|
HC REPR,PALATE LACERATION LT 2 CM
|
Facility
|
IP
|
$1,167.00
|
|
|
Service Code
|
CPT 42180
|
| Hospital Charge Code |
900501564
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$233.40 |
| Max. Negotiated Rate |
$1,050.30 |
| Rate for Payer: Cash Price |
$525.15
|
| Rate for Payer: Central Health Plan Commercial |
$933.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$466.80
|
| 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: Kaiser Permanente of CA Commercial/Self Funded |
$778.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$444.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$233.40
|
| 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
|
|
|
HC REPR POST LINGUAL LAC LT 2.5CM
|
Facility
|
OP
|
$5,008.00
|
|
|
Service Code
|
CPT 41251
|
| Hospital Charge Code |
900501149
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$145.71 |
| 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 |
$457.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$305.19
|
| 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 |
$3,004.80
|
| Rate for Payer: Caremore Medicare Advantage |
$305.19
|
| Rate for Payer: Cash Price |
$2,253.60
|
| Rate for Payer: Cash Price |
$2,253.60
|
| Rate for Payer: Cash Price |
$2,253.60
|
| Rate for Payer: Cash Price |
$2,253.60
|
| Rate for Payer: Central Health Plan Commercial |
$4,006.40
|
| Rate for Payer: Cigna of CA PPO |
$3,705.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: Dignity Health Media |
$305.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$4,256.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,004.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,507.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,756.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$500.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$305.19
|
| Rate for Payer: InnovAge PACE Commercial |
$457.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,340.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$145.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,001.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$3,756.00
|
| Rate for Payer: Networks By Design Commercial |
$3,255.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,256.80
|
| Rate for Payer: Prime Health Services Medicare |
$323.50
|
| Rate for Payer: Riverside University Health System MISP |
$335.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,004.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,504.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,504.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,504.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,504.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC REPR POST LINGUAL LAC LT 2.5CM
|
Facility
|
OP
|
$5,008.00
|
|
|
Service Code
|
CPT 41251
|
| Hospital Charge Code |
900501149
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$145.71 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$305.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$305.19
|
| 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 |
$3,004.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,150.03
|
| Rate for Payer: Blue Shield of California EPN |
$2,448.91
|
| Rate for Payer: Caremore Medicare Advantage |
$305.19
|
| Rate for Payer: Cash Price |
$2,253.60
|
| Rate for Payer: Cash Price |
$2,253.60
|
| Rate for Payer: Central Health Plan Commercial |
$4,006.40
|
| Rate for Payer: Cigna of CA HMO |
$3,205.12
|
| Rate for Payer: Cigna of CA PPO |
$3,705.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: Dignity Health Media |
$305.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$4,256.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,004.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,507.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,756.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$500.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$503.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$305.19
|
| Rate for Payer: InnovAge PACE Commercial |
$457.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,340.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$145.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,001.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$3,756.00
|
| Rate for Payer: Networks By Design Commercial |
$3,255.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,256.80
|
| Rate for Payer: Prime Health Services Medicare |
$323.50
|
| Rate for Payer: Riverside University Health System MISP |
$335.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,004.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,004.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,504.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,504.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,504.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,504.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC REPR POST LINGUAL LAC LT 2.5CM
|
Facility
|
IP
|
$5,008.00
|
|
|
Service Code
|
CPT 41251
|
| Hospital Charge Code |
900501149
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$1,001.60 |
| Max. Negotiated Rate |
$4,507.20 |
| Rate for Payer: Cash Price |
$2,253.60
|
| Rate for Payer: Central Health Plan Commercial |
$4,006.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,003.20
|
| Rate for Payer: Galaxy Health WC |
$4,256.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,004.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,507.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,340.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,908.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,001.60
