|
HC REP BLOOD VESSEL HAND, FINGER
|
Facility
IP
|
$7,932.00
|
|
|
Service Code
|
CPT 35207
|
| Hospital Charge Code |
900501131
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,586.40 |
| Max. Negotiated Rate |
$7,138.80 |
| Rate for Payer: Cash Price |
$3,569.40
|
| Rate for Payer: Central Health Plan Commercial |
$6,345.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,172.80
|
| Rate for Payer: Galaxy Health WC |
$6,742.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,759.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,138.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,290.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,586.40
|
| Rate for Payer: Multiplan Commercial |
$5,949.00
|
| Rate for Payer: Networks By Design Commercial |
$5,155.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,742.20
|
|
|
HC REP BLOOD VESSEL HAND, FINGER
|
Facility
OP
|
$7,932.00
|
|
|
Service Code
|
CPT 35207
|
| Hospital Charge Code |
900501131
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$10,567.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,759.20
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$3,569.40
|
| Rate for Payer: Cash Price |
$3,569.40
|
| Rate for Payer: Cash Price |
$3,569.40
|
| Rate for Payer: Cash Price |
$3,569.40
|
| Rate for Payer: Central Health Plan Commercial |
$6,345.60
|
| Rate for Payer: Cigna of CA PPO |
$5,869.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$6,742.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,759.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,138.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,949.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Innovage PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,290.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,586.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$5,949.00
|
| Rate for Payer: Networks By Design Commercial |
$5,155.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,742.20
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,759.20
|
| Rate for Payer: Riverside University Health MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,759.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,966.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,966.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,966.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,966.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC REP BLOOD VESSEL HEAD & NECK
|
Facility
OP
|
$6,269.00
|
|
|
Service Code
|
CPT 35201
|
| Hospital Charge Code |
900501619
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$11,260.35 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6,866.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,761.40
|
| Rate for Payer: Caremore Medicare Advantage |
$6,866.07
|
| Rate for Payer: Cash Price |
$2,821.05
|
| Rate for Payer: Cash Price |
$2,821.05
|
| Rate for Payer: Cash Price |
$2,821.05
|
| Rate for Payer: Cash Price |
$2,821.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,015.20
|
| Rate for Payer: Cigna of CA PPO |
$4,639.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,299.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,269.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6,866.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,866.07
|
| Rate for Payer: Galaxy Health WC |
$5,328.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,761.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,642.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,701.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,260.35
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$6,866.07
|
| Rate for Payer: Innovage PACE Commercial |
$10,299.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,181.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,866.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,253.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,200.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,200.53
|
| Rate for Payer: Multiplan Commercial |
$4,701.75
|
| Rate for Payer: Networks By Design Commercial |
$4,074.85
|
| Rate for Payer: Prime Health Services Commercial |
$5,328.65
|
| Rate for Payer: Prime Health Services Medicare |
$7,278.03
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,761.40
|
| Rate for Payer: Riverside University Health MISP |
$7,552.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,761.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,134.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,134.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,134.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,134.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: Vantage Medical Group Senior |
$6,866.07
|
|
|
HC REP BLOOD VESSEL HEAD & NECK
|
Facility
IP
|
$6,269.00
|
|
|
Service Code
|
CPT 35201
|
| Hospital Charge Code |
900501619
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,253.80 |
| Max. Negotiated Rate |
$5,642.10 |
| Rate for Payer: Cash Price |
$2,821.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,015.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,507.60
|
| Rate for Payer: Galaxy Health WC |
$5,328.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,761.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,642.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,181.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,253.80
|
| Rate for Payer: Multiplan Commercial |
$4,701.75
|
| Rate for Payer: Networks By Design Commercial |
$4,074.85
|
| Rate for Payer: Prime Health Services Commercial |
$5,328.65
|
|
|
