|
HC PRIM ART MECH THROMBECTOMY
|
Facility
|
OP
|
$14,829.00
|
|
|
Service Code
|
CPT 37184
|
| Hospital Charge Code |
909081843
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$769.61 |
| Max. Negotiated Rate |
$36,149.78 |
| Rate for Payer: Adventist Health Medi-Cal |
$21,908.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$26,109.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21,908.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$29,952.68
|
| Rate for Payer: Blue Distinction Transplant |
$8,897.40
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Caremore Medicare Advantage |
$21,908.96
|
| Rate for Payer: Cash Price |
$6,673.05
|
| Rate for Payer: Cash Price |
$6,673.05
|
| Rate for Payer: Central Health Plan Commercial |
$11,863.20
|
| Rate for Payer: Cigna of CA PPO |
$10,973.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Dignity Health Media |
$21,908.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$24,099.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,577.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,908.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$21,908.96
|
| Rate for Payer: Galaxy Health WC |
$12,604.65
|
| Rate for Payer: Global Benefits Group Commercial |
$8,897.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,346.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11,121.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$35,930.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$36,149.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,908.96
|
| Rate for Payer: InnovAge PACE Commercial |
$32,863.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,890.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$769.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,965.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,358.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,358.01
|
| Rate for Payer: Multiplan Commercial |
$11,121.75
|
| Rate for Payer: Multiplan WC |
$29,952.68
|
| Rate for Payer: Networks By Design Commercial |
$9,638.85
|
| Rate for Payer: Preferred Health Network WC |
$30,563.96
|
| Rate for Payer: Prime Health Services Commercial |
$12,604.65
|
| Rate for Payer: Prime Health Services Medicare |
$23,223.50
|
| Rate for Payer: Prime Health Services WC |
$29,647.04
|
| Rate for Payer: Riverside University Health System MISP |
$24,099.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,897.40
|
| 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 |
$32,863.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: Vantage Medical Group Senior |
$21,908.96
|
|
|
HC PRIM ART M-THROMECTOMY ADD-ON
|
Facility
|
IP
|
$12,452.00
|
|
|
Service Code
|
CPT 37185
|
| Hospital Charge Code |
906820198
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,490.40 |
| Max. Negotiated Rate |
$11,206.80 |
| Rate for Payer: Cash Price |
$5,603.40
|
| Rate for Payer: Central Health Plan Commercial |
$9,961.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,980.80
|
| Rate for Payer: Galaxy Health WC |
$10,584.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7,471.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,206.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,305.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,744.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,490.40
|
| Rate for Payer: Multiplan Commercial |
$9,339.00
|
| Rate for Payer: Networks By Design Commercial |
$8,093.80
|
| Rate for Payer: Prime Health Services Commercial |
$10,584.20
|
|
|
HC PRIM ART M-THROMECTOMY ADD-ON
|
Facility
|
OP
|
$12,452.00
|
|
|
Service Code
|
CPT 37185
|
| Hospital Charge Code |
909081844
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$951.00 |
| Max. Negotiated Rate |
$11,206.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,584.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,848.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,848.60
|
| 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: Blue Distinction Transplant |
$7,471.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Cash Price |
$5,603.40
|
| Rate for Payer: Cash Price |
$5,603.40
|
| Rate for Payer: Central Health Plan Commercial |
$9,961.60
|
| Rate for Payer: Cigna of CA PPO |
$9,214.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,584.20
|
| Rate for Payer: Dignity Health Media |
$10,584.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,584.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,980.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,980.80
|
| Rate for Payer: Galaxy Health WC |
$10,584.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7,471.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,206.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9,339.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4,358.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,305.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,629.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,490.40
|
| Rate for Payer: Multiplan Commercial |
$9,339.00
|
| Rate for Payer: Networks By Design Commercial |
$8,093.80
|
| Rate for Payer: Prime Health Services Commercial |
$10,584.20
|
| Rate for Payer: Riverside University Health System MISP |
$4,980.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,471.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,584.20
|
| Rate for Payer: Vantage Medical Group Senior |
$10,584.20
|
|
|
HC PRIM ART M-THROMECTOMY ADD-ON
|
Facility
|
IP
|
$12,452.00
|
|
|
Service Code
|
CPT 37185
|
| Hospital Charge Code |
909081844
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,490.40 |
| Max. Negotiated Rate |
$11,206.80 |
| Rate for Payer: Cash Price |
