|
HC REMOVE ARM/ELBOW LESION LT 3 CM
|
Facility
|
IP
|
$8,074.00
|
|
|
Service Code
|
CPT 24075
|
| Hospital Charge Code |
904000005
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,614.80 |
| Max. Negotiated Rate |
$7,266.60 |
| Rate for Payer: Adventist Health Commercial |
$1,614.80
|
| Rate for Payer: Cash Price |
$4,440.70
|
| Rate for Payer: Central Health Plan Commercial |
$6,459.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,229.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,229.60
|
| Rate for Payer: Galaxy Health WC |
$6,862.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,844.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,266.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,385.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,076.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,997.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,614.80
|
| Rate for Payer: Multiplan Commercial |
$6,055.50
|
| Rate for Payer: Networks By Design Commercial |
$5,248.10
|
| Rate for Payer: Prime Health Services Commercial |
$6,862.90
|
|
|
HC REMOVE BLOOD CLOT FROM EYE
|
Facility
|
OP
|
$10,888.00
|
|
|
Service Code
|
CPT 65930
|
| Hospital Charge Code |
900501635
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$210.81 |
| Max. Negotiated Rate |
$11,071.00 |
| Rate for Payer: Adventist Health Commercial |
$4,464.08
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,187.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,897.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,786.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$4,617.28
|
| Rate for Payer: Cash Price |
$5,988.40
|
| Rate for Payer: Cash Price |
$5,988.40
|
| Rate for Payer: Cash Price |
$5,988.40
|
| Rate for Payer: Cash Price |
$5,988.40
|
| Rate for Payer: Central Health Plan Commercial |
$8,710.40
|
| Rate for Payer: Cigna of CA HMO |
$6,968.32
|
| Rate for Payer: Cigna of CA PPO |
$8,057.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,187.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,897.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,912.16
|
| Rate for Payer: EPIC Health Plan Senior |
$2,897.90
|
| Rate for Payer: Galaxy Health WC |
$9,254.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,532.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,799.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,752.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,897.90
|
| Rate for Payer: InnovAge PACE Commercial |
$4,346.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,262.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$210.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,897.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,177.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,883.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,883.19
|
| Rate for Payer: Multiplan Commercial |
$8,166.00
|
| Rate for Payer: Multiplan WC |
$4,617.28
|
| Rate for Payer: Networks By Design Commercial |
$7,077.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,897.90
|
| Rate for Payer: Preferred Health Network WC |
$4,711.51
|
| Rate for Payer: Prime Health Services Commercial |
$9,254.80
|
| Rate for Payer: Prime Health Services Medicare |
$3,071.77
|
| Rate for Payer: Prime Health Services WC |
$4,570.16
|
| Rate for Payer: Riverside University Health System MISP |
$3,187.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,532.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,532.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,897.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,187.69
|
| Rate for Payer: Vantage Medical Group Senior |
$2,897.90
|
|
|
HC REMOVE BLOOD CLOT FROM EYE
|
Facility
|
IP
|
$10,888.00
|
|
|
Service Code
|
CPT 65930
|
| Hospital Charge Code |
900501635
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$2,177.60 |
| Max. Negotiated Rate |
$9,799.20 |
| Rate for Payer: Adventist Health Commercial |
$2,177.60
|
| Rate for Payer: Cash Price |
$5,988.40
|
| Rate for Payer: Central Health Plan Commercial |
$8,710.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,355.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4,355.20
|
| Rate for Payer: Galaxy Health WC |
$9,254.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,532.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,799.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,262.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,148.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,739.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,177.60
|
| Rate for Payer: Multiplan Commercial |
$8,166.00
|
| Rate for Payer: Networks By Design Commercial |
$7,077.20
|
| Rate for Payer: Prime Health Services Commercial |
$9,254.80
|
|
|
HC REMOVE BLOOD CLOT FROM EYE
|
Facility
|
OP
|
$10,888.00
|
|
|
Service Code
|
CPT 65930
|
| Hospital Charge Code |
900501635
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$210.81 |
| Max. Negotiated Rate |
$11,071.00 |
| Rate for Payer: Adventist Health Commercial |
$2,177.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,187.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,897.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,786.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$4,617.28
|
| Rate for Payer: Cash Price |
$5,988.40
|
| Rate for Payer: Cash Price |
$5,988.40
|
| Rate for Payer: Cash Price |
$5,988.40
|
| Rate for Payer: Cash Price |
$5,988.40
|
| Rate for Payer: Central Health Plan Commercial |
$8,710.40
|
| Rate for Payer: Cigna of CA HMO |
$6,968.32
|
| Rate for Payer: Cigna of CA PPO |
$8,057.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,187.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,897.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,912.16
|
| Rate for Payer: EPIC Health Plan Senior |
$2,897.90
|
| Rate for Payer: Galaxy Health WC |
$9,254.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,532.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,799.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,752.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,897.90
