|
HC REPLC COMP NON/TUN CNTRL INSRT
|
Facility
IP
|
$3,736.00
|
|
|
Service Code
|
CPT 36580
|
| Hospital Charge Code |
909080018
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$747.20 |
| Max. Negotiated Rate |
$3,362.40 |
| Rate for Payer: Cash Price |
$1,681.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,988.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,494.40
|
| Rate for Payer: Galaxy Health WC |
$3,175.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,241.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,362.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,491.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$747.20
|
| Rate for Payer: Multiplan Commercial |
$2,802.00
|
| Rate for Payer: Networks By Design Commercial |
$2,428.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,175.60
|
|
|
HC REPLCMNT GJ TUBE WO FLUORO
|
Facility
OP
|
$4,179.00
|
|
|
Service Code
|
CPT 43999
|
| Hospital Charge Code |
906743990
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$835.80 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,132.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,023.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,468.95
|
| Rate for Payer: BCBS Transplant Transplant |
$2,507.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,132.59
|
| Rate for Payer: Cash Price |
$1,880.55
|
| Rate for Payer: Cash Price |
$1,880.55
|
| Rate for Payer: Central Health Plan Commercial |
$3,343.20
|
| Rate for Payer: Cigna of CA PPO |
$3,092.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$3,552.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,507.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,761.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,134.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,857.45
|
| Rate for Payer: IEHP medi-cal |
$1,868.77
|
| Rate for Payer: IEHP Medicare Advantage |
$1,132.59
|
| Rate for Payer: Innovage PACE Commercial |
$1,698.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,787.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$835.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,517.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$3,134.25
|
| Rate for Payer: Networks By Design Commercial |
$2,716.35
|
| Rate for Payer: Prime Health Services Commercial |
$3,552.15
|
| Rate for Payer: Prime Health Services Medicare |
$1,200.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,245.85
|
| Rate for Payer: Riverside University Health MISP |
$1,245.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,507.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,359.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC REPLCMNT GJ TUBE WO FLUORO
|
Facility
IP
|
$4,179.00
|
|
|
Service Code
|
CPT 43999
|
| Hospital Charge Code |
906743990
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$835.80 |
| Max. Negotiated Rate |
$3,761.10 |
| Rate for Payer: Cash Price |
$1,880.55
|
| Rate for Payer: Central Health Plan Commercial |
$3,343.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,671.60
|
| Rate for Payer: Galaxy Health WC |
$3,552.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,507.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,761.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,787.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$835.80
|
| Rate for Payer: Multiplan Commercial |
$3,134.25
|
| Rate for Payer: Networks By Design Commercial |
$2,716.35
|
| Rate for Payer: Prime Health Services Commercial |
$3,552.15
|
|
|
HC REPLC PERIPH INSRT CV CATH W/O
|
Facility
IP
|
$6,126.00
|
|
|
Service Code
|
CPT 36584
|
| Hospital Charge Code |
909080020
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,225.20 |
| Max. Negotiated Rate |
$5,513.40 |
| Rate for Payer: Cash Price |
$2,756.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,900.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,450.40
|
| Rate for Payer: Galaxy Health WC |
$5,207.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,513.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,086.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,225.20
|
| Rate for Payer: Multiplan Commercial |
$4,594.50
|
| Rate for Payer: Networks By Design Commercial |
$3,981.90
|
| Rate for Payer: Prime Health Services Commercial |
$5,207.10
|
|
|
HC REPLC PERIPH INSRT CV CATH W/O
|
Facility
IP
|
$6,126.00
|
|
|
Service Code
|
CPT 36584
|
| Hospital Charge Code |
901200086
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,225.20 |
| Max. Negotiated Rate |
$5,513.40 |
| Rate for Payer: Cash Price |
$2,756.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,900.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,450.40
|
| Rate for Payer: Galaxy Health WC |
$5,207.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,513.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,086.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,225.20
|
| Rate for Payer: Multiplan Commercial |
$4,594.50
|
| Rate for Payer: Networks By Design Commercial |
$3,981.90
|
| Rate for Payer: Prime Health Services Commercial |
$5,207.10
|
|
|
HC REPLC PERIPH INSRT CV CATH W/O
|
Facility
IP
|
$6,126.00
|
|
|
Service Code
|
CPT 36584
|
| Hospital Charge Code |
909080020
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$1,225.20 |
| Max. Negotiated Rate |
$5,513.40 |
| Rate for Payer: Cash Price |
$2,756.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,900.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,450.40
|
| Rate for Payer: Galaxy Health WC |
$5,207.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,513.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,086.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,225.20
|
| Rate for Payer: Multiplan Commercial |
$4,594.50
|
| Rate for Payer: Networks By Design Commercial |
$3,981.90
|
| Rate for Payer: Prime Health Services Commercial |
$5,207.10
|
|
|
HC REPLC PERIPH INSRT CV CATH W/O
|
Facility
OP
|
$6,126.00
|
|
|
Service Code
|
CPT 36584
|
| Hospital Charge Code |
