|
HC RENAL BILAT 2ND ORDER
|
Facility
|
OP
|
$8,446.00
|
|
|
Service Code
|
CPT 36254
|
| Hospital Charge Code |
909036254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$586.57 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$1,689.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,089.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,960.34
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$4,645.30
|
| Rate for Payer: Cash Price |
$4,645.30
|
| Rate for Payer: Cash Price |
$4,645.30
|
| Rate for Payer: Central Health Plan Commercial |
$6,756.80
|
| Rate for Payer: Cigna of CA HMO |
$5,405.44
|
| Rate for Payer: Cigna of CA PPO |
$6,250.04
|
| 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 |
$7,179.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,067.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,601.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$586.57
|
| 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 |
$5,633.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$647.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,689.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$6,334.50
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$5,489.90
|
| 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 |
$7,179.10
|
| 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 |
$5,067.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC RENAL BILAT SELECTIVE INC AO
|
Facility
|
IP
|
$10,436.00
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
906820207
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,087.20 |
| Max. Negotiated Rate |
$9,392.40 |
| Rate for Payer: Adventist Health Commercial |
$2,087.20
|
| Rate for Payer: Cash Price |
$5,739.80
|
| Rate for Payer: Central Health Plan Commercial |
$8,348.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,174.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,174.40
|
| Rate for Payer: Galaxy Health WC |
$8,870.60
|
| Rate for Payer: Global Benefits Group Commercial |
$6,261.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,392.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,960.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,976.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,459.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,087.20
|
| Rate for Payer: Multiplan Commercial |
$7,827.00
|
| Rate for Payer: Networks By Design Commercial |
$6,783.40
|
| Rate for Payer: Prime Health Services Commercial |
$8,870.60
|
|
|
HC RENAL BILAT SELECTIVE INC AO
|
Facility
|
IP
|
$8,871.00
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
909036252
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,774.20 |
| Max. Negotiated Rate |
$7,983.90 |
| Rate for Payer: Adventist Health Commercial |
$1,774.20
|
| Rate for Payer: Cash Price |
$4,879.05
|
| Rate for Payer: Central Health Plan Commercial |
$7,096.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,548.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,548.40
|
| Rate for Payer: Galaxy Health WC |
$7,540.35
|
| Rate for Payer: Global Benefits Group Commercial |
$5,322.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,983.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,916.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,379.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,491.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,774.20
|
| Rate for Payer: Multiplan Commercial |
$6,653.25
|
| Rate for Payer: Networks By Design Commercial |
$5,766.15
|
| Rate for Payer: Prime Health Services Commercial |
$7,540.35
|
|
|
HC RENAL BILAT SELECTIVE INC AO
|
Facility
|
OP
|
$8,871.00
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
909036252
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$510.36 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$1,774.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,295.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,209.94
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$4,879.05
|
| Rate for Payer: Cash Price |
$4,879.05
|
| Rate for Payer: Cash Price |
$4,879.05
|
| Rate for Payer: Central Health Plan Commercial |
$7,096.80
|
| Rate for Payer: Cigna of CA HMO |
$5,677.44
|
| Rate for Payer: Cigna of CA PPO |
$6,564.54
|
| 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 |
$7,540.35
|
| Rate for Payer: Global Benefits Group Commercial |
$5,322.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,983.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$510.36
|
| 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 |
$5,916.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$563.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,774.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$6,653.25
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$5,766.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$7,540.35
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,322.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC RENAL BILAT SELECTIVE INC AO
|
Facility
|
OP
|
$10,436.00
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
906820207
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$510.36 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$2,087.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,053.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,129.06
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$5,739.80
|
| Rate for Payer: Cash Price |
$5,739.80
|
| Rate for Payer: Cash Price |
$5,739.80
|
| Rate for Payer: Central Health Plan Commercial |
$8,348.80
|
