|
HC RMVL OF IMPLANT,SUPERFICIAL
|
Facility
|
OP
|
$8,089.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
900501283
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$220.00 |
| Max. Negotiated Rate |
$7,280.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,025.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,853.40
|
| Rate for Payer: Blue Shield of California Commercial |
$5,087.98
|
| Rate for Payer: Blue Shield of California EPN |
$3,955.52
|
| Rate for Payer: Caremore Medicare Advantage |
$2,025.69
|
| Rate for Payer: Cash Price |
$3,640.05
|
| Rate for Payer: Cash Price |
$3,640.05
|
| Rate for Payer: Central Health Plan Commercial |
$6,471.20
|
| Rate for Payer: Cigna of CA HMO |
$5,176.96
|
| Rate for Payer: Cigna of CA PPO |
$5,985.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Dignity Health Media |
$2,025.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
| Rate for Payer: Galaxy Health WC |
$6,875.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,853.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,280.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,066.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,322.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,342.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
| Rate for Payer: InnovAge PACE Commercial |
$3,038.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,395.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,617.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,714.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
| Rate for Payer: Multiplan Commercial |
$6,066.75
|
| Rate for Payer: Networks By Design Commercial |
$5,257.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,875.65
|
| Rate for Payer: Prime Health Services Medicare |
$2,147.23
|
| Rate for Payer: Riverside University Health System MISP |
$2,228.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,853.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,853.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,044.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,044.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,044.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,044.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC RMVL OF IMPL FROM HAND
|
Facility
|
OP
|
$9,542.00
|
|
|
Service Code
|
CPT 26320
|
| Hospital Charge Code |
900501699
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$8,587.80 |
| 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 |
$3,038.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| 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 |
$5,725.20
|
| Rate for Payer: Caremore Medicare Advantage |
$2,025.69
|
| Rate for Payer: Cash Price |
$4,293.90
|
| Rate for Payer: Cash Price |
$4,293.90
|
| Rate for Payer: Cash Price |
$4,293.90
|
| Rate for Payer: Cash Price |
$4,293.90
|
| Rate for Payer: Central Health Plan Commercial |
$7,633.60
|
| Rate for Payer: Cigna of CA PPO |
$7,061.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Dignity Health Media |
$2,025.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
| Rate for Payer: Galaxy Health WC |
$8,110.70
|
| Rate for Payer: Global Benefits Group Commercial |
$5,725.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,587.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,156.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,322.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
| Rate for Payer: InnovAge PACE Commercial |
$3,038.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,364.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$560.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,908.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,714.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
| Rate for Payer: Multiplan Commercial |
$7,156.50
|
| Rate for Payer: Networks By Design Commercial |
$6,202.30
|
| Rate for Payer: Prime Health Services Commercial |
$8,110.70
|
| Rate for Payer: Prime Health Services Medicare |
$2,147.23
|
| Rate for Payer: Riverside University Health System MISP |
$2,228.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,725.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,771.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,771.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,771.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,771.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC RMVL OF IMPL FROM HAND
|
Facility
|
IP
|
$9,542.00
|
|
|
Service Code
|
CPT 26320
|
| Hospital Charge Code |
900501699
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,908.40 |
| Max. Negotiated Rate |
$8,587.80 |
| Rate for Payer: Cash Price |
$4,293.90
|
| Rate for Payer: Central Health Plan Commercial |
$7,633.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,816.80
|
| Rate for Payer: Galaxy Health WC |
$8,110.70
|
| Rate for Payer: Global Benefits Group Commercial |
$5,725.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,587.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,364.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,635.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,908.40
|
| Rate for Payer: Multiplan Commercial |
$7,156.50
|
| Rate for Payer: Networks By Design Commercial |
$6,202.30
|
| Rate for Payer: Prime Health Services Commercial |
$8,110.70
|
|
|
HC RMVL OF SKIN TAGS 1-15 LESIONS
|
Facility
|
OP
|
$468.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
900501378
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$60.14 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$250.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$280.80
|
| Rate for Payer: Caremore Medicare Advantage |
$250.14
|
| Rate for Payer: Cash Price |
$210.60
|
| Rate for Payer: Cash Price |
$210.60
|
| Rate for Payer: Cash Price |
$210.60
|
| Rate for Payer: Cash Price |
