|
HC RHC,CORO CATH,CORO ANG,GRFT,IM
|
Facility
|
IP
|
$19,588.00
|
|
|
Service Code
|
CPT 93457
|
| Hospital Charge Code |
906811404
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,917.60 |
| Max. Negotiated Rate |
$17,629.20 |
| Rate for Payer: Adventist Health Commercial |
$3,917.60
|
| Rate for Payer: Cash Price |
$8,814.60
|
| Rate for Payer: Central Health Plan Commercial |
$15,670.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,835.20
|
| Rate for Payer: EPIC Health Plan Senior |
$7,835.20
|
| Rate for Payer: Galaxy Health WC |
$16,649.80
|
| Rate for Payer: Global Benefits Group Commercial |
$11,752.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,629.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,065.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,463.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,124.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,917.60
|
| Rate for Payer: Multiplan Commercial |
$14,691.00
|
| Rate for Payer: Networks By Design Commercial |
$12,732.20
|
| Rate for Payer: Prime Health Services Commercial |
$16,649.80
|
|
|
HC RHC,CORO CATH,CORO ANG,GRFT,IM
|
Facility
|
IP
|
$23,045.00
|
|
|
Service Code
|
CPT 93457
|
| Hospital Charge Code |
906820062
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,609.00 |
| Max. Negotiated Rate |
$20,740.50 |
| Rate for Payer: Adventist Health Commercial |
$4,609.00
|
| Rate for Payer: Cash Price |
$10,370.25
|
| Rate for Payer: Central Health Plan Commercial |
$18,436.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,218.00
|
| Rate for Payer: EPIC Health Plan Senior |
$9,218.00
|
| Rate for Payer: Galaxy Health WC |
$19,588.25
|
| Rate for Payer: Global Benefits Group Commercial |
$13,827.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,740.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,371.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,780.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,264.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,609.00
|
| Rate for Payer: Multiplan Commercial |
$17,283.75
|
| Rate for Payer: Networks By Design Commercial |
$14,979.25
|
| Rate for Payer: Prime Health Services Commercial |
$19,588.25
|
|
|
HC RHC,CORO CATH,CORO ANG,GRFT,IM
|
Facility
|
OP
|
$19,588.00
|
|
|
Service Code
|
CPT 93457
|
| Hospital Charge Code |
906811404
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,800.00 |
| Max. Negotiated Rate |
$26,788.00 |
| Rate for Payer: Adventist Health Commercial |
$3,917.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,086.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,086.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$8,814.60
|
| Rate for Payer: Cash Price |
$8,814.60
|
| Rate for Payer: Cash Price |
$8,814.60
|
| Rate for Payer: Central Health Plan Commercial |
$15,670.40
|
| Rate for Payer: Cigna of CA HMO |
$12,732.20
|
| Rate for Payer: Cigna of CA PPO |
$14,495.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,495.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,086.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,517.14
|
| Rate for Payer: EPIC Health Plan Senior |
$4,086.77
|
| Rate for Payer: Galaxy Health WC |
$16,649.80
|
| Rate for Payer: Global Benefits Group Commercial |
$11,752.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,629.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,702.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,920.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,086.77
|
| Rate for Payer: InnovAge PACE Commercial |
$6,130.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,065.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,121.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,086.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,917.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,476.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,476.27
|
| Rate for Payer: Multiplan Commercial |
$14,691.00
|
| Rate for Payer: Networks By Design Commercial |
$12,732.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,086.77
|
| Rate for Payer: Prime Health Services Commercial |
$16,649.80
|
| Rate for Payer: Prime Health Services Medicare |
$4,331.98
|
| Rate for Payer: Riverside University Health System MISP |
$4,495.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,752.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,630.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,086.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Vantage Medical Group Senior |
$4,086.77
|
|
|
HC RHC, CORO CATH, CORO ANGIO
|
Facility
|
OP
|
$22,126.00
|
|
|
Service Code
|
CPT 93456
|
| Hospital Charge Code |
906820061
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,694.22 |
| Max. Negotiated Rate |
$26,788.00 |
| Rate for Payer: Adventist Health Commercial |
$4,425.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,086.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,086.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$9,956.70
|
| Rate for Payer: Cash Price |
$9,956.70
|
| Rate for Payer: Cash Price |
$9,956.70
|
| Rate for Payer: Central Health Plan Commercial |
$17,700.80
|
| Rate for Payer: Cigna of CA HMO |
$14,381.90
|