$5,603.40
|
| Rate for Payer: Central Health Plan Commercial |
$9,961.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,980.80
|
| Rate for Payer: Galaxy Health WC |
$10,584.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7,471.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,206.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,305.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,744.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,490.40
|
| Rate for Payer: Multiplan Commercial |
$9,339.00
|
| Rate for Payer: Networks By Design Commercial |
$8,093.80
|
| Rate for Payer: Prime Health Services Commercial |
$10,584.20
|
|
|
HC PRIM ART M-THROMECTOMY ADD-ON
|
Facility
|
OP
|
$12,452.00
|
|
|
Service Code
|
CPT 37185
|
| Hospital Charge Code |
906820198
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$951.00 |
| Max. Negotiated Rate |
$11,206.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,584.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,848.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,848.60
|
| 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: Blue Distinction Transplant |
$7,471.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Cash Price |
$5,603.40
|
| Rate for Payer: Cash Price |
$5,603.40
|
| Rate for Payer: Central Health Plan Commercial |
$9,961.60
|
| Rate for Payer: Cigna of CA PPO |
$9,214.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,584.20
|
| Rate for Payer: Dignity Health Media |
$10,584.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,584.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,980.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,980.80
|
| Rate for Payer: Galaxy Health WC |
$10,584.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7,471.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,206.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9,339.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4,358.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,305.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,629.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,490.40
|
| Rate for Payer: Multiplan Commercial |
$9,339.00
|
| Rate for Payer: Networks By Design Commercial |
$8,093.80
|
| Rate for Payer: Prime Health Services Commercial |
$10,584.20
|
| Rate for Payer: Riverside University Health System MISP |
$4,980.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,471.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,584.20
|
| Rate for Payer: Vantage Medical Group Senior |
$10,584.20
|
|
|
HC PRIMOBOOT BARIATRIC PRPL/NAVY
|
Facility
|
OP
|
$291.90
|
|
| Hospital Charge Code |
901698652
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$58.38 |
| Max. Negotiated Rate |
$262.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$177.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$248.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$160.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$160.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$141.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$172.45
|
| Rate for Payer: Blue Distinction Transplant |
$175.14
|
| Rate for Payer: Blue Shield of California Commercial |
$183.61
|
| Rate for Payer: Blue Shield of California EPN |
$142.74
|
| Rate for Payer: Cash Price |
$131.36
|
| Rate for Payer: Central Health Plan Commercial |
$233.52
|
| Rate for Payer: Cigna of CA HMO |
$186.82
|
| Rate for Payer: Cigna of CA PPO |
$216.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$248.12
|
| Rate for Payer: Dignity Health Media |
$248.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$116.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$116.76
|
| Rate for Payer: Galaxy Health WC |
$248.12
|
| Rate for Payer: Global Benefits Group Commercial |
$175.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$262.71
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$218.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$102.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$194.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.38
|
| Rate for Payer: Multiplan Commercial |
$218.92
|
| Rate for Payer: Networks By Design Commercial |
$189.74
|
| Rate for Payer: Prime Health Services Commercial |
$248.12
|
| Rate for Payer: Riverside University Health System MISP |
$116.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$175.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$175.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$145.95
|
| Rate for Payer: United Healthcare All Other HMO |
$145.95
|
| Rate for Payer: United Healthcare HMO Rider |
$145.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$145.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.12
|
| Rate for Payer: Vantage Medical Group Senior |
$248.12
|
|
|
HC PRIMOBOOT BARIATRIC PRPL/NAVY
|
Facility
|
IP
|
$291.90
|
|
| Hospital Charge Code |
901698652
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$58.38 |
| Max. Negotiated Rate |
$262.71 |
| Rate for Payer: Cash Price |
$131.36
|
| Rate for Payer: Central Health Plan Commercial |
$233.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$116.76
|
| Rate for Payer: Galaxy Health WC |
$248.12
|
| Rate for Payer: Global Benefits Group Commercial |
$175.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$262.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$194.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.38
|
| Rate for Payer: Multiplan Commercial |
$218.92
|
| Rate for Payer: Networks By Design Commercial |
$189.74
|
| Rate for Payer: Prime Health Services Commercial |
$248.12
|
|
|
HC PRIMOBOOT STD PURPLE/NAVY
|
Facility
|