$210.60
|
| Rate for Payer: Central Health Plan Commercial |
$374.40
|
| Rate for Payer: Cigna of CA PPO |
$346.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: Dignity Health Media |
$250.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$275.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$250.14
|
| Rate for Payer: Galaxy Health WC |
$397.80
|
| Rate for Payer: Global Benefits Group Commercial |
$280.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$421.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$351.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$410.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$250.14
|
| Rate for Payer: InnovAge PACE Commercial |
$375.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$312.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$60.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$335.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.19
|
| Rate for Payer: Multiplan Commercial |
$351.00
|
| Rate for Payer: Networks By Design Commercial |
$304.20
|
| Rate for Payer: Prime Health Services Commercial |
$397.80
|
| Rate for Payer: Prime Health Services Medicare |
$265.15
|
| Rate for Payer: Riverside University Health System MISP |
$275.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$280.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$234.00
|
| Rate for Payer: United Healthcare All Other HMO |
$234.00
|
| Rate for Payer: United Healthcare HMO Rider |
$234.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$234.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
|
HC RMVL OF SKIN TAGS 1-15 LESIONS
|
Facility
|
IP
|
$468.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
900501378
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$93.60 |
| Max. Negotiated Rate |
$421.20 |
| Rate for Payer: Cash Price |
$210.60
|
| Rate for Payer: Central Health Plan Commercial |
$374.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$187.20
|
| Rate for Payer: Galaxy Health WC |
$397.80
|
| Rate for Payer: Global Benefits Group Commercial |
$280.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$421.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$312.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$178.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.60
|
| Rate for Payer: Multiplan Commercial |
$351.00
|
| Rate for Payer: Networks By Design Commercial |
$304.20
|
| Rate for Payer: Prime Health Services Commercial |
$397.80
|
|
|
HC RMVL OF SKIN TAGS 1-15 LESIONS
|
Facility
|
IP
|
$468.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
900501378
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$93.60 |
| Max. Negotiated Rate |
$421.20 |
| Rate for Payer: Cash Price |
$210.60
|
| Rate for Payer: Central Health Plan Commercial |
$374.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$187.20
|
| Rate for Payer: Galaxy Health WC |
$397.80
|
| Rate for Payer: Global Benefits Group Commercial |
$280.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$421.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$312.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$178.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.60
|
| Rate for Payer: Multiplan Commercial |
$351.00
|
| Rate for Payer: Networks By Design Commercial |
$304.20
|
| Rate for Payer: Prime Health Services Commercial |
$397.80
|
|
|
HC RMVL OF SKIN TAGS 1-15 LESIONS
|
Facility
|
OP
|
$468.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
900501378
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$60.14 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$250.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$250.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$280.80
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$250.14
|
| Rate for Payer: Cash Price |
$210.60
|
| Rate for Payer: Cash Price |
$210.60
|
| Rate for Payer: Central Health Plan Commercial |
$374.40
|
| Rate for Payer: Cigna of CA PPO |
$346.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: Dignity Health Media |
$250.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$275.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$250.14
|
| Rate for Payer: Galaxy Health WC |
$397.80
|
| Rate for Payer: Global Benefits Group Commercial |
$280.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$421.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$351.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$410.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$412.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$250.14
|
| Rate for Payer: InnovAge PACE Commercial |
$375.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$312.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$60.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$335.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.19
|
| Rate for Payer: Multiplan Commercial |
$351.00
|
| Rate for Payer: Networks By Design Commercial |
$304.20
|
| Rate for Payer: Prime Health Services Commercial |
$397.80
|
| Rate for Payer: Prime Health Services Medicare |
$265.15
|
| Rate for Payer: Riverside University Health System MISP |
$275.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$280.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
|
HC RMVL OF SKIN TAGS 1-15 LESIONS
|
Facility
|
OP
|
$468.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
900501378
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$60.14 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$250.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$250.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$280.80
|
| Rate for Payer: Blue Shield of California Commercial |
$294.37
|
| Rate for Payer: Blue Shield of California EPN |
$228.85
|
| Rate for Payer: Caremore Medicare Advantage |
$250.14
|
| Rate for Payer: Cash Price |