|
| Rate for Payer: Multiplan Commercial |
$3,756.00
|
| Rate for Payer: Networks By Design Commercial |
$3,255.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,256.80
|
|
|
HC REPR POST LINGUAL LAC LT 2.5CM
|
Facility
|
IP
|
$5,008.00
|
|
|
Service Code
|
CPT 41251
|
| Hospital Charge Code |
900501149
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,001.60 |
| Max. Negotiated Rate |
$4,507.20 |
| Rate for Payer: Cash Price |
$2,253.60
|
| Rate for Payer: Central Health Plan Commercial |
$4,006.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,003.20
|
| Rate for Payer: Galaxy Health WC |
$4,256.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,004.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,507.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,340.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,908.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,001.60
|
| Rate for Payer: Multiplan Commercial |
$3,756.00
|
| Rate for Payer: Networks By Design Commercial |
$3,255.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,256.80
|
|
|
HC REPR SUB/ANT LINGL LAC LT 2.5C
|
Facility
|
IP
|
$1,555.00
|
|
|
Service Code
|
CPT 41250
|
| Hospital Charge Code |
900501148
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$311.00 |
| Max. Negotiated Rate |
$1,399.50 |
| Rate for Payer: Cash Price |
$699.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,244.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$622.00
|
| Rate for Payer: Galaxy Health WC |
$1,321.75
|
| Rate for Payer: Global Benefits Group Commercial |
$933.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,399.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,037.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$592.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$311.00
|
| Rate for Payer: Multiplan Commercial |
$1,166.25
|
| Rate for Payer: Networks By Design Commercial |
$1,010.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,321.75
|
|
|
HC REPR SUB/ANT LINGL LAC LT 2.5C
|
Facility
|
OP
|
$1,555.00
|
|
|
Service Code
|
CPT 41250
|
| Hospital Charge Code |
900501148
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$142.18 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$497.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$746.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$547.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$497.82
|
| 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 |
$933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$978.10
|
| Rate for Payer: Blue Shield of California EPN |
$760.40
|
| Rate for Payer: Caremore Medicare Advantage |
$497.82
|
| Rate for Payer: Cash Price |
$699.75
|
| Rate for Payer: Cash Price |
$699.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,244.00
|
| Rate for Payer: Cigna of CA HMO |
$995.20
|
| Rate for Payer: Cigna of CA PPO |
$1,150.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$746.73
|
| Rate for Payer: Dignity Health Media |
$497.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$547.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$672.06
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$497.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$497.82
|
| Rate for Payer: Galaxy Health WC |
$1,321.75
|
| Rate for Payer: Global Benefits Group Commercial |
$933.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,399.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,166.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$816.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$821.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$497.82
|
| Rate for Payer: InnovAge PACE Commercial |
$746.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,037.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$497.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$311.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$667.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$667.08
|
| Rate for Payer: Multiplan Commercial |
$1,166.25
|
| Rate for Payer: Networks By Design Commercial |
$1,010.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,321.75
|
| Rate for Payer: Prime Health Services Medicare |
$527.69
|
| Rate for Payer: Riverside University Health System MISP |
$547.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$933.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$933.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$777.50
|
| Rate for Payer: United Healthcare All Other HMO |
$777.50
|
| Rate for Payer: United Healthcare HMO Rider |
$777.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$777.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$746.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$547.60
|
| Rate for Payer: Vantage Medical Group Senior |
$497.82
|
|
|
HC REPR SUB/ANT LINGL LAC LT 2.5C
|
Facility
|
OP
|
$1,555.00
|
|
|
Service Code
|
CPT 41250
|
| Hospital Charge Code |
900501148
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$142.18 |
| 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 |
$746.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$547.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$497.82
|
| 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 |
$933.00
|
| Rate for Payer: Caremore Medicare Advantage |
$497.82
|
| Rate for Payer: Cash Price |
$699.75
|
| Rate for Payer: Cash Price |
$699.75
|
| Rate for Payer: Cash Price |
$699.75
|
| Rate for Payer: Cash Price |