|
| Rate for Payer: InnovAge PACE Commercial |
$4,346.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,262.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$210.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,897.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,177.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,883.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,883.19
|
| Rate for Payer: Multiplan Commercial |
$8,166.00
|
| Rate for Payer: Multiplan WC |
$4,617.28
|
| Rate for Payer: Networks By Design Commercial |
$7,077.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,897.90
|
| Rate for Payer: Preferred Health Network WC |
$4,711.51
|
| Rate for Payer: Prime Health Services Commercial |
$9,254.80
|
| Rate for Payer: Prime Health Services Medicare |
$3,071.77
|
| Rate for Payer: Prime Health Services WC |
$4,570.16
|
| Rate for Payer: Riverside University Health System MISP |
$3,187.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,532.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,444.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,444.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,444.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,897.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,187.69
|
| Rate for Payer: Vantage Medical Group Senior |
$2,897.90
|
|
|
HC REMOVE BLOOD CLOT FROM EYE
|
Facility
|
IP
|
$10,888.00
|
|
|
Service Code
|
CPT 65930
|
| Hospital Charge Code |
900501635
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,177.60 |
| Max. Negotiated Rate |
$9,799.20 |
| Rate for Payer: Adventist Health Commercial |
$2,177.60
|
| Rate for Payer: Cash Price |
$5,988.40
|
| Rate for Payer: Central Health Plan Commercial |
$8,710.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,355.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4,355.20
|
| Rate for Payer: Galaxy Health WC |
$9,254.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,532.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,799.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,262.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,148.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,739.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,177.60
|
| Rate for Payer: Multiplan Commercial |
$8,166.00
|
| Rate for Payer: Networks By Design Commercial |
$7,077.20
|
| Rate for Payer: Prime Health Services Commercial |
$9,254.80
|
|
|
HC REMOVE CERCLAGE SUTURE
|
Facility
|
OP
|
$10,704.00
|
|
|
Service Code
|
CPT 59871
|
| Hospital Charge Code |
902400749
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$231.82 |
| Max. Negotiated Rate |
$11,071.00 |
| Rate for Payer: Adventist Health Commercial |
$2,140.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,039.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,059.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,443.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,039.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,786.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,540.14
|
| Rate for Payer: Blue Shield of California EPN |
$4,270.90
|
| Rate for Payer: Cash Price |
$5,887.20
|
| Rate for Payer: Cash Price |
$5,887.20
|
| Rate for Payer: Cash Price |
$5,887.20
|
| Rate for Payer: Central Health Plan Commercial |
$8,563.20
|
| Rate for Payer: Cigna of CA HMO |
$6,850.56
|
| Rate for Payer: Cigna of CA PPO |
$7,920.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,059.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,443.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,039.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,453.88
|
| Rate for Payer: EPIC Health Plan Senior |
$4,039.91
|
| Rate for Payer: Galaxy Health WC |
$9,098.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,422.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,633.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,625.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$231.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,039.91
|
| Rate for Payer: InnovAge PACE Commercial |
$6,059.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,139.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$256.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,039.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,140.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,413.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,413.48
|
| Rate for Payer: Multiplan Commercial |
$8,028.00
|
| Rate for Payer: Networks By Design Commercial |
$6,957.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,039.91
|
| Rate for Payer: Prime Health Services Commercial |
$9,098.40
|
| Rate for Payer: Prime Health Services Medicare |
$4,282.30
|
| Rate for Payer: Riverside University Health System MISP |
$4,443.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,422.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,422.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,091.00
|
| Rate for Payer: United Healthcare All Other HMO |
$839.00
|
| Rate for Payer: United Healthcare HMO Rider |
$635.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$581.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,039.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,059.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,443.90
|
| Rate for Payer: Vantage Medical Group Senior |
$4,039.91
|
|
|
HC REMOVE CERCLAGE SUTURE
|
Facility
|
IP
|
$10,704.00
|
|
|
Service Code
|
CPT 59871
|
| Hospital Charge Code |
902400749
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$2,140.80 |
| Max. Negotiated Rate |
$9,633.60 |
| Rate for Payer: Adventist Health Commercial |
$2,140.80
|
| Rate for Payer: Cash Price |
$5,887.20
|
| Rate for Payer: Central Health Plan Commercial |
$8,563.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,281.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,281.60
|
| Rate for Payer: Galaxy Health WC |
