|
HC RHC,CORO CATH,CORO ANG,GRFT,IM
|
Facility
OP
|
$24,258.00
|
|
|
Service Code
|
CPT 93457
|
| Hospital Charge Code |
906811404
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,800.00 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,071.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15,471.75
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| 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: BCBS Transplant Transplant |
$14,554.80
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$4,071.36
|
| Rate for Payer: Cash Price |
$10,916.10
|
| Rate for Payer: Cash Price |
$10,916.10
|
| Rate for Payer: Cash Price |
$10,916.10
|
| Rate for Payer: Central Health Plan Commercial |
$19,406.40
|
| Rate for Payer: Cigna of CA PPO |
$17,950.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$20,619.30
|
| Rate for Payer: Global Benefits Group Commercial |
$14,554.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$21,832.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$18,193.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,677.03
|
| Rate for Payer: IEHP medi-cal |
$6,717.74
|
| Rate for Payer: IEHP Medicare Advantage |
$4,071.36
|
| Rate for Payer: Innovage PACE Commercial |
$6,107.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,180.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,851.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,455.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$18,193.50
|
| Rate for Payer: Networks By Design Commercial |
$15,767.70
|
| Rate for Payer: Prime Health Services Commercial |
$20,619.30
|
| Rate for Payer: Prime Health Services Medicare |
$4,315.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: Riverside University Health MISP |
$4,478.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,554.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC RHC, CORO CATH, CORO ANGIO
|
Facility
OP
|
$23,291.00
|
|
|
Service Code
|
CPT 93456
|
| Hospital Charge Code |
906811403
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,800.00 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,071.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14,855.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| 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: BCBS Transplant Transplant |
$13,974.60
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$4,071.36
|
| Rate for Payer: Cash Price |
$10,480.95
|
| Rate for Payer: Cash Price |
$10,480.95
|
| Rate for Payer: Cash Price |
$10,480.95
|
| Rate for Payer: Central Health Plan Commercial |
$18,632.80
|
| Rate for Payer: Cigna of CA PPO |
$17,235.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$19,797.35
|
| Rate for Payer: Global Benefits Group Commercial |
$13,974.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,961.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$17,468.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,677.03
|
| Rate for Payer: IEHP medi-cal |
$6,717.74
|
| Rate for Payer: IEHP Medicare Advantage |
$4,071.36
|
| Rate for Payer: Innovage PACE Commercial |
$6,107.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,535.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,658.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,455.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$17,468.25
|
| Rate for Payer: Networks By Design Commercial |
$15,139.15
|
| Rate for Payer: Prime Health Services Commercial |
$19,797.35
|
| Rate for Payer: Prime Health Services Medicare |
$4,315.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: Riverside University Health MISP |
$4,478.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,974.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC RHC, CORO CATH, CORO ANGIO
|
Facility
IP
|
$23,291.00
|
|
|
Service Code
|
CPT 93456
|
| Hospital Charge Code |
906811403
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,658.20 |
| Max. Negotiated Rate |
$20,961.90 |
| Rate for Payer: Cash Price |
$10,480.95
|
| Rate for Payer: Central Health Plan Commercial |
$18,632.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,316.40
|
| Rate for Payer: Galaxy Health WC |
$19,797.35
|
| Rate for Payer: Global Benefits Group Commercial |
$13,974.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,961.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,535.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,658.20
|
| Rate for Payer: Multiplan Commercial |
$17,468.25
|
| Rate for Payer: Networks By Design Commercial |
$15,139.15
|
| Rate for Payer: Prime Health Services Commercial |
$19,797.35
|
|
|
HC RHC, CORO CATH, CORO ANGIO
|
Facility
OP
|
$23,291.00
|
|
|
Service Code
|
CPT 93456
|
| Hospital Charge Code |
906820061
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,800.00 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,071.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14,855.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| 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: BCBS Transplant Transplant |
$13,974.60
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$4,071.36
|
| Rate for Payer: Cash Price |
$10,480.95
|
| Rate for Payer: Cash Price |
$10,480.95
|
| Rate for Payer: Cash Price |
$10,480.95
|
| Rate for Payer: Central Health Plan Commercial |
$18,632.80
|
| Rate for Payer: Cigna of CA PPO |
$17,235.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$19,797.35
|