$699.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,244.00
|
| Rate for Payer: Cigna of CA PPO |
$1,150.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$746.73
|
| Rate for Payer: Dignity Health Media |
$497.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$547.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$672.06
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$497.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$497.82
|
| Rate for Payer: Galaxy Health WC |
$1,321.75
|
| Rate for Payer: Global Benefits Group Commercial |
$933.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,399.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,166.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$816.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$497.82
|
| Rate for Payer: InnovAge PACE Commercial |
$746.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,037.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$497.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$311.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$667.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$667.08
|
| Rate for Payer: Multiplan Commercial |
$1,166.25
|
| Rate for Payer: Networks By Design Commercial |
$1,010.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,321.75
|
| Rate for Payer: Prime Health Services Medicare |
$527.69
|
| Rate for Payer: Riverside University Health System MISP |
$547.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$933.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$777.50
|
| Rate for Payer: United Healthcare All Other HMO |
$777.50
|
| Rate for Payer: United Healthcare HMO Rider |
$777.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$777.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$746.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$547.60
|
| Rate for Payer: Vantage Medical Group Senior |
$497.82
|
|
|
HC REPR SUB/ANT LINGL LAC LT 2.5C
|
Facility
|
IP
|
$1,555.00
|
|
|
Service Code
|
CPT 41250
|
| Hospital Charge Code |
900501148
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$311.00 |
| Max. Negotiated Rate |
$1,399.50 |
| Rate for Payer: Cash Price |
$699.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,244.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$622.00
|
| Rate for Payer: Galaxy Health WC |
$1,321.75
|
| Rate for Payer: Global Benefits Group Commercial |
$933.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,399.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,037.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$592.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$311.00
|
| Rate for Payer: Multiplan Commercial |
$1,166.25
|
| Rate for Payer: Networks By Design Commercial |
$1,010.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,321.75
|
|
|
HC REP TEND/MUSC FLEX,FOREARM
|
Facility
|
IP
|
$9,379.00
|
|
|
Service Code
|
CPT 25260
|
| Hospital Charge Code |
900501066
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,875.80 |
| Max. Negotiated Rate |
$8,441.10 |
| Rate for Payer: Cash Price |
$4,220.55
|
| Rate for Payer: Central Health Plan Commercial |
$7,503.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,751.60
|
| Rate for Payer: Galaxy Health WC |
$7,972.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,627.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,441.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,255.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,573.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,875.80
|
| Rate for Payer: Multiplan Commercial |
$7,034.25
|
| Rate for Payer: Networks By Design Commercial |
$6,096.35
|
| Rate for Payer: Prime Health Services Commercial |
$7,972.15
|
|
|
HC REP TEND/MUSC FLEX,FOREARM
|
Facility
|
OP
|
$9,379.00
|
|
|
Service Code
|
CPT 25260
|
| Hospital Charge Code |
900501066
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$10,567.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,627.40
|
| Rate for Payer: Caremore Medicare Advantage |
$4,044.21
|
| Rate for Payer: Cash Price |
$4,220.55
|
| Rate for Payer: Cash Price |
$4,220.55
|
| Rate for Payer: Cash Price |
$4,220.55
|
| Rate for Payer: Cash Price |
$4,220.55
|
| Rate for Payer: Central Health Plan Commercial |
$7,503.20
|
| Rate for Payer: Cigna of CA PPO |
$6,940.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Dignity Health Media |
$4,044.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,459.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,044.21
|
| Rate for Payer: Galaxy Health WC |
$7,972.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,627.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,441.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,034.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,632.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,044.21
|
| Rate for Payer: InnovAge PACE Commercial |
$6,066.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,255.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$710.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,044.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,875.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,419.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,419.24
|
| Rate for Payer: Multiplan Commercial |
$7,034.25
|
| Rate for Payer: Networks By Design Commercial |
$6,096.35
|
| Rate for Payer: Prime Health Services Commercial |
$7,972.15
|
| Rate for Payer: Prime Health Services Medicare |
$4,286.86
|
| Rate for Payer: Riverside University Health System MISP |