$9,098.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,422.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,633.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,139.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,078.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,625.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,140.80
|
| Rate for Payer: Multiplan Commercial |
$8,028.00
|
| Rate for Payer: Networks By Design Commercial |
$6,957.60
|
| Rate for Payer: Prime Health Services Commercial |
$9,098.40
|
|
|
HC REMOVE FIBRIN SHEATH
|
Facility
|
IP
|
$6,668.00
|
|
|
Service Code
|
CPT 36595
|
| Hospital Charge Code |
909020014
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,333.60 |
| Max. Negotiated Rate |
$6,001.20 |
| Rate for Payer: Adventist Health Commercial |
$1,333.60
|
| Rate for Payer: Cash Price |
$3,667.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,334.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,667.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,667.20
|
| Rate for Payer: Galaxy Health WC |
$5,667.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,000.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,001.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,447.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,540.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,127.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,333.60
|
| Rate for Payer: Multiplan Commercial |
$5,001.00
|
| Rate for Payer: Networks By Design Commercial |
$4,334.20
|
| Rate for Payer: Prime Health Services Commercial |
$5,667.80
|
|
|
HC REMOVE FIBRIN SHEATH
|
Facility
|
OP
|
$6,668.00
|
|
|
Service Code
|
CPT 36595
|
| Hospital Charge Code |
909020014
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,251.90 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$1,333.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$3,667.40
|
| Rate for Payer: Cash Price |
$3,667.40
|
| Rate for Payer: Cash Price |
$3,667.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,334.40
|
| Rate for Payer: Cigna of CA HMO |
$4,267.52
|
| Rate for Payer: Cigna of CA PPO |
$4,934.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$5,667.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,000.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,001.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,251.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: InnovAge PACE Commercial |
$5,998.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,447.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,382.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,333.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$5,001.00
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$4,334.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$5,667.80
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,000.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC REMOVE FOREIGN BODY (RENAL)
|
Facility
|
OP
|
$11,347.00
|
|
|
Service Code
|
CPT 50561
|
| Hospital Charge Code |
909081362
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$726.17 |
| Max. Negotiated Rate |
$16,122.00 |
| Rate for Payer: Adventist Health Commercial |
$2,269.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$6,459.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9,688.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,105.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,459.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$10,291.67
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$6,240.85
|
| Rate for Payer: Cash Price |
$6,240.85
|
| Rate for Payer: Cash Price |
$6,240.85
|
| Rate for Payer: Central Health Plan Commercial |
$9,077.60
|
| Rate for Payer: Cigna of CA HMO |
$7,262.08
|
| Rate for Payer: Cigna of CA PPO |
$8,396.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,688.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,105.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,459.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,719.99
|
| Rate for Payer: EPIC Health Plan Senior |
$6,459.25
|
| Rate for Payer: Galaxy Health WC |
$9,644.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,808.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,212.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10,593.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$726.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,459.25
|
| Rate for Payer: InnovAge PACE Commercial |
$9,688.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,568.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$802.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,459.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,269.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,655.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,655.40
|
| Rate for Payer: Multiplan Commercial |
$8,510.25
|
| Rate for Payer: Multiplan WC |
$10,291.67
|
| Rate for Payer: Networks By Design Commercial |
$7,375.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6,459.25
|
| Rate for Payer: Preferred Health Network WC |
$10,501.70
|
| Rate for Payer: Prime Health Services Commercial |
$9,644.95
|
| Rate for Payer: Prime Health Services Medicare |
$6,846.81
|
| Rate for Payer: Prime Health Services WC |
$10,186.65
|
| Rate for Payer: Riverside University Health System MISP |
$7,105.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,808.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,984.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$6,459.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9,688.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,105.18
|
| Rate for Payer: Vantage Medical Group Senior |
$6,459.25
|
|
|
HC REMOVE FOREIGN BODY (RENAL)
|
Facility
|
IP
|
$11,347.00
|
|
|
Service Code
|
CPT 50561
|
| Hospital Charge Code |
909081362
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,269.40 |
| Max. Negotiated Rate |
$10,212.30 |
| Rate for Payer: Adventist Health Commercial |
$2,269.40
|
| Rate for Payer: Cash Price |
$6,240.85
|
| Rate for Payer: Central Health Plan Commercial |