HC REP BLOOD VESSEL UPPER EXT
|
Facility
IP
|
$6,269.00
|
|
|
Service Code
|
CPT 35206
|
| Hospital Charge Code |
900501130
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,253.80 |
| Max. Negotiated Rate |
$5,642.10 |
| Rate for Payer: Cash Price |
$2,821.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,015.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,507.60
|
| Rate for Payer: Galaxy Health WC |
$5,328.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,761.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,642.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,181.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,253.80
|
| Rate for Payer: Multiplan Commercial |
$4,701.75
|
| Rate for Payer: Networks By Design Commercial |
$4,074.85
|
| Rate for Payer: Prime Health Services Commercial |
$5,328.65
|
|
|
HC REP BLOOD VESSEL UPPER EXT
|
Facility
OP
|
$6,269.00
|
|
|
Service Code
|
CPT 35206
|
| Hospital Charge Code |
900501130
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$10,567.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,761.40
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$2,821.05
|
| Rate for Payer: Cash Price |
$2,821.05
|
| Rate for Payer: Cash Price |
$2,821.05
|
| Rate for Payer: Cash Price |
$2,821.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,015.20
|
| Rate for Payer: Cigna of CA PPO |
$4,639.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$5,328.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,761.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,642.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,701.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Innovage PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,181.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,253.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$4,701.75
|
| Rate for Payer: Networks By Design Commercial |
$4,074.85
|
| Rate for Payer: Prime Health Services Commercial |
$5,328.65
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,761.40
|
| Rate for Payer: Riverside University Health MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,761.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,134.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,134.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,134.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,134.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC REP COM 1.1-2.5 CM, EYELIDS,NO
|
Facility
OP
|
$1,980.00
|
|
|
Service Code
|
CPT 13151
|
| Hospital Charge Code |
900501043
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$396.00 |
| Max. Negotiated Rate |
$8,114.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$784.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,177.06
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$863.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$784.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,188.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,245.42
|
| Rate for Payer: Blue Shield of California EPN |
$968.22
|
| Rate for Payer: Caremore Medicare Advantage |
$784.71
|
| Rate for Payer: Cash Price |
$891.00
|
| Rate for Payer: Cash Price |
$891.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,584.00
|
| Rate for Payer: Cigna of CA HMO |
$1,267.20
|
| Rate for Payer: Cigna of CA PPO |
$1,465.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,177.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,059.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$784.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$784.71
|
| Rate for Payer: Galaxy Health WC |
$1,683.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,188.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,782.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,485.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,286.92
|
| Rate for Payer: IEHP medi-cal |
$1,294.77
|
| Rate for Payer: IEHP Medicare Advantage |
$784.71
|
| Rate for Payer: Innovage PACE Commercial |
$1,177.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,320.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$396.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,051.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,051.51
|
| Rate for Payer: Multiplan Commercial |
$1,485.00
|
| Rate for Payer: Networks By Design Commercial |
$1,287.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,683.00
|
| Rate for Payer: Prime Health Services Medicare |
$831.79
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,188.00
|
| Rate for Payer: Riverside University Health MISP |
$863.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,188.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,188.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$990.00
|
| Rate for Payer: United Healthcare All Other HMO |
$990.00
|
| Rate for Payer: United Healthcare HMO Rider |
$990.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$990.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,177.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.18
|
| Rate for Payer: Vantage Medical Group Senior |
$784.71
|
|
|
HC REP COM 1.1-2.5 CM, EYELIDS,NO
|
Facility
OP
|
$1,980.00
|
|
|
Service Code
|
CPT 13151
|
| Hospital Charge Code |
900501043
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$396.00 |
| Max. Negotiated Rate |
$8,114.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,177.06
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$863.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$784.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,188.00
|
| Rate for Payer: Caremore Medicare Advantage |