$4,448.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,627.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,689.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,689.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,689.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,689.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
|
HC REP TEND/MUSC FLEX,FOREARM
|
Facility
|
OP
|
$9,379.00
|
|
|
Service Code
|
CPT 25260
|
| Hospital Charge Code |
900501066
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$710.20 |
| Max. Negotiated Rate |
$10,567.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,044.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,627.40
|
| Rate for Payer: Blue Shield of California Commercial |
$5,899.39
|
| Rate for Payer: Blue Shield of California EPN |
$4,586.33
|
| Rate for Payer: Caremore Medicare Advantage |
$4,044.21
|
| Rate for Payer: Cash Price |
$4,220.55
|
| Rate for Payer: Cash Price |
$4,220.55
|
| Rate for Payer: Central Health Plan Commercial |
$7,503.20
|
| Rate for Payer: Cigna of CA HMO |
$6,002.56
|
| Rate for Payer: Cigna of CA PPO |
$6,940.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Dignity Health Media |
$4,044.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,459.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,044.21
|
| Rate for Payer: Galaxy Health WC |
$7,972.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,627.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,441.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,034.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,632.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,672.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,044.21
|
| Rate for Payer: InnovAge PACE Commercial |
$6,066.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,255.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$710.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,044.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,875.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,419.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,419.24
|
| Rate for Payer: Multiplan Commercial |
$7,034.25
|
| Rate for Payer: Networks By Design Commercial |
$6,096.35
|
| Rate for Payer: Prime Health Services Commercial |
$7,972.15
|
| Rate for Payer: Prime Health Services Medicare |
$4,286.86
|
| Rate for Payer: Riverside University Health System MISP |
$4,448.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,627.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,627.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,689.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,689.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,689.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,689.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
|
HC REP TEND/MUSC FLEX,FOREARM
|
Facility
|
IP
|
$9,379.00
|
|
|
Service Code
|
CPT 25260
|
| Hospital Charge Code |
900501066
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$1,875.80 |
| Max. Negotiated Rate |
$8,441.10 |
| Rate for Payer: Cash Price |
$4,220.55
|
| Rate for Payer: Central Health Plan Commercial |
$7,503.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,751.60
|
| Rate for Payer: Galaxy Health WC |
$7,972.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,627.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,441.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,255.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,573.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,875.80
|
| Rate for Payer: Multiplan Commercial |
$7,034.25
|
| Rate for Payer: Networks By Design Commercial |
$6,096.35
|
| Rate for Payer: Prime Health Services Commercial |
$7,972.15
|
|
|
HC RESEARCH CLINIC VISIT
|
Facility
|
OP
|
$289.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
908600210
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$260.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$158.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$158.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$139.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.74
|
| Rate for Payer: Blue Distinction Transplant |
$173.40
|
| Rate for Payer: Blue Shield of California Commercial |
$181.78
|
| Rate for Payer: Blue Shield of California EPN |
$141.32
|
| Rate for Payer: Cash Price |
$130.05
|
| Rate for Payer: Cash Price |
$130.05
|
| Rate for Payer: Cash Price |
$130.05
|
| Rate for Payer: Central Health Plan Commercial |
$231.20
|
| Rate for Payer: Cigna of CA HMO |
$184.96
|
| Rate for Payer: Cigna of CA PPO |
$213.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.65
|
| Rate for Payer: Dignity Health Media |
$245.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$245.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$115.60
|
| Rate for Payer: Galaxy Health WC |
$245.65
|
| Rate for Payer: Global Benefits Group Commercial |
$173.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$260.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$216.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$101.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$192.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.80
|
| Rate for Payer: Multiplan Commercial |
$216.75
|
| Rate for Payer: Networks By Design Commercial |
$187.85
|
| Rate for Payer: Prime Health Services Commercial |
$245.65
|
| Rate for Payer: Riverside University Health System MISP |
$115.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$173.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$144.50
|
