|
HC REPOSITION CENTRAL CATH PICC
|
Facility
|
IP
|
$3,316.00
|
|
|
Service Code
|
CPT 37799
|
| Hospital Charge Code |
901200119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$663.20 |
| Max. Negotiated Rate |
$2,984.40 |
| Rate for Payer: Cash Price |
$1,492.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,652.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,326.40
|
| Rate for Payer: Galaxy Health WC |
$2,818.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,989.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,984.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,211.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,263.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$663.20
|
| Rate for Payer: Multiplan Commercial |
$2,487.00
|
| Rate for Payer: Networks By Design Commercial |
$2,155.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,818.60
|
|
|
HC REPOSITION CENTRAL CATH PICC
|
Facility
|
OP
|
$3,316.00
|
|
|
Service Code
|
CPT 37799
|
| Hospital Charge Code |
901200119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$663.20 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$784.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$784.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,605.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,959.09
|
| Rate for Payer: Blue Distinction Transplant |
$1,989.60
|
| 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 |
$784.90
|
| Rate for Payer: Cash Price |
$1,492.20
|
| Rate for Payer: Cash Price |
$1,492.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,652.80
|
| Rate for Payer: Cigna of CA PPO |
$2,453.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Dignity Health Media |
$784.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$863.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,059.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$784.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$784.90
|
| Rate for Payer: Galaxy Health WC |
$2,818.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,989.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,984.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,487.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,287.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,295.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$784.90
|
| Rate for Payer: InnovAge PACE Commercial |
$1,177.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,211.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$663.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,051.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,051.77
|
| Rate for Payer: Multiplan Commercial |
$2,487.00
|
| Rate for Payer: Networks By Design Commercial |
$2,155.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,818.60
|
| Rate for Payer: Prime Health Services Medicare |
$831.99
|
| Rate for Payer: Riverside University Health System MISP |
$863.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,989.60
|
| 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 |
$1,177.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: Vantage Medical Group Senior |
$784.90
|
|
|
HC REPOSITION CENTRAL CATH PICC
|
Facility
|
OP
|
$3,316.00
|
|
|
Service Code
|
CPT 37799
|
| Hospital Charge Code |
901200119
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| 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: Alpha Care Medical Group Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$784.90
|
| 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: Blue Distinction Transplant |
$1,989.60
|
| Rate for Payer: Caremore Medicare Advantage |
$784.90
|
| Rate for Payer: Cash Price |
$1,492.20
|
| Rate for Payer: Cash Price |
$1,492.20
|
| Rate for Payer: Cash Price |
$1,492.20
|
| Rate for Payer: Cash Price |
$1,492.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,652.80
|
| Rate for Payer: Cigna of CA PPO |
$2,453.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Dignity Health Media |
$784.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$863.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,059.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$784.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$784.90
|
| Rate for Payer: Galaxy Health WC |
$2,818.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,989.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,984.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,487.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,287.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$784.90
|
| Rate for Payer: InnovAge PACE Commercial |
$1,177.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,211.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$663.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,051.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,051.77
|
| Rate for Payer: Multiplan Commercial |
$2,487.00
|
| Rate for Payer: Networks By Design Commercial |
$2,155.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,818.60
|
| Rate for Payer: Prime Health Services Medicare |
$831.99
|
| Rate for Payer: Riverside University Health System MISP |
$863.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,989.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,658.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,658.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,658.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,658.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: Vantage Medical Group Senior |
$784.90
|
|
|
HC REPOSITION CENTRAL CATH PICC
|
Facility
|
IP
|
$3,316.00
|
|
|
Service Code
|
CPT 37799
|
| Hospital Charge Code |
901200119
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$663.20 |
| Max. Negotiated Rate |
$2,984.40 |
| Rate for Payer: Cash Price |