| Rate for Payer: Global Benefits Group Commercial |
$13,974.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,961.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$17,468.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,677.03
|
| Rate for Payer: IEHP medi-cal |
$6,717.74
|
| Rate for Payer: IEHP Medicare Advantage |
$4,071.36
|
| Rate for Payer: Innovage PACE Commercial |
$6,107.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,535.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,658.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,455.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$17,468.25
|
| Rate for Payer: Networks By Design Commercial |
$15,139.15
|
| Rate for Payer: Prime Health Services Commercial |
$19,797.35
|
| Rate for Payer: Prime Health Services Medicare |
$4,315.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: Riverside University Health MISP |
$4,478.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,974.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC RHC, CORO CATH, CORO ANGIO
|
Facility
IP
|
$23,291.00
|
|
|
Service Code
|
CPT 93456
|
| Hospital Charge Code |
906820061
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,658.20 |
| Max. Negotiated Rate |
$20,961.90 |
| Rate for Payer: Cash Price |
$10,480.95
|
| Rate for Payer: Central Health Plan Commercial |
$18,632.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,316.40
|
| Rate for Payer: Galaxy Health WC |
$19,797.35
|
| Rate for Payer: Global Benefits Group Commercial |
$13,974.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,961.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,535.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,658.20
|
| Rate for Payer: Multiplan Commercial |
$17,468.25
|
| Rate for Payer: Networks By Design Commercial |
$15,139.15
|
| Rate for Payer: Prime Health Services Commercial |
$19,797.35
|
|
|
HC RHC & LHC,CORONARY ANG,W/WO LV
|
Facility
IP
|
$25,199.00
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
906811407
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,039.80 |
| Max. Negotiated Rate |
$22,679.10 |
| Rate for Payer: Cash Price |
$11,339.55
|
| Rate for Payer: Central Health Plan Commercial |
$20,159.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,079.60
|
| Rate for Payer: Galaxy Health WC |
$21,419.15
|
| Rate for Payer: Global Benefits Group Commercial |
$15,119.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,679.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,807.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,039.80
|
| Rate for Payer: Multiplan Commercial |
$18,899.25
|
| Rate for Payer: Networks By Design Commercial |
$16,379.35
|
| Rate for Payer: Prime Health Services Commercial |
$21,419.15
|
|
|
HC RHC & LHC,CORONARY ANG,W/WO LV
|
Facility
OP
|
$25,199.00
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
906820065
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,800.00 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,071.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16,071.92
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| 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: BCBS Transplant Transplant |
$15,119.40
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$4,071.36
|
| Rate for Payer: Cash Price |
$11,339.55
|
| Rate for Payer: Cash Price |
$11,339.55
|
| Rate for Payer: Cash Price |
$11,339.55
|
| Rate for Payer: Central Health Plan Commercial |
$20,159.20
|
| Rate for Payer: Cigna of CA PPO |
$18,647.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$21,419.15
|
| Rate for Payer: Global Benefits Group Commercial |
$15,119.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,679.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$18,899.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,677.03
|
| Rate for Payer: IEHP medi-cal |
$6,717.74
|
| Rate for Payer: IEHP Medicare Advantage |
$4,071.36
|
| Rate for Payer: Innovage PACE Commercial |
$6,107.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,807.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,039.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,455.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$18,899.25
|
| Rate for Payer: Networks By Design Commercial |
$16,379.35
|
| Rate for Payer: Prime Health Services Commercial |
$21,419.15
|
| Rate for Payer: Prime Health Services Medicare |
$4,315.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: Riverside University Health MISP |
$4,478.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,119.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC RHC & LHC,CORONARY ANG,W/WO LV
|
Facility
IP
|
$25,199.00
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
906820065
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,039.80 |
| Max. Negotiated Rate |
$22,679.10 |
| Rate for Payer: Cash Price |
$11,339.55
|
| Rate for Payer: Central Health Plan Commercial |
$20,159.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,079.60
|
| Rate for Payer: Galaxy Health WC |
$21,419.15
|
| Rate for Payer: Global Benefits Group Commercial |
$15,119.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,679.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,807.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,039.80
|
| Rate for Payer: Multiplan Commercial |
$18,899.25
|
| Rate for Payer: Networks By Design Commercial |
$16,379.35
|