| Rate for Payer: Cigna of CA PPO |
$16,373.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,495.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,086.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,517.14
|
| Rate for Payer: EPIC Health Plan Senior |
$4,086.77
|
| Rate for Payer: Galaxy Health WC |
$18,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$13,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,913.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,702.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,694.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,086.77
|
| Rate for Payer: InnovAge PACE Commercial |
$6,130.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,758.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,871.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,086.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,425.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,476.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,476.27
|
| Rate for Payer: Multiplan Commercial |
$16,594.50
|
| Rate for Payer: Networks By Design Commercial |
$14,381.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,086.77
|
| Rate for Payer: Prime Health Services Commercial |
$18,807.10
|
| Rate for Payer: Prime Health Services Medicare |
$4,331.98
|
| Rate for Payer: Riverside University Health System MISP |
$4,495.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,275.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,630.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,086.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Vantage Medical Group Senior |
$4,086.77
|
|
|
HC RHC, CORO CATH, CORO ANGIO
|
Facility
|
IP
|
$22,126.00
|
|
|
Service Code
|
CPT 93456
|
| Hospital Charge Code |
906820061
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,425.20 |
| Max. Negotiated Rate |
$19,913.40 |
| Rate for Payer: Adventist Health Commercial |
$4,425.20
|
| Rate for Payer: Cash Price |
$9,956.70
|
| Rate for Payer: Central Health Plan Commercial |
$17,700.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,850.40
|
| Rate for Payer: EPIC Health Plan Senior |
$8,850.40
|
| Rate for Payer: Galaxy Health WC |
$18,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$13,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,913.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,758.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,430.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,695.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,425.20
|
| Rate for Payer: Multiplan Commercial |
$16,594.50
|
| Rate for Payer: Networks By Design Commercial |
$14,381.90
|
| Rate for Payer: Prime Health Services Commercial |
$18,807.10
|
|
|
HC RHC, CORO CATH, CORO ANGIO
|
Facility
|
OP
|
$18,807.00
|
|
|
Service Code
|
CPT 93456
|
| Hospital Charge Code |
906811403
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,694.22 |
| Max. Negotiated Rate |
$26,788.00 |
| Rate for Payer: Adventist Health Commercial |
$3,761.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,086.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,086.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$8,463.15
|
| Rate for Payer: Cash Price |
$8,463.15
|
| Rate for Payer: Cash Price |
$8,463.15
|
| Rate for Payer: Central Health Plan Commercial |
$15,045.60
|
| Rate for Payer: Cigna of CA HMO |
$12,224.55
|
| Rate for Payer: Cigna of CA PPO |
$13,917.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,495.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,086.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,517.14
|
| Rate for Payer: EPIC Health Plan Senior |
$4,086.77
|
| Rate for Payer: Galaxy Health WC |
$15,985.95
|
| Rate for Payer: Global Benefits Group Commercial |
$11,284.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,926.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,702.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,694.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,086.77
|
| Rate for Payer: InnovAge PACE Commercial |
$6,130.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,544.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,871.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,086.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,761.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,476.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,476.27
|
| Rate for Payer: Multiplan Commercial |
$14,105.25
|
| Rate for Payer: Networks By Design Commercial |
$12,224.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,086.77
|
| Rate for Payer: Prime Health Services Commercial |
$15,985.95
|
| Rate for Payer: Prime Health Services Medicare |
$4,331.98
|
| Rate for Payer: Riverside University Health System MISP |
$4,495.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,284.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,630.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,086.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Vantage Medical Group Senior |
$4,086.77
|
|
|
HC RHC, CORO CATH, CORO ANGIO
|
Facility
|
IP
|
$18,807.00
|
|
|
Service Code
|
CPT 93456
|
| Hospital Charge Code |
906811403