$1,492.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,652.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,326.40
|
| Rate for Payer: Galaxy Health WC |
$2,818.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,989.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,984.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,211.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,263.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$663.20
|
| Rate for Payer: Multiplan Commercial |
$2,487.00
|
| Rate for Payer: Networks By Design Commercial |
$2,155.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,818.60
|
|
|
HC REPOSITION CVP CATH W/FLUORO
|
Facility
|
OP
|
$4,296.00
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
906820089
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$84.89 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,001.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,577.60
|
| 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 |
$1,933.20
|
| Rate for Payer: Cash Price |
$1,933.20
|
| Rate for Payer: Central Health Plan Commercial |
$3,436.80
|
| Rate for Payer: Cigna of CA PPO |
$3,179.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Dignity Health Media |
$2,001.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,201.11
|
| 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 |
$3,651.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,577.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,866.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,222.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,281.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,301.67
|
| Rate for Payer: Inland Empire Health Plan (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 |
$2,865.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$84.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$859.20
|
| 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 |
$3,222.00
|
| Rate for Payer: Networks By Design Commercial |
$2,792.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,651.60
|
| Rate for Payer: Prime Health Services Medicare |
$2,121.07
|
| Rate for Payer: Riverside University Health System MISP |
$2,201.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,577.60
|
| 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 REPOSITION CVP CATH W/FLUORO
|
Facility
|
IP
|
$4,296.00
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
906812250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$859.20 |
| Max. Negotiated Rate |
$3,866.40 |
| Rate for Payer: Cash Price |
$1,933.20
|
| Rate for Payer: Central Health Plan Commercial |
$3,436.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,718.40
|
| Rate for Payer: Galaxy Health WC |
$3,651.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,577.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,866.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,865.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,636.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$859.20
|
| Rate for Payer: Multiplan Commercial |
$3,222.00
|
| Rate for Payer: Networks By Design Commercial |
$2,792.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,651.60
|
|
|
HC REPOSITION CVP CATH W/FLUORO
|
Facility
|
OP
|
$4,296.00
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
906812250
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$84.89 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,001.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,577.60
|
| 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 |
$1,933.20
|
| Rate for Payer: Cash Price |
$1,933.20
|
| Rate for Payer: Central Health Plan Commercial |
$3,436.80
|
| Rate for Payer: Cigna of CA PPO |
$3,179.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Dignity Health Media |
$2,001.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,201.11
|
| 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 |
$3,651.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,577.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,866.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,222.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,281.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,301.67
|
| Rate for Payer: Inland Empire Health Plan (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 |
$2,865.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$84.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$859.20
|
| 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 |
$3,222.00
|
| Rate for Payer: Networks By Design Commercial |
$2,792.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,651.60
|
| Rate for Payer: Prime Health Services Medicare |
$2,121.07
|
| Rate for Payer: Riverside University Health System MISP |
$2,201.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,577.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,577.60
|
| 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 REPOSITION CVP CATH W/FLUORO
|
Facility
|
IP
|
$4,296.00
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
906812250
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$859.20 |
| Max. Negotiated Rate |
$3,866.40 |
| Rate for Payer: Cash Price |
$1,933.20
|
| Rate for Payer: Central Health Plan Commercial |
$3,436.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,718.40
|
| Rate for Payer: Galaxy Health WC |
$3,651.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,577.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,866.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,865.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,636.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$859.20
|
| Rate for Payer: Multiplan Commercial |
$3,222.00
|
| Rate for Payer: Networks By Design Commercial |