| Rate for Payer: Prime Health Services Commercial |
$21,419.15
|
|
|
HC RHC & LHC,CORONARY ANG,W/WO LV
|
Facility
OP
|
$25,199.00
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
906811407
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,800.00 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,071.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16,071.92
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| 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: BCBS Transplant Transplant |
$15,119.40
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$4,071.36
|
| Rate for Payer: Cash Price |
$11,339.55
|
| Rate for Payer: Cash Price |
$11,339.55
|
| Rate for Payer: Cash Price |
$11,339.55
|
| Rate for Payer: Central Health Plan Commercial |
$20,159.20
|
| Rate for Payer: Cigna of CA PPO |
$18,647.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$21,419.15
|
| Rate for Payer: Global Benefits Group Commercial |
$15,119.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,679.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$18,899.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,677.03
|
| Rate for Payer: IEHP medi-cal |
$6,717.74
|
| Rate for Payer: IEHP Medicare Advantage |
$4,071.36
|
| Rate for Payer: Innovage PACE Commercial |
$6,107.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,807.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,039.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,455.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$18,899.25
|
| Rate for Payer: Networks By Design Commercial |
$16,379.35
|
| Rate for Payer: Prime Health Services Commercial |
$21,419.15
|
| Rate for Payer: Prime Health Services Medicare |
$4,315.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: Riverside University Health MISP |
$4,478.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,119.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC RHC & LHC,CORO,W/WO LV,GRFT,IM
|
Facility
IP
|
$17,605.00
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
906820066
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,521.00 |
| Max. Negotiated Rate |
$15,844.50 |
| Rate for Payer: Cash Price |
$7,922.25
|
| Rate for Payer: Central Health Plan Commercial |
$14,084.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,042.00
|
| Rate for Payer: Galaxy Health WC |
$14,964.25
|
| Rate for Payer: Global Benefits Group Commercial |
$10,563.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,844.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,742.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,521.00
|
| Rate for Payer: Multiplan Commercial |
$13,203.75
|
| Rate for Payer: Networks By Design Commercial |
$11,443.25
|
| Rate for Payer: Prime Health Services Commercial |
$14,964.25
|
|
|
HC RHC & LHC,CORO,W/WO LV,GRFT,IM
|
Facility
IP
|
$17,605.00
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
906811408
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,521.00 |
| Max. Negotiated Rate |
$15,844.50 |
| Rate for Payer: Cash Price |
$7,922.25
|
| Rate for Payer: Central Health Plan Commercial |
$14,084.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,042.00
|
| Rate for Payer: Galaxy Health WC |
$14,964.25
|
| Rate for Payer: Global Benefits Group Commercial |
$10,563.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,844.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,742.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,521.00
|
| Rate for Payer: Multiplan Commercial |
$13,203.75
|
| Rate for Payer: Networks By Design Commercial |
$11,443.25
|
| Rate for Payer: Prime Health Services Commercial |
$14,964.25
|
|
|
HC RHC & LHC,CORO,W/WO LV,GRFT,IM
|
Facility
OP
|
$17,605.00
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
906811408
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,800.00 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,071.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,228.47
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| 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: BCBS Transplant Transplant |
$10,563.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$4,071.36
|
| Rate for Payer: Cash Price |
$7,922.25
|
| Rate for Payer: Cash Price |
$7,922.25
|
| Rate for Payer: Cash Price |
$7,922.25
|
| Rate for Payer: Central Health Plan Commercial |
$14,084.00
|
| Rate for Payer: Cigna of CA PPO |
$13,027.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$14,964.25
|
| Rate for Payer: Global Benefits Group Commercial |
$10,563.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,844.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13,203.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,677.03
|
| Rate for Payer: IEHP medi-cal |
$6,717.74
|
| Rate for Payer: IEHP Medicare Advantage |
$4,071.36
|
| Rate for Payer: Innovage PACE Commercial |
$6,107.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,742.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,521.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,455.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$13,203.75
|
| Rate for Payer: Networks By Design Commercial |
$11,443.25
|
| Rate for Payer: Prime Health Services Commercial |
$14,964.25
|
| Rate for Payer: Prime Health Services Medicare |
$4,315.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: Riverside University Health MISP |
