|
HC RMVL FB INTRAOCULAR
|
Facility
|
IP
|
$6,445.00
|
|
|
Service Code
|
CPT 65235
|
| Hospital Charge Code |
900501180
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,289.00 |
| Max. Negotiated Rate |
$5,800.50 |
| Rate for Payer: Adventist Health Commercial |
$1,289.00
|
| Rate for Payer: Cash Price |
$3,544.75
|
| Rate for Payer: Central Health Plan Commercial |
$5,156.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,578.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,578.00
|
| Rate for Payer: Galaxy Health WC |
$5,478.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,867.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,800.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,298.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,455.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,989.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,289.00
|
| Rate for Payer: Multiplan Commercial |
$4,833.75
|
| Rate for Payer: Networks By Design Commercial |
$4,189.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,478.25
|
|
|
HC RMVL FB INTRAOCULAR
|
Facility
|
OP
|
$6,445.00
|
|
|
Service Code
|
CPT 65235
|
| Hospital Charge Code |
900501180
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,333.00 |
| Rate for Payer: Adventist Health Commercial |
$2,642.45
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,187.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,897.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$4,617.28
|
| Rate for Payer: Cash Price |
$3,544.75
|
| Rate for Payer: Cash Price |
$3,544.75
|
| Rate for Payer: Cash Price |
$3,544.75
|
| Rate for Payer: Cash Price |
$3,544.75
|
| Rate for Payer: Central Health Plan Commercial |
$5,156.00
|
| Rate for Payer: Cigna of CA HMO |
$4,124.80
|
| Rate for Payer: Cigna of CA PPO |
$4,769.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,187.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,897.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,912.16
|
| Rate for Payer: EPIC Health Plan Senior |
$2,897.90
|
| Rate for Payer: Galaxy Health WC |
$5,478.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,867.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,800.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,752.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,897.90
|
| Rate for Payer: InnovAge PACE Commercial |
$4,346.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,298.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$867.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,897.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,289.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,883.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,883.19
|
| Rate for Payer: Multiplan Commercial |
$4,833.75
|
| Rate for Payer: Multiplan WC |
$4,617.28
|
| Rate for Payer: Networks By Design Commercial |
$4,189.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,897.90
|
| Rate for Payer: Preferred Health Network WC |
$4,711.51
|
| Rate for Payer: Prime Health Services Commercial |
$5,478.25
|
| Rate for Payer: Prime Health Services Medicare |
$3,071.77
|
| Rate for Payer: Prime Health Services WC |
$4,570.16
|
| Rate for Payer: Riverside University Health System MISP |
$3,187.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,867.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,867.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,897.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,187.69
|
| Rate for Payer: Vantage Medical Group Senior |
$2,897.90
|
|
|
HC RMVL FB MSCLE/TNDN SHEATH DEEP
|
Facility
|
IP
|
$11,144.00
|
|
|
Service Code
|
CPT 20525
|
| Hospital Charge Code |
900501534
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,228.80 |
| Max. Negotiated Rate |
$10,029.60 |
| Rate for Payer: Adventist Health Commercial |
$2,228.80
|
| Rate for Payer: Cash Price |
$6,129.20
|
| Rate for Payer: Central Health Plan Commercial |
$8,915.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,457.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,457.60
|
| Rate for Payer: Galaxy Health WC |
$9,472.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,686.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,029.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,433.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,245.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,898.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,228.80
|
| Rate for Payer: Multiplan Commercial |
$8,358.00
|
| Rate for Payer: Networks By Design Commercial |
$7,243.60
|
| Rate for Payer: Prime Health Services Commercial |
$9,472.40
|
|
|
HC RMVL FB MSCLE/TNDN SHEATH DEEP
|
Facility
|
OP
|
$11,144.00
|
|
|
Service Code
|
CPT 20525
|
| Hospital Charge Code |
900501534
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$10,029.60 |
| Rate for Payer: Adventist Health Commercial |
$2,228.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,636.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,764.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$5,794.14
|
| Rate for Payer: Cash Price |
$6,129.20
|
| Rate for Payer: Cash Price |
$6,129.20
|
| Rate for Payer: Cash Price |
$6,129.20
|
| Rate for Payer: Cash Price |
$6,129.20
|
| Rate for Payer: Central Health Plan Commercial |
$8,915.20
|
| Rate for Payer: Cigna of CA HMO |
$7,132.16
|
| Rate for Payer: Cigna of CA PPO |
$8,246.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,000.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,636.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,909.30
|
| Rate for Payer: EPIC Health Plan Senior |
$3,636.52
|
| Rate for Payer: Galaxy Health WC |
$9,472.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,686.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,029.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,963.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,636.52
|
| Rate for Payer: InnovAge PACE Commercial |