| Rate for Payer: Cigna of CA HMO |
$6,679.04
|
| Rate for Payer: Cigna of CA PPO |
$7,722.64
|
| 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 |
$8,870.60
|
| Rate for Payer: Global Benefits Group Commercial |
$6,261.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,392.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$510.36
|
| 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 |
$6,960.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$563.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,087.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$7,827.00
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$6,783.40
|
| 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 |
$8,870.60
|
| 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 |
$6,261.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC RENAL BIOP PERCUT BY NEEDLE
|
Facility
|
IP
|
$437.00
|
|
|
Service Code
|
CPT 50200
|
| Hospital Charge Code |
903800069
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$87.40 |
| Max. Negotiated Rate |
$393.30 |
| Rate for Payer: Adventist Health Commercial |
$87.40
|
| Rate for Payer: Cash Price |
$240.35
|
| Rate for Payer: Central Health Plan Commercial |
$349.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$174.80
|
| Rate for Payer: EPIC Health Plan Senior |
$174.80
|
| Rate for Payer: Galaxy Health WC |
$371.45
|
| Rate for Payer: Global Benefits Group Commercial |
$262.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$393.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$291.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$166.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$270.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.40
|
| Rate for Payer: Multiplan Commercial |
$327.75
|
| Rate for Payer: Networks By Design Commercial |
$284.05
|
| Rate for Payer: Prime Health Services Commercial |
$371.45
|
|
|
HC RENAL BIOP PERCUT BY NEEDLE
|
Facility
|
OP
|
$437.00
|
|
|
Service Code
|
CPT 50200
|
| Hospital Charge Code |
903800069
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$87.40 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$87.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,058.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| 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 |
$3,280.13
|
| 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 |
$240.35
|
| Rate for Payer: Cash Price |
$240.35
|
| Rate for Payer: Cash Price |
$240.35
|
| Rate for Payer: Central Health Plan Commercial |
$349.60
|
| Rate for Payer: Cigna of CA HMO |
$279.68
|
| Rate for Payer: Cigna of CA PPO |
$323.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,779.22
|
| Rate for Payer: EPIC Health Plan Senior |
$2,058.68
|
| Rate for Payer: Galaxy Health WC |
$371.45
|
| Rate for Payer: Global Benefits Group Commercial |
$262.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$393.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$121.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: InnovAge PACE Commercial |
$3,088.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$291.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$134.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,758.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,758.63
|
| Rate for Payer: Multiplan Commercial |
$327.75
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$284.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$371.45
|
| Rate for Payer: Prime Health Services Medicare |
$2,182.20
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,264.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$262.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,058.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
HC RENAL BIOPSY,PERCUTANEOUS
|
Facility
|
IP
|
$6,469.00
|
|
|
Service Code
|
CPT 50200
|
| Hospital Charge Code |
909000163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,293.80 |
| Max. Negotiated Rate |
$5,822.10 |
| Rate for Payer: Adventist Health Commercial |
$1,293.80
|
| Rate for Payer: Cash Price |
$3,557.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,175.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,587.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,587.60
|
| Rate for Payer: Galaxy Health WC |
$5,498.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,881.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,822.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,314.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,464.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,004.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,293.80
|
| Rate for Payer: Multiplan Commercial |
$4,851.75
|
| Rate for Payer: Networks By Design Commercial |
$4,204.85
|
| Rate for Payer: Prime Health Services Commercial |
$5,498.65
|
|
|
HC RENAL BIOPSY,PERCUTANEOUS
|
Facility
|
OP
|
$6,469.00
|
|
|
Service Code
|
CPT 50200
|
| Hospital Charge Code |
909000163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$121.67 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$1,293.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,058.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| 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 |
$3,280.13
|
| 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 |
$3,557.95
|
| Rate for Payer: Cash Price |
$3,557.95
|
| Rate for Payer: Cash Price |
$3,557.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,175.20
|
| Rate for Payer: Cigna of CA HMO |
$4,140.16
|
| Rate for Payer: Cigna of CA PPO |
$4,787.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,779.22