| Rate for Payer: United Healthcare All Other HMO |
$144.50
|
| Rate for Payer: United Healthcare HMO Rider |
$144.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$144.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$245.65
|
| Rate for Payer: Vantage Medical Group Senior |
$245.65
|
|
|
HC RESEARCH CLINIC VISIT
|
Facility
|
IP
|
$289.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
908600210
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$57.80 |
| Max. Negotiated Rate |
$260.10 |
| Rate for Payer: Cash Price |
$130.05
|
| Rate for Payer: Central Health Plan Commercial |
$231.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.60
|
| Rate for Payer: Galaxy Health WC |
$245.65
|
| Rate for Payer: Global Benefits Group Commercial |
$173.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$260.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$192.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$110.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.80
|
| Rate for Payer: Multiplan Commercial |
$216.75
|
| Rate for Payer: Networks By Design Commercial |
$187.85
|
| Rate for Payer: Prime Health Services Commercial |
$245.65
|
|
|
HC RESEARCH IV HEPARIN LOCK PLACEMENT/BLOOD DRAW ESTAB PORT
|
Facility
|
OP
|
$345.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
900100027
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$69.00 |
| Max. Negotiated Rate |
$310.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$145.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$179.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$218.47
|
| Rate for Payer: Blue Distinction Transplant |
$207.00
|
| Rate for Payer: Blue Shield of California Commercial |
$213.21
|
| Rate for Payer: Blue Shield of California EPN |
$167.67
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$155.25
|
| Rate for Payer: Cash Price |
$155.25
|
| Rate for Payer: Central Health Plan Commercial |
$276.00
|
| Rate for Payer: Cigna of CA HMO |
$220.80
|
| Rate for Payer: Cigna of CA PPO |
$255.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: Dignity Health Media |
$159.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$293.25
|
| Rate for Payer: Global Benefits Group Commercial |
$207.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$310.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$258.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$263.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$159.60
|
| Rate for Payer: InnovAge PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$230.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$131.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$258.75
|
| Rate for Payer: Networks By Design Commercial |
$224.25
|
| Rate for Payer: Prime Health Services Commercial |
$293.25
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Riverside University Health System MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$207.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$207.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$172.50
|
| Rate for Payer: United Healthcare All Other HMO |
$172.50
|
| Rate for Payer: United Healthcare HMO Rider |
$172.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$172.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC RESEARCH IV HEPARIN LOCK PLACEMENT/BLOOD DRAW ESTAB PORT
|
Facility
|
IP
|
$345.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
900100027
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$69.00 |
| Max. Negotiated Rate |
$310.50 |
| Rate for Payer: Cash Price |
$155.25
|
| Rate for Payer: Central Health Plan Commercial |
$276.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$138.00
|
| Rate for Payer: Galaxy Health WC |
$293.25
|
| Rate for Payer: Global Benefits Group Commercial |
$207.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$310.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$230.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$131.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.00
|
| Rate for Payer: Multiplan Commercial |
$258.75
|
| Rate for Payer: Networks By Design Commercial |
$224.25
|
| Rate for Payer: Prime Health Services Commercial |
$293.25
|
|
|
HC RESEARCH OBSERVATION 1-4 HOURS
|
Facility
|
IP
|
$440.00
|
|
| Hospital Charge Code |
900100025
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$88.00 |
| Max. Negotiated Rate |
$396.00 |
| Rate for Payer: Cash Price |
$198.00
|
| Rate for Payer: Central Health Plan Commercial |
$352.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$176.00
|
| Rate for Payer: Galaxy Health WC |
$374.00
|
| Rate for Payer: Global Benefits Group Commercial |
$264.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$396.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$293.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$167.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.00
|
| Rate for Payer: Multiplan Commercial |
$330.00
|
| Rate for Payer: Networks By Design Commercial |
$286.00
|
| Rate for Payer: Prime Health Services Commercial |
$374.00
|
|
|
HC RESEARCH OBSERVATION 1-4 HOURS
|
Facility
|
OP
|
$440.00
|
|
| Hospital Charge Code |
900100025
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$88.00 |
| Max. Negotiated Rate |
$2,545.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$267.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$374.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$242.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$242.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,981.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,545.00