$5,454.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,433.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$551.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,636.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,228.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,872.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,872.94
|
| Rate for Payer: Multiplan Commercial |
$8,358.00
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: Networks By Design Commercial |
$7,243.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,636.52
|
| Rate for Payer: Preferred Health Network WC |
$5,912.39
|
| Rate for Payer: Prime Health Services Commercial |
$9,472.40
|
| Rate for Payer: Prime Health Services Medicare |
$3,854.71
|
| Rate for Payer: Prime Health Services WC |
$5,735.02
|
| Rate for Payer: Riverside University Health System MISP |
$4,000.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,686.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,572.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,572.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,572.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,636.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Vantage Medical Group Senior |
$3,636.52
|
|
|
HC RMVL FB MSCLE/TNDN SHEATH SMPL
|
Facility
|
IP
|
$2,559.00
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
900501492
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$511.80 |
| Max. Negotiated Rate |
$2,303.10 |
| Rate for Payer: Adventist Health Commercial |
$511.80
|
| Rate for Payer: Cash Price |
$1,407.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,047.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,023.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,023.60
|
| Rate for Payer: Galaxy Health WC |
$2,175.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,535.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,303.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,706.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$974.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,584.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$511.80
|
| Rate for Payer: Multiplan Commercial |
$1,919.25
|
| Rate for Payer: Networks By Design Commercial |
$1,663.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,175.15
|
|
|
HC RMVL FB MSCLE/TNDN SHEATH SMPL
|
Facility
|
OP
|
$2,559.00
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
900501492
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$213.62 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Commercial |
$511.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$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 |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Cash Price |
$1,407.45
|
| Rate for Payer: Cash Price |
$1,407.45
|
| Rate for Payer: Cash Price |
$1,407.45
|
| Rate for Payer: Cash Price |
$1,407.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,047.20
|
| Rate for Payer: Cigna of CA HMO |
$1,637.76
|
| Rate for Payer: Cigna of CA PPO |
$1,893.66
|
| 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 |
$2,175.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,535.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,303.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| 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 |
$1,706.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$213.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$511.80
|
| 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 |
$1,919.25
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$1,663.35
|
| 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 |
$2,175.15
|
| 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 |
$1,535.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,279.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,279.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,279.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,279.50
|
| 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 RMVL FB OUTER EAR CANAL W/ANES
|
Facility
|
IP
|
$11,583.00
|
|
|
Service Code
|
CPT 69205
|
| Hospital Charge Code |
900501755
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,316.60 |
| Max. Negotiated Rate |
$10,424.70 |
| Rate for Payer: Adventist Health Commercial |
$2,316.60
|
| Rate for Payer: Cash Price |
$6,370.65
|
| Rate for Payer: Central Health Plan Commercial |
$9,266.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,633.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4,633.20
|
| Rate for Payer: Galaxy Health WC |
$9,845.55
|
| Rate for Payer: Global Benefits Group Commercial |
$6,949.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,424.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,725.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,413.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,169.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,316.60
|
| Rate for Payer: Multiplan Commercial |
$8,687.25
|
| Rate for Payer: Networks By Design Commercial |
$7,528.95
|
| Rate for Payer: Prime Health Services Commercial |
$9,845.55
|
|
|
HC RMVL FB OUTER EAR CANAL W/ANES
|
Facility
|
OP
|
$11,583.00
|
|
|
Service Code
|
CPT 69205
|
| Hospital Charge Code |
900501755
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$152.80 |
| Max. Negotiated Rate |
$10,424.70 |
| Rate for Payer: Adventist Health Commercial |
$2,316.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$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 |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Cash Price |
$6,370.65
|
| Rate for Payer: Cash Price |
$6,370.65
|
| Rate for Payer: Cash Price |
$6,370.65
|
| Rate for Payer: Cash Price |
$6,370.65
|
| Rate for Payer: Central Health Plan Commercial |
$9,266.40
|
| Rate for Payer: Cigna of CA HMO |
$7,413.12
|
| Rate for Payer: Cigna of CA PPO |
$8,571.42
|
| 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 |
$9,845.55
|
| Rate for Payer: Global Benefits Group Commercial |
$6,949.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,424.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| 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 |