$9,077.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,538.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,538.80
|
| Rate for Payer: Galaxy Health WC |
$9,644.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,808.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,212.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,568.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,323.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,023.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,269.40
|
| Rate for Payer: Multiplan Commercial |
$8,510.25
|
| Rate for Payer: Networks By Design Commercial |
$7,375.55
|
| Rate for Payer: Prime Health Services Commercial |
$9,644.95
|
|
|
HC REMOVE FOREIGN BODY (URETER
|
Facility
|
IP
|
$11,347.00
|
|
|
Service Code
|
CPT 50961
|
| Hospital Charge Code |
909081363
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,269.40 |
| Max. Negotiated Rate |
$10,212.30 |
| Rate for Payer: Adventist Health Commercial |
$2,269.40
|
| Rate for Payer: Cash Price |
$6,240.85
|
| Rate for Payer: Central Health Plan Commercial |
$9,077.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,538.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,538.80
|
| Rate for Payer: Galaxy Health WC |
$9,644.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,808.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,212.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,568.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,323.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,023.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,269.40
|
| Rate for Payer: Multiplan Commercial |
$8,510.25
|
| Rate for Payer: Networks By Design Commercial |
$7,375.55
|
| Rate for Payer: Prime Health Services Commercial |
$9,644.95
|
|
|
HC REMOVE FOREIGN BODY (URETER
|
Facility
|
OP
|
$11,347.00
|
|
|
Service Code
|
CPT 50961
|
| Hospital Charge Code |
909081363
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$858.71 |
| Max. Negotiated Rate |
$16,122.00 |
| Rate for Payer: Adventist Health Commercial |
$2,269.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$6,459.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9,688.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,105.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,459.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$10,291.67
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$6,240.85
|
| Rate for Payer: Cash Price |
$6,240.85
|
| Rate for Payer: Cash Price |
$6,240.85
|
| Rate for Payer: Central Health Plan Commercial |
$9,077.60
|
| Rate for Payer: Cigna of CA HMO |
$7,262.08
|
| Rate for Payer: Cigna of CA PPO |
$8,396.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,688.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,105.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,459.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,719.99
|
| Rate for Payer: EPIC Health Plan Senior |
$6,459.25
|
| Rate for Payer: Galaxy Health WC |
$9,644.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,808.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,212.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10,593.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$858.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,459.25
|
| Rate for Payer: InnovAge PACE Commercial |
$9,688.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,568.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$948.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,459.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,269.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,655.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,655.40
|
| Rate for Payer: Multiplan Commercial |
$8,510.25
|
| Rate for Payer: Multiplan WC |
$10,291.67
|
| Rate for Payer: Networks By Design Commercial |
$7,375.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6,459.25
|
| Rate for Payer: Preferred Health Network WC |
$10,501.70
|
| Rate for Payer: Prime Health Services Commercial |
$9,644.95
|
| Rate for Payer: Prime Health Services Medicare |
$6,846.81
|
| Rate for Payer: Prime Health Services WC |
$10,186.65
|
| Rate for Payer: Riverside University Health System MISP |
$7,105.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,808.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,984.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$6,459.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9,688.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,105.18
|
| Rate for Payer: Vantage Medical Group Senior |
$6,459.25
|
|
|
HC REMOVE OBSTRUCT GAST/JEJ/CEC T
|
Facility
|
OP
|
$3,801.00
|
|
|
Service Code
|
CPT 49460
|
| Hospital Charge Code |
909020008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$760.20 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$760.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,191.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,898.06
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$2,090.55
|
| Rate for Payer: Cash Price |
$2,090.55
|
| Rate for Payer: Cash Price |
$2,090.55
|
| Rate for Payer: Central Health Plan Commercial |
$3,040.80
|
| Rate for Payer: Cigna of CA HMO |
$2,432.64
|
| Rate for Payer: Cigna of CA PPO |
$2,812.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,608.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,191.26
|
| Rate for Payer: Galaxy Health WC |
$3,230.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,280.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,420.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,953.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,169.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: InnovAge PACE Commercial |
$1,786.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,535.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,291.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,191.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$760.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,596.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,596.29