$784.71
|
| Rate for Payer: Cash Price |
$891.00
|
| Rate for Payer: Cash Price |
$891.00
|
| Rate for Payer: Cash Price |
$891.00
|
| Rate for Payer: Cash Price |
$891.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,584.00
|
| Rate for Payer: Cigna of CA PPO |
$1,465.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,177.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,059.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$784.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$784.71
|
| Rate for Payer: Galaxy Health WC |
$1,683.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,188.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,782.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,485.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,286.92
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$784.71
|
| Rate for Payer: Innovage PACE Commercial |
$1,177.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,320.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$396.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,051.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,051.51
|
| Rate for Payer: Multiplan Commercial |
$1,485.00
|
| Rate for Payer: Networks By Design Commercial |
$1,287.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,683.00
|
| Rate for Payer: Prime Health Services Medicare |
$831.79
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,188.00
|
| Rate for Payer: Riverside University Health MISP |
$863.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,188.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$990.00
|
| Rate for Payer: United Healthcare All Other HMO |
$990.00
|
| Rate for Payer: United Healthcare HMO Rider |
$990.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$990.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,177.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.18
|
| Rate for Payer: Vantage Medical Group Senior |
$784.71
|
|
|
HC REP COM 1.1-2.5 CM, EYELIDS,NO
|
Facility
IP
|
$1,980.00
|
|
|
Service Code
|
CPT 13151
|
| Hospital Charge Code |
900501043
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$396.00 |
| Max. Negotiated Rate |
$1,782.00 |
| Rate for Payer: Cash Price |
$891.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,584.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$792.00
|
| Rate for Payer: Galaxy Health WC |
$1,683.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,188.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,782.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,320.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$396.00
|
| Rate for Payer: Multiplan Commercial |
$1,485.00
|
| Rate for Payer: Networks By Design Commercial |
$1,287.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,683.00
|
|
|
HC REP COM 1.1-2.5 CM, EYELIDS,NO
|
Facility
IP
|
$1,980.00
|
|
|
Service Code
|
CPT 13151
|
| Hospital Charge Code |
900501043
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$396.00 |
| Max. Negotiated Rate |
$1,782.00 |
| Rate for Payer: Cash Price |
$891.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,584.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$792.00
|
| Rate for Payer: Galaxy Health WC |
$1,683.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,188.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,782.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,320.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$396.00
|
| Rate for Payer: Multiplan Commercial |
$1,485.00
|
| Rate for Payer: Networks By Design Commercial |
$1,287.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,683.00
|
|
|
HC REP COM 1.1-2.5 CM, FOREHEAD,C
|
Facility
IP
|
$1,687.00
|
|
|
Service Code
|
CPT 13131
|
| Hospital Charge Code |
900501041
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$337.40 |
| Max. Negotiated Rate |
$1,518.30 |
| Rate for Payer: Cash Price |
$759.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,349.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$674.80
|
| Rate for Payer: Galaxy Health WC |
$1,433.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,012.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,518.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,125.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$337.40
|
| Rate for Payer: Multiplan Commercial |
$1,265.25
|
| Rate for Payer: Networks By Design Commercial |
$1,096.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,433.95
|
|
|
HC REP COM 1.1-2.5 CM, FOREHEAD,C
|
Facility
OP
|
$1,687.00
|
|
|
Service Code
|
CPT 13131
|
| Hospital Charge Code |
900501041
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$337.40 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$498.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$498.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,012.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,061.12
|
| Rate for Payer: Blue Shield of California EPN |
$824.94
|
| Rate for Payer: Caremore Medicare Advantage |
$498.20
|
| Rate for Payer: Cash Price |
$759.15
|
| Rate for Payer: Cash Price |
$759.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,349.60
|
| Rate for Payer: Cigna of CA HMO |
$1,079.68
|
| Rate for Payer: Cigna of CA PPO |
$1,248.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$672.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$498.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$498.20
|
| Rate for Payer: Galaxy Health WC |
$1,433.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,012.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,518.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,265.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$817.05