|
| Rate for Payer: EPIC Health Plan Senior |
$2,058.68
|
| Rate for Payer: Galaxy Health WC |
$5,498.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,881.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,822.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$121.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: InnovAge PACE Commercial |
$3,088.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,314.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$134.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,293.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,758.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,758.63
|
| Rate for Payer: Multiplan Commercial |
$4,851.75
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$4,204.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$5,498.65
|
| Rate for Payer: Prime Health Services Medicare |
$2,182.20
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,264.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,881.40
|
| 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 |
$2,058.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
HC RENAL CYST ASPIRATION
|
Facility
|
OP
|
$3,650.00
|
|
|
Service Code
|
CPT 50390
|
| Hospital Charge Code |
909000164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$121.67 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$730.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$893.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$893.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,424.40
|
| 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 |
$2,007.50
|
| Rate for Payer: Cash Price |
$2,007.50
|
| Rate for Payer: Cash Price |
$2,007.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,920.00
|
| Rate for Payer: Cigna of CA HMO |
$2,336.00
|
| Rate for Payer: Cigna of CA PPO |
$2,701.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$983.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$893.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,206.87
|
| Rate for Payer: EPIC Health Plan Senior |
$893.98
|
| Rate for Payer: Galaxy Health WC |
$3,102.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,190.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,285.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,466.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$121.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$893.98
|
| Rate for Payer: InnovAge PACE Commercial |
$1,340.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,434.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$134.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$893.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$730.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,197.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,197.93
|
| Rate for Payer: Multiplan Commercial |
$2,737.50
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$2,372.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$893.98
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$3,102.50
|
| Rate for Payer: Prime Health Services Medicare |
$947.62
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$983.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,190.00
|
| 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 |
$893.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Vantage Medical Group Senior |
$893.98
|
|
|
HC RENAL CYST ASPIRATION
|
Facility
|
IP
|
$3,650.00
|
|
|
Service Code
|
CPT 50390
|
| Hospital Charge Code |
909000164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$730.00 |
| Max. Negotiated Rate |
$3,285.00 |
| Rate for Payer: Adventist Health Commercial |
$730.00
|
| Rate for Payer: Cash Price |
$2,007.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,920.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,460.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,460.00
|
| Rate for Payer: Galaxy Health WC |
$3,102.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,190.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,285.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,434.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,390.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,259.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$730.00
|
| Rate for Payer: Multiplan Commercial |
$2,737.50
|
| Rate for Payer: Networks By Design Commercial |
$2,372.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,102.50
|
|
|
HC RENAL CYST PUNCTURE
|
Facility
|
OP
|
$1,282.00
|
|
|
Service Code
|
CPT 74470
|
| Hospital Charge Code |
909001941
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$52.90 |
| Max. Negotiated Rate |
$1,153.80 |
| Rate for Payer: Adventist Health Commercial |
$256.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$696.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$778.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,045.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$766.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$696.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$260.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.90
|
| Rate for Payer: Blue Shield of California Commercial |
$778.17
|
| Rate for Payer: Blue Shield of California EPN |
$508.95
|
| Rate for Payer: Cash Price |
$705.10
|
| Rate for Payer: Cash Price |
$705.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,025.60
|
| Rate for Payer: Cigna of CA HMO |
$820.48
|
| Rate for Payer: Cigna of CA PPO |