$2,792.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,651.60
|
|
|
HC REPOSITION CVP CATH W/FLUORO
|
Facility
|
IP
|
$4,296.00
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
906820089
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$859.20 |
| Max. Negotiated Rate |
$3,866.40 |
| Rate for Payer: Cash Price |
$1,933.20
|
| Rate for Payer: Central Health Plan Commercial |
$3,436.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,718.40
|
| Rate for Payer: Galaxy Health WC |
$3,651.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,577.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,866.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,865.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,636.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$859.20
|
| Rate for Payer: Multiplan Commercial |
$3,222.00
|
| Rate for Payer: Networks By Design Commercial |
$2,792.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,651.60
|
|
|
HC REPOSITION CVP CATH W/FLUORO
|
Facility
|
OP
|
$4,296.00
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
906812250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$84.89 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,001.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,577.60
|
| 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 |
$1,933.20
|
| Rate for Payer: Cash Price |
$1,933.20
|
| Rate for Payer: Central Health Plan Commercial |
$3,436.80
|
| Rate for Payer: Cigna of CA PPO |
$3,179.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Dignity Health Media |
$2,001.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,201.11
|
| 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 |
$3,651.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,577.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,866.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,222.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,281.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,301.67
|
| Rate for Payer: Inland Empire Health Plan (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 |
$2,865.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$84.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$859.20
|
| 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 |
$3,222.00
|
| Rate for Payer: Networks By Design Commercial |
$2,792.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,651.60
|
| Rate for Payer: Prime Health Services Medicare |
$2,121.07
|
| Rate for Payer: Riverside University Health System MISP |
$2,201.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,577.60
|
| 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 REPOSITION VAD DIFF SESSION
|
Facility
|
OP
|
$7,597.00
|
|
|
Service Code
|
CPT 33993
|
| Hospital Charge Code |
906820234
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$55.18 |
| Max. Negotiated Rate |
$13,979.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$938.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,457.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,178.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,178.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,558.20
|
| Rate for Payer: Blue Shield of California Commercial |
$8,958.72
|
| Rate for Payer: Blue Shield of California EPN |
$6,434.55
|
| Rate for Payer: Cash Price |
$3,418.65
|
| Rate for Payer: Cash Price |
$3,418.65
|
| Rate for Payer: Central Health Plan Commercial |
$6,077.60
|
| Rate for Payer: Cigna of CA PPO |
$5,621.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,457.45
|
| Rate for Payer: Dignity Health Media |
$6,457.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,457.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,038.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,038.80
|
| Rate for Payer: Galaxy Health WC |
$6,457.45
|
| Rate for Payer: Global Benefits Group Commercial |
$4,558.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,837.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,697.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,658.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,067.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,519.40
|
| Rate for Payer: Multiplan Commercial |
$5,697.75
|
| Rate for Payer: Networks By Design Commercial |
$4,938.05
|
| Rate for Payer: Prime Health Services Commercial |
$6,457.45
|
| Rate for Payer: Riverside University Health System MISP |
$3,038.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,558.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,558.20
|
| 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 Medi-Cal |
$6,457.45
|
| Rate for Payer: Vantage Medical Group Senior |
$6,457.45
|
|
|
HC REPOSITION VAD DIFF SESSION
|
Facility
|
IP
|
$7,597.00
|
|
|
Service Code
|
CPT 33993
|
| Hospital Charge Code |
906811431
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,519.40 |
| Max. Negotiated Rate |
$6,837.30 |
| Rate for Payer: Cash Price |
$3,418.65
|
| Rate for Payer: Central Health Plan Commercial |
$6,077.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,038.80
|
| Rate for Payer: Galaxy Health WC |
$6,457.45
|
| Rate for Payer: Global Benefits Group Commercial |
$4,558.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,837.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,067.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,894.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,519.40
|
| Rate for Payer: Multiplan Commercial |
$5,697.75
|
| Rate for Payer: Networks By Design Commercial |
$4,938.05
|
| Rate for Payer: Prime Health Services Commercial |
$6,457.45
|
|
|
HC REPOSITION VAD DIFF SESSION
|
Facility
|
IP
|
$7,597.00
|
|
|
Service Code
|
CPT 33993
|
| Hospital Charge Code |
906820234
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,519.40 |