IP
|
$268.17
|
|
| Hospital Charge Code |
901698653
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$53.63 |
| Max. Negotiated Rate |
$241.35 |
| Rate for Payer: Cash Price |
$120.68
|
| Rate for Payer: Central Health Plan Commercial |
$214.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$107.27
|
| Rate for Payer: Galaxy Health WC |
$227.94
|
| Rate for Payer: Global Benefits Group Commercial |
$160.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$241.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$178.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.63
|
| Rate for Payer: Multiplan Commercial |
$201.13
|
| Rate for Payer: Networks By Design Commercial |
$174.31
|
| Rate for Payer: Prime Health Services Commercial |
$227.94
|
|
|
HC PRIMOBOOT STD PURPLE/NAVY
|
Facility
|
OP
|
$268.17
|
|
| Hospital Charge Code |
901698653
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$53.63 |
| Max. Negotiated Rate |
$241.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$162.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$227.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$147.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$129.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$158.43
|
| Rate for Payer: Blue Distinction Transplant |
$160.90
|
| Rate for Payer: Blue Shield of California Commercial |
$168.68
|
| Rate for Payer: Blue Shield of California EPN |
$131.14
|
| Rate for Payer: Cash Price |
$120.68
|
| Rate for Payer: Central Health Plan Commercial |
$214.54
|
| Rate for Payer: Cigna of CA HMO |
$171.63
|
| Rate for Payer: Cigna of CA PPO |
$198.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$227.94
|
| Rate for Payer: Dignity Health Media |
$227.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$227.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$107.27
|
| Rate for Payer: EPIC Health Plan Transplant |
$107.27
|
| Rate for Payer: Galaxy Health WC |
$227.94
|
| Rate for Payer: Global Benefits Group Commercial |
$160.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$241.35
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$201.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$93.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$178.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.63
|
| Rate for Payer: Multiplan Commercial |
$201.13
|
| Rate for Payer: Networks By Design Commercial |
$174.31
|
| Rate for Payer: Prime Health Services Commercial |
$227.94
|
| Rate for Payer: Riverside University Health System MISP |
$107.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$160.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$160.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$134.08
|
| Rate for Payer: United Healthcare All Other HMO |
$134.08
|
| Rate for Payer: United Healthcare HMO Rider |
$134.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$134.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$227.94
|
| Rate for Payer: Vantage Medical Group Senior |
$227.94
|
|
|
HC PRIMOBOOT STD W/WEDGE PUR/NAVY
|
Facility
|
OP
|
$291.90
|
|
| Hospital Charge Code |
901698678
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$58.38 |
| Max. Negotiated Rate |
$262.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$177.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$248.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$160.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$160.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$141.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$172.45
|
| Rate for Payer: Blue Distinction Transplant |
$175.14
|
| Rate for Payer: Blue Shield of California Commercial |
$183.61
|
| Rate for Payer: Blue Shield of California EPN |
$142.74
|
| Rate for Payer: Cash Price |
$131.36
|
| Rate for Payer: Central Health Plan Commercial |
$233.52
|
| Rate for Payer: Cigna of CA HMO |
$186.82
|
| Rate for Payer: Cigna of CA PPO |
$216.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$248.12
|
| Rate for Payer: Dignity Health Media |
$248.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$116.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$116.76
|
| Rate for Payer: Galaxy Health WC |
$248.12
|
| Rate for Payer: Global Benefits Group Commercial |
$175.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$262.71
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$218.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$102.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$194.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.38
|
| Rate for Payer: Multiplan Commercial |
$218.92
|
| Rate for Payer: Networks By Design Commercial |
$189.74
|
| Rate for Payer: Prime Health Services Commercial |
$248.12
|
| Rate for Payer: Riverside University Health System MISP |
$116.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$175.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$175.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$145.95
|
| Rate for Payer: United Healthcare All Other HMO |
$145.95
|
| Rate for Payer: United Healthcare HMO Rider |
$145.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$145.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.12
|
| Rate for Payer: Vantage Medical Group Senior |
$248.12
|
|
|
HC PRIMOBOOT STD W/WEDGE PUR/NAVY
|
Facility
|
IP
|
$291.90
|
|
| Hospital Charge Code |
901698678
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$58.38 |
| Max. Negotiated Rate |
$262.71 |
| Rate for Payer: Cash Price |
$131.36
|
| Rate for Payer: Central Health Plan Commercial |
$233.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$116.76
|
| Rate for Payer: Galaxy Health WC |
$248.12
|