$948.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,045.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$766.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$696.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$940.50
|
| Rate for Payer: EPIC Health Plan Senior |
$696.67
|
| Rate for Payer: Galaxy Health WC |
$1,089.70
|
| Rate for Payer: Global Benefits Group Commercial |
$769.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,153.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,142.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$74.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$696.67
|
| Rate for Payer: InnovAge PACE Commercial |
$1,045.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$855.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$696.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$933.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$933.54
|
| Rate for Payer: Multiplan Commercial |
$961.50
|
| Rate for Payer: Networks By Design Commercial |
$833.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$696.67
|
| Rate for Payer: Prime Health Services Commercial |
$1,089.70
|
| Rate for Payer: Prime Health Services Medicare |
$738.47
|
| Rate for Payer: Riverside University Health System MISP |
$766.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$769.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$769.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$605.23
|
| Rate for Payer: United Healthcare All Other HMO |
$605.23
|
| Rate for Payer: United Healthcare HMO Rider |
$605.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$605.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$696.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,045.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$766.34
|
| Rate for Payer: Vantage Medical Group Senior |
$696.67
|
|
|
HC RENAL CYST PUNCTURE
|
Facility
|
IP
|
$1,282.00
|
|
|
Service Code
|
CPT 74470
|
| Hospital Charge Code |
909001941
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$256.40 |
| Max. Negotiated Rate |
$1,153.80 |
| Rate for Payer: Adventist Health Commercial |
$256.40
|
| Rate for Payer: Cash Price |
$705.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,025.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$512.80
|
| Rate for Payer: EPIC Health Plan Senior |
$512.80
|
| Rate for Payer: Galaxy Health WC |
$1,089.70
|
| Rate for Payer: Global Benefits Group Commercial |
$769.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,153.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$855.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$488.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$793.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.40
|
| Rate for Payer: Multiplan Commercial |
$961.50
|
| Rate for Payer: Networks By Design Commercial |
$833.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,089.70
|
|
|
HC RENAL DILATOR SET
|
Facility
|
OP
|
$714.00
|
|
|
Service Code
|
CPT C1726
|
| Hospital Charge Code |
909081253
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$142.80 |
| Max. Negotiated Rate |
$642.60 |
| Rate for Payer: Adventist Health Commercial |
$142.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$606.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$392.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$535.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$326.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$395.34
|
| Rate for Payer: Blue Shield of California Commercial |
$551.92
|
| Rate for Payer: Blue Shield of California EPN |
$359.86
|
| Rate for Payer: Cash Price |
$392.70
|
| Rate for Payer: Central Health Plan Commercial |
$571.20
|
| Rate for Payer: Cigna of CA HMO |
$499.80
|
| Rate for Payer: Cigna of CA PPO |
$499.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$606.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$606.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$606.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$285.60
|
| Rate for Payer: EPIC Health Plan Senior |
$285.60
|
| Rate for Payer: Galaxy Health WC |
$606.90
|
| Rate for Payer: Global Benefits Group Commercial |
$428.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$642.60
|
| Rate for Payer: InnovAge PACE Commercial |
$357.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$476.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$272.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$441.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$142.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$499.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$499.80
|
| Rate for Payer: Multiplan Commercial |
$535.50
|
| Rate for Payer: Networks By Design Commercial |
$357.00
|
| Rate for Payer: Prime Health Services Commercial |
$606.90
|
| Rate for Payer: Riverside University Health System MISP |
$285.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$428.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$428.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$267.96
|
| Rate for Payer: United Healthcare All Other HMO |
$260.82
|
| Rate for Payer: United Healthcare HMO Rider |
$255.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$233.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$606.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$606.90
|
| Rate for Payer: Vantage Medical Group Senior |
$606.90
|
|
|
HC RENAL DILATOR SET
|
Facility
|
IP
|
$714.00
|
|
|
Service Code
|
CPT C1726
|
| Hospital Charge Code |
909081253
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$142.80 |
| Max. Negotiated Rate |
$642.60 |