| Max. Negotiated Rate |
$6,837.30 |
| Rate for Payer: Cash Price |
$3,418.65
|
| Rate for Payer: Central Health Plan Commercial |
$6,077.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,038.80
|
| Rate for Payer: Galaxy Health WC |
$6,457.45
|
| Rate for Payer: Global Benefits Group Commercial |
$4,558.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,837.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,067.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,894.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,519.40
|
| Rate for Payer: Multiplan Commercial |
$5,697.75
|
| Rate for Payer: Networks By Design Commercial |
$4,938.05
|
| Rate for Payer: Prime Health Services Commercial |
$6,457.45
|
|
|
HC REPOSITION VAD DIFF SESSION
|
Facility
|
OP
|
$7,597.00
|
|
|
Service Code
|
CPT 33993
|
| Hospital Charge Code |
906811431
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$55.18 |
| Max. Negotiated Rate |
$13,979.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$938.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,457.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,178.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,178.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,558.20
|
| Rate for Payer: Blue Shield of California Commercial |
$8,958.72
|
| Rate for Payer: Blue Shield of California EPN |
$6,434.55
|
| Rate for Payer: Cash Price |
$3,418.65
|
| Rate for Payer: Cash Price |
$3,418.65
|
| Rate for Payer: Central Health Plan Commercial |
$6,077.60
|
| Rate for Payer: Cigna of CA PPO |
$5,621.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,457.45
|
| Rate for Payer: Dignity Health Media |
$6,457.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,457.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,038.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,038.80
|
| Rate for Payer: Galaxy Health WC |
$6,457.45
|
| Rate for Payer: Global Benefits Group Commercial |
$4,558.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,837.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,697.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,658.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,067.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,519.40
|
| Rate for Payer: Multiplan Commercial |
$5,697.75
|
| Rate for Payer: Networks By Design Commercial |
$4,938.05
|
| Rate for Payer: Prime Health Services Commercial |
$6,457.45
|
| Rate for Payer: Riverside University Health System MISP |
$3,038.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,558.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,558.20
|
| 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 Medi-Cal |
$6,457.45
|
| Rate for Payer: Vantage Medical Group Senior |
$6,457.45
|
|
|
HC REP PRIM, RUPTRD ACHILLES TEND
|
Facility
|
IP
|
$16,108.00
|
|
|
Service Code
|
CPT 27650
|
| Hospital Charge Code |
900501585
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,221.60 |
| Max. Negotiated Rate |
$14,497.20 |
| Rate for Payer: Blue Shield of California Commercial |
$12,081.00
|
| Rate for Payer: Cash Price |
$7,248.60
|
| Rate for Payer: Central Health Plan Commercial |
$12,886.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,443.20
|
| Rate for Payer: Galaxy Health WC |
$13,691.80
|
| Rate for Payer: Global Benefits Group Commercial |
$9,664.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,497.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,744.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,137.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,221.60
|
| Rate for Payer: Multiplan Commercial |
$12,081.00
|
| Rate for Payer: Networks By Design Commercial |
$10,470.20
|
| Rate for Payer: Prime Health Services Commercial |
$13,691.80
|
|
|
HC REP PRIM, RUPTRD ACHILLES TEND
|
Facility
|
OP
|
$16,108.00
|
|
|
Service Code
|
CPT 27650
|
| Hospital Charge Code |
900501585
|
|
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 |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,938.53
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$12,220.24
|
| Rate for Payer: Blue Distinction Transplant |
$9,664.80
|
| Rate for Payer: Caremore Medicare Advantage |
$8,938.53
|
| Rate for Payer: Cash Price |
$7,248.60
|
| Rate for Payer: Cash Price |
$7,248.60
|
| Rate for Payer: Cash Price |
$7,248.60
|
| Rate for Payer: Cash Price |
$7,248.60
|
| Rate for Payer: Central Health Plan Commercial |
$12,886.40
|
| Rate for Payer: Cigna of CA PPO |
$11,919.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Dignity Health Media |
$8,938.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,832.38
|
| 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 |
$13,691.80
|
| Rate for Payer: Global Benefits Group Commercial |
$9,664.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,497.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$12,081.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14,659.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (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 |
$10,744.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$881.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,938.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,221.60
|
| 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 |
$12,081.00
|
| Rate for Payer: Multiplan WC |
$12,220.24
|
| Rate for Payer: Networks By Design Commercial |
$10,470.20
|
| Rate for Payer: Preferred Health Network WC |
$12,469.63
|
| Rate for Payer: Prime Health Services Commercial |
$13,691.80
|
| Rate for Payer: Prime Health Services Medicare |
$9,474.84
|
| Rate for Payer: Prime Health Services WC |
$12,095.54
|
| Rate for Payer: Riverside University Health System MISP |