| Rate for Payer: Global Benefits Group Commercial |
$175.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$262.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$194.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.38
|
| Rate for Payer: Multiplan Commercial |
$218.92
|
| Rate for Payer: Networks By Design Commercial |
$189.74
|
| Rate for Payer: Prime Health Services Commercial |
$248.12
|
|
|
HC PROBE NASOLACRIMAL DUCT W/ANES
|
Facility
|
OP
|
$4,586.00
|
|
|
Service Code
|
CPT 68811
|
| Hospital Charge Code |
900501656
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$212.91 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,379.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,211.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,919.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,751.60
|
| Rate for Payer: Caremore Medicare Advantage |
$2,919.67
|
| Rate for Payer: Cash Price |
$2,063.70
|
| Rate for Payer: Cash Price |
$2,063.70
|
| Rate for Payer: Cash Price |
$2,063.70
|
| Rate for Payer: Cash Price |
$2,063.70
|
| Rate for Payer: Central Health Plan Commercial |
$3,668.80
|
| Rate for Payer: Cigna of CA PPO |
$3,393.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,379.50
|
| Rate for Payer: Dignity Health Media |
$2,919.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,211.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,941.55
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,919.67
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,919.67
|
| Rate for Payer: Galaxy Health WC |
$3,898.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,751.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,127.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,439.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,788.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,919.67
|
| Rate for Payer: InnovAge PACE Commercial |
$4,379.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,058.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$212.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,919.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$917.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,912.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,912.36
|
| Rate for Payer: Multiplan Commercial |
$3,439.50
|
| Rate for Payer: Networks By Design Commercial |
$2,980.90
|
| Rate for Payer: Prime Health Services Commercial |
$3,898.10
|
| Rate for Payer: Prime Health Services Medicare |
$3,094.85
|
| Rate for Payer: Riverside University Health System MISP |
$3,211.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,751.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,293.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,293.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,293.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,293.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,379.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,211.64
|
| Rate for Payer: Vantage Medical Group Senior |
$2,919.67
|
|
|
HC PROBE NASOLACRIMAL DUCT W/ANES
|
Facility
|
IP
|
$4,586.00
|
|
|
Service Code
|
CPT 68811
|
| Hospital Charge Code |
900501656
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$917.20 |
| Max. Negotiated Rate |
$4,127.40 |
| Rate for Payer: Cash Price |
$2,063.70
|
| Rate for Payer: Central Health Plan Commercial |
$3,668.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,834.40
|
| Rate for Payer: Galaxy Health WC |
$3,898.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,751.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,127.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,058.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,747.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$917.20
|
| Rate for Payer: Multiplan Commercial |
$3,439.50
|
| Rate for Payer: Networks By Design Commercial |
$2,980.90
|
| Rate for Payer: Prime Health Services Commercial |
$3,898.10
|
|
|
HC PROBE NASOLACRIMAL DUCT W/TUBE
|
Facility
|
IP
|
$8,087.00
|
|
|
Service Code
|
CPT 68815
|
| Hospital Charge Code |
900501677
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,617.40 |
| Max. Negotiated Rate |
$7,278.30 |
| Rate for Payer: Cash Price |
$3,639.15
|
| Rate for Payer: Central Health Plan Commercial |
$6,469.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,234.80
|
| Rate for Payer: Galaxy Health WC |
$6,873.95
|
| Rate for Payer: Global Benefits Group Commercial |
$4,852.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,278.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,394.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,081.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,617.40
|
| Rate for Payer: Multiplan Commercial |
$6,065.25
|
| Rate for Payer: Networks By Design Commercial |
$5,256.55
|
| Rate for Payer: Prime Health Services Commercial |
$6,873.95
|
|
|
HC PROBE NASOLACRIMAL DUCT W/TUBE
|
Facility
|
OP
|
$8,087.00
|
|
|
Service Code
|
CPT 68815
|
| Hospital Charge Code |
900501677
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$84.17 |
| Max. Negotiated Rate |
$7,278.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,379.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,211.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,919.67
|
| 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: Blue Distinction Transplant |
$4,852.20
|
| Rate for Payer: Caremore Medicare Advantage |
$2,919.67
|
| Rate for Payer: Cash Price |
$3,639.15
|
| Rate for Payer: Cash Price |
$3,639.15
|
| Rate for Payer: Cash Price |
$3,639.15
|
| Rate for Payer: Cash Price |
$3,639.15
|
| Rate for Payer: Central Health Plan Commercial |
$6,469.60
|