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,761.40 |
| Max. Negotiated Rate |
$16,926.30 |
| Rate for Payer: Adventist Health Commercial |
$3,761.40
|
| Rate for Payer: Cash Price |
$8,463.15
|
| Rate for Payer: Central Health Plan Commercial |
$15,045.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,522.80
|
| Rate for Payer: EPIC Health Plan Senior |
$7,522.80
|
| Rate for Payer: Galaxy Health WC |
$15,985.95
|
| Rate for Payer: Global Benefits Group Commercial |
$11,284.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,926.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,544.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,165.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,641.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,761.40
|
| Rate for Payer: Multiplan Commercial |
$14,105.25
|
| Rate for Payer: Networks By Design Commercial |
$12,224.55
|
| Rate for Payer: Prime Health Services Commercial |
$15,985.95
|
|
|
HC RHC & LHC,CORONARY ANG,W/WO LV
|
Facility
|
OP
|
$23,939.00
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
906820065
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,800.00 |
| Max. Negotiated Rate |
$26,788.00 |
| Rate for Payer: Adventist Health Commercial |
$4,787.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,086.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,086.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$10,772.55
|
| Rate for Payer: Cash Price |
$10,772.55
|
| Rate for Payer: Cash Price |
$10,772.55
|
| Rate for Payer: Central Health Plan Commercial |
$19,151.20
|
| Rate for Payer: Cigna of CA HMO |
$15,560.35
|
| Rate for Payer: Cigna of CA PPO |
$17,714.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,495.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,086.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,517.14
|
| Rate for Payer: EPIC Health Plan Senior |
$4,086.77
|
| Rate for Payer: Galaxy Health WC |
$20,348.15
|
| Rate for Payer: Global Benefits Group Commercial |
$14,363.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21,545.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,702.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,926.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,086.77
|
| Rate for Payer: InnovAge PACE Commercial |
$6,130.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,967.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,128.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,086.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,787.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,476.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,476.27
|
| Rate for Payer: Multiplan Commercial |
$17,954.25
|
| Rate for Payer: Networks By Design Commercial |
$15,560.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,086.77
|
| Rate for Payer: Prime Health Services Commercial |
$20,348.15
|
| Rate for Payer: Prime Health Services Medicare |
$4,331.98
|
| Rate for Payer: Riverside University Health System MISP |
$4,495.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,363.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,630.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,086.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Vantage Medical Group Senior |
$4,086.77
|
|
|
HC RHC & LHC,CORONARY ANG,W/WO LV
|
Facility
|
OP
|
$20,348.00
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
906811407
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,800.00 |
| Max. Negotiated Rate |
$26,788.00 |
| Rate for Payer: Adventist Health Commercial |
$4,069.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,086.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,086.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$9,156.60
|
| Rate for Payer: Cash Price |
$9,156.60
|
| Rate for Payer: Cash Price |
$9,156.60
|
| Rate for Payer: Central Health Plan Commercial |
$16,278.40
|
| Rate for Payer: Cigna of CA HMO |
$13,226.20
|
| Rate for Payer: Cigna of CA PPO |
$15,057.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,495.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,086.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,517.14
|
| Rate for Payer: EPIC Health Plan Senior |
$4,086.77
|
| Rate for Payer: Galaxy Health WC |
$17,295.80
|
| Rate for Payer: Global Benefits Group Commercial |
$12,208.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,313.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,702.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,926.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,086.77
|
| Rate for Payer: InnovAge PACE Commercial |
$6,130.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,572.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,128.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,086.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,069.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,476.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,476.27
|
| Rate for Payer: Multiplan Commercial |
$15,261.00
|
| Rate for Payer: Networks By Design Commercial |
$13,226.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,086.77
|
| Rate for Payer: Prime Health Services Commercial |