|
| Rate for Payer: Blue Distinction Transplant |
$264.00
|
| Rate for Payer: Blue Shield of California Commercial |
$276.76
|
| Rate for Payer: Blue Shield of California EPN |
$215.16
|
| Rate for Payer: Cash Price |
$198.00
|
| Rate for Payer: Cash Price |
$198.00
|
| Rate for Payer: Central Health Plan Commercial |
$352.00
|
| Rate for Payer: Cigna of CA HMO |
$281.60
|
| Rate for Payer: Cigna of CA PPO |
$325.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$374.00
|
| Rate for Payer: Dignity Health Media |
$374.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$374.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$176.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$176.00
|
| Rate for Payer: Galaxy Health WC |
$374.00
|
| Rate for Payer: Global Benefits Group Commercial |
$264.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$396.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$330.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$154.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$293.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$167.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.00
|
| Rate for Payer: Multiplan Commercial |
$330.00
|
| Rate for Payer: Networks By Design Commercial |
$286.00
|
| Rate for Payer: Prime Health Services Commercial |
$374.00
|
| Rate for Payer: Riverside University Health System MISP |
$176.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$264.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$264.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$220.00
|
| Rate for Payer: United Healthcare All Other HMO |
$220.00
|
| Rate for Payer: United Healthcare HMO Rider |
$220.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$220.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$374.00
|
| Rate for Payer: Vantage Medical Group Senior |
$374.00
|
|
|
HC RESEARCH OBSERVATION 4-8 HOURS
|
Facility
|
IP
|
$881.00
|
|
| Hospital Charge Code |
900100026
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$176.20 |
| Max. Negotiated Rate |
$792.90 |
| Rate for Payer: Cash Price |
$396.45
|
| Rate for Payer: Central Health Plan Commercial |
$704.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$352.40
|
| Rate for Payer: Galaxy Health WC |
$748.85
|
| Rate for Payer: Global Benefits Group Commercial |
$528.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$792.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$587.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$335.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$176.20
|
| Rate for Payer: Multiplan Commercial |
$660.75
|
| Rate for Payer: Networks By Design Commercial |
$572.65
|
| Rate for Payer: Prime Health Services Commercial |
$748.85
|
|
|
HC RESEARCH OBSERVATION 4-8 HOURS
|
Facility
|
OP
|
$881.00
|
|
| Hospital Charge Code |
900100026
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$176.20 |
| Max. Negotiated Rate |
$2,545.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$535.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$748.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$484.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$484.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,981.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,545.00
|
| Rate for Payer: Blue Distinction Transplant |
$528.60
|
| Rate for Payer: Blue Shield of California Commercial |
$554.15
|
| Rate for Payer: Blue Shield of California EPN |
$430.81
|
| Rate for Payer: Cash Price |
$396.45
|
| Rate for Payer: Cash Price |
$396.45
|
| Rate for Payer: Central Health Plan Commercial |
$704.80
|
| Rate for Payer: Cigna of CA HMO |
$563.84
|
| Rate for Payer: Cigna of CA PPO |
$651.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$748.85
|
| Rate for Payer: Dignity Health Media |
$748.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$748.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$352.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$352.40
|
| Rate for Payer: Galaxy Health WC |
$748.85
|
| Rate for Payer: Global Benefits Group Commercial |
$528.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$792.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$660.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$308.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$587.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$335.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$176.20
|
| Rate for Payer: Multiplan Commercial |
$660.75
|
| Rate for Payer: Networks By Design Commercial |
$572.65
|
| Rate for Payer: Prime Health Services Commercial |
$748.85
|
| Rate for Payer: Riverside University Health System MISP |
$352.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$528.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$528.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$440.50
|
| Rate for Payer: United Healthcare All Other HMO |
$440.50
|
| Rate for Payer: United Healthcare HMO Rider |
$440.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$748.85
|
| Rate for Payer: Vantage Medical Group Senior |
$748.85
|
|
|
HC RESECTION/DEBRID PANCREAS
|
Facility
|
IP
|
$11,170.00
|
|
|
Service Code
|
CPT 48105
|
| Hospital Charge Code |
906748105
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,234.00 |
| Max. Negotiated Rate |
$10,053.00 |
| Rate for Payer: Cash Price |
$5,026.50
|
| Rate for Payer: Central Health Plan Commercial |
$8,936.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,468.00
|
| Rate for Payer: Galaxy Health WC |