$210.60
|
| Rate for Payer: Cash Price |
$210.60
|
| Rate for Payer: Cash Price |
$210.60
|
| Rate for Payer: Central Health Plan Commercial |
$374.40
|
| Rate for Payer: Cigna of CA HMO |
$299.52
|
| Rate for Payer: Cigna of CA PPO |
$346.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: Dignity Health Media |
$250.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$275.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$250.14
|
| Rate for Payer: Galaxy Health WC |
$397.80
|
| Rate for Payer: Global Benefits Group Commercial |
$280.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$421.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$351.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$410.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$412.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$250.14
|
| Rate for Payer: InnovAge PACE Commercial |
$375.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$312.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$60.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$335.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.19
|
| Rate for Payer: Multiplan Commercial |
$351.00
|
| Rate for Payer: Networks By Design Commercial |
$304.20
|
| Rate for Payer: Prime Health Services Commercial |
$397.80
|
| Rate for Payer: Prime Health Services Medicare |
$265.15
|
| Rate for Payer: Riverside University Health System MISP |
$275.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$280.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$280.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$234.00
|
| Rate for Payer: United Healthcare All Other HMO |
$234.00
|
| Rate for Payer: United Healthcare HMO Rider |
$234.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$234.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
|
HC RMVL OF SKIN TAGS 1-15 LESIONS
|
Facility
|
IP
|
$468.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
900501378
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$93.60 |
| Max. Negotiated Rate |
$421.20 |
| Rate for Payer: Cash Price |
$210.60
|
| Rate for Payer: Central Health Plan Commercial |
$374.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$187.20
|
| Rate for Payer: Galaxy Health WC |
$397.80
|
| Rate for Payer: Global Benefits Group Commercial |
$280.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$421.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$312.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$178.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.60
|
| Rate for Payer: Multiplan Commercial |
$351.00
|
| Rate for Payer: Networks By Design Commercial |
$304.20
|
| Rate for Payer: Prime Health Services Commercial |
$397.80
|
|
|
HC RMVL OR BIVALVING GAUNTLET BOOT OR BODY CAST
|
Facility
|
IP
|
$766.00
|
|
|
Service Code
|
CPT 29700
|
| Hospital Charge Code |
900101506
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$153.20 |
| Max. Negotiated Rate |
$689.40 |
| Rate for Payer: Cash Price |
$344.70
|
| Rate for Payer: Central Health Plan Commercial |
$612.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$306.40
|
| Rate for Payer: Galaxy Health WC |
$651.10
|
| Rate for Payer: Global Benefits Group Commercial |
$459.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$689.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$510.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$291.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$153.20
|
| Rate for Payer: Multiplan Commercial |
$574.50
|
| Rate for Payer: Networks By Design Commercial |
$497.90
|
| Rate for Payer: Prime Health Services Commercial |
$651.10
|
|
|
HC RMVL OR BIVALVING GAUNTLET BOOT OR BODY CAST
|
Facility
|
OP
|
$766.00
|
|
|
Service Code
|
CPT 29700
|
| Hospital Charge Code |
900101506
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$43.15 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$335.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$177.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$503.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$369.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$335.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$459.60
|
| Rate for Payer: Blue Shield of California Commercial |
$481.81
|
| Rate for Payer: Blue Shield of California EPN |
$374.57
|
| Rate for Payer: Caremore Medicare Advantage |
$335.55
|
| Rate for Payer: Cash Price |
$344.70
|
| Rate for Payer: Cash Price |
$344.70
|
| Rate for Payer: Central Health Plan Commercial |
$612.80
|
| Rate for Payer: Cigna of CA HMO |
$490.24
|
| Rate for Payer: Cigna of CA PPO |
$566.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$503.32
|
| Rate for Payer: Dignity Health Media |
$335.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$369.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$452.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$335.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$335.55
|
| Rate for Payer: Galaxy Health WC |
$651.10
|
| Rate for Payer: Global Benefits Group Commercial |
$459.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$689.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$574.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$550.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$553.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$335.55
|
| Rate for Payer: InnovAge PACE Commercial |
$503.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$510.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$335.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$153.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$449.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$449.64
|
| Rate for Payer: Multiplan Commercial |
$574.50
|
| Rate for Payer: Networks By Design Commercial |
$497.90
|
| Rate for Payer: Prime Health Services Commercial |