|
| Rate for Payer: Multiplan Commercial |
$2,850.75
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: Networks By Design Commercial |
$2,470.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,191.26
|
| Rate for Payer: Preferred Health Network WC |
$1,936.80
|
| Rate for Payer: Prime Health Services Commercial |
$3,230.85
|
| Rate for Payer: Prime Health Services Medicare |
$1,262.74
|
| Rate for Payer: Prime Health Services WC |
$1,878.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,310.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,280.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,191.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
HC REMOVE OBSTRUCT GAST/JEJ/CEC T
|
Facility
|
IP
|
$3,801.00
|
|
|
Service Code
|
CPT 49460
|
| Hospital Charge Code |
909020008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$760.20 |
| Max. Negotiated Rate |
$3,420.90 |
| Rate for Payer: Adventist Health Commercial |
$760.20
|
| Rate for Payer: Cash Price |
$2,090.55
|
| Rate for Payer: Central Health Plan Commercial |
$3,040.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,520.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,520.40
|
| Rate for Payer: Galaxy Health WC |
$3,230.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,280.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,420.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,535.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,448.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,352.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$760.20
|
| Rate for Payer: Multiplan Commercial |
$2,850.75
|
| Rate for Payer: Networks By Design Commercial |
$2,470.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,230.85
|
|
|
HC REMOVE PERICATH OBSTRUCTION
|
Facility
|
IP
|
$3,582.00
|
|
|
Service Code
|
CPT 75901
|
| Hospital Charge Code |
909020013
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$716.40 |
| Max. Negotiated Rate |
$3,223.80 |
| Rate for Payer: Adventist Health Commercial |
$716.40
|
| Rate for Payer: Cash Price |
$1,970.10
|
| Rate for Payer: Central Health Plan Commercial |
$2,865.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,432.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,432.80
|
| Rate for Payer: Galaxy Health WC |
$3,044.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,149.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,223.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,389.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,364.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,217.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$716.40
|
| Rate for Payer: Multiplan Commercial |
$2,686.50
|
| Rate for Payer: Networks By Design Commercial |
$2,328.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,044.70
|
|
|
HC REMOVE PERICATH OBSTRUCTION
|
Facility
|
OP
|
$3,582.00
|
|
|
Service Code
|
CPT 75901
|
| Hospital Charge Code |
909020013
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$77.24 |
| Max. Negotiated Rate |
$3,223.80 |
| Rate for Payer: Adventist Health Commercial |
$716.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,175.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,044.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,970.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,686.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$380.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$77.24
|
| Rate for Payer: Blue Shield of California Commercial |
$2,174.27
|
| Rate for Payer: Blue Shield of California EPN |
$1,422.05
|
| Rate for Payer: Cash Price |
$1,970.10
|
| Rate for Payer: Cash Price |
$1,970.10
|
| Rate for Payer: Central Health Plan Commercial |
$2,865.60
|
| Rate for Payer: Cigna of CA HMO |
$2,292.48
|
| Rate for Payer: Cigna of CA PPO |
$2,650.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,044.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,044.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,044.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,432.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,432.80
|
| Rate for Payer: Galaxy Health WC |
$3,044.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,149.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,223.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$170.90
|
| Rate for Payer: InnovAge PACE Commercial |
$1,791.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,389.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$188.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,217.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$716.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,507.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,507.40
|
| Rate for Payer: Multiplan Commercial |
$2,686.50
|
| Rate for Payer: Networks By Design Commercial |
$2,328.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,044.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,432.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,149.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,149.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,791.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,791.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,791.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,791.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,044.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,044.70
|
| Rate for Payer: Vantage Medical Group Senior |
$3,044.70
|
|
|
HC REMOVE PERM CANNULA/CATHETER
|
Facility
|
IP
|
$11,342.00
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
909001458
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,268.40 |
| Max. Negotiated Rate |
$10,207.80 |
| Rate for Payer: Adventist Health Commercial |
$2,268.40
|
| Rate for Payer: Cash Price |
$6,238.10
|
| Rate for Payer: Central Health Plan Commercial |
$9,073.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,536.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,536.80
|
| Rate for Payer: Galaxy Health WC |