$9,494.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6,702.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,053.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,450.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,255.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,234.00
|
| Rate for Payer: Multiplan Commercial |
$8,377.50
|
| Rate for Payer: Networks By Design Commercial |
$7,260.50
|
| Rate for Payer: Prime Health Services Commercial |
$9,494.50
|
|
|
HC RESECTION/DEBRID PANCREAS
|
Facility
|
OP
|
$11,170.00
|
|
|
Service Code
|
CPT 48105
|
| Hospital Charge Code |
906748105
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,234.00 |
| Max. Negotiated Rate |
$14,279.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$14,279.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9,494.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,143.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,143.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,702.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$5,026.50
|
| Rate for Payer: Cash Price |
$5,026.50
|
| Rate for Payer: Cash Price |
$5,026.50
|
| Rate for Payer: Central Health Plan Commercial |
$8,936.00
|
| Rate for Payer: Cigna of CA PPO |
$8,265.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,494.50
|
| Rate for Payer: Dignity Health Media |
$9,494.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,494.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,468.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,468.00
|
| Rate for Payer: Galaxy Health WC |
$9,494.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6,702.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,053.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,377.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,909.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,450.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,230.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,234.00
|
| Rate for Payer: Multiplan Commercial |
$8,377.50
|
| Rate for Payer: Networks By Design Commercial |
$7,260.50
|
| Rate for Payer: Prime Health Services Commercial |
$9,494.50
|
| Rate for Payer: Riverside University Health System MISP |
$4,468.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,702.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,702.00
|
| 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 |
$9,494.50
|
| Rate for Payer: Vantage Medical Group Senior |
$9,494.50
|
|
|
HC RESPIRATOR W/STRAP PEDS SZ 3
|
Facility
|
OP
|
$231.70
|
|
| Hospital Charge Code |
901698719
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$46.34 |
| Max. Negotiated Rate |
$208.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$140.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$196.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$127.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$127.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$112.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$136.89
|
| Rate for Payer: Blue Distinction Transplant |
$139.02
|
| Rate for Payer: Blue Shield of California Commercial |
$145.74
|
| Rate for Payer: Blue Shield of California EPN |
$113.30
|
| Rate for Payer: Cash Price |
$104.27
|
| Rate for Payer: Central Health Plan Commercial |
$185.36
|
| Rate for Payer: Cigna of CA HMO |
$148.29
|
| Rate for Payer: Cigna of CA PPO |
$171.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$196.94
|
| Rate for Payer: Dignity Health Media |
$196.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$196.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$92.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$92.68
|
| Rate for Payer: Galaxy Health WC |
$196.94
|
| Rate for Payer: Global Benefits Group Commercial |
$139.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$208.53
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$173.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$81.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$154.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.34
|
| Rate for Payer: Multiplan Commercial |
$173.78
|
| Rate for Payer: Networks By Design Commercial |
$150.60
|
| Rate for Payer: Prime Health Services Commercial |
$196.94
|
| Rate for Payer: Riverside University Health System MISP |
$92.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$139.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$139.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$115.85
|
| Rate for Payer: United Healthcare All Other HMO |
$115.85
|
| Rate for Payer: United Healthcare HMO Rider |
$115.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$115.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$196.94
|
| Rate for Payer: Vantage Medical Group Senior |
$196.94
|
|
|
HC RESPIRATOR W/STRAP PEDS SZ 3
|
Facility
|
IP
|
$231.70
|
|
| Hospital Charge Code |
901698719
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$46.34 |
| Max. Negotiated Rate |
$208.53 |
| Rate for Payer: Cash Price |
$104.27
|
| Rate for Payer: Central Health Plan Commercial |
$185.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$92.68
|
| Rate for Payer: Galaxy Health WC |
$196.94
|
| Rate for Payer: Global Benefits Group Commercial |
$139.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$208.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$154.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.34
|
| Rate for Payer: Multiplan Commercial |
$173.78
|
| Rate for Payer: Networks By Design Commercial |
$150.60
|
| Rate for Payer: Prime Health Services Commercial |
$196.94
|
|