$17,295.80
|
| Rate for Payer: Prime Health Services Medicare |
$4,331.98
|
| Rate for Payer: Riverside University Health System MISP |
$4,495.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,208.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,630.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,086.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Vantage Medical Group Senior |
$4,086.77
|
|
|
HC RHC & LHC,CORONARY ANG,W/WO LV
|
Facility
|
IP
|
$20,348.00
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
906811407
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,069.60 |
| Max. Negotiated Rate |
$18,313.20 |
| Rate for Payer: Adventist Health Commercial |
$4,069.60
|
| Rate for Payer: Cash Price |
$9,156.60
|
| Rate for Payer: Central Health Plan Commercial |
$16,278.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,139.20
|
| Rate for Payer: EPIC Health Plan Senior |
$8,139.20
|
| Rate for Payer: Galaxy Health WC |
$17,295.80
|
| Rate for Payer: Global Benefits Group Commercial |
$12,208.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,313.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,572.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,752.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,595.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,069.60
|
| Rate for Payer: Multiplan Commercial |
$15,261.00
|
| Rate for Payer: Networks By Design Commercial |
$13,226.20
|
| Rate for Payer: Prime Health Services Commercial |
$17,295.80
|
|
|
HC RHC & LHC,CORONARY ANG,W/WO LV
|
Facility
|
IP
|
$23,939.00
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
906820065
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,787.80 |
| Max. Negotiated Rate |
$21,545.10 |
| Rate for Payer: Adventist Health Commercial |
$4,787.80
|
| Rate for Payer: Cash Price |
$10,772.55
|
| Rate for Payer: Central Health Plan Commercial |
$19,151.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,575.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9,575.60
|
| Rate for Payer: Galaxy Health WC |
$20,348.15
|
| Rate for Payer: Global Benefits Group Commercial |
$14,363.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21,545.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,967.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,120.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,818.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,787.80
|
| Rate for Payer: Multiplan Commercial |
$17,954.25
|
| Rate for Payer: Networks By Design Commercial |
$15,560.35
|
| Rate for Payer: Prime Health Services Commercial |
$20,348.15
|
|
|
HC RHC & LHC,CORO,W/WO LV,GRFT,IM
|
Facility
|
IP
|
$14,216.00
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
906811408
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,843.20 |
| Max. Negotiated Rate |
$12,794.40 |
| Rate for Payer: Adventist Health Commercial |
$2,843.20
|
| Rate for Payer: Cash Price |
$6,397.20
|
| Rate for Payer: Central Health Plan Commercial |
$11,372.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,686.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,686.40
|
| Rate for Payer: Galaxy Health WC |
$12,083.60
|
| Rate for Payer: Global Benefits Group Commercial |
$8,529.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,794.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,482.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,416.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,799.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,843.20
|
| Rate for Payer: Multiplan Commercial |
$10,662.00
|
| Rate for Payer: Networks By Design Commercial |
$9,240.40
|
| Rate for Payer: Prime Health Services Commercial |
$12,083.60
|
|
|
HC RHC & LHC,CORO,W/WO LV,GRFT,IM
|
Facility
|
IP
|
$16,725.00
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
906820066
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,345.00 |
| Max. Negotiated Rate |
$15,052.50 |
| Rate for Payer: Adventist Health Commercial |
$3,345.00
|
| Rate for Payer: Cash Price |
$7,526.25
|
| Rate for Payer: Central Health Plan Commercial |
$13,380.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,690.00
|
| Rate for Payer: EPIC Health Plan Senior |
$6,690.00
|
| Rate for Payer: Galaxy Health WC |
$14,216.25
|
| Rate for Payer: Global Benefits Group Commercial |
$10,035.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,052.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,155.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,372.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,352.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,345.00
|
| Rate for Payer: Multiplan Commercial |
$12,543.75
|
| Rate for Payer: Networks By Design Commercial |
$10,871.25
|
| Rate for Payer: Prime Health Services Commercial |
$14,216.25
|
|
|
HC RHC & LHC,CORO,W/WO LV,GRFT,IM
|
Facility
|
OP
|
$14,216.00
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
906811408
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,800.00 |
| Max. Negotiated Rate |
$26,788.00 |
| Rate for Payer: Adventist Health Commercial |
$2,843.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,086.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,086.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$6,397.20