| Rate for Payer: Adventist Health Commercial |
$142.80
|
| Rate for Payer: Blue Shield of California Commercial |
$551.92
|
| Rate for Payer: Blue Shield of California EPN |
$359.86
|
| Rate for Payer: Cash Price |
$392.70
|
| Rate for Payer: Central Health Plan Commercial |
$571.20
|
| Rate for Payer: Cigna of CA HMO |
$499.80
|
| Rate for Payer: Cigna of CA PPO |
$499.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$285.60
|
| Rate for Payer: EPIC Health Plan Senior |
$285.60
|
| Rate for Payer: Galaxy Health WC |
$606.90
|
| Rate for Payer: Global Benefits Group Commercial |
$428.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$642.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$476.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$272.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$441.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$142.80
|
| Rate for Payer: Multiplan Commercial |
$535.50
|
| Rate for Payer: Networks By Design Commercial |
$357.00
|
| Rate for Payer: Prime Health Services Commercial |
$606.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$267.96
|
| Rate for Payer: United Healthcare All Other HMO |
$260.82
|
| Rate for Payer: United Healthcare HMO Rider |
$255.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$233.84
|
|
|
HC RENAL FUNCTION PANEL
|
Facility
|
IP
|
$561.00
|
|
|
Service Code
|
CPT 80069
|
| Hospital Charge Code |
900912172
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$112.20 |
| Max. Negotiated Rate |
$504.90 |
| Rate for Payer: Adventist Health Commercial |
$112.20
|
| Rate for Payer: Cash Price |
$308.55
|
| Rate for Payer: Central Health Plan Commercial |
$448.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$224.40
|
| Rate for Payer: EPIC Health Plan Senior |
$224.40
|
| Rate for Payer: Galaxy Health WC |
$476.85
|
| Rate for Payer: Global Benefits Group Commercial |
$336.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$504.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$374.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$213.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$347.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.20
|
| Rate for Payer: Multiplan Commercial |
$420.75
|
| Rate for Payer: Networks By Design Commercial |
$364.65
|
| Rate for Payer: Prime Health Services Commercial |
$476.85
|
|
|
HC RENAL FUNCTION PANEL
|
Facility
|
OP
|
$561.00
|
|
|
Service Code
|
CPT 80069
|
| Hospital Charge Code |
900912172
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.03 |
| Max. Negotiated Rate |
$504.90 |
| Rate for Payer: Adventist Health Commercial |
$112.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$340.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$63.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.81
|
| Rate for Payer: Blue Shield of California Commercial |
$340.53
|
| Rate for Payer: Blue Shield of California EPN |
$222.72
|
| Rate for Payer: Cash Price |
$308.55
|
| Rate for Payer: Cash Price |
$308.55
|
| Rate for Payer: Central Health Plan Commercial |
$448.80
|
| Rate for Payer: Cigna of CA HMO |
$359.04
|
| Rate for Payer: Cigna of CA PPO |
$415.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.72
|
| Rate for Payer: EPIC Health Plan Senior |
$8.68
|
| Rate for Payer: Galaxy Health WC |
$476.85
|
| Rate for Payer: Global Benefits Group Commercial |
$336.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$504.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.68
|
| Rate for Payer: InnovAge PACE Commercial |
$13.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$374.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.63
|
| Rate for Payer: Multiplan Commercial |
$420.75
|
| Rate for Payer: Networks By Design Commercial |
$364.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.68
|
| Rate for Payer: Prime Health Services Commercial |
$476.85
|
| Rate for Payer: Prime Health Services Medicare |
$9.20
|
| Rate for Payer: Riverside University Health System MISP |
$9.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$336.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$336.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.03
|
| Rate for Payer: United Healthcare All Other HMO |
$7.03
|
| Rate for Payer: United Healthcare HMO Rider |
$7.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.03
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.55
|
| Rate for Payer: Vantage Medical Group Senior |
$8.68
|
|
|
HC RENAL SELECTIVE 2ND ORDER
|
Facility
|
IP
|
$9,937.00
|
|
|
Service Code
|
CPT 36253
|
| Hospital Charge Code |
906820206
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,987.40 |
| Max. Negotiated Rate |
$8,943.30 |
| Rate for Payer: Adventist Health Commercial |
$1,987.40
|
| Rate for Payer: Cash Price |
$5,465.35
|
| Rate for Payer: Central Health Plan Commercial |
$7,949.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,974.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,974.80
|
| Rate for Payer: Galaxy Health WC |
$8,446.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,962.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,943.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,627.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,786.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,151.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,987.40
|
| Rate for Payer: Multiplan Commercial |
$7,452.75
|
| Rate for Payer: Networks By Design Commercial |
$6,459.05
|
| Rate for Payer: Prime Health Services Commercial |
$8,446.45
|
|
|
HC RENAL SELECTIVE 2ND ORDER
|
Facility
|