| Rate for Payer: Cigna of CA PPO |
$5,984.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,379.50
|
| Rate for Payer: Dignity Health Media |
$2,919.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,211.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,941.55
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,919.67
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,919.67
|
| Rate for Payer: Galaxy Health WC |
$6,873.95
|
| Rate for Payer: Global Benefits Group Commercial |
$4,852.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,278.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,065.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,788.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,919.67
|
| Rate for Payer: InnovAge PACE Commercial |
$4,379.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,394.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$84.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,919.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,617.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,912.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,912.36
|
| Rate for Payer: Multiplan Commercial |
$6,065.25
|
| Rate for Payer: Networks By Design Commercial |
$5,256.55
|
| Rate for Payer: Prime Health Services Commercial |
$6,873.95
|
| Rate for Payer: Prime Health Services Medicare |
$3,094.85
|
| Rate for Payer: Riverside University Health System MISP |
$3,211.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,852.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,043.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,043.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,043.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,043.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,379.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,211.64
|
| Rate for Payer: Vantage Medical Group Senior |
$2,919.67
|
|
|
HC PROB NASOLACRIMAL DUCT
|
Facility
|
OP
|
$2,947.00
|
|
|
Service Code
|
CPT 68810
|
| Hospital Charge Code |
900501582
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$352.98 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$545.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$400.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$363.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,768.20
|
| Rate for Payer: Caremore Medicare Advantage |
$363.98
|
| Rate for Payer: Cash Price |
$1,326.15
|
| Rate for Payer: Cash Price |
$1,326.15
|
| Rate for Payer: Cash Price |
$1,326.15
|
| Rate for Payer: Cash Price |
$1,326.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,357.60
|
| Rate for Payer: Cigna of CA PPO |
$2,180.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$545.97
|
| Rate for Payer: Dignity Health Media |
$363.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$400.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$491.37
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$363.98
|
| Rate for Payer: EPIC Health Plan Transplant |
$363.98
|
| Rate for Payer: Galaxy Health WC |
$2,504.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,768.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,652.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,210.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$596.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$363.98
|
| Rate for Payer: InnovAge PACE Commercial |
$545.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,965.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$352.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$363.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$589.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$487.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$487.73
|
| Rate for Payer: Multiplan Commercial |
$2,210.25
|
| Rate for Payer: Networks By Design Commercial |
$1,915.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,504.95
|
| Rate for Payer: Prime Health Services Medicare |
$385.82
|
| Rate for Payer: Riverside University Health System MISP |
$400.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,768.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,473.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,473.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,473.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,473.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$545.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$400.38
|
| Rate for Payer: Vantage Medical Group Senior |
$363.98
|
|
|
HC PROB NASOLACRIMAL DUCT
|
Facility
|
IP
|
$2,947.00
|
|
|
Service Code
|
CPT 68810
|
| Hospital Charge Code |
900501582
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$589.40 |
| Max. Negotiated Rate |
$2,652.30 |
| Rate for Payer: Cash Price |
$1,326.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,357.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,178.80
|
| Rate for Payer: Galaxy Health WC |
$2,504.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,768.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,652.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,965.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,122.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$589.40
|
| Rate for Payer: Multiplan Commercial |
$2,210.25
|
| Rate for Payer: Networks By Design Commercial |
$1,915.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,504.95
|
|
|
HC PROB-NATRIURETIC PEPTIDE
|
Facility
|
IP
|
$592.00
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
900912306
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$118.40 |
| Max. Negotiated Rate |
$532.80 |
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Central Health Plan Commercial |