|
| Rate for Payer: Cash Price |
$6,397.20
|
| Rate for Payer: Cash Price |
$6,397.20
|
| Rate for Payer: Central Health Plan Commercial |
$11,372.80
|
| Rate for Payer: Cigna of CA HMO |
$9,240.40
|
| Rate for Payer: Cigna of CA PPO |
$10,519.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,495.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,086.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,517.14
|
| Rate for Payer: EPIC Health Plan Senior |
$4,086.77
|
| Rate for Payer: Galaxy Health WC |
$12,083.60
|
| Rate for Payer: Global Benefits Group Commercial |
$8,529.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,794.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,702.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,211.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,086.77
|
| Rate for Payer: InnovAge PACE Commercial |
$6,130.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,482.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,442.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,086.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,843.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,476.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,476.27
|
| Rate for Payer: Multiplan Commercial |
$10,662.00
|
| Rate for Payer: Networks By Design Commercial |
$9,240.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,086.77
|
| Rate for Payer: Prime Health Services Commercial |
$12,083.60
|
| Rate for Payer: Prime Health Services Medicare |
$4,331.98
|
| Rate for Payer: Riverside University Health System MISP |
$4,495.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,529.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,630.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,086.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Vantage Medical Group Senior |
$4,086.77
|
|
|
HC RHC & LHC,CORO,W/WO LV,GRFT,IM
|
Facility
|
OP
|
$16,725.00
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
906820066
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,800.00 |
| Max. Negotiated Rate |
$26,788.00 |
| Rate for Payer: Adventist Health Commercial |
$3,345.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,086.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,086.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$7,526.25
|
| Rate for Payer: Cash Price |
$7,526.25
|
| Rate for Payer: Cash Price |
$7,526.25
|
| Rate for Payer: Central Health Plan Commercial |
$13,380.00
|
| Rate for Payer: Cigna of CA HMO |
$10,871.25
|
| Rate for Payer: Cigna of CA PPO |
$12,376.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,495.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,086.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,517.14
|
| Rate for Payer: EPIC Health Plan Senior |
$4,086.77
|
| Rate for Payer: Galaxy Health WC |
$14,216.25
|
| Rate for Payer: Global Benefits Group Commercial |
$10,035.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,052.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,702.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,211.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,086.77
|
| Rate for Payer: InnovAge PACE Commercial |
$6,130.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,155.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,442.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,086.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,345.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,476.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,476.27
|
| Rate for Payer: Multiplan Commercial |
$12,543.75
|
| Rate for Payer: Networks By Design Commercial |
$10,871.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,086.77
|
| Rate for Payer: Prime Health Services Commercial |
$14,216.25
|
| Rate for Payer: Prime Health Services Medicare |
$4,331.98
|
| Rate for Payer: Riverside University Health System MISP |
$4,495.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,035.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,630.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,086.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Vantage Medical Group Senior |
$4,086.77
|
|
|
HC RHC & LHC W/WO LV
|
Facility
|
IP
|
$15,455.00
|
|
|
Service Code
|
CPT 93453
|
| Hospital Charge Code |
906820088
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,091.00 |
| Max. Negotiated Rate |
$13,909.50 |
| Rate for Payer: Adventist Health Commercial |
$3,091.00
|
| Rate for Payer: Cash Price |
$6,954.75
|
| Rate for Payer: Central Health Plan Commercial |
$12,364.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,182.00
|
| Rate for Payer: EPIC Health Plan Senior |
$6,182.00
|
| Rate for Payer: Galaxy Health WC |
$13,136.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9,273.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,909.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,308.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,888.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,566.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,091.00
|
| Rate for Payer: Multiplan Commercial |