$9,832.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,664.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,054.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,054.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,054.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,054.00
|
| 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 REPR DETACHED RETINA BY INJ
|
Facility
|
IP
|
$7,094.00
|
|
|
Service Code
|
CPT 67110
|
| Hospital Charge Code |
900501721
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,418.80 |
| Max. Negotiated Rate |
$6,384.60 |
| Rate for Payer: Cash Price |
$3,192.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,675.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,837.60
|
| Rate for Payer: Galaxy Health WC |
$6,029.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,256.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,384.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,731.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,702.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,418.80
|
| Rate for Payer: Multiplan Commercial |
$5,320.50
|
| Rate for Payer: Networks By Design Commercial |
$4,611.10
|
| Rate for Payer: Prime Health Services Commercial |
$6,029.90
|
|
|
HC REPR DETACHED RETINA BY INJ
|
Facility
|
OP
|
$7,094.00
|
|
|
Service Code
|
CPT 67110
|
| Hospital Charge Code |
900501721
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,384.60 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,367.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,202.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,911.63
|
| 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: Blue Distinction Transplant |
$4,256.40
|
| Rate for Payer: Caremore Medicare Advantage |
$2,911.63
|
| Rate for Payer: Cash Price |
$3,192.30
|
| Rate for Payer: Cash Price |
$3,192.30
|
| Rate for Payer: Cash Price |
$3,192.30
|
| Rate for Payer: Cash Price |
$3,192.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,675.20
|
| Rate for Payer: Cigna of CA PPO |
$5,249.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,367.44
|
| Rate for Payer: Dignity Health Media |
$2,911.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,202.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,930.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,911.63
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,911.63
|
| Rate for Payer: Galaxy Health WC |
$6,029.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,256.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,384.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,320.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,775.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,911.63
|
| Rate for Payer: InnovAge PACE Commercial |
$4,367.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,731.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,768.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,911.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,418.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,901.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,901.58
|
| Rate for Payer: Multiplan Commercial |
$5,320.50
|
| Rate for Payer: Networks By Design Commercial |
$4,611.10
|
| Rate for Payer: Prime Health Services Commercial |
$6,029.90
|
| Rate for Payer: Prime Health Services Medicare |
$3,086.33
|
| Rate for Payer: Riverside University Health System MISP |
$3,202.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,256.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,547.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,547.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,547.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,547.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,367.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,202.79
|
| Rate for Payer: Vantage Medical Group Senior |
$2,911.63
|
|
|
HC REPR F/THICK VERM LAC, GT 1/2 VE
|
Facility
|
OP
|
$4,564.00
|
|
|
Service Code
|
CPT 40654
|
| Hospital Charge Code |
900501145
|
|
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: Alpha Care Medical Group Commercial/Exchange |
$2,858.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,095.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,905.44
|
| 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: Blue Distinction Transplant |
$2,738.40
|
| Rate for Payer: Caremore Medicare Advantage |
$1,905.44
|
| Rate for Payer: Cash Price |
$2,053.80
|
| Rate for Payer: Cash Price |
$2,053.80
|
| Rate for Payer: Cash Price |
$2,053.80
|
| Rate for Payer: Cash Price |
$2,053.80
|
| Rate for Payer: Central Health Plan Commercial |
$3,651.20
|
| Rate for Payer: Cigna of CA PPO |
$3,377.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,858.16
|
| Rate for Payer: Dignity Health Media |
$1,905.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,095.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,572.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,905.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,905.44
|
| Rate for Payer: Galaxy Health WC |
$3,879.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,738.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,107.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,423.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,124.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,905.44
|
| Rate for Payer: InnovAge PACE Commercial |
$2,858.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,044.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$713.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,905.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$912.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,553.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,553.29
|
| Rate for Payer: Multiplan Commercial |
$3,423.00
|