909080020
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$5,513.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,675.60
|
| Rate for Payer: Caremore Medicare Advantage |
$2,001.01
|
| Rate for Payer: Cash Price |
$2,756.70
|
| Rate for Payer: Cash Price |
$2,756.70
|
| Rate for Payer: Cash Price |
$2,756.70
|
| Rate for Payer: Cash Price |
$2,756.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,900.80
|
| Rate for Payer: Cigna of CA PPO |
$4,533.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,701.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,001.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,001.01
|
| Rate for Payer: Galaxy Health WC |
$5,207.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,513.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,594.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,281.66
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$2,001.01
|
| Rate for Payer: Innovage PACE Commercial |
$3,001.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,086.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,225.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,681.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,681.35
|
| Rate for Payer: Multiplan Commercial |
$4,594.50
|
| Rate for Payer: Networks By Design Commercial |
$3,981.90
|
| Rate for Payer: Prime Health Services Commercial |
$5,207.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,121.07
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,675.60
|
| Rate for Payer: Riverside University Health MISP |
$2,201.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,675.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,063.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,063.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,063.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,063.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Vantage Medical Group Senior |
$2,001.01
|
|
|
HC REPLC PERIPH INSRT CV CATH W/O
|
Facility
OP
|
$6,126.00
|
|
|
Service Code
|
CPT 36584
|
| Hospital Charge Code |
909080020
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,225.20 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,001.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,675.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$2,001.01
|
| Rate for Payer: Cash Price |
$2,756.70
|
| Rate for Payer: Cash Price |
$2,756.70
|
| Rate for Payer: Cash Price |
$2,756.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,900.80
|
| Rate for Payer: Cigna of CA PPO |
$4,533.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,701.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,001.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,001.01
|
| Rate for Payer: Galaxy Health WC |
$5,207.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,513.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,594.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,281.66
|
| Rate for Payer: IEHP medi-cal |
$3,301.67
|
| Rate for Payer: IEHP Medicare Advantage |
$2,001.01
|
| Rate for Payer: Innovage PACE Commercial |
$3,001.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,086.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,225.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,681.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,681.35
|
| Rate for Payer: Multiplan Commercial |
$4,594.50
|
| Rate for Payer: Networks By Design Commercial |
$3,981.90
|
| Rate for Payer: Prime Health Services Commercial |
$5,207.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,121.07
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,675.60
|
| Rate for Payer: Riverside University Health MISP |
$2,201.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,675.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Vantage Medical Group Senior |
$2,001.01
|
|
|
HC REPLC PERIPH INSRT CV CATH W/O
|
Facility
OP
|
$6,126.00
|
|
|
Service Code
|
CPT 36584
|
| Hospital Charge Code |
901200086
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,225.20 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,001.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,675.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$2,001.01
|
| Rate for Payer: Cash Price |
$2,756.70
|
| Rate for Payer: Cash Price |
$2,756.70
|
| Rate for Payer: Cash Price |
$2,756.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,900.80
|
| Rate for Payer: Cigna of CA PPO |
$4,533.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,701.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,001.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,001.01
|
| Rate for Payer: Galaxy Health WC |
$5,207.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,513.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,594.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,281.66
|
| Rate for Payer: IEHP medi-cal |
$3,301.67
|
| Rate for Payer: IEHP Medicare Advantage |
$2,001.01
|
| Rate for Payer: Innovage PACE Commercial |
$3,001.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,086.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,225.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,681.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,681.35
|
| Rate for Payer: Multiplan Commercial |
$4,594.50
|
| Rate for Payer: Networks By Design Commercial |
$3,981.90
|
| Rate for Payer: Prime Health Services Commercial |
$5,207.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,121.07
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,675.60
|
| Rate for Payer: Riverside University Health MISP |
$2,201.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,675.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Vantage Medical Group Senior |
$2,001.01
|
|
|
HC REPLC PERIPH INSRT CV CATH W/O
|
Facility
OP
|
$6,126.00
|
|
|
Service Code
|
CPT 36584
|
| Hospital Charge Code |
909080020
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$1,225.20 |
| Max. Negotiated Rate |