$11,591.25
|
| Rate for Payer: Networks By Design Commercial |
$10,045.75
|
| Rate for Payer: Prime Health Services Commercial |
$13,136.75
|
|
|
HC RHC & LHC W/WO LV
|
Facility
|
OP
|
$13,137.00
|
|
|
Service Code
|
CPT 93453
|
| Hospital Charge Code |
906811400
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,717.32 |
| Max. Negotiated Rate |
$26,788.00 |
| Rate for Payer: Adventist Health Commercial |
$2,627.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,086.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,086.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$5,911.65
|
| Rate for Payer: Cash Price |
$5,911.65
|
| Rate for Payer: Cash Price |
$5,911.65
|
| Rate for Payer: Central Health Plan Commercial |
$10,509.60
|
| Rate for Payer: Cigna of CA HMO |
$8,539.05
|
| Rate for Payer: Cigna of CA PPO |
$9,721.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,495.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,086.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,517.14
|
| Rate for Payer: EPIC Health Plan Senior |
$4,086.77
|
| Rate for Payer: Galaxy Health WC |
$11,166.45
|
| Rate for Payer: Global Benefits Group Commercial |
$7,882.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,823.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,702.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,717.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,086.77
|
| Rate for Payer: InnovAge PACE Commercial |
$6,130.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,762.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,897.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,086.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,627.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,476.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,476.27
|
| Rate for Payer: Multiplan Commercial |
$9,852.75
|
| Rate for Payer: Networks By Design Commercial |
$8,539.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,086.77
|
| Rate for Payer: Prime Health Services Commercial |
$11,166.45
|
| Rate for Payer: Prime Health Services Medicare |
$4,331.98
|
| Rate for Payer: Riverside University Health System MISP |
$4,495.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,882.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,630.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,086.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Vantage Medical Group Senior |
$4,086.77
|
|
|
HC RHC & LHC W/WO LV
|
Facility
|
IP
|
$13,137.00
|
|
|
Service Code
|
CPT 93453
|
| Hospital Charge Code |
906811400
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,627.40 |
| Max. Negotiated Rate |
$11,823.30 |
| Rate for Payer: Adventist Health Commercial |
$2,627.40
|
| Rate for Payer: Cash Price |
$5,911.65
|
| Rate for Payer: Central Health Plan Commercial |
$10,509.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,254.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,254.80
|
| Rate for Payer: Galaxy Health WC |
$11,166.45
|
| Rate for Payer: Global Benefits Group Commercial |
$7,882.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,823.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,762.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,005.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,131.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,627.40
|
| Rate for Payer: Multiplan Commercial |
$9,852.75
|
| Rate for Payer: Networks By Design Commercial |
$8,539.05
|
| Rate for Payer: Prime Health Services Commercial |
$11,166.45
|
|
|
HC RHC & LHC W/WO LV
|
Facility
|
OP
|
$15,455.00
|
|
|
Service Code
|
CPT 93453
|
| Hospital Charge Code |
906820088
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,717.32 |
| Max. Negotiated Rate |
$26,788.00 |
| Rate for Payer: Adventist Health Commercial |
$3,091.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,086.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,086.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$6,954.75
|
| Rate for Payer: Cash Price |
$6,954.75
|
| Rate for Payer: Cash Price |
$6,954.75
|
| Rate for Payer: Central Health Plan Commercial |
$12,364.00
|
| Rate for Payer: Cigna of CA HMO |
$10,045.75
|
| Rate for Payer: Cigna of CA PPO |
$11,436.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,495.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,086.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,517.14
|
| Rate for Payer: EPIC Health Plan Senior |
$4,086.77
|
| Rate for Payer: Galaxy Health WC |
$13,136.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9,273.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,909.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,702.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,717.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,086.77
|
| Rate for Payer: InnovAge PACE Commercial |
$6,130.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,308.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,897.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,086.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,091.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,476.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,476.27