| Rate for Payer: Networks By Design Commercial |
$2,966.60
|
| Rate for Payer: Prime Health Services Commercial |
$3,879.40
|
| Rate for Payer: Prime Health Services Medicare |
$2,019.77
|
| Rate for Payer: Riverside University Health System MISP |
$2,095.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,738.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,282.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,282.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,282.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,282.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,858.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,095.98
|
| Rate for Payer: Vantage Medical Group Senior |
$1,905.44
|
|
|
HC REPR F/THICK VERM LAC, GT 1/2 VE
|
Facility
|
IP
|
$4,564.00
|
|
|
Service Code
|
CPT 40654
|
| Hospital Charge Code |
900501145
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$912.80 |
| Max. Negotiated Rate |
$4,107.60 |
| Rate for Payer: Cash Price |
$2,053.80
|
| Rate for Payer: Central Health Plan Commercial |
$3,651.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,825.60
|
| Rate for Payer: Galaxy Health WC |
$3,879.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,738.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,107.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,044.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,738.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$912.80
|
| Rate for Payer: Multiplan Commercial |
$3,423.00
|
| Rate for Payer: Networks By Design Commercial |
$2,966.60
|
| Rate for Payer: Prime Health Services Commercial |
$3,879.40
|
|
|
HC REPROGRAM OF PROGRAM CSF SHUNT
|
Facility
|
IP
|
$1,109.00
|
|
|
Service Code
|
CPT 62252
|
| Hospital Charge Code |
900501354
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$221.80 |
| Max. Negotiated Rate |
$998.10 |
| Rate for Payer: Cash Price |
$499.05
|
| Rate for Payer: Central Health Plan Commercial |
$887.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$443.60
|
| Rate for Payer: Galaxy Health WC |
$942.65
|
| Rate for Payer: Global Benefits Group Commercial |
$665.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$998.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$739.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$422.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.80
|
| Rate for Payer: Multiplan Commercial |
$831.75
|
| Rate for Payer: Networks By Design Commercial |
$720.85
|
| Rate for Payer: Prime Health Services Commercial |
$942.65
|
|
|
HC REPROGRAM OF PROGRAM CSF SHUNT
|
Facility
|
IP
|
$1,109.00
|
|
|
Service Code
|
CPT 62252
|
| Hospital Charge Code |
900501354
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$221.80 |
| Max. Negotiated Rate |
$998.10 |
| Rate for Payer: Cash Price |
$499.05
|
| Rate for Payer: Central Health Plan Commercial |
$887.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$443.60
|
| Rate for Payer: Galaxy Health WC |
$942.65
|
| Rate for Payer: Global Benefits Group Commercial |
$665.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$998.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$739.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$422.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.80
|
| Rate for Payer: Multiplan Commercial |
$831.75
|
| Rate for Payer: Networks By Design Commercial |
$720.85
|
| Rate for Payer: Prime Health Services Commercial |
$942.65
|
|
|
HC REPROGRAM OF PROGRAM CSF SHUNT
|
Facility
|
OP
|
$1,109.00
|
|
|
Service Code
|
CPT 62252
|
| Hospital Charge Code |
900501354
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$137.94 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$373.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$256.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$559.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$410.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$373.19
|
| 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: Blue Distinction Transplant |
$665.40
|
| Rate for Payer: Blue Shield of California Commercial |
$697.56
|
| Rate for Payer: Blue Shield of California EPN |
$542.30
|
| Rate for Payer: Caremore Medicare Advantage |
$373.19
|
| Rate for Payer: Cash Price |
$499.05
|
| Rate for Payer: Cash Price |
$499.05
|
| Rate for Payer: Cash Price |
$499.05
|
| Rate for Payer: Central Health Plan Commercial |
$887.20
|
| Rate for Payer: Cigna of CA HMO |
$709.76
|
| Rate for Payer: Cigna of CA PPO |
$820.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$559.78
|
| Rate for Payer: Dignity Health Media |
$373.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$410.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$503.81
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$373.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$373.19
|
| Rate for Payer: Galaxy Health WC |
$942.65
|
| Rate for Payer: Global Benefits Group Commercial |
$665.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$998.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$831.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$612.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$615.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$373.19
|
| Rate for Payer: InnovAge PACE Commercial |
$559.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$739.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$373.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$500.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$500.07
|
| Rate for Payer: Multiplan Commercial |
$831.75
|
| Rate for Payer: Networks By Design Commercial |
$720.85
|
| Rate for Payer: Prime Health Services Commercial |
$942.65
|
| Rate for Payer: Prime Health Services Medicare |
$395.58
|
| Rate for Payer: Riverside University Health System MISP |