|
| Rate for Payer: IEHP medi-cal |
$822.03
|
| Rate for Payer: IEHP Medicare Advantage |
$498.20
|
| Rate for Payer: Innovage PACE Commercial |
$747.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,125.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$498.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$337.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$667.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$667.59
|
| Rate for Payer: Multiplan Commercial |
$1,265.25
|
| Rate for Payer: Networks By Design Commercial |
$1,096.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,433.95
|
| Rate for Payer: Prime Health Services Medicare |
$528.09
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,012.20
|
| Rate for Payer: Riverside University Health MISP |
$548.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,012.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,012.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$843.50
|
| Rate for Payer: United Healthcare All Other HMO |
$843.50
|
| Rate for Payer: United Healthcare HMO Rider |
$843.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$843.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Vantage Medical Group Senior |
$498.20
|
|
|
HC REP COM 1.1-2.5 CM, FOREHEAD,C
|
Facility
IP
|
$1,687.00
|
|
|
Service Code
|
CPT 13131
|
| Hospital Charge Code |
900501041
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$337.40 |
| Max. Negotiated Rate |
$1,518.30 |
| Rate for Payer: Cash Price |
$759.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,349.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$674.80
|
| Rate for Payer: Galaxy Health WC |
$1,433.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,012.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,518.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,125.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$337.40
|
| Rate for Payer: Multiplan Commercial |
$1,265.25
|
| Rate for Payer: Networks By Design Commercial |
$1,096.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,433.95
|
|
|
HC REP COM 1.1-2.5 CM, FOREHEAD,C
|
Facility
OP
|
$1,687.00
|
|
|
Service Code
|
CPT 13131
|
| Hospital Charge Code |
900501041
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$337.40 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$498.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,012.20
|
| Rate for Payer: Caremore Medicare Advantage |
$498.20
|
| Rate for Payer: Cash Price |
$759.15
|
| Rate for Payer: Cash Price |
$759.15
|
| Rate for Payer: Cash Price |
$759.15
|
| Rate for Payer: Cash Price |
$759.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,349.60
|
| Rate for Payer: Cigna of CA PPO |
$1,248.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$672.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$498.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$498.20
|
| Rate for Payer: Galaxy Health WC |
$1,433.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,012.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,518.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,265.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$817.05
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$498.20
|
| Rate for Payer: Innovage PACE Commercial |
$747.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,125.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$498.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$337.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$667.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$667.59
|
| Rate for Payer: Multiplan Commercial |
$1,265.25
|
| Rate for Payer: Networks By Design Commercial |
$1,096.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,433.95
|
| Rate for Payer: Prime Health Services Medicare |
$528.09
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,012.20
|
| Rate for Payer: Riverside University Health MISP |
$548.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,012.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$843.50
|
| Rate for Payer: United Healthcare All Other HMO |
$843.50
|
| Rate for Payer: United Healthcare HMO Rider |
$843.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$843.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Vantage Medical Group Senior |
$498.20
|
|
|
HC REP COM 1.1-2.5 CM SCALP/ARM/L
|
Facility
IP
|
$1,485.00
|
|
|
Service Code
|
CPT 13120
|
| Hospital Charge Code |
900501320
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$297.00 |
| Max. Negotiated Rate |
$1,336.50 |
| Rate for Payer: Cash Price |
$668.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,188.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$594.00
|
| Rate for Payer: Galaxy Health WC |
$1,262.25
|
| Rate for Payer: Global Benefits Group Commercial |
$891.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,336.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$990.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$297.00
|
| Rate for Payer: Multiplan Commercial |
$1,113.75
|
| Rate for Payer: Networks By Design Commercial |
$965.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,262.25
|
|
|
HC REP COM 1.1-2.5 CM SCALP/ARM/L
|
Facility
IP
|
$1,485.00
|
|
|
Service Code
|
CPT 13120
|
| Hospital Charge Code |
900501320
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$297.00 |
| Max. Negotiated Rate |
$1,336.50 |
| Rate for Payer: Cash Price |
$668.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,188.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$594.00