$7,725.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$152.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,316.60
|
| 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 |
$8,687.25
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$7,528.95
|
| 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 |
$9,845.55
|
| 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 |
$6,949.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,791.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,791.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,791.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,791.50
|
| 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 RMVL FB PHARYNGEAL
|
Facility
|
IP
|
$889.00
|
|
|
Service Code
|
CPT 42809
|
| Hospital Charge Code |
900501152
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$177.80 |
| Max. Negotiated Rate |
$800.10 |
| Rate for Payer: Adventist Health Commercial |
$177.80
|
| Rate for Payer: Cash Price |
$488.95
|
| Rate for Payer: Central Health Plan Commercial |
$711.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$355.60
|
| Rate for Payer: EPIC Health Plan Senior |
$355.60
|
| Rate for Payer: Galaxy Health WC |
$755.65
|
| Rate for Payer: Global Benefits Group Commercial |
$533.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$800.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$592.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$338.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$550.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$177.80
|
| Rate for Payer: Multiplan Commercial |
$666.75
|
| Rate for Payer: Networks By Design Commercial |
$577.85
|
| Rate for Payer: Prime Health Services Commercial |
$755.65
|
|
|
HC RMVL FB PHARYNGEAL
|
Facility
|
IP
|
$889.00
|
|
|
Service Code
|
CPT 42809
|
| Hospital Charge Code |
900501152
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$177.80 |
| Max. Negotiated Rate |
$800.10 |
| Rate for Payer: Adventist Health Commercial |
$177.80
|
| Rate for Payer: Cash Price |
$488.95
|
| Rate for Payer: Central Health Plan Commercial |
$711.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$355.60
|
| Rate for Payer: EPIC Health Plan Senior |
$355.60
|
| Rate for Payer: Galaxy Health WC |
$755.65
|
| Rate for Payer: Global Benefits Group Commercial |
$533.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$800.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$592.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$338.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$550.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$177.80
|
| Rate for Payer: Multiplan Commercial |
$666.75
|
| Rate for Payer: Networks By Design Commercial |
$577.85
|
| Rate for Payer: Prime Health Services Commercial |
$755.65
|
|
|
HC RMVL FB PHARYNGEAL
|
Facility
|
OP
|
$889.00
|
|
|
Service Code
|
CPT 42809
|
| Hospital Charge Code |
900501152
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$177.80 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$177.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$760.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$557.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$507.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$807.84
|
| Rate for Payer: Cash Price |
$488.95
|
| Rate for Payer: Cash Price |
$488.95
|
| Rate for Payer: Cash Price |
$488.95
|
| Rate for Payer: Cash Price |
$488.95
|
| Rate for Payer: Central Health Plan Commercial |
$711.20
|
| Rate for Payer: Cigna of CA HMO |
$568.96
|
| Rate for Payer: Cigna of CA PPO |
$657.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$760.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$557.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$507.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$684.48
|
| Rate for Payer: EPIC Health Plan Senior |
$507.02
|
| Rate for Payer: Galaxy Health WC |
$755.65
|
| Rate for Payer: Global Benefits Group Commercial |
$533.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$800.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$831.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$507.02
|
| Rate for Payer: InnovAge PACE Commercial |
$760.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$592.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$282.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$507.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$177.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$679.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$679.41
|
| Rate for Payer: Multiplan Commercial |
$666.75
|
| Rate for Payer: Multiplan WC |
$807.84
|
| Rate for Payer: Networks By Design Commercial |
$577.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$507.02
|
| Rate for Payer: Preferred Health Network WC |
$824.33
|
| Rate for Payer: Prime Health Services Commercial |
$755.65
|
| Rate for Payer: Prime Health Services Medicare |
$537.44
|
| Rate for Payer: Prime Health Services WC |
$799.60
|
| Rate for Payer: Riverside University Health System MISP |
$557.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$533.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$444.50
|
| Rate for Payer: United Healthcare All Other HMO |
$444.50
|
| Rate for Payer: United Healthcare HMO Rider |
$444.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$444.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$507.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$760.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$557.72
|
| Rate for Payer: Vantage Medical Group Senior |
$507.02
|
|
|
HC RMVL FB PHARYNGEAL
|
Facility
|
OP
|
$889.00
|
|
|
Service Code
|
CPT 42809
|
| Hospital Charge Code |
900501152
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$177.80 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$364.49
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$760.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$557.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$507.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$522.11