$651.10
|
| Rate for Payer: Prime Health Services Medicare |
$355.68
|
| Rate for Payer: Riverside University Health System MISP |
$369.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$459.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$459.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$383.00
|
| Rate for Payer: United Healthcare All Other HMO |
$383.00
|
| Rate for Payer: United Healthcare HMO Rider |
$383.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$383.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$503.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$369.10
|
| Rate for Payer: Vantage Medical Group Senior |
$335.55
|
|
|
HC RMVL REPAIR FULL ARM/LEG CAST
|
Facility
|
OP
|
$1,164.00
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
900501111
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$55.18 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$503.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$369.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$335.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$698.40
|
| Rate for Payer: Caremore Medicare Advantage |
$335.55
|
| Rate for Payer: Cash Price |
$523.80
|
| Rate for Payer: Cash Price |
$523.80
|
| Rate for Payer: Cash Price |
$523.80
|
| Rate for Payer: Cash Price |
$523.80
|
| Rate for Payer: Central Health Plan Commercial |
$931.20
|
| Rate for Payer: Cigna of CA PPO |
$861.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$503.32
|
| Rate for Payer: Dignity Health Media |
$335.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$369.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$452.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$335.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$335.55
|
| Rate for Payer: Galaxy Health WC |
$989.40
|
| Rate for Payer: Global Benefits Group Commercial |
$698.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,047.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$873.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$550.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$335.55
|
| Rate for Payer: InnovAge PACE Commercial |
$503.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$776.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$335.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$232.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$449.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$449.64
|
| Rate for Payer: Multiplan Commercial |
$873.00
|
| Rate for Payer: Networks By Design Commercial |
$756.60
|
| Rate for Payer: Prime Health Services Commercial |
$989.40
|
| Rate for Payer: Prime Health Services Medicare |
$355.68
|
| Rate for Payer: Riverside University Health System MISP |
$369.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$698.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$582.00
|
| Rate for Payer: United Healthcare All Other HMO |
$582.00
|
| Rate for Payer: United Healthcare HMO Rider |
$582.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$582.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$503.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$369.10
|
| Rate for Payer: Vantage Medical Group Senior |
$335.55
|
|
|
HC RMVL REPAIR FULL ARM/LEG CAST
|
Facility
|
IP
|
$1,164.00
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
900501111
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$232.80 |
| Max. Negotiated Rate |
$1,047.60 |
| Rate for Payer: Cash Price |
$523.80
|
| Rate for Payer: Central Health Plan Commercial |
$931.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$465.60
|
| Rate for Payer: Galaxy Health WC |
$989.40
|
| Rate for Payer: Global Benefits Group Commercial |
$698.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,047.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$776.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$443.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$232.80
|
| Rate for Payer: Multiplan Commercial |
$873.00
|
| Rate for Payer: Networks By Design Commercial |
$756.60
|
| Rate for Payer: Prime Health Services Commercial |
$989.40
|
|
|
HC RMVL REPAIR FULL ARM/LEG CAST
|
Facility
|
IP
|
$1,164.00
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
900501111
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$232.80 |
| Max. Negotiated Rate |
$1,047.60 |
| Rate for Payer: Cash Price |
$523.80
|
| Rate for Payer: Central Health Plan Commercial |
$931.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$465.60
|
| Rate for Payer: Galaxy Health WC |
$989.40
|
| Rate for Payer: Global Benefits Group Commercial |
$698.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,047.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$776.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$443.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$232.80
|
| Rate for Payer: Multiplan Commercial |
$873.00
|
| Rate for Payer: Networks By Design Commercial |
$756.60
|
| Rate for Payer: Prime Health Services Commercial |
$989.40
|
|
|
HC RMVL REPAIR FULL ARM/LEG CAST
|
Facility
|
OP
|
$1,164.00
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
900501111
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$55.18 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$335.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$243.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$503.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$369.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$335.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$698.40
|
| Rate for Payer: Blue Shield of California Commercial |
$732.16
|
| Rate for Payer: Blue Shield of California EPN |
$569.20
|
| Rate for Payer: Caremore Medicare Advantage |
$335.55
|
| Rate for Payer: Cash Price |
$523.80
|
| Rate for Payer: Cash Price |
$523.80
|
| Rate for Payer: Cash Price |