$5,513.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,001.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,675.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,853.25
|
| Rate for Payer: Blue Shield of California EPN |
$2,995.61
|
| Rate for Payer: Caremore Medicare Advantage |
$2,001.01
|
| Rate for Payer: Cash Price |
$2,756.70
|
| Rate for Payer: Cash Price |
$2,756.70
|
| Rate for Payer: Cash Price |
$2,756.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,900.80
|
| Rate for Payer: Cigna of CA HMO |
$3,920.64
|
| Rate for Payer: Cigna of CA PPO |
$4,533.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,701.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,001.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,001.01
|
| Rate for Payer: Galaxy Health WC |
$5,207.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,513.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,594.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,281.66
|
| Rate for Payer: IEHP medi-cal |
$3,301.67
|
| Rate for Payer: IEHP Medicare Advantage |
$2,001.01
|
| Rate for Payer: Innovage PACE Commercial |
$3,001.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,086.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,225.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,681.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,681.35
|
| Rate for Payer: Multiplan Commercial |
$4,594.50
|
| Rate for Payer: Networks By Design Commercial |
$3,981.90
|
| Rate for Payer: Prime Health Services Commercial |
$5,207.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,121.07
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,675.60
|
| Rate for Payer: Riverside University Health MISP |
$2,201.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,675.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,675.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,063.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,063.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,063.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,063.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Vantage Medical Group Senior |
$2,001.01
|
|
|
HC REPLC PERIPH INSRT CV CATH W/O
|
Facility
IP
|
$6,126.00
|
|
|
Service Code
|
CPT 36584
|
| Hospital Charge Code |
909080020
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,225.20 |
| Max. Negotiated Rate |
$5,513.40 |
| Rate for Payer: Cash Price |
$2,756.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,900.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,450.40
|
| Rate for Payer: Galaxy Health WC |
$5,207.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,513.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,086.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,225.20
|
| Rate for Payer: Multiplan Commercial |
$4,594.50
|
| Rate for Payer: Networks By Design Commercial |
$3,981.90
|
| Rate for Payer: Prime Health Services Commercial |
$5,207.10
|
|
|
HC REPLC SOCKT ABOVE ELBOW DISA
|
Facility
IP
|
$4,980.00
|
|
|
Service Code
|
CPT L6884
|
| Hospital Charge Code |
905356884
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$996.00 |
| Max. Negotiated Rate |
$4,482.00 |
| Rate for Payer: Blue Shield of California EPN |
$2,659.32
|
| Rate for Payer: Cash Price |
$2,241.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,984.00
|
| Rate for Payer: Cigna of CA HMO |
$3,486.00
|
| Rate for Payer: Cigna of CA PPO |
$3,486.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,992.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,992.00
|
| Rate for Payer: Galaxy Health WC |
$4,233.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,988.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,482.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,321.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$996.00
|
| Rate for Payer: Multiplan Commercial |
$3,735.00
|
| Rate for Payer: Networks By Design Commercial |
$2,490.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,233.00
|
|
|
HC REPLC SOCKT ABOVE ELBOW DISA
|
Facility
OP
|
$4,980.00
|
|
|
Service Code
|
CPT L6884
|
| Hospital Charge Code |
905356884
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,743.00 |
| Max. Negotiated Rate |
$9,874.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,874.49
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,233.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,739.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,739.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,411.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,942.18
|
| Rate for Payer: BCBS Transplant Transplant |
$2,988.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,735.00
|
| Rate for Payer: Blue Shield of California EPN |
$2,709.12
|
| Rate for Payer: Cash Price |
$2,241.00
|
| Rate for Payer: Cash Price |
$2,241.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,984.00
|
| Rate for Payer: Cigna of CA HMO |
$3,486.00
|
| Rate for Payer: Cigna of CA PPO |
$3,486.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,233.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,992.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,992.00
|
| Rate for Payer: Galaxy Health WC |
$4,233.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,988.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,482.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,735.00
|
| Rate for Payer: IEHP medi-cal |
$1,743.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,321.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,041.80
|
| Rate for Payer: Multiplan Commercial |
$3,735.00
|
| Rate for Payer: Networks By Design Commercial |
$2,490.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,233.00
|
| Rate for Payer: Riverside University Health MISP |
$1,992.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,988.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,988.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,490.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,490.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,490.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,490.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,233.00