$9,640.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,805.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,207.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,565.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,321.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,020.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,268.40
|
| Rate for Payer: Multiplan Commercial |
$8,506.50
|
| Rate for Payer: Networks By Design Commercial |
$7,372.30
|
| Rate for Payer: Prime Health Services Commercial |
$9,640.70
|
|
|
HC REMOVE PERM CANNULA/CATHETER
|
Facility
|
OP
|
$11,342.00
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
909001458
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$541.09 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$2,268.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$6,238.10
|
| Rate for Payer: Cash Price |
$6,238.10
|
| Rate for Payer: Cash Price |
$6,238.10
|
| Rate for Payer: Central Health Plan Commercial |
$9,073.60
|
| Rate for Payer: Cigna of CA HMO |
$7,258.88
|
| Rate for Payer: Cigna of CA PPO |
$8,393.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$9,640.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,805.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,207.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$541.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: InnovAge PACE Commercial |
$5,998.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,565.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$597.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,268.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$8,506.50
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$7,372.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$9,640.70
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,805.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC REMOVE PERM CANNULA/CATHETER
|
Facility
|
IP
|
$11,342.00
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
909001458
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,268.40 |
| Max. Negotiated Rate |
$10,207.80 |
| Rate for Payer: Adventist Health Commercial |
$2,268.40
|
| Rate for Payer: Cash Price |
$6,238.10
|
| Rate for Payer: Central Health Plan Commercial |
$9,073.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,536.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,536.80
|
| Rate for Payer: Galaxy Health WC |
$9,640.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,805.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,207.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,565.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,321.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,020.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,268.40
|
| Rate for Payer: Multiplan Commercial |
$8,506.50
|
| Rate for Payer: Networks By Design Commercial |
$7,372.30
|
| Rate for Payer: Prime Health Services Commercial |
$9,640.70
|
|
|
HC REMOVE PERM CANNULA/CATHETER
|
Facility
|
OP
|
$11,342.00
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
909001458
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$541.09 |
| Max. Negotiated Rate |
$10,207.80 |
| Rate for Payer: Adventist Health Commercial |
$2,268.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,929.96
|
| Rate for Payer: Blue Shield of California EPN |
$4,525.46
|
| Rate for Payer: Cash Price |
$6,238.10
|
| Rate for Payer: Cash Price |
$6,238.10
|
| Rate for Payer: Cash Price |
$6,238.10
|
| Rate for Payer: Central Health Plan Commercial |
$9,073.60
|
| Rate for Payer: Cigna of CA HMO |
$7,258.88
|
| Rate for Payer: Cigna of CA PPO |
$8,393.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$9,640.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,805.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,207.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$541.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: InnovAge PACE Commercial |
$5,998.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,565.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$597.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,268.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$8,506.50
|
| Rate for Payer: Networks By Design Commercial |
$7,372.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Prime Health Services Commercial |
$9,640.70
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,805.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,805.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,671.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,671.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,671.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,671.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC REMOVE RENAL TUBE W/FLUORO
|
Facility
|
IP
|
$2,900.00
|
|
|
Service Code
|
CPT 50389
|
| Hospital Charge Code |
909081853
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$580.00 |
| Max. Negotiated Rate |
$2,610.00 |
| Rate for Payer: Adventist Health Commercial |
$580.00
|
| Rate for Payer: Cash Price |
$1,595.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,320.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,160.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,160.00
|
| Rate for Payer: Galaxy Health WC |
$2,465.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,740.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,610.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,934.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,104.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,795.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$580.00
|
| Rate for Payer: Multiplan Commercial |
$2,175.00
|
| Rate for Payer: Networks By Design Commercial |
$1,885.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,465.00
|
|
|
HC REMOVE RENAL TUBE W/FLUORO
|
Facility
|
OP
|
$2,900.00
|
|
|
Service Code
|
CPT 50389
|
| Hospital Charge Code |
909081853
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$580.00 |
| Max. Negotiated Rate |
$6,333.00 |