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$807.84
|
| Rate for Payer: Cash Price |
$488.95
|
| Rate for Payer: Cash Price |
$488.95
|
| Rate for Payer: Cash Price |
$488.95
|
| Rate for Payer: Cash Price |
$488.95
|
| Rate for Payer: Central Health Plan Commercial |
$711.20
|
| Rate for Payer: Cigna of CA HMO |
$568.96
|
| Rate for Payer: Cigna of CA PPO |
$657.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$760.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$557.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$507.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$684.48
|
| Rate for Payer: EPIC Health Plan Senior |
$507.02
|
| Rate for Payer: Galaxy Health WC |
$755.65
|
| Rate for Payer: Global Benefits Group Commercial |
$533.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$800.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$831.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$507.02
|
| Rate for Payer: InnovAge PACE Commercial |
$760.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$592.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$282.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$507.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$177.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$679.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$679.41
|
| Rate for Payer: Multiplan Commercial |
$666.75
|
| Rate for Payer: Multiplan WC |
$807.84
|
| Rate for Payer: Networks By Design Commercial |
$577.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$507.02
|
| Rate for Payer: Preferred Health Network WC |
$824.33
|
| Rate for Payer: Prime Health Services Commercial |
$755.65
|
| Rate for Payer: Prime Health Services Medicare |
$537.44
|
| Rate for Payer: Prime Health Services WC |
$799.60
|
| Rate for Payer: Riverside University Health System MISP |
$557.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$533.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$533.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$507.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$760.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$557.72
|
| Rate for Payer: Vantage Medical Group Senior |
$507.02
|
|
|
HC RMVL F.B. UPPER ARM/ELBOW,SUBC
|
Facility
|
OP
|
$2,559.00
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
900501468
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$210.08 |
| Max. Negotiated Rate |
$3,376.24 |
| Rate for Payer: Adventist Health Commercial |
$511.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$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 |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Cash Price |
$1,407.45
|
| Rate for Payer: Cash Price |
$1,407.45
|
| Rate for Payer: Cash Price |
$1,407.45
|
| Rate for Payer: Cash Price |
$1,407.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,047.20
|
| Rate for Payer: Cigna of CA HMO |
$1,637.76
|
| Rate for Payer: Cigna of CA PPO |
$1,893.66
|
| 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 |
$2,175.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,535.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,303.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| 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 |
$1,706.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$210.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$511.80
|
| 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 |
$1,919.25
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$1,663.35
|
| 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 |
$2,175.15
|
| 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 |
$1,535.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,279.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,279.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,279.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,279.50
|
| 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 RMVL F.B. UPPER ARM/ELBOW,SUBC
|
Facility
|
IP
|
$2,559.00
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
900501468
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$511.80 |
| Max. Negotiated Rate |
$2,303.10 |
| Rate for Payer: Adventist Health Commercial |
$511.80
|
| Rate for Payer: Cash Price |
$1,407.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,047.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,023.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,023.60
|
| Rate for Payer: Galaxy Health WC |
$2,175.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,535.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,303.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,706.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$974.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,584.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$511.80
|
| Rate for Payer: Multiplan Commercial |
$1,919.25
|
| Rate for Payer: Networks By Design Commercial |
$1,663.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,175.15
|
|
|
HC RMVL F.B. UPPER ARM/ELBOW,SUBC
|
Facility
|
IP
|
$2,559.00
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
900501468
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$511.80 |
| Max. Negotiated Rate |
$2,303.10 |
| Rate for Payer: Adventist Health Commercial |
$511.80
|
| Rate for Payer: Cash Price |
$1,407.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,047.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,023.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,023.60
|
| Rate for Payer: Galaxy Health WC |
$2,175.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,535.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,303.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,706.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$974.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,584.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$511.80
|
| Rate for Payer: Multiplan Commercial |
$1,919.25
|
| Rate for Payer: Networks By Design Commercial |
$1,663.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,175.15
|
|
|
HC RMVL F.B. UPPER ARM/ELBOW,SUBC