|
| Rate for Payer: Vantage Medical Group Senior |
$4,233.00
|
|
|
HC REPLC SOCKT BELOW E/W DISA
|
Facility
IP
|
$2,875.00
|
|
|
Service Code
|
CPT L6883
|
| Hospital Charge Code |
905356883
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$575.00 |
| Max. Negotiated Rate |
$2,587.50 |
| Rate for Payer: Blue Shield of California EPN |
$1,535.25
|
| Rate for Payer: Cash Price |
$1,293.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,300.00
|
| Rate for Payer: Cigna of CA HMO |
$2,012.50
|
| Rate for Payer: Cigna of CA PPO |
$2,012.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,150.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,150.00
|
| Rate for Payer: Galaxy Health WC |
$2,443.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,725.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,587.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,917.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$575.00
|
| Rate for Payer: Multiplan Commercial |
$2,156.25
|
| Rate for Payer: Networks By Design Commercial |
$1,437.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,443.75
|
|
|
HC REPLC SOCKT BELOW E/W DISA
|
Facility
OP
|
$2,875.00
|
|
|
Service Code
|
CPT L6883
|
| Hospital Charge Code |
905356883
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,006.25 |
| Max. Negotiated Rate |
$7,018.87 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,018.87
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,443.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,581.25
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,581.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,392.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,698.55
|
| Rate for Payer: BCBS Transplant Transplant |
$1,725.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,156.25
|
| Rate for Payer: Blue Shield of California EPN |
$1,564.00
|
| Rate for Payer: Cash Price |
$1,293.75
|
| Rate for Payer: Cash Price |
$1,293.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,300.00
|
| Rate for Payer: Cigna of CA HMO |
$2,012.50
|
| Rate for Payer: Cigna of CA PPO |
$2,012.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,443.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,150.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,150.00
|
| Rate for Payer: Galaxy Health WC |
$2,443.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,725.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,587.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,156.25
|
| Rate for Payer: IEHP medi-cal |
$1,006.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,917.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,178.75
|
| Rate for Payer: Multiplan Commercial |
$2,156.25
|
| Rate for Payer: Networks By Design Commercial |
$1,437.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,443.75
|
| Rate for Payer: Riverside University Health MISP |
$1,150.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,725.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,725.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,437.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,437.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,437.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,437.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,443.75
|
| Rate for Payer: Vantage Medical Group Senior |
$2,443.75
|
|
|
HC REPLC SOCKT SHLDR DIS/INTERC
|
Facility
IP
|
$7,105.00
|
|
|
Service Code
|
CPT L6885
|
| Hospital Charge Code |
905356885
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,421.00 |
| Max. Negotiated Rate |
$6,394.50 |
| Rate for Payer: Blue Shield of California EPN |
$3,794.07
|
| Rate for Payer: Cash Price |
$3,197.25
|
| Rate for Payer: Central Health Plan Commercial |
$5,684.00
|
| Rate for Payer: Cigna of CA HMO |
$4,973.50
|
| Rate for Payer: Cigna of CA PPO |
$4,973.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,842.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,842.00
|
| Rate for Payer: Galaxy Health WC |
$6,039.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,263.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,394.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,739.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,421.00
|
| Rate for Payer: Multiplan Commercial |
$5,328.75
|
| Rate for Payer: Networks By Design Commercial |
$3,552.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,039.25
|
|
|
HC REPLC SOCKT SHLDR DIS/INTERC
|
Facility
OP
|
$7,105.00
|
|
|
Service Code
|
CPT L6885
|
| Hospital Charge Code |
905356885
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$2,486.75 |
| Max. Negotiated Rate |
$14,088.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$14,088.18
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,039.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,907.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,907.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,440.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,197.63
|
| Rate for Payer: BCBS Transplant Transplant |
$4,263.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,328.75
|
| Rate for Payer: Blue Shield of California EPN |
$3,865.12
|
| Rate for Payer: Cash Price |
$3,197.25
|
| Rate for Payer: Cash Price |
$3,197.25
|
| Rate for Payer: Central Health Plan Commercial |
$5,684.00
|
| Rate for Payer: Cigna of CA HMO |
$4,973.50
|
| Rate for Payer: Cigna of CA PPO |
$4,973.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,039.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,842.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,842.00
|
| Rate for Payer: Galaxy Health WC |
$6,039.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,263.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,394.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,328.75
|