$473.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$236.80
|
| Rate for Payer: Galaxy Health WC |
$503.20
|
| Rate for Payer: Global Benefits Group Commercial |
$355.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$532.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$394.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$225.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.40
|
| Rate for Payer: Multiplan Commercial |
$444.00
|
| Rate for Payer: Networks By Design Commercial |
$384.80
|
| Rate for Payer: Prime Health Services Commercial |
$503.20
|
|
|
HC PROB-NATRIURETIC PEPTIDE
|
Facility
|
OP
|
$95.00
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
900912306
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.00 |
| Max. Negotiated Rate |
$301.27 |
| Rate for Payer: Adventist Health Medi-Cal |
$39.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$249.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$58.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$43.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$39.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$246.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$301.27
|
| Rate for Payer: Blue Distinction Transplant |
$57.00
|
| Rate for Payer: Blue Shield of California Commercial |
$58.71
|
| Rate for Payer: Blue Shield of California EPN |
$46.17
|
| Rate for Payer: Caremore Medicare Advantage |
$39.26
|
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: Central Health Plan Commercial |
$76.00
|
| Rate for Payer: Cigna of CA HMO |
$60.80
|
| Rate for Payer: Cigna of CA PPO |
$70.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$58.89
|
| Rate for Payer: Dignity Health Media |
$39.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$43.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$39.26
|
| Rate for Payer: EPIC Health Plan Transplant |
$39.26
|
| Rate for Payer: Galaxy Health WC |
$80.75
|
| Rate for Payer: Global Benefits Group Commercial |
$57.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$71.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$64.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$64.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39.26
|
| Rate for Payer: InnovAge PACE Commercial |
$58.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$52.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52.61
|
| Rate for Payer: Multiplan Commercial |
$71.25
|
| Rate for Payer: Networks By Design Commercial |
$61.75
|
| Rate for Payer: Prime Health Services Commercial |
$80.75
|
| Rate for Payer: Prime Health Services Medicare |
$41.62
|
| Rate for Payer: Riverside University Health System MISP |
$43.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$31.80
|
| Rate for Payer: United Healthcare All Other HMO |
$31.80
|
| Rate for Payer: United Healthcare HMO Rider |
$31.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$58.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$43.19
|
| Rate for Payer: Vantage Medical Group Senior |
$39.26
|
|
|
HC PROCALCITONIN
|
Facility
|
IP
|
$260.00
|
|
|
Service Code
|
CPT 84145
|
| Hospital Charge Code |
900912171
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$52.00 |
| Max. Negotiated Rate |
$234.00 |
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: Central Health Plan Commercial |
$208.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$104.00
|
| Rate for Payer: Galaxy Health WC |
$221.00
|
| Rate for Payer: Global Benefits Group Commercial |
$156.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$234.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$173.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$99.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.00
|
| Rate for Payer: Multiplan Commercial |
$195.00
|
| Rate for Payer: Networks By Design Commercial |
$169.00
|
| Rate for Payer: Prime Health Services Commercial |
$221.00
|
|
|
HC PROCALCITONIN
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
CPT 84145
|
| Hospital Charge Code |
900912171
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$196.59 |
| Rate for Payer: Adventist Health Medi-Cal |
$27.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$196.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$124.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$151.92
|
| Rate for Payer: Blue Distinction Transplant |
$61.20
|
| Rate for Payer: Blue Shield of California Commercial |
$63.04
|
| Rate for Payer: Blue Shield of California EPN |
$49.57
|
| Rate for Payer: Caremore Medicare Advantage |
$27.22
|
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Central Health Plan Commercial |
$81.60
|
| Rate for Payer: Cigna of CA HMO |
$65.28
|
| Rate for Payer: Cigna of CA PPO |
$75.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.83
|
| Rate for Payer: Dignity Health Media |
$27.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$27.22
|
| Rate for Payer: Galaxy Health WC |
$86.70
|
| Rate for Payer: Global Benefits Group Commercial |
$61.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$91.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$76.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$44.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$44.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27.22
|
| Rate for Payer: InnovAge PACE Commercial |
$40.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36.47
|
| Rate for Payer: Multiplan Commercial |
$76.50
|
| Rate for Payer: Networks By Design Commercial |
$66.30
|
| Rate for Payer: Prime Health Services Commercial |
$86.70
|
| Rate for Payer: Prime Health Services Medicare |
$28.85