|
Facility
|
OP
|
$2,559.00
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
900501468
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$210.08 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$1,049.19
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,554.08
|
| 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 |
$1,833.00
|
| 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: Cash Price |
$1,407.45
|
| Rate for Payer: Cash Price |
$1,407.45
|
| Rate for Payer: Cash Price |
$1,407.45
|
| Rate for Payer: Cash Price |
$1,407.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,047.20
|
| Rate for Payer: Cigna of CA HMO |
$1,637.76
|
| Rate for Payer: Cigna of CA PPO |
$1,893.66
|
| 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 |
$2,175.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,535.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,303.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| 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 |
$1,706.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$210.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$511.80
|
| 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 |
$1,919.25
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$1,663.35
|
| 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 |
$2,175.15
|
| 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 |
$1,535.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,535.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,058.68
|
| 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 RMVL FECAL IMPACTION W/ANESTHE
|
Facility
|
OP
|
$6,116.00
|
|
|
Service Code
|
CPT 45915
|
| Hospital Charge Code |
900501608
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$391.17 |
| Max. Negotiated Rate |
$5,504.40 |
| Rate for Payer: Adventist Health Commercial |
$1,223.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,498.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$2,387.03
|
| Rate for Payer: Cash Price |
$3,363.80
|
| Rate for Payer: Cash Price |
$3,363.80
|
| Rate for Payer: Cash Price |
$3,363.80
|
| Rate for Payer: Cash Price |
$3,363.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,892.80
|
| Rate for Payer: Cigna of CA HMO |
$3,914.24
|
| Rate for Payer: Cigna of CA PPO |
$4,525.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,647.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,498.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,022.49
|
| Rate for Payer: EPIC Health Plan Senior |
$1,498.14
|
| Rate for Payer: Galaxy Health WC |
$5,198.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,669.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,504.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,456.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: InnovAge PACE Commercial |
$2,247.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,079.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$391.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,223.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,007.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,007.51
|
| Rate for Payer: Multiplan Commercial |
$4,587.00
|
| Rate for Payer: Multiplan WC |
$2,387.03
|
| Rate for Payer: Networks By Design Commercial |
$3,975.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Preferred Health Network WC |
$2,435.74
|
| Rate for Payer: Prime Health Services Commercial |
$5,198.60
|
| Rate for Payer: Prime Health Services Medicare |
$1,588.03
|
| Rate for Payer: Prime Health Services WC |
$2,362.67
|
| Rate for Payer: Riverside University Health System MISP |
$1,647.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,669.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,058.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,058.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,058.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,058.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,498.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,498.14
|
|
|
HC RMVL FECAL IMPACTION W/ANESTHE
|
Facility
|
IP
|
$6,116.00
|
|
|
Service Code
|
CPT 45915
|
| Hospital Charge Code |
900501608
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,223.20 |
| Max. Negotiated Rate |
$5,504.40 |
| Rate for Payer: Adventist Health Commercial |
$1,223.20
|
| Rate for Payer: Cash Price |
$3,363.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,892.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,446.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,446.40
|
| Rate for Payer: Galaxy Health WC |
$5,198.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,669.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,504.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,079.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,330.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,785.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,223.20
|
| Rate for Payer: Multiplan Commercial |
$4,587.00
|
| Rate for Payer: Networks By Design Commercial |
$3,975.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,198.60
|
|
|
HC RMVL FOREARM LESION SUBCU
|
Facility
|
IP
|
$11,144.00
|
|
|
Service Code
|
CPT 25075
|
| Hospital Charge Code |
902890327
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$2,228.80 |
| Max. Negotiated Rate |
$10,029.60 |
| Rate for Payer: Adventist Health Commercial |
$2,228.80
|
| Rate for Payer: Cash Price |
$6,129.20
|
| Rate for Payer: Central Health Plan Commercial |
$8,915.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,457.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,457.60
|
| Rate for Payer: Galaxy Health WC |
$9,472.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,686.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,029.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,433.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,245.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,898.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,228.80
|
| Rate for Payer: Multiplan Commercial |
$8,358.00
|