$4,478.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,563.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC RHC & LHC,CORO,W/WO LV,GRFT,IM
|
Facility
OP
|
$17,605.00
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
906820066
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,800.00 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,071.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,228.47
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| 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: BCBS Transplant Transplant |
$10,563.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$4,071.36
|
| Rate for Payer: Cash Price |
$7,922.25
|
| Rate for Payer: Cash Price |
$7,922.25
|
| Rate for Payer: Cash Price |
$7,922.25
|
| Rate for Payer: Central Health Plan Commercial |
$14,084.00
|
| Rate for Payer: Cigna of CA PPO |
$13,027.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$14,964.25
|
| Rate for Payer: Global Benefits Group Commercial |
$10,563.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,844.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13,203.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,677.03
|
| Rate for Payer: IEHP medi-cal |
$6,717.74
|
| Rate for Payer: IEHP Medicare Advantage |
$4,071.36
|
| Rate for Payer: Innovage PACE Commercial |
$6,107.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,742.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,521.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,455.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$13,203.75
|
| Rate for Payer: Networks By Design Commercial |
$11,443.25
|
| Rate for Payer: Prime Health Services Commercial |
$14,964.25
|
| Rate for Payer: Prime Health Services Medicare |
$4,315.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: Riverside University Health MISP |
$4,478.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,563.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC RHC & LHC W/WO LV
|
Facility
IP
|
$16,268.00
|
|
|
Service Code
|
CPT 93453
|
| Hospital Charge Code |
906820088
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,253.60 |
| Max. Negotiated Rate |
$14,641.20 |
| Rate for Payer: Cash Price |
$7,320.60
|
| Rate for Payer: Central Health Plan Commercial |
$13,014.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,507.20
|
| Rate for Payer: Galaxy Health WC |
$13,827.80
|
| Rate for Payer: Global Benefits Group Commercial |
$9,760.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,641.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,850.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,253.60
|
| Rate for Payer: Multiplan Commercial |
$12,201.00
|
| Rate for Payer: Networks By Design Commercial |
$10,574.20
|
| Rate for Payer: Prime Health Services Commercial |
$13,827.80
|
|
|
HC RHC & LHC W/WO LV
|
Facility
IP
|
$16,268.00
|
|
|
Service Code
|
CPT 93453
|
| Hospital Charge Code |
906811400
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,253.60 |
| Max. Negotiated Rate |
$14,641.20 |
| Rate for Payer: Cash Price |
$7,320.60
|
| Rate for Payer: Central Health Plan Commercial |
$13,014.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,507.20
|
| Rate for Payer: Galaxy Health WC |
$13,827.80
|
| Rate for Payer: Global Benefits Group Commercial |
$9,760.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,641.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,850.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,253.60
|
| Rate for Payer: Multiplan Commercial |
$12,201.00
|
| Rate for Payer: Networks By Design Commercial |
$10,574.20
|
| Rate for Payer: Prime Health Services Commercial |
$13,827.80
|
|
|
HC RHC & LHC W/WO LV
|
Facility
OP
|
$16,268.00
|
|
|
Service Code
|
CPT 93453
|
| Hospital Charge Code |
906811400
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,800.00 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,071.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,375.73
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| 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: BCBS Transplant Transplant |
$9,760.80
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$4,071.36
|
| Rate for Payer: Cash Price |
$7,320.60
|
| Rate for Payer: Cash Price |
$7,320.60
|
| Rate for Payer: Cash Price |
$7,320.60
|
| Rate for Payer: Central Health Plan Commercial |
$13,014.40
|
| Rate for Payer: Cigna of CA PPO |
$12,038.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$13,827.80
|
| Rate for Payer: Global Benefits Group Commercial |
$9,760.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,641.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12,201.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,677.03
|
| Rate for Payer: IEHP medi-cal |
$6,717.74
|
| Rate for Payer: IEHP Medicare Advantage |
$4,071.36
|
| Rate for Payer: Innovage PACE Commercial |
$6,107.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,850.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,253.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,455.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$12,201.00
|
| Rate for Payer: Networks By Design Commercial |
$10,574.20
|
| Rate for Payer: Prime Health Services Commercial |
$13,827.80
|
| Rate for Payer: Prime Health Services Medicare |
$4,315.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: Riverside University Health MISP |