IP
|
$8,446.00
|
|
|
Service Code
|
CPT 36253
|
| Hospital Charge Code |
909036253
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,689.20 |
| Max. Negotiated Rate |
$7,601.40 |
| Rate for Payer: Adventist Health Commercial |
$1,689.20
|
| Rate for Payer: Cash Price |
$4,645.30
|
| Rate for Payer: Central Health Plan Commercial |
$6,756.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,378.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,378.40
|
| Rate for Payer: Galaxy Health WC |
$7,179.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,067.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,601.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,633.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,217.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,228.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,689.20
|
| Rate for Payer: Multiplan Commercial |
$6,334.50
|
| Rate for Payer: Networks By Design Commercial |
$5,489.90
|
| Rate for Payer: Prime Health Services Commercial |
$7,179.10
|
|
|
HC RENAL SELECTIVE 2ND ORDER
|
Facility
|
OP
|
$8,446.00
|
|
|
Service Code
|
CPT 36253
|
| Hospital Charge Code |
909036253
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$544.31 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$1,689.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$6,868.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,868.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,089.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,960.34
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$10,943.70
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$4,645.30
|
| Rate for Payer: Cash Price |
$4,645.30
|
| Rate for Payer: Cash Price |
$4,645.30
|
| Rate for Payer: Central Health Plan Commercial |
$6,756.80
|
| Rate for Payer: Cigna of CA HMO |
$5,405.44
|
| Rate for Payer: Cigna of CA PPO |
$6,250.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,555.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,868.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,272.45
|
| Rate for Payer: EPIC Health Plan Senior |
$6,868.48
|
| Rate for Payer: Galaxy Health WC |
$7,179.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,067.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,601.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,264.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$544.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,868.48
|
| Rate for Payer: InnovAge PACE Commercial |
$10,302.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,633.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$601.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,868.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,689.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,203.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,203.76
|
| Rate for Payer: Multiplan Commercial |
$6,334.50
|
| Rate for Payer: Multiplan WC |
$10,943.70
|
| Rate for Payer: Networks By Design Commercial |
$5,489.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6,868.48
|
| Rate for Payer: Preferred Health Network WC |
$11,167.04
|
| Rate for Payer: Prime Health Services Commercial |
$7,179.10
|
| Rate for Payer: Prime Health Services Medicare |
$7,280.59
|
| Rate for Payer: Prime Health Services WC |
$10,832.03
|
| Rate for Payer: Riverside University Health System MISP |
$7,555.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,067.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$6,868.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Vantage Medical Group Senior |
$6,868.48
|
|
|
HC RENAL SELECTIVE 2ND ORDER
|
Facility
|
OP
|
$9,937.00
|
|
|
Service Code
|
CPT 36253
|
| Hospital Charge Code |
906820206
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$544.31 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$1,987.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$6,868.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,868.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,811.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,836.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$10,943.70
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$5,465.35
|
| Rate for Payer: Cash Price |
$5,465.35
|
| Rate for Payer: Cash Price |
$5,465.35
|
| Rate for Payer: Central Health Plan Commercial |
$7,949.60
|
| Rate for Payer: Cigna of CA HMO |
$6,359.68
|
| Rate for Payer: Cigna of CA PPO |
$7,353.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,555.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,868.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,272.45
|
| Rate for Payer: EPIC Health Plan Senior |
$6,868.48
|
| Rate for Payer: Galaxy Health WC |
$8,446.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,962.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,943.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,264.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$544.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,868.48
|
| Rate for Payer: InnovAge PACE Commercial |
$10,302.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,627.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$601.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,868.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,987.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,203.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,203.76
|
| Rate for Payer: Multiplan Commercial |
$7,452.75
|
| Rate for Payer: Multiplan WC |
$10,943.70
|
| Rate for Payer: Networks By Design Commercial |