$523.80
|
| Rate for Payer: Central Health Plan Commercial |
$931.20
|
| Rate for Payer: Cigna of CA HMO |
$744.96
|
| Rate for Payer: Cigna of CA PPO |
$861.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$503.32
|
| Rate for Payer: Dignity Health Media |
$335.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$369.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$452.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$335.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$335.55
|
| Rate for Payer: Galaxy Health WC |
$989.40
|
| Rate for Payer: Global Benefits Group Commercial |
$698.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,047.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$873.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$550.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$553.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$335.55
|
| Rate for Payer: InnovAge PACE Commercial |
$503.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$776.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$335.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$232.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$449.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$449.64
|
| Rate for Payer: Multiplan Commercial |
$873.00
|
| Rate for Payer: Networks By Design Commercial |
$756.60
|
| Rate for Payer: Prime Health Services Commercial |
$989.40
|
| Rate for Payer: Prime Health Services Medicare |
$355.68
|
| Rate for Payer: Riverside University Health System MISP |
$369.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$698.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$698.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$582.00
|
| Rate for Payer: United Healthcare All Other HMO |
$582.00
|
| Rate for Payer: United Healthcare HMO Rider |
$582.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$582.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$503.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$369.10
|
| Rate for Payer: Vantage Medical Group Senior |
$335.55
|
|
|
HC RMVL SUBQ CARDIAC RHYTHM MNTR
|
Facility
|
OP
|
$3,500.00
|
|
|
Service Code
|
CPT 33286
|
| Hospital Charge Code |
906813407
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$43.85 |
| Max. Negotiated Rate |
$5,824.53 |
| Rate for Payer: Adventist Health Medi-Cal |
$879.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.07
|
| 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 |
$2,100.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,824.53
|
| Rate for Payer: Blue Shield of California EPN |
$4,183.44
|
| Rate for Payer: Caremore Medicare Advantage |
$879.07
|
| Rate for Payer: Cash Price |
$1,575.00
|
| Rate for Payer: Cash Price |
$1,575.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,800.00
|
| Rate for Payer: Cigna of CA PPO |
$2,590.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Dignity Health Media |
$879.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$966.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,186.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.07
|
| Rate for Payer: Galaxy Health WC |
$2,975.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,100.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,150.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,625.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,441.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,450.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.07
|
| Rate for Payer: InnovAge PACE Commercial |
$1,318.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,334.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$700.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,177.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,177.95
|
| Rate for Payer: Multiplan Commercial |
$2,625.00
|
| Rate for Payer: Networks By Design Commercial |
$2,275.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,975.00
|
| Rate for Payer: Prime Health Services Medicare |
$931.81
|
| Rate for Payer: Riverside University Health System MISP |
$966.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,100.00
|
| 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 Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
|
HC RMVL SUBQ CARDIAC RHYTHM MNTR
|
Facility
|
OP
|
$3,500.00
|
|
|
Service Code
|
CPT 33286
|
| Hospital Charge Code |
906820139
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$43.85 |
| Max. Negotiated Rate |
$5,824.53 |
| Rate for Payer: Adventist Health Medi-Cal |
$879.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.07
|
| 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 |
$2,100.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,824.53
|
| Rate for Payer: Blue Shield of California EPN |
$4,183.44
|
| Rate for Payer: Caremore Medicare Advantage |
$879.07
|
| Rate for Payer: Cash Price |
$1,575.00
|
| Rate for Payer: Cash Price |
$1,575.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,800.00
|
| Rate for Payer: Cigna of CA PPO |
$2,590.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Dignity Health Media |
$879.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$966.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,186.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.07
|
| Rate for Payer: Galaxy Health WC |
$2,975.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,100.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,150.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,625.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,441.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,450.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.07
|
| Rate for Payer: InnovAge PACE Commercial |
$1,318.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,334.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$700.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,177.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,177.95
