679.61
|
| Rate for Payer: IEHP Medicare Advantage |
$13,745.22
|
| Rate for Payer: Innovage PACE Commercial |
$20,617.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,446.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,132.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,418.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,418.59
|
| Rate for Payer: Multiplan Commercial |
$11,746.50
|
| Rate for Payer: Networks By Design Commercial |
$10,180.30
|
| Rate for Payer: Prime Health Services Commercial |
$13,312.70
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$9,397.20
|
| Rate for Payer: Riverside University Health MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,397.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,397.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC PCI BYPASS GRAFT ADD
|
Facility
OP
|
$28,104.00
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
906820262
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$25,293.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17,067.56
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$23,888.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,457.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$15,457.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: BCBS Transplant Transplant |
$16,862.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Cash Price |
$12,646.80
|
| Rate for Payer: Cash Price |
$12,646.80
|
| Rate for Payer: Cash Price |
$12,646.80
|
| Rate for Payer: Central Health Plan Commercial |
$22,483.20
|
| Rate for Payer: Cigna of CA HMO |
$17,986.56
|
| Rate for Payer: Cigna of CA PPO |
$20,796.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23,888.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,241.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$11,241.60
|
| Rate for Payer: Galaxy Health WC |
$23,888.40
|
| Rate for Payer: Global Benefits Group Commercial |
$16,862.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,293.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$21,078.00
|
| Rate for Payer: IEHP medi-cal |
$9,836.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,745.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,620.80
|
| Rate for Payer: Multiplan Commercial |
$21,078.00
|
| Rate for Payer: Networks By Design Commercial |
$18,267.60
|
| Rate for Payer: Prime Health Services Commercial |
$23,888.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$16,862.40
|
| Rate for Payer: Riverside University Health MISP |
$11,241.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,862.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16,862.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23,888.40
|
| Rate for Payer: Vantage Medical Group Senior |
$23,888.40
|
|
|
HC PCI BYPASS GRAFT ADD
|
Facility
IP
|
$28,104.00
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
906820262
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5,620.80 |
| Max. Negotiated Rate |
$25,293.60 |
| Rate for Payer: Cash Price |
$12,646.80
|
| Rate for Payer: Central Health Plan Commercial |
$22,483.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,241.60
|
| Rate for Payer: Galaxy Health WC |
$23,888.40
|
| Rate for Payer: Global Benefits Group Commercial |
$16,862.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,293.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,745.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,620.80
|
| Rate for Payer: Multiplan Commercial |
$21,078.00
|
| Rate for Payer: Networks By Design Commercial |
$18,267.60
|
| Rate for Payer: Prime Health Services Commercial |
$23,888.40
|
|
|
HC PCI BYPASS GRAFT ADD
|
Facility
IP
|
$28,104.00
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
906811464
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5,620.80 |
| Max. Negotiated Rate |
$25,293.60 |
| Rate for Payer: Cash Price |
$12,646.80
|
| Rate for Payer: Central Health Plan Commercial |
$22,483.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,241.60
|
| Rate for Payer: Galaxy Health WC |
$23,888.40
|
| Rate for Payer: Global Benefits Group Commercial |
$16,862.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,293.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,745.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,620.80
|
| Rate for Payer: Multiplan Commercial |
$21,078.00
|
| Rate for Payer: Networks By Design Commercial |
$18,267.60
|
| Rate for Payer: Prime Health Services Commercial |
$23,888.40
|
|
|
HC PCI BYPASS GRAFT ADD
|
Facility
OP
|
$28,104.00
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
906811464
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$25,293.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17,067.56
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$23,888.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,457.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$15,457.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: BCBS Transplant Transplant |
$16,862.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Cash Price |
$12,646.80
|
| Rate for Payer: Cash Price |
$12,646.80
|
| Rate for Payer: Cash Price |
$12,646.80
|
| Rate for Payer: Central Health Plan Commercial |
$22,483.20
|
| Rate for Payer: Cigna of CA HMO |
$17,986.56
|
| Rate for Payer: Cigna of CA PPO |
$20,796.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23,888.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,241.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$11,241.60
|
| Rate for Payer: Galaxy Health WC |
$23,888.40
|
| Rate for Payer: Global Benefits Group Commercial |
$16,862.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,293.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$21,078.00
|
| Rate for Payer: IEHP medi-cal |
$9,836.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,745.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,620.80
|
| Rate for Payer: Multiplan Commercial |
$21,078.00
|
| Rate for Payer: Networks By Design Commercial |
$18,267.60
|
| Rate for Payer: Prime Health Services Commercial |
$23,888.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$16,862.40
|
| Rate for Payer: Riverside University Health MISP |
$11,241.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,862.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16,862.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23,888.40
|
| Rate for Payer: Vantage Medical Group Senior |
$23,888.40
|
|