| Rate for Payer: Networks By Design Commercial |
$7,243.60
|
| Rate for Payer: Prime Health Services Commercial |
$9,472.40
|
|
|
HC RMVL FOREARM LESION SUBCU
|
Facility
|
OP
|
$11,144.00
|
|
|
Service Code
|
CPT 25075
|
| Hospital Charge Code |
902890327
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$124.49 |
| Max. Negotiated Rate |
$10,029.60 |
| Rate for Payer: Adventist Health Commercial |
$4,569.04
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$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 |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Cash Price |
$6,129.20
|
| Rate for Payer: Cash Price |
$6,129.20
|
| Rate for Payer: Cash Price |
$6,129.20
|
| Rate for Payer: Cash Price |
$6,129.20
|
| Rate for Payer: Central Health Plan Commercial |
$8,915.20
|
| Rate for Payer: Cigna of CA HMO |
$7,132.16
|
| Rate for Payer: Cigna of CA PPO |
$8,246.56
|
| 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 |
$9,472.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,686.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,029.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| 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 |
$7,433.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$124.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,228.80
|
| 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 |
$8,358.00
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$7,243.60
|
| 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 |
$9,472.40
|
| 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 |
$6,686.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,686.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,058.68
|
| 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 RMVL FOREIGN BODY EYELID
|
Facility
|
IP
|
$1,538.00
|
|
|
Service Code
|
CPT 67938
|
| Hospital Charge Code |
900501599
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$307.60 |
| Max. Negotiated Rate |
$1,384.20 |
| Rate for Payer: Adventist Health Commercial |
$307.60
|
| Rate for Payer: Cash Price |
$845.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,230.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$615.20
|
| Rate for Payer: EPIC Health Plan Senior |
$615.20
|
| Rate for Payer: Galaxy Health WC |
$1,307.30
|
| Rate for Payer: Global Benefits Group Commercial |
$922.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,384.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,025.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$585.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$952.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$307.60
|
| Rate for Payer: Multiplan Commercial |
$1,153.50
|
| Rate for Payer: Networks By Design Commercial |
$999.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,307.30
|
|
|
HC RMVL FOREIGN BODY EYELID
|
Facility
|
OP
|
$1,538.00
|
|
|
Service Code
|
CPT 67938
|
| Hospital Charge Code |
900501599
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$103.99 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$307.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$569.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$417.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$379.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$605.18
|
| Rate for Payer: Cash Price |
$845.90
|
| Rate for Payer: Cash Price |
$845.90
|
| Rate for Payer: Cash Price |
$845.90
|
| Rate for Payer: Cash Price |
$845.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,230.40
|
| Rate for Payer: Cigna of CA HMO |
$984.32
|
| Rate for Payer: Cigna of CA PPO |
$1,138.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$569.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$417.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$379.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$512.76
|
| Rate for Payer: EPIC Health Plan Senior |
$379.82
|
| Rate for Payer: Galaxy Health WC |
$1,307.30
|
| Rate for Payer: Global Benefits Group Commercial |
$922.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,384.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$622.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$379.82
|
| Rate for Payer: InnovAge PACE Commercial |
$569.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,025.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$103.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$379.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$307.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$508.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$508.96
|
| Rate for Payer: Multiplan Commercial |
$1,153.50
|
| Rate for Payer: Multiplan WC |
$605.18
|
| Rate for Payer: Networks By Design Commercial |
$999.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$379.82
|
| Rate for Payer: Preferred Health Network WC |
$617.53
|
| Rate for Payer: Prime Health Services Commercial |
$1,307.30
|
| Rate for Payer: Prime Health Services Medicare |
$402.61
|
| Rate for Payer: Prime Health Services WC |
$599.00
|
| Rate for Payer: Riverside University Health System MISP |
$417.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$922.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$769.00
|
| Rate for Payer: United Healthcare All Other HMO |
$769.00
|
| Rate for Payer: United Healthcare HMO Rider |
$769.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$769.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$379.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$569.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$417.80
|
| Rate for Payer: Vantage Medical Group Senior |
$379.82
|
|
|
HC RMVL FOREIGN BODY EYELID
|
Facility
|
IP
|
$1,538.00
|
|
|
Service Code
|
CPT 67938
|
| Hospital Charge Code |
900501599
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$307.60 |
| Max. Negotiated Rate |
$1,384.20 |
| Rate for Payer: Adventist Health Commercial |
$307.60
|
| Rate for Payer: Cash Price |
$845.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,230.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$615.20
|
| Rate for Payer: EPIC Health Plan Senior |