$4,478.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,760.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC RHC & LHC W/WO LV
|
Facility
OP
|
$16,268.00
|
|
|
Service Code
|
CPT 93453
|
| Hospital Charge Code |
906820088
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,800.00 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,071.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,375.73
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| 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: BCBS Transplant Transplant |
$9,760.80
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$4,071.36
|
| Rate for Payer: Cash Price |
$7,320.60
|
| Rate for Payer: Cash Price |
$7,320.60
|
| Rate for Payer: Cash Price |
$7,320.60
|
| Rate for Payer: Central Health Plan Commercial |
$13,014.40
|
| Rate for Payer: Cigna of CA PPO |
$12,038.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$13,827.80
|
| Rate for Payer: Global Benefits Group Commercial |
$9,760.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,641.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12,201.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,677.03
|
| Rate for Payer: IEHP medi-cal |
$6,717.74
|
| Rate for Payer: IEHP Medicare Advantage |
$4,071.36
|
| Rate for Payer: Innovage PACE Commercial |
$6,107.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,850.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,253.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,455.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$12,201.00
|
| Rate for Payer: Networks By Design Commercial |
$10,574.20
|
| Rate for Payer: Prime Health Services Commercial |
$13,827.80
|
| Rate for Payer: Prime Health Services Medicare |
$4,315.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: Riverside University Health MISP |
$4,478.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,760.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC RHEUMATOID FACTOR
|
Facility
OP
|
$19.00
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
900910868
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.80 |
| Max. Negotiated Rate |
$49.58 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$41.60
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$8.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.24
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$40.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$49.58
|
| Rate for Payer: BCBS Transplant Transplant |
$11.40
|
| Rate for Payer: Blue Shield of California Commercial |
$11.74
|
| Rate for Payer: Blue Shield of California EPN |
$9.23
|
| Rate for Payer: Caremore Medicare Advantage |
$5.67
|
| Rate for Payer: Cash Price |
$8.55
|
| Rate for Payer: Cash Price |
$8.55
|
| Rate for Payer: Central Health Plan Commercial |
$15.20
|
| Rate for Payer: Cigna of CA HMO |
$12.16
|
| Rate for Payer: Cigna of CA PPO |
$14.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.65
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.67
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.67
|
| Rate for Payer: Galaxy Health WC |
$16.15
|
| Rate for Payer: Global Benefits Group Commercial |
$11.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.30
|
| Rate for Payer: IEHP medi-cal |
$9.36
|
| Rate for Payer: IEHP Medicare Advantage |
$5.67
|
| Rate for Payer: Innovage PACE Commercial |
$8.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.60
|
| Rate for Payer: Multiplan Commercial |
$14.25
|
| Rate for Payer: Networks By Design Commercial |
$12.35
|
| Rate for Payer: Prime Health Services Commercial |
$16.15
|
| Rate for Payer: Prime Health Services Medicare |
$6.01
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.40
|
| Rate for Payer: Riverside University Health MISP |
$6.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.59
|
| Rate for Payer: United Healthcare All Other HMO |
$4.59
|
| Rate for Payer: United Healthcare HMO Rider |
$4.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.24
|
| Rate for Payer: Vantage Medical Group Senior |
$5.67
|
|
|
HC RHEUMATOID FACTOR
|
Facility
IP
|
$129.00
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
900910868
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.80 |
| Max. Negotiated Rate |
$116.10 |
| Rate for Payer: Cash Price |
$58.05
|
| Rate for Payer: Central Health Plan Commercial |
$103.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.60
|
| Rate for Payer: Galaxy Health WC |
$109.65
|
| Rate for Payer: Global Benefits Group Commercial |
$77.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$116.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$86.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.80
|
| Rate for Payer: Multiplan Commercial |
$96.75
|
| Rate for Payer: Networks By Design Commercial |
$83.85
|
| Rate for Payer: Prime Health Services Commercial |
$109.65
|
|
|
HC RH IMMUNE GLOBULIN
|
Facility
IP
|
$217.00
|
|
|
Service Code
|
CPT J2790
|
| Hospital Charge Code |
900904586
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$43.40 |
| Max. Negotiated Rate |
$195.30 |
| Rate for Payer: Blue Shield of California Commercial |
$162.75
|
| Rate for Payer: Blue Shield of California EPN |
$115.88
|
| Rate for Payer: Cash Price |
$97.65
|
| Rate for Payer: Central Health Plan Commercial |
$173.60
|
| Rate for Payer: Cigna of CA HMO |
$151.90
|
| Rate for Payer: Cigna of CA PPO |
$151.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$86.80