| Rate for Payer: Adventist Health Commercial |
$580.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$848.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,272.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$932.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$848.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,351.26
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$1,595.00
|
| Rate for Payer: Cash Price |
$1,595.00
|
| Rate for Payer: Cash Price |
$1,595.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,320.00
|
| Rate for Payer: Cigna of CA HMO |
$1,856.00
|
| Rate for Payer: Cigna of CA PPO |
$2,146.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,272.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$932.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$848.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,144.92
|
| Rate for Payer: EPIC Health Plan Senior |
$848.09
|
| Rate for Payer: Galaxy Health WC |
$2,465.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,740.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,610.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,390.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$781.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$848.09
|
| Rate for Payer: InnovAge PACE Commercial |
$1,272.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,934.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$863.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$848.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$580.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,136.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,136.44
|
| Rate for Payer: Multiplan Commercial |
$2,175.00
|
| Rate for Payer: Multiplan WC |
$1,351.26
|
| Rate for Payer: Networks By Design Commercial |
$1,885.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$848.09
|
| Rate for Payer: Preferred Health Network WC |
$1,378.84
|
| Rate for Payer: Prime Health Services Commercial |
$2,465.00
|
| Rate for Payer: Prime Health Services Medicare |
$898.98
|
| Rate for Payer: Prime Health Services WC |
$1,337.47
|
| Rate for Payer: Riverside University Health System MISP |
$932.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,740.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$848.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,272.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$932.90
|
| Rate for Payer: Vantage Medical Group Senior |
$848.09
|
|
|
HC REMOVE TUN CV CATH WO PORT
|
Facility
|
OP
|
$7,704.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
900501636
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$233.73 |
| Max. Negotiated Rate |
$6,933.60 |
| Rate for Payer: Adventist Health Commercial |
$1,540.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$785.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$864.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$785.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,251.66
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$4,237.20
|
| Rate for Payer: Cash Price |
$4,237.20
|
| Rate for Payer: Cash Price |
$4,237.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,163.20
|
| Rate for Payer: Cigna of CA HMO |
$4,930.56
|
| Rate for Payer: Cigna of CA PPO |
$5,700.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$864.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$785.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,060.51
|
| Rate for Payer: EPIC Health Plan Senior |
$785.56
|
| Rate for Payer: Galaxy Health WC |
$6,548.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,622.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,933.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,288.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$233.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$785.56
|
| Rate for Payer: InnovAge PACE Commercial |
$1,178.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,138.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$258.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$785.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,540.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,052.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,052.65
|
| Rate for Payer: Multiplan Commercial |
$5,778.00
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$5,007.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$785.56
|
| Rate for Payer: Preferred Health Network WC |
$1,277.20
|
| Rate for Payer: Prime Health Services Commercial |
$6,548.40
|
| Rate for Payer: Prime Health Services Medicare |
$832.69
|
| Rate for Payer: Prime Health Services WC |
$1,238.88
|
| Rate for Payer: Riverside University Health System MISP |
$864.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,622.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$785.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$864.12
|
| Rate for Payer: Vantage Medical Group Senior |
$785.56
|
|
|
HC REMOVE TUN CV CATH WO PORT
|
Facility
|
IP
|
$7,704.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
909080021
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,540.80 |
| Max. Negotiated Rate |
$6,933.60 |
| Rate for Payer: Adventist Health Commercial |
$1,540.80
|
| Rate for Payer: Cash Price |
$4,237.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,163.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,081.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,081.60
|
| Rate for Payer: Galaxy Health WC |
$6,548.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,622.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,933.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,138.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,935.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,768.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,540.80
|
| Rate for Payer: Multiplan Commercial |
$5,778.00
|
| Rate for Payer: Networks By Design Commercial |
$5,007.60
|
| Rate for Payer: Prime Health Services Commercial |
$6,548.40
|
|