|
| Rate for Payer: Multiplan Commercial |
$2,625.00
|
| Rate for Payer: Networks By Design Commercial |
$2,275.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,975.00
|
| Rate for Payer: Prime Health Services Medicare |
$931.81
|
| Rate for Payer: Riverside University Health System MISP |
$966.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,100.00
|
| 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 Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
|
HC RMVL SUBQ CARDIAC RHYTHM MNTR
|
Facility
|
IP
|
$3,500.00
|
|
|
Service Code
|
CPT 33286
|
| Hospital Charge Code |
906813407
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$700.00 |
| Max. Negotiated Rate |
$3,150.00 |
| Rate for Payer: Cash Price |
$1,575.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,800.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,400.00
|
| Rate for Payer: Galaxy Health WC |
$2,975.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,100.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,150.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,334.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,333.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$700.00
|
| Rate for Payer: Multiplan Commercial |
$2,625.00
|
| Rate for Payer: Networks By Design Commercial |
$2,275.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,975.00
|
|
|
HC RMVL SUBQ CARDIAC RHYTHM MNTR
|
Facility
|
IP
|
$3,500.00
|
|
|
Service Code
|
CPT 33286
|
| Hospital Charge Code |
906820139
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$700.00 |
| Max. Negotiated Rate |
$3,150.00 |
| Rate for Payer: Cash Price |
$1,575.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,800.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,400.00
|
| Rate for Payer: Galaxy Health WC |
$2,975.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,100.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,150.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,334.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,333.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$700.00
|
| Rate for Payer: Multiplan Commercial |
$2,625.00
|
| Rate for Payer: Networks By Design Commercial |
$2,275.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,975.00
|
|
|
HC RMV SELF-CONTD PENIS PROS
|
Facility
|
IP
|
$10,383.00
|
|
|
Service Code
|
CPT 54415
|
| Hospital Charge Code |
900501733
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,076.60 |
| Max. Negotiated Rate |
$9,344.70 |
| Rate for Payer: Cash Price |
$4,672.35
|
| Rate for Payer: Central Health Plan Commercial |
$8,306.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,153.20
|
| Rate for Payer: Galaxy Health WC |
$8,825.55
|
| Rate for Payer: Global Benefits Group Commercial |
$6,229.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,344.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,925.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,955.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,076.60
|
| Rate for Payer: Multiplan Commercial |
$7,787.25
|
| Rate for Payer: Networks By Design Commercial |
$6,748.95
|
| Rate for Payer: Prime Health Services Commercial |
$8,825.55
|
|
|
HC RMV SELF-CONTD PENIS PROS
|
Facility
|
OP
|
$10,383.00
|
|
|
Service Code
|
CPT 54415
|
| Hospital Charge Code |
900501733
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$9,344.70 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,533.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,791.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,355.72
|
| 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 |
$6,229.80
|
| Rate for Payer: Caremore Medicare Advantage |
$4,355.72
|
| Rate for Payer: Cash Price |
$4,672.35
|
| Rate for Payer: Cash Price |
$4,672.35
|
| Rate for Payer: Cash Price |
$4,672.35
|
| Rate for Payer: Cash Price |
$4,672.35
|
| Rate for Payer: Central Health Plan Commercial |
$8,306.40
|
| Rate for Payer: Cigna of CA PPO |
$7,683.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,533.58
|
| Rate for Payer: Dignity Health Media |
$4,355.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,791.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,880.22
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,355.72
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,355.72
|
| Rate for Payer: Galaxy Health WC |
$8,825.55
|
| Rate for Payer: Global Benefits Group Commercial |
$6,229.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,344.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,787.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,143.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,355.72
|
| Rate for Payer: InnovAge PACE Commercial |
$6,533.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,925.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$821.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,355.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,076.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,836.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,836.66
|
| Rate for Payer: Multiplan Commercial |
$7,787.25
|
| Rate for Payer: Networks By Design Commercial |
$6,748.95
|
| Rate for Payer: Prime Health Services Commercial |
$8,825.55
|
| Rate for Payer: Prime Health Services Medicare |
$4,617.06
|
| Rate for Payer: Riverside University Health System MISP |
$4,791.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,229.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,191.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,191.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,191.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,191.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,533.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,791.29