|
| Rate for Payer: Galaxy Health WC |
$1,262.25
|
| Rate for Payer: Global Benefits Group Commercial |
$891.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,336.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$990.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$297.00
|
| Rate for Payer: Multiplan Commercial |
$1,113.75
|
| Rate for Payer: Networks By Design Commercial |
$965.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,262.25
|
|
|
HC REP COM 1.1-2.5 CM SCALP/ARM/L
|
Facility
OP
|
$1,485.00
|
|
|
Service Code
|
CPT 13120
|
| Hospital Charge Code |
900501320
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$297.00 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,177.06
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$863.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$784.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$891.00
|
| Rate for Payer: Caremore Medicare Advantage |
$784.71
|
| Rate for Payer: Cash Price |
$668.25
|
| Rate for Payer: Cash Price |
$668.25
|
| Rate for Payer: Cash Price |
$668.25
|
| Rate for Payer: Cash Price |
$668.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,188.00
|
| Rate for Payer: Cigna of CA PPO |
$1,098.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,177.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,059.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$784.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$784.71
|
| Rate for Payer: Galaxy Health WC |
$1,262.25
|
| Rate for Payer: Global Benefits Group Commercial |
$891.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,336.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,113.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,286.92
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$784.71
|
| Rate for Payer: Innovage PACE Commercial |
$1,177.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$990.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$297.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,051.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,051.51
|
| Rate for Payer: Multiplan Commercial |
$1,113.75
|
| Rate for Payer: Networks By Design Commercial |
$965.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,262.25
|
| Rate for Payer: Prime Health Services Medicare |
$831.79
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$891.00
|
| Rate for Payer: Riverside University Health MISP |
$863.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$891.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$742.50
|
| Rate for Payer: United Healthcare All Other HMO |
$742.50
|
| Rate for Payer: United Healthcare HMO Rider |
$742.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$742.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,177.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.18
|
| Rate for Payer: Vantage Medical Group Senior |
$784.71
|
|
|
HC REP COM 1.1-2.5 CM SCALP/ARM/L
|
Facility
OP
|
$1,485.00
|
|
|
Service Code
|
CPT 13120
|
| Hospital Charge Code |
900501320
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$297.00 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$784.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,177.06
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$863.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$784.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$891.00
|
| Rate for Payer: Blue Shield of California Commercial |
$934.06
|
| Rate for Payer: Blue Shield of California EPN |
$726.16
|
| Rate for Payer: Caremore Medicare Advantage |
$784.71
|
| Rate for Payer: Cash Price |
$668.25
|
| Rate for Payer: Cash Price |
$668.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,188.00
|
| Rate for Payer: Cigna of CA HMO |
$950.40
|
| Rate for Payer: Cigna of CA PPO |
$1,098.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,177.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,059.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$784.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$784.71
|
| Rate for Payer: Galaxy Health WC |
$1,262.25
|
| Rate for Payer: Global Benefits Group Commercial |
$891.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,336.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,113.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,286.92
|
| Rate for Payer: IEHP medi-cal |
$1,294.77
|
| Rate for Payer: IEHP Medicare Advantage |
$784.71
|
| Rate for Payer: Innovage PACE Commercial |
$1,177.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$990.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$297.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,051.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,051.51
|
| Rate for Payer: Multiplan Commercial |
$1,113.75
|
| Rate for Payer: Networks By Design Commercial |
$965.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,262.25
|
| Rate for Payer: Prime Health Services Medicare |
$831.79
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$891.00
|
| Rate for Payer: Riverside University Health MISP |
$863.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$891.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$891.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$742.50
|
| Rate for Payer: United Healthcare All Other HMO |
$742.50
|
| Rate for Payer: United Healthcare HMO Rider |
$742.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$742.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,177.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.18
|
| Rate for Payer: Vantage Medical Group Senior |
$784.71
|
|
|