| Rate for Payer: IEHP medi-cal |
$2,486.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,739.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,913.05
|
| Rate for Payer: Multiplan Commercial |
$5,328.75
|
| Rate for Payer: Networks By Design Commercial |
$3,552.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,039.25
|
| Rate for Payer: Riverside University Health MISP |
$2,842.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,263.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,263.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,552.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,552.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,552.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,552.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,039.25
|
| Rate for Payer: Vantage Medical Group Senior |
$6,039.25
|
|
|
HC REPLC TUN CNTRL INSRT CATH W/O
|
Facility
IP
|
$9,240.00
|
|
|
Service Code
|
CPT 36581
|
| Hospital Charge Code |
909080019
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,848.00 |
| Max. Negotiated Rate |
$8,316.00 |
| Rate for Payer: Cash Price |
$4,158.00
|
| Rate for Payer: Central Health Plan Commercial |
$7,392.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,696.00
|
| Rate for Payer: Galaxy Health WC |
$7,854.00
|
| Rate for Payer: Global Benefits Group Commercial |
$5,544.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,316.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,163.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,848.00
|
| Rate for Payer: Multiplan Commercial |
$6,930.00
|
| Rate for Payer: Networks By Design Commercial |
$6,006.00
|
| Rate for Payer: Prime Health Services Commercial |
$7,854.00
|
|
|
HC REPLC TUN CNTRL INSRT CATH W/O
|
Facility
OP
|
$9,240.00
|
|
|
Service Code
|
CPT 36581
|
| Hospital Charge Code |
909080019
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,848.00 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| 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 |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$5,544.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$4,158.00
|
| Rate for Payer: Cash Price |
$4,158.00
|
| Rate for Payer: Cash Price |
$4,158.00
|
| Rate for Payer: Central Health Plan Commercial |
$7,392.00
|
| Rate for Payer: Cigna of CA PPO |
$6,837.60
|
| 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 |
$7,854.00
|
| Rate for Payer: Global Benefits Group Commercial |
$5,544.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,316.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6,930.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: IEHP medi-cal |
$6,571.21
|
| 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 |
$6,163.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,848.00
|
| 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 |
$6,930.00
|
| Rate for Payer: Networks By Design Commercial |
$6,006.00
|
| Rate for Payer: Prime Health Services Commercial |
$7,854.00
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,544.00
|
| Rate for Payer: Riverside University Health MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,544.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| 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 LEG TENDON PRIMARY EA
|
Facility
IP
|
$10,237.00
|
|
|
Service Code
|
CPT 27664
|
| Hospital Charge Code |
900501603
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,047.40 |
| Max. Negotiated Rate |
$9,213.30 |
| Rate for Payer: Blue Shield of California Commercial |
$7,677.75
|
| Rate for Payer: Cash Price |
$4,606.65
|
| Rate for Payer: Central Health Plan Commercial |
$8,189.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,094.80
|
| Rate for Payer: Galaxy Health WC |
$8,701.45
|
| Rate for Payer: Global Benefits Group Commercial |
$6,142.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,213.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,828.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,047.40
|
| Rate for Payer: Multiplan Commercial |
$7,677.75
|
| Rate for Payer: Networks By Design Commercial |
$6,654.05
|
| Rate for Payer: Prime Health Services Commercial |
$8,701.45
|
|
|
HC REP LEG TENDON PRIMARY EA
|
Facility
OP
|
$10,237.00
|
|
|
Service Code
|
CPT 27664
|
| Hospital Charge Code |
900501603
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$14,659.19 |
| 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 |
$13,407.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8,938.53
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$12,220.24
|
| Rate for Payer: BCBS Transplant Transplant |
$6,142.20
|
| Rate for Payer: Caremore Medicare Advantage |
$8,938.53
|
| Rate for Payer: Cash Price |
$4,606.65
|
| Rate for Payer: Cash Price |
$4,606.65
|
| Rate for Payer: Cash Price |
$4,606.65
|
| Rate for Payer: Cash Price |
$4,606.65
|
| Rate for Payer: Central Health Plan Commercial |
$8,189.60
|
| Rate for Payer: Cigna of CA PPO |
$7,575.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,407.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,067.02
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,938.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,938.53
|
| Rate for Payer: Galaxy Health WC |
$8,701.45
|
| Rate for Payer: Global Benefits Group Commercial |
$6,142.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,213.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7,677.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14,659.19
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$8,938.53
|
| Rate for Payer: Innovage PACE Commercial |
$13,407.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,828.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,938.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,047.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,977.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,977.63
|
| Rate for Payer: Multiplan Commercial |
$7,677.75
|
| Rate for Payer: Multiplan WC |
$12,220.24
|