|
| Rate for Payer: Multiplan Commercial |
$11,591.25
|
| Rate for Payer: Networks By Design Commercial |
$10,045.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,086.77
|
| Rate for Payer: Prime Health Services Commercial |
$13,136.75
|
| Rate for Payer: Prime Health Services Medicare |
$4,331.98
|
| Rate for Payer: Riverside University Health System MISP |
$4,495.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,273.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,630.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,086.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Vantage Medical Group Senior |
$4,086.77
|
|
|
HC RHEUMATOID FACTOR
|
Facility
|
IP
|
$170.00
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
900910868
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Adventist Health Commercial |
$34.00
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Central Health Plan Commercial |
$136.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.00
|
| Rate for Payer: EPIC Health Plan Senior |
$68.00
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$153.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$113.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$64.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$105.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.00
|
| Rate for Payer: Multiplan Commercial |
$127.50
|
| Rate for Payer: Networks By Design Commercial |
$110.50
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
|
|
HC RHEUMATOID FACTOR
|
Facility
|
OP
|
$58.00
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
900910868
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.59 |
| Max. Negotiated Rate |
$52.20 |
| Rate for Payer: Adventist Health Commercial |
$11.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$35.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$40.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.25
|
| Rate for Payer: Blue Shield of California Commercial |
$35.21
|
| Rate for Payer: Blue Shield of California EPN |
$23.03
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Central Health Plan Commercial |
$46.40
|
| Rate for Payer: Cigna of CA HMO |
$37.12
|
| Rate for Payer: Cigna of CA PPO |
$42.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.65
|
| Rate for Payer: EPIC Health Plan Senior |
$5.67
|
| Rate for Payer: Galaxy Health WC |
$49.30
|
| Rate for Payer: Global Benefits Group Commercial |
$34.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$52.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.67
|
| Rate for Payer: InnovAge PACE Commercial |
$8.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.60
|
| Rate for Payer: Multiplan Commercial |
$43.50
|
| Rate for Payer: Networks By Design Commercial |
$37.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.67
|
| Rate for Payer: Prime Health Services Commercial |
$49.30
|
| Rate for Payer: Prime Health Services Medicare |
$6.01
|
| Rate for Payer: Riverside University Health System MISP |
$6.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.59
|
| Rate for Payer: United Healthcare All Other HMO |
$4.59
|
| Rate for Payer: United Healthcare HMO Rider |
$4.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.24
|
| Rate for Payer: Vantage Medical Group Senior |
$5.67
|
|
|
HC RH IMMUNE GLOBULIN
|
Facility
|
OP
|
$217.00
|
|
|
Service Code
|
CPT J2790
|
| Hospital Charge Code |
900904586
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$43.40 |
| Max. Negotiated Rate |
$195.30 |
| Rate for Payer: Adventist Health Commercial |
$43.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$131.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$184.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$119.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$162.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$182.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55.90
|
| Rate for Payer: Blue Shield of California Commercial |
$109.34
|
| Rate for Payer: Blue Shield of California EPN |
$99.40
|
| Rate for Payer: Cash Price |
$97.65
|
| Rate for Payer: Cash Price |
$97.65
|
| Rate for Payer: Central Health Plan Commercial |
$173.60
|
| Rate for Payer: Cigna of CA HMO |
$151.90
|
| Rate for Payer: Cigna of CA PPO |
$151.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$184.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$184.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$184.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.80
|
| Rate for Payer: EPIC Health Plan Senior |
$86.80
|
| Rate for Payer: Galaxy Health WC |
$184.45
|
| Rate for Payer: Global Benefits Group Commercial |
$130.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$195.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$77.16
|
| Rate for Payer: InnovAge PACE Commercial |
$108.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$144.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$166.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$134.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$151.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$151.90
|
| Rate for Payer: Multiplan Commercial |
$162.75
|
| Rate for Payer: Networks By Design Commercial |