HC REP COM 2.6-7.5 CM EYELID, NOS
|
Facility
OP
|
$2,678.00
|
|
|
Service Code
|
CPT 13152
|
| Hospital Charge Code |
900501329
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$8,114.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,177.06
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$863.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$784.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,606.80
|
| Rate for Payer: Caremore Medicare Advantage |
$784.71
|
| Rate for Payer: Cash Price |
$1,205.10
|
| Rate for Payer: Cash Price |
$1,205.10
|
| Rate for Payer: Cash Price |
$1,205.10
|
| Rate for Payer: Cash Price |
$1,205.10
|
| Rate for Payer: Central Health Plan Commercial |
$2,142.40
|
| Rate for Payer: Cigna of CA PPO |
$1,981.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,177.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,059.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$784.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$784.71
|
| Rate for Payer: Galaxy Health WC |
$2,276.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,606.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,410.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,008.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,286.92
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$784.71
|
| Rate for Payer: Innovage PACE Commercial |
$1,177.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,786.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$535.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,051.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,051.51
|
| Rate for Payer: Multiplan Commercial |
$2,008.50
|
| Rate for Payer: Networks By Design Commercial |
$1,740.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,276.30
|
| Rate for Payer: Prime Health Services Medicare |
$831.79
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,606.80
|
| Rate for Payer: Riverside University Health MISP |
$863.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,606.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,339.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,339.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,339.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,339.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,177.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.18
|
| Rate for Payer: Vantage Medical Group Senior |
$784.71
|
|
|
HC REP COM 2.6-7.5 CM EYELID, NOS
|
Facility
IP
|
$2,678.00
|
|
|
Service Code
|
CPT 13152
|
| Hospital Charge Code |
900501329
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$535.60 |
| Max. Negotiated Rate |
$2,410.20 |
| Rate for Payer: Cash Price |
$1,205.10
|
| Rate for Payer: Central Health Plan Commercial |
$2,142.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,071.20
|
| Rate for Payer: Galaxy Health WC |
$2,276.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,606.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,410.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,786.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$535.60
|
| Rate for Payer: Multiplan Commercial |
$2,008.50
|
| Rate for Payer: Networks By Design Commercial |
$1,740.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,276.30
|
|
|
HC REP COM 2.6-7.5 CM EYELID, NOS
|
Facility
OP
|
$2,678.00
|
|
|
Service Code
|
CPT 13152
|
| Hospital Charge Code |
900501329
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$535.60 |
| Max. Negotiated Rate |
$8,114.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$784.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,177.06
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$863.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$784.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,606.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,684.46
|
| Rate for Payer: Blue Shield of California EPN |
$1,309.54
|
| Rate for Payer: Caremore Medicare Advantage |
$784.71
|
| Rate for Payer: Cash Price |
$1,205.10
|
| Rate for Payer: Cash Price |
$1,205.10
|
| Rate for Payer: Central Health Plan Commercial |
$2,142.40
|
| Rate for Payer: Cigna of CA HMO |
$1,713.92
|
| Rate for Payer: Cigna of CA PPO |
$1,981.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,177.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,059.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$784.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$784.71
|
| Rate for Payer: Galaxy Health WC |
$2,276.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,606.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,410.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,008.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,286.92
|
| Rate for Payer: IEHP medi-cal |
$1,294.77
|
| Rate for Payer: IEHP Medicare Advantage |
$784.71
|
| Rate for Payer: Innovage PACE Commercial |
$1,177.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,786.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$535.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,051.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,051.51
|
| Rate for Payer: Multiplan Commercial |
$2,008.50
|
| Rate for Payer: Networks By Design Commercial |
$1,740.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,276.30
|
| Rate for Payer: Prime Health Services Medicare |
$831.79
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,606.80
|
| Rate for Payer: Riverside University Health MISP |