|
| Rate for Payer: Galaxy Health WC |
$184.45
|
| Rate for Payer: Global Benefits Group Commercial |
$130.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$195.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$144.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.40
|
| Rate for Payer: Multiplan Commercial |
$162.75
|
| Rate for Payer: Networks By Design Commercial |
$108.50
|
| Rate for Payer: Prime Health Services Commercial |
$184.45
|
|
|
HC RH IMMUNE GLOBULIN
|
Facility
OP
|
$217.00
|
|
|
Service Code
|
CPT J2790
|
| Hospital Charge Code |
900904586
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$43.40 |
| Max. Negotiated Rate |
$502.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$502.94
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$184.45
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$119.35
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$119.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$197.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$216.71
|
| Rate for Payer: BCBS Transplant Transplant |
$130.20
|
| Rate for Payer: Blue Shield of California Commercial |
$99.68
|
| Rate for Payer: Blue Shield of California EPN |
$90.62
|
| Rate for Payer: Cash Price |
$97.65
|
| Rate for Payer: Cash Price |
$97.65
|
| Rate for Payer: Central Health Plan Commercial |
$173.60
|
| Rate for Payer: Cigna of CA HMO |
$151.90
|
| Rate for Payer: Cigna of CA PPO |
$151.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$184.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$86.80
|
| Rate for Payer: Galaxy Health WC |
$184.45
|
| Rate for Payer: Global Benefits Group Commercial |
$130.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$195.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$162.75
|
| Rate for Payer: IEHP medi-cal |
$77.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$144.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.40
|
| Rate for Payer: Multiplan Commercial |
$162.75
|
| Rate for Payer: Networks By Design Commercial |
$108.50
|
| Rate for Payer: Prime Health Services Commercial |
$184.45
|
| Rate for Payer: Riverside University Health MISP |
$86.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$130.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$130.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$108.50
|
| Rate for Payer: United Healthcare All Other HMO |
$108.50
|
| Rate for Payer: United Healthcare HMO Rider |
$108.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$108.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$184.45
|
| Rate for Payer: Vantage Medical Group Senior |
$184.45
|
|
|
HC RH UNIT CONFIRMATION
|
Facility
IP
|
$125.00
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
900904621
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$25.00 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Cash Price |
$56.25
|
| Rate for Payer: Central Health Plan Commercial |
$100.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.00
|
| Rate for Payer: Galaxy Health WC |
$106.25
|
| Rate for Payer: Global Benefits Group Commercial |
$75.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$112.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.00
|
| Rate for Payer: Multiplan Commercial |
$93.75
|
| Rate for Payer: Networks By Design Commercial |
$81.25
|
| Rate for Payer: Prime Health Services Commercial |
$106.25
|
|
|
HC RH UNIT CONFIRMATION
|
Facility
OP
|
$125.00
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
900904621
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$21.90 |
| Max. Negotiated Rate |
$631.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$50.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.90
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$75.16
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$55.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$50.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$45.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$73.85
|
| Rate for Payer: BCBS Transplant Transplant |
$75.00
|
| Rate for Payer: Blue Shield of California Commercial |
$78.62
|
| Rate for Payer: Blue Shield of California EPN |
$61.12
|
| Rate for Payer: Caremore Medicare Advantage |
$50.11
|
| Rate for Payer: Cash Price |
$56.25
|
| Rate for Payer: Cash Price |
$56.25
|
| Rate for Payer: Cash Price |
$56.25
|
| Rate for Payer: Central Health Plan Commercial |
$100.00
|
| Rate for Payer: Cigna of CA HMO |
$80.00
|
| Rate for Payer: Cigna of CA PPO |
$92.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$75.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$67.65
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$50.11
|
| Rate for Payer: EPIC Health Plan Transplant |
$50.11
|
| Rate for Payer: Galaxy Health WC |
$106.25
|
| Rate for Payer: Global Benefits Group Commercial |
$75.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$112.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$93.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$82.18
|
| Rate for Payer: IEHP medi-cal |
$82.68
|
| Rate for Payer: IEHP Medicare Advantage |
$50.11
|
| Rate for Payer: Innovage PACE Commercial |
$75.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$67.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$67.15
|
| Rate for Payer: Multiplan Commercial |
$93.75
|
| Rate for Payer: Networks By Design Commercial |
$81.25
|