| Rate for Payer: Networks By Design Commercial |
$6,654.05
|
| Rate for Payer: Preferred Health Network WC |
$12,469.63
|
| Rate for Payer: Prime Health Services Commercial |
$8,701.45
|
| Rate for Payer: Prime Health Services Medicare |
$9,474.84
|
| Rate for Payer: Prime Health Services WC |
$12,095.54
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6,142.20
|
| Rate for Payer: Riverside University Health MISP |
$9,832.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,142.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,118.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,118.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,118.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,118.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: Vantage Medical Group Senior |
$8,938.53
|
|
|
HC REP OF NAIL BED
|
Facility
IP
|
$2,078.00
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
900501018
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$415.60 |
| Max. Negotiated Rate |
$1,870.20 |
| Rate for Payer: Cash Price |
$935.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,662.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$831.20
|
| Rate for Payer: Galaxy Health WC |
$1,766.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,246.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,870.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,386.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$415.60
|
| Rate for Payer: Multiplan Commercial |
$1,558.50
|
| Rate for Payer: Networks By Design Commercial |
$1,350.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,766.30
|
|
|
HC REP OF NAIL BED
|
Facility
OP
|
$2,078.00
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
900501018
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$415.60 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$784.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| 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 |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,246.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,307.06
|
| Rate for Payer: Blue Shield of California EPN |
$1,016.14
|
| Rate for Payer: Caremore Medicare Advantage |
$784.71
|
| Rate for Payer: Cash Price |
$935.10
|
| Rate for Payer: Cash Price |
$935.10
|
| Rate for Payer: Cash Price |
$935.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,662.40
|
| Rate for Payer: Cigna of CA HMO |
$1,329.92
|
| Rate for Payer: Cigna of CA PPO |
$1,537.72
|
| 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 |
$1,766.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,246.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,870.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,558.50
|
| 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 |
$1,386.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$415.60
|
| 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 |
$1,558.50
|
| Rate for Payer: Networks By Design Commercial |
$1,350.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,766.30
|
| Rate for Payer: Prime Health Services Medicare |
$831.79
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,246.80
|
| Rate for Payer: Riverside University Health MISP |
$863.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,246.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,246.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,039.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,039.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,039.00
|
| 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 OF NAIL BED
|
Facility
IP
|
$2,078.00
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
900501018
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$415.60 |
| Max. Negotiated Rate |
$1,870.20 |
| Rate for Payer: Cash Price |
$935.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,662.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$831.20
|
| Rate for Payer: Galaxy Health WC |
$1,766.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,246.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,870.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,386.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$415.60
|
| Rate for Payer: Multiplan Commercial |
$1,558.50
|
| Rate for Payer: Networks By Design Commercial |
$1,350.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,766.30
|
|
|
HC REP OF NAIL BED
|
Facility
OP
|
$2,078.00
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
900501018
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| 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 |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,246.80
|
| Rate for Payer: Caremore Medicare Advantage |
$784.71
|
| Rate for Payer: Cash Price |
$935.10
|
| Rate for Payer: Cash Price |
$935.10
|
| Rate for Payer: Cash Price |
$935.10
|
| Rate for Payer: Cash Price |
$935.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,662.40
|
| Rate for Payer: Cigna of CA PPO |
$1,537.72
|
| 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 |
$1,766.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,246.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,870.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,558.50
|
| 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 |
$1,386.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$415.60
|
| 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 |
$1,558.50
|
| Rate for Payer: Networks By Design Commercial |
$1,350.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,766.30
|
| Rate for Payer: Prime Health Services Medicare |
$831.79
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,246.80
|
| Rate for Payer: Riverside University Health MISP |
$863.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,246.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,039.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,039.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,039.00
|
| 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
|
|