|
| Rate for Payer: Riverside University Health System MISP |
$29.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$22.05
|
| Rate for Payer: United Healthcare All Other HMO |
$22.05
|
| Rate for Payer: United Healthcare HMO Rider |
$22.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.94
|
| Rate for Payer: Vantage Medical Group Senior |
$27.22
|
|
|
HC PROC BILIARY TRACT
|
Facility
|
OP
|
$9,093.00
|
|
|
Service Code
|
CPT 47999
|
| Hospital Charge Code |
907247999
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,132.59 |
| Max. Negotiated Rate |
$8,183.70 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,132.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5,522.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,402.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,372.14
|
| Rate for Payer: Blue Distinction Transplant |
$5,455.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,132.59
|
| Rate for Payer: Cash Price |
$4,091.85
|
| Rate for Payer: Cash Price |
$4,091.85
|
| Rate for Payer: Central Health Plan Commercial |
$7,274.40
|
| Rate for Payer: Cigna of CA PPO |
$6,728.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$7,729.05
|
| Rate for Payer: Global Benefits Group Commercial |
$5,455.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,183.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,819.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,868.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: InnovAge PACE Commercial |
$1,698.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,065.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,818.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,517.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$6,819.75
|
| Rate for Payer: Networks By Design Commercial |
$5,910.45
|
| Rate for Payer: Prime Health Services Commercial |
$7,729.05
|
| Rate for Payer: Prime Health Services Medicare |
$1,200.55
|
| Rate for Payer: Riverside University Health System MISP |
$1,245.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,455.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC PROC BILIARY TRACT
|
Facility
|
IP
|
$9,093.00
|
|
|
Service Code
|
CPT 47999
|
| Hospital Charge Code |
907247999
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,818.60 |
| Max. Negotiated Rate |
$8,183.70 |
| Rate for Payer: Cash Price |
$4,091.85
|
| Rate for Payer: Central Health Plan Commercial |
$7,274.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,637.20
|
| Rate for Payer: Galaxy Health WC |
$7,729.05
|
| Rate for Payer: Global Benefits Group Commercial |
$5,455.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,183.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,065.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,464.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,818.60
|
| Rate for Payer: Multiplan Commercial |
$6,819.75
|
| Rate for Payer: Networks By Design Commercial |
$5,910.45
|
| Rate for Payer: Prime Health Services Commercial |
$7,729.05
|
|
|
HC PROC BILIARY TRACT
|
Facility
|
IP
|
$9,093.00
|
|
|
Service Code
|
CPT 47999
|
| Hospital Charge Code |
907247999
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,818.60 |
| Max. Negotiated Rate |
$8,183.70 |
| Rate for Payer: Cash Price |
$4,091.85
|
| Rate for Payer: Central Health Plan Commercial |
$7,274.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,637.20
|
| Rate for Payer: Galaxy Health WC |
$7,729.05
|
| Rate for Payer: Global Benefits Group Commercial |
$5,455.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,183.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,065.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,464.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,818.60
|
| Rate for Payer: Multiplan Commercial |
$6,819.75
|
| Rate for Payer: Networks By Design Commercial |
$5,910.45
|
| Rate for Payer: Prime Health Services Commercial |
$7,729.05
|
|
|
HC PROC BILIARY TRACT
|
Facility
|
OP
|
$9,093.00
|
|
|
Service Code
|
CPT 47999
|
| Hospital Charge Code |
907247999
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$8,183.70 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,455.80
|
| Rate for Payer: Caremore Medicare Advantage |
$1,132.59
|
| Rate for Payer: Cash Price |
$4,091.85
|
| Rate for Payer: Cash Price |
$4,091.85
|
| Rate for Payer: Cash Price |
$4,091.85
|
| Rate for Payer: Cash Price |
$4,091.85
|
| Rate for Payer: Central Health Plan Commercial |
$7,274.40
|
| Rate for Payer: Cigna of CA PPO |
$6,728.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$7,729.05
|
| Rate for Payer: Global Benefits Group Commercial |
$5,455.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,183.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,819.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: InnovAge PACE Commercial |
$1,698.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,065.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,818.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,517.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$6,819.75
|
| Rate for Payer: Networks By Design Commercial |
$5,910.45
|
| Rate for Payer: Prime Health Services Commercial |
$7,729.05
|
| Rate for Payer: Prime Health Services Medicare |
$1,200.55
|
| Rate for Payer: Riverside University Health System MISP |
$1,245.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,455.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,546.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,546.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,546.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,546.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