$410.51
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$665.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$665.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$554.50
|
| Rate for Payer: United Healthcare All Other HMO |
$554.50
|
| Rate for Payer: United Healthcare HMO Rider |
$554.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$554.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$559.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$410.51
|
| Rate for Payer: Vantage Medical Group Senior |
$373.19
|
|
|
HC REPROGRAM OF PROGRAM CSF SHUNT
|
Facility
|
OP
|
$1,109.00
|
|
|
Service Code
|
CPT 62252
|
| Hospital Charge Code |
900501354
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$137.94 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$559.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$410.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$373.19
|
| 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: Blue Distinction Transplant |
$665.40
|
| Rate for Payer: Caremore Medicare Advantage |
$373.19
|
| Rate for Payer: Cash Price |
$499.05
|
| Rate for Payer: Cash Price |
$499.05
|
| Rate for Payer: Cash Price |
$499.05
|
| Rate for Payer: Cash Price |
$499.05
|
| Rate for Payer: Central Health Plan Commercial |
$887.20
|
| Rate for Payer: Cigna of CA PPO |
$820.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$559.78
|
| Rate for Payer: Dignity Health Media |
$373.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$410.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$503.81
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$373.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$373.19
|
| Rate for Payer: Galaxy Health WC |
$942.65
|
| Rate for Payer: Global Benefits Group Commercial |
$665.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$998.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$831.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$612.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$373.19
|
| Rate for Payer: InnovAge PACE Commercial |
$559.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$739.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$373.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$500.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$500.07
|
| Rate for Payer: Multiplan Commercial |
$831.75
|
| Rate for Payer: Networks By Design Commercial |
$720.85
|
| Rate for Payer: Prime Health Services Commercial |
$942.65
|
| Rate for Payer: Prime Health Services Medicare |
$395.58
|
| Rate for Payer: Riverside University Health System MISP |
$410.51
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$665.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$554.50
|
| Rate for Payer: United Healthcare All Other HMO |
$554.50
|
| Rate for Payer: United Healthcare HMO Rider |
$554.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$554.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$559.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$410.51
|
| Rate for Payer: Vantage Medical Group Senior |
$373.19
|
|
|
HC REPR,PALATE LACERATION LT 2 CM
|
Facility
|
OP
|
$1,167.00
|
|
|
Service Code
|
CPT 42180
|
| Hospital Charge Code |
900501564
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$233.40 |
| 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: Alpha Care Medical Group Commercial/Exchange |
$1,031.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$756.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$687.44
|
| 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: Blue Distinction Transplant |
$700.20
|
| Rate for Payer: Caremore Medicare Advantage |
$687.44
|
| Rate for Payer: Cash Price |
$525.15
|
| Rate for Payer: Cash Price |
$525.15
|
| Rate for Payer: Cash Price |
$525.15
|
| Rate for Payer: Cash Price |
$525.15
|
| Rate for Payer: Central Health Plan Commercial |
$933.60
|
| Rate for Payer: Cigna of CA PPO |
$863.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,031.16
|
| Rate for Payer: Dignity Health Media |
$687.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$756.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$928.04
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$687.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$687.44
|
| Rate for Payer: Galaxy Health WC |
$991.95
|
| Rate for Payer: Global Benefits Group Commercial |
$700.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,050.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$875.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,127.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$687.44
|
| Rate for Payer: InnovAge PACE Commercial |
$1,031.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$778.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$297.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$687.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$233.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$921.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$921.17
|
| Rate for Payer: Multiplan Commercial |
$875.25
|
| Rate for Payer: Networks By Design Commercial |
$758.55
|
| Rate for Payer: Prime Health Services Commercial |
$991.95
|
| Rate for Payer: Prime Health Services Medicare |
$728.69
|
| Rate for Payer: Riverside University Health System MISP |
$756.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$700.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$583.50
|
| Rate for Payer: United Healthcare All Other HMO |
$583.50
|
| Rate for Payer: United Healthcare HMO Rider |
$583.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$583.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,031.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$756.18
|
| Rate for Payer: Vantage Medical Group Senior |
$687.44
|
|