|
| Rate for Payer: Vantage Medical Group Senior |
$4,355.72
|
|
|
HC ROCKER BOTTOM CONTACT AFO
|
Facility
|
IP
|
$203.90
|
|
|
Service Code
|
CPT L2232
|
| Hospital Charge Code |
905352232
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$40.78 |
| Max. Negotiated Rate |
$183.51 |
| Rate for Payer: Blue Shield of California EPN |
$108.88
|
| Rate for Payer: Cash Price |
$91.76
|
| Rate for Payer: Central Health Plan Commercial |
$163.12
|
| Rate for Payer: Cigna of CA HMO |
$142.73
|
| Rate for Payer: Cigna of CA PPO |
$142.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$81.56
|
| Rate for Payer: Galaxy Health WC |
$173.32
|
| Rate for Payer: Global Benefits Group Commercial |
$122.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$183.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$136.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.78
|
| Rate for Payer: Multiplan Commercial |
$152.92
|
| Rate for Payer: Networks By Design Commercial |
$101.95
|
| Rate for Payer: Prime Health Services Commercial |
$173.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$76.99
|
| Rate for Payer: United Healthcare All Other HMO |
$75.20
|
| Rate for Payer: United Healthcare HMO Rider |
$73.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$67.29
|
|
|
HC ROCKER BOTTOM CONTACT AFO
|
Facility
|
OP
|
$203.90
|
|
|
Service Code
|
CPT L2232
|
| Hospital Charge Code |
905352232
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$71.36 |
| Max. Negotiated Rate |
$183.51 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$173.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$112.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$112.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$98.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$120.46
|
| Rate for Payer: Blue Distinction Transplant |
$122.34
|
| Rate for Payer: Blue Shield of California Commercial |
$152.92
|
| Rate for Payer: Blue Shield of California EPN |
$110.92
|
| Rate for Payer: Cash Price |
$91.76
|
| Rate for Payer: Cash Price |
$91.76
|
| Rate for Payer: Central Health Plan Commercial |
$163.12
|
| Rate for Payer: Cigna of CA HMO |
$142.73
|
| Rate for Payer: Cigna of CA PPO |
$142.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$173.32
|
| Rate for Payer: Dignity Health Media |
$173.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$173.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$81.56
|
| Rate for Payer: Galaxy Health WC |
$173.32
|
| Rate for Payer: Global Benefits Group Commercial |
$122.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$183.51
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$152.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$71.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$136.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$118.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$83.60
|
| Rate for Payer: Multiplan Commercial |
$152.92
|
| Rate for Payer: Networks By Design Commercial |
$101.95
|
| Rate for Payer: Prime Health Services Commercial |
$173.32
|
| Rate for Payer: Riverside University Health System MISP |
$81.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$122.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$122.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$101.95
|
| Rate for Payer: United Healthcare All Other HMO |
$101.95
|
| Rate for Payer: United Healthcare HMO Rider |
$101.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$101.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$173.32
|
| Rate for Payer: Vantage Medical Group Senior |
$173.32
|
|
|
HC ROOM BOARDER BABY
|
Facility
|
IP
|
$3,452.00
|
|
| Hospital Charge Code |
902300021
|
|
Hospital Revenue Code
|
171
|
| Min. Negotiated Rate |
$690.40 |
| Max. Negotiated Rate |
$3,106.80 |
| Rate for Payer: Blue Shield of California Commercial |
$1,836.00
|
| Rate for Payer: Blue Shield of California EPN |
$1,319.00
|
| Rate for Payer: Cash Price |
$1,553.40
|
| Rate for Payer: Cash Price |
$1,553.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,761.60
|
| Rate for Payer: Cigna of CA HMO |
$945.00
|
| Rate for Payer: Cigna of CA PPO |
$1,155.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,380.80
|
| Rate for Payer: Galaxy Health WC |
$2,934.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,071.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,106.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,302.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,315.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$690.40
|
| Rate for Payer: Multiplan Commercial |
$2,589.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,934.20
|
|
|
HC ROOM DOU/INTERMEDIATE
|
Facility
|
IP
|
$6,875.00
|
|
| Hospital Charge Code |
902348107
|
|
Hospital Revenue Code
|
206
|
| Min. Negotiated Rate |
$1,375.00 |
| Max. Negotiated Rate |
$9,809.00 |
| Rate for Payer: Blue Shield of California Commercial |
$9,809.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,040.00
|
| Rate for Payer: Cash Price |
$3,093.75
|
| Rate for Payer: Cash Price |
$3,093.75
|
| Rate for Payer: Central Health Plan Commercial |
$5,500.00
|
| Rate for Payer: Cigna of CA HMO |
$5,390.00
|
| Rate for Payer: Cigna of CA PPO |
$6,775.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,750.00
|
| Rate for Payer: Galaxy Health WC |
$5,843.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,125.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,187.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,200.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,585.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,619.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,375.00
|
| Rate for Payer: Multiplan Commercial |
$5,156.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,843.75
|
|