$108.50
|
| Rate for Payer: Prime Health Services Commercial |
$184.45
|
| Rate for Payer: Riverside University Health System MISP |
$86.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$130.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$130.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$81.44
|
| Rate for Payer: United Healthcare All Other HMO |
$79.27
|
| Rate for Payer: United Healthcare HMO Rider |
$77.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$71.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$184.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$184.45
|
| Rate for Payer: Vantage Medical Group Senior |
$184.45
|
|
|
HC RH IMMUNE GLOBULIN
|
Facility
|
IP
|
$217.00
|
|
|
Service Code
|
CPT J2790
|
| Hospital Charge Code |
900904586
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$43.40 |
| Max. Negotiated Rate |
$195.30 |
| Rate for Payer: Adventist Health Commercial |
$43.40
|
| Rate for Payer: Blue Shield of California Commercial |
$167.74
|
| Rate for Payer: Blue Shield of California EPN |
$109.37
|
| Rate for Payer: Cash Price |
$97.65
|
| Rate for Payer: Central Health Plan Commercial |
$173.60
|
| Rate for Payer: Cigna of CA HMO |
$151.90
|
| Rate for Payer: Cigna of CA PPO |
$151.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.80
|
| Rate for Payer: EPIC Health Plan Senior |
$86.80
|
| Rate for Payer: Galaxy Health WC |
$184.45
|
| Rate for Payer: Global Benefits Group Commercial |
$130.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$195.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$144.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$134.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.40
|
| Rate for Payer: Multiplan Commercial |
$162.75
|
| Rate for Payer: Networks By Design Commercial |
$108.50
|
| Rate for Payer: Prime Health Services Commercial |
$184.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$81.44
|
| Rate for Payer: United Healthcare All Other HMO |
$79.27
|
| Rate for Payer: United Healthcare HMO Rider |
$77.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$71.07
|
|
|
HC RH UNIT CONFIRMATION
|
Facility
|
OP
|
$117.00
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
900904621
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$676.00 |
| Rate for Payer: Adventist Health Commercial |
$23.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$2.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$71.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68.71
|
| Rate for Payer: Blue Shield of California Commercial |
$71.49
|
| Rate for Payer: Blue Shield of California EPN |
$46.68
|
| Rate for Payer: Cash Price |
$52.65
|
| Rate for Payer: Cash Price |
$52.65
|
| Rate for Payer: Cash Price |
$52.65
|
| Rate for Payer: Central Health Plan Commercial |
$93.60
|
| Rate for Payer: Cigna of CA HMO |
$74.88
|
| Rate for Payer: Cigna of CA PPO |
$86.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.04
|
| Rate for Payer: EPIC Health Plan Senior |
$2.99
|
| Rate for Payer: Galaxy Health WC |
$99.45
|
| Rate for Payer: Global Benefits Group Commercial |
$70.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$105.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2.99
|
| Rate for Payer: InnovAge PACE Commercial |
$4.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$78.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.01
|
| Rate for Payer: Multiplan Commercial |
$87.75
|
| Rate for Payer: Networks By Design Commercial |
$76.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2.99
|
| Rate for Payer: Prime Health Services Commercial |
$99.45
|
| Rate for Payer: Prime Health Services Medicare |
$3.17
|
| Rate for Payer: Riverside University Health System MISP |
$3.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$70.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$70.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$676.00
|
| Rate for Payer: United Healthcare All Other HMO |
$663.00
|
| Rate for Payer: United Healthcare HMO Rider |
$662.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$605.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.29
|
| Rate for Payer: Vantage Medical Group Senior |
$2.99
|
|
|
HC RH UNIT CONFIRMATION
|
Facility
|
IP
|
$117.00
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
900904621
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$23.40 |
| Max. Negotiated Rate |
$105.30 |
| Rate for Payer: Adventist Health Commercial |
$23.40
|
| Rate for Payer: Cash Price |
$52.65
|
| Rate for Payer: Central Health Plan Commercial |
$93.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.80
|
| Rate for Payer: EPIC Health Plan Senior |
$46.80
|
| Rate for Payer: Galaxy Health WC |
$99.45
|
| Rate for Payer: Global Benefits Group Commercial |
$70.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$105.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$78.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$72.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.40
|
| Rate for Payer: Multiplan Commercial |
$87.75
|
| Rate for Payer: Networks By Design Commercial |
$76.05
|
| Rate for Payer: Prime Health Services Commercial |
$99.45
|
|