| Rate for Payer: Prime Health Services Commercial |
$106.25
|
| Rate for Payer: Prime Health Services Medicare |
$53.12
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$75.00
|
| Rate for Payer: Riverside University Health MISP |
$55.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$75.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$75.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$62.50
|
| Rate for Payer: United Healthcare All Other HMO |
$631.00
|
| Rate for Payer: United Healthcare HMO Rider |
$630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$75.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$55.12
|
| Rate for Payer: Vantage Medical Group Senior |
$50.11
|
|
|
HC RHYTHM ECG TRACING ONLY
|
Facility
OP
|
$452.00
|
|
|
Service Code
|
CPT 93041
|
| Hospital Charge Code |
900200102
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$34.11 |
| Max. Negotiated Rate |
$656.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$76.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.11
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$76.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$267.04
|
| Rate for Payer: BCBS Transplant Transplant |
$271.20
|
| Rate for Payer: Blue Shield of California Commercial |
$279.34
|
| Rate for Payer: Blue Shield of California EPN |
$219.67
|
| Rate for Payer: Caremore Medicare Advantage |
$76.42
|
| Rate for Payer: Cash Price |
$203.40
|
| Rate for Payer: Cash Price |
$203.40
|
| Rate for Payer: Cash Price |
$203.40
|
| Rate for Payer: Central Health Plan Commercial |
$361.60
|
| Rate for Payer: Cigna of CA HMO |
$289.28
|
| Rate for Payer: Cigna of CA PPO |
$334.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$114.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$76.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$76.42
|
| Rate for Payer: Galaxy Health WC |
$384.20
|
| Rate for Payer: Global Benefits Group Commercial |
$271.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$406.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$339.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$125.33
|
| Rate for Payer: IEHP medi-cal |
$126.09
|
| Rate for Payer: IEHP Medicare Advantage |
$76.42
|
| Rate for Payer: Innovage PACE Commercial |
$114.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$301.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$102.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$102.40
|
| Rate for Payer: Multiplan Commercial |
$339.00
|
| Rate for Payer: Networks By Design Commercial |
$293.80
|
| Rate for Payer: Prime Health Services Commercial |
$384.20
|
| Rate for Payer: Prime Health Services Medicare |
$81.01
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$271.20
|
| Rate for Payer: Riverside University Health MISP |
$84.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$271.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$271.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$656.00
|
| Rate for Payer: United Healthcare All Other HMO |
$399.00
|
| Rate for Payer: United Healthcare HMO Rider |
$302.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$276.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: Vantage Medical Group Senior |
$76.42
|
|
|
HC RHYTHM ECG TRACING ONLY
|
Facility
OP
|
$452.00
|
|
|
Service Code
|
CPT 93041
|
| Hospital Charge Code |
900200102
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$34.11 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.11
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$76.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$271.20
|
| Rate for Payer: Caremore Medicare Advantage |
$76.42
|
| Rate for Payer: Cash Price |
$203.40
|
| Rate for Payer: Cash Price |
$203.40
|
| Rate for Payer: Cash Price |
$203.40
|
| Rate for Payer: Cash Price |
$203.40
|
| Rate for Payer: Central Health Plan Commercial |
$361.60
|
| Rate for Payer: Cigna of CA PPO |
$334.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$114.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$76.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$76.42
|
| Rate for Payer: Galaxy Health WC |
$384.20
|
| Rate for Payer: Global Benefits Group Commercial |
$271.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$406.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$339.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$125.33
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$76.42
|
| Rate for Payer: Innovage PACE Commercial |
$114.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$301.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$102.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$102.40
|
| Rate for Payer: Multiplan Commercial |
$339.00
|
| Rate for Payer: Networks By Design Commercial |
$293.80
|
| Rate for Payer: Prime Health Services Commercial |
$384.20
|
| Rate for Payer: Prime Health Services Medicare |
$81.01
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$271.20
|
| Rate for Payer: Riverside University Health MISP |
$84.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$271.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$226.00
|
| Rate for Payer: United Healthcare All Other HMO |
$226.00
|
| Rate for Payer: United Healthcare HMO Rider |
$226.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$226.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: Vantage Medical Group Senior |
$76.42
|
|