$863.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,606.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,606.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,339.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,339.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,339.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,339.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,177.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.18
|
| Rate for Payer: Vantage Medical Group Senior |
$784.71
|
|
|
HC REP COM 2.6-7.5 CM EYELID, NOS
|
Facility
IP
|
$2,678.00
|
|
|
Service Code
|
CPT 13152
|
| Hospital Charge Code |
900501329
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$535.60 |
| Max. Negotiated Rate |
$2,410.20 |
| Rate for Payer: Cash Price |
$1,205.10
|
| Rate for Payer: Central Health Plan Commercial |
$2,142.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,071.20
|
| Rate for Payer: Galaxy Health WC |
$2,276.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,606.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,410.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,786.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$535.60
|
| Rate for Payer: Multiplan Commercial |
$2,008.50
|
| Rate for Payer: Networks By Design Commercial |
$1,740.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,276.30
|
|
|
HC REP COM 2.6-7.5 CM, FOREHEAD,C
|
Facility
IP
|
$1,868.00
|
|
|
Service Code
|
CPT 13132
|
| Hospital Charge Code |
900501042
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$373.60 |
| Max. Negotiated Rate |
$1,681.20 |
| Rate for Payer: Cash Price |
$840.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,494.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$747.20
|
| Rate for Payer: Galaxy Health WC |
$1,587.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,120.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,681.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,245.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$373.60
|
| Rate for Payer: Multiplan Commercial |
$1,401.00
|
| Rate for Payer: Networks By Design Commercial |
$1,214.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,587.80
|
|
|
HC REP COM 2.6-7.5 CM, FOREHEAD,C
|
Facility
OP
|
$1,868.00
|
|
|
Service Code
|
CPT 13132
|
| Hospital Charge Code |
900501042
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$373.60 |
| Max. Negotiated Rate |
$8,114.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$784.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,177.06
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$863.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$784.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,120.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,174.97
|
| Rate for Payer: Blue Shield of California EPN |
$913.45
|
| Rate for Payer: Caremore Medicare Advantage |
$784.71
|
| Rate for Payer: Cash Price |
$840.60
|
| Rate for Payer: Cash Price |
$840.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,494.40
|
| Rate for Payer: Cigna of CA HMO |
$1,195.52
|
| Rate for Payer: Cigna of CA PPO |
$1,382.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,177.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,059.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$784.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$784.71
|
| Rate for Payer: Galaxy Health WC |
$1,587.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,120.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,681.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,401.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,286.92
|
| Rate for Payer: IEHP medi-cal |
$1,294.77
|
| Rate for Payer: IEHP Medicare Advantage |
$784.71
|
| Rate for Payer: Innovage PACE Commercial |
$1,177.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,245.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$373.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,051.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,051.51
|
| Rate for Payer: Multiplan Commercial |
$1,401.00
|
| Rate for Payer: Networks By Design Commercial |
$1,214.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,587.80
|
| Rate for Payer: Prime Health Services Medicare |
$831.79
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,120.80
|
| Rate for Payer: Riverside University Health MISP |
$863.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,120.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,120.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$934.00
|
| Rate for Payer: United Healthcare All Other HMO |
$934.00
|
| Rate for Payer: United Healthcare HMO Rider |
$934.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$934.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,177.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.18
|
| Rate for Payer: Vantage Medical Group Senior |
$784.71
|
|
|
HC REP COM 2.6-7.5 CM, FOREHEAD,C
|
Facility
IP
|
$1,868.00
|
|
|
Service Code
|
CPT 13132
|
| Hospital Charge Code |
900501042
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$373.60 |
| Max. Negotiated Rate |
$1,681.20 |
| Rate for Payer: Cash Price |
$840.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,494.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$747.20
|
| Rate for Payer: Galaxy Health WC |
$1,587.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,120.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,681.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,245.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$373.60
|
| Rate for Payer: Multiplan Commercial |
$1,401.00
|
| Rate for Payer: Networks By Design Commercial |
$1,214.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,587.80
|
|