$615.20
|
| Rate for Payer: Galaxy Health WC |
$1,307.30
|
| Rate for Payer: Global Benefits Group Commercial |
$922.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,384.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,025.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$585.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$952.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$307.60
|
| Rate for Payer: Multiplan Commercial |
$1,153.50
|
| Rate for Payer: Networks By Design Commercial |
$999.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,307.30
|
|
|
HC RMVL FOREIGN BODY EYELID
|
Facility
|
OP
|
$1,538.00
|
|
|
Service Code
|
CPT 67938
|
| Hospital Charge Code |
900501599
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$103.99 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$630.58
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$569.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$417.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$379.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$605.18
|
| Rate for Payer: Cash Price |
$845.90
|
| Rate for Payer: Cash Price |
$845.90
|
| Rate for Payer: Cash Price |
$845.90
|
| Rate for Payer: Cash Price |
$845.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,230.40
|
| Rate for Payer: Cigna of CA HMO |
$984.32
|
| Rate for Payer: Cigna of CA PPO |
$1,138.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$569.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$417.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$379.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$512.76
|
| Rate for Payer: EPIC Health Plan Senior |
$379.82
|
| Rate for Payer: Galaxy Health WC |
$1,307.30
|
| Rate for Payer: Global Benefits Group Commercial |
$922.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,384.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$622.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$379.82
|
| Rate for Payer: InnovAge PACE Commercial |
$569.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,025.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$103.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$379.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$307.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$508.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$508.96
|
| Rate for Payer: Multiplan Commercial |
$1,153.50
|
| Rate for Payer: Multiplan WC |
$605.18
|
| Rate for Payer: Networks By Design Commercial |
$999.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$379.82
|
| Rate for Payer: Preferred Health Network WC |
$617.53
|
| Rate for Payer: Prime Health Services Commercial |
$1,307.30
|
| Rate for Payer: Prime Health Services Medicare |
$402.61
|
| Rate for Payer: Prime Health Services WC |
$599.00
|
| Rate for Payer: Riverside University Health System MISP |
$417.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$922.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$922.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$379.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$569.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$417.80
|
| Rate for Payer: Vantage Medical Group Senior |
$379.82
|
|
|
HC RMVL FOREIGN BODY LARYNX
|
Facility
|
OP
|
$785.00
|
|
|
Service Code
|
CPT 31511
|
| Hospital Charge Code |
900501339
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$157.00 |
| Max. Negotiated Rate |
$6,333.00 |
| Rate for Payer: Adventist Health Commercial |
$157.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$370.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$271.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$246.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$393.03
|
| Rate for Payer: Cash Price |
$431.75
|
| Rate for Payer: Cash Price |
$431.75
|
| Rate for Payer: Cash Price |
$431.75
|
| Rate for Payer: Cash Price |
$431.75
|
| Rate for Payer: Central Health Plan Commercial |
$628.00
|
| Rate for Payer: Cigna of CA HMO |
$502.40
|
| Rate for Payer: Cigna of CA PPO |
$580.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$370.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$271.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$246.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$333.00
|
| Rate for Payer: EPIC Health Plan Senior |
$246.67
|
| Rate for Payer: Galaxy Health WC |
$667.25
|
| Rate for Payer: Global Benefits Group Commercial |
$471.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$706.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$404.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$246.67
|
| Rate for Payer: InnovAge PACE Commercial |
$370.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$523.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$157.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$246.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$157.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$330.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$330.54
|
| Rate for Payer: Multiplan Commercial |
$588.75
|
| Rate for Payer: Multiplan WC |
$393.03
|
| Rate for Payer: Networks By Design Commercial |
$510.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$246.67
|
| Rate for Payer: Preferred Health Network WC |
$401.05
|
| Rate for Payer: Prime Health Services Commercial |
$667.25
|
| Rate for Payer: Prime Health Services Medicare |
$261.47
|
| Rate for Payer: Prime Health Services WC |
$389.02
|
| Rate for Payer: Riverside University Health System MISP |
$271.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$471.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$392.50
|
| Rate for Payer: United Healthcare All Other HMO |
$392.50
|
| Rate for Payer: United Healthcare HMO Rider |
$392.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$392.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$246.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$370.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$271.34
|
| Rate for Payer: Vantage Medical Group Senior |
$246.67
|
|