$6,459.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6,868.48
|
| Rate for Payer: Preferred Health Network WC |
$11,167.04
|
| Rate for Payer: Prime Health Services Commercial |
$8,446.45
|
| Rate for Payer: Prime Health Services Medicare |
$7,280.59
|
| Rate for Payer: Prime Health Services WC |
$10,832.03
|
| Rate for Payer: Riverside University Health System MISP |
$7,555.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,962.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$6,868.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Vantage Medical Group Senior |
$6,868.48
|
|
|
HC RENAL SELECTIVE INC AO
|
Facility
|
IP
|
$8,871.00
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
909036251
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,774.20 |
| Max. Negotiated Rate |
$7,983.90 |
| Rate for Payer: Adventist Health Commercial |
$1,774.20
|
| Rate for Payer: Cash Price |
$4,879.05
|
| Rate for Payer: Central Health Plan Commercial |
$7,096.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,548.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,548.40
|
| Rate for Payer: Galaxy Health WC |
$7,540.35
|
| Rate for Payer: Global Benefits Group Commercial |
$5,322.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,983.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,916.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,379.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,491.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,774.20
|
| Rate for Payer: Multiplan Commercial |
$6,653.25
|
| Rate for Payer: Networks By Design Commercial |
$5,766.15
|
| Rate for Payer: Prime Health Services Commercial |
$7,540.35
|
|
|
HC RENAL SELECTIVE INC AO
|
Facility
|
OP
|
$8,871.00
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
909036251
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$391.90 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$1,774.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,295.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,209.94
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$4,879.05
|
| Rate for Payer: Cash Price |
$4,879.05
|
| Rate for Payer: Cash Price |
$4,879.05
|
| Rate for Payer: Central Health Plan Commercial |
$7,096.80
|
| Rate for Payer: Cigna of CA HMO |
$5,677.44
|
| Rate for Payer: Cigna of CA PPO |
$6,564.54
|
| 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 |
$7,540.35
|
| Rate for Payer: Global Benefits Group Commercial |
$5,322.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,983.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$391.90
|
| 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 |
$5,916.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$432.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,774.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$6,653.25
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$5,766.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$7,540.35
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,322.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC RENAL SELECTIVE INC AO
|
Facility
|
OP
|
$10,436.00
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
906820205
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$391.90 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$2,087.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,053.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,129.06
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$5,739.80
|
| Rate for Payer: Cash Price |
$5,739.80
|
| Rate for Payer: Cash Price |
$5,739.80
|
| Rate for Payer: Central Health Plan Commercial |
$8,348.80
|
| Rate for Payer: Cigna of CA HMO |
$6,679.04
|
| Rate for Payer: Cigna of CA PPO |
$7,722.64
|
| 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 |
$8,870.60
|
| Rate for Payer: Global Benefits Group Commercial |
$6,261.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,392.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$391.90
|
| 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 |
$6,960.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$432.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,087.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$7,827.00
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$6,783.40
|
| 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 |
$8,870.60
|
| 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 |
$6,261.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC RENAL SELECTIVE INC AO
|
Facility
|
IP
|
$10,436.00
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
906820205
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,087.20 |
| Max. Negotiated Rate |
$9,392.40 |
| Rate for Payer: Adventist Health Commercial |
$2,087.20
|
| Rate for Payer: Cash Price |
$5,739.80
|
| Rate for Payer: Central Health Plan Commercial |
$8,348.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,174.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,174.40
|
| Rate for Payer: Galaxy Health WC |
$8,870.60
|
| Rate for Payer: Global Benefits Group Commercial |
$6,261.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,392.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,960.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,976.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,459.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,087.20
|
| Rate for Payer: Multiplan Commercial |
$7,827.00
|
| Rate for Payer: Networks By Design Commercial |
$6,783.40
|
| Rate for Payer: Prime Health Services Commercial |
$8,870.60
|
|
