|
HC THRPTC INTVN EA ADD 15MIN
|
Facility
|
IP
|
$64.00
|
|
|
Service Code
|
CPT 97130
|
| Hospital Charge Code |
905107130
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$54.40 |
| Rate for Payer: Adventist Health Commercial |
$12.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$44.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: EPIC Health Plan Senior |
$25.60
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$37.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.36
|
| Rate for Payer: Multiplan Commercial |
$51.20
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
|
|
HC THRPTC INTVN EA ADD 15MIN
|
Facility
|
OP
|
$64.00
|
|
|
Service Code
|
CPT 97130
|
| Hospital Charge Code |
905107130
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$15.36 |
| Max. Negotiated Rate |
$478.00 |
| Rate for Payer: Adventist Health Commercial |
$26.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$113.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$54.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$35.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$478.00
|
| Rate for Payer: Blue Shield of California Commercial |
$291.00
|
| Rate for Payer: Blue Shield of California Commercial |
$439.00
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cigna of CA HMO |
$40.96
|
| Rate for Payer: Cigna of CA PPO |
$47.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$54.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$54.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$54.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$44.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: EPIC Health Plan Senior |
$25.60
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$33.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$37.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$37.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44.80
|
| Rate for Payer: Multiplan Commercial |
$51.20
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$54.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$54.40
|
| Rate for Payer: Vantage Medical Group Senior |
$54.40
|
|
|
HC THRPTC INTVN EA ADD 15MIN OT
|
Facility
|
OP
|
$64.00
|
|
|
Service Code
|
CPT 97130
|
| Hospital Charge Code |
905107133
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$15.36 |
| Max. Negotiated Rate |
$478.00 |
| Rate for Payer: Adventist Health Commercial |
$26.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$113.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$54.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$35.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$478.00
|
| Rate for Payer: Blue Shield of California Commercial |
$291.00
|
| Rate for Payer: Blue Shield of California Commercial |
$439.00
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cigna of CA HMO |
$40.96
|
| Rate for Payer: Cigna of CA PPO |
$47.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$54.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$54.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$54.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$44.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: EPIC Health Plan Senior |
$25.60
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$33.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$37.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$37.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44.80
|
| Rate for Payer: Multiplan Commercial |
$51.20
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$54.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$54.40
|
| Rate for Payer: Vantage Medical Group Senior |
$54.40
|
|
|
HC THRPTC INTVN EA ADD 15MIN OT
|
Facility
|
IP
|
$64.00
|
|
|
Service Code
|
CPT 97130
|
| Hospital Charge Code |
905107133
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$54.40 |
| Rate for Payer: Adventist Health Commercial |
$12.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$44.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: EPIC Health Plan Senior |
$25.60
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$37.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.36
|
| Rate for Payer: Multiplan Commercial |
$51.20
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
|
|
HC THRPTC INTVN EA ADD 15MIN ST
|
Facility
|
OP
|
$64.00
|
|
|
Service Code
|
CPT 97130
|
| Hospital Charge Code |
905107134
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$15.36 |
| Max. Negotiated Rate |
$478.00 |
| Rate for Payer: Adventist Health Commercial |
$26.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$113.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$54.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$35.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$478.00
|
| Rate for Payer: Blue Shield of California Commercial |
$291.00
|
| Rate for Payer: Blue Shield of California Commercial |
$439.00
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cigna of CA HMO |
$40.96
|
| Rate for Payer: Cigna of CA PPO |
$47.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$54.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$54.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$54.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$44.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: EPIC Health Plan Senior |
$25.60
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$33.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$37.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$37.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44.80
|
| Rate for Payer: Multiplan Commercial |
$51.20
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$54.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$54.40
|
| Rate for Payer: Vantage Medical Group Senior |
$54.40
|
|
|
HC THRPTC INTVN EA ADD 15MIN ST
|
Facility
|
IP
|
$64.00
|
|
|
Service Code
|
CPT 97130
|
| Hospital Charge Code |
905107134
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$54.40 |
| Rate for Payer: Adventist Health Commercial |
$12.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$44.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: EPIC Health Plan Senior |
$25.60
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$37.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.36
|
| Rate for Payer: Multiplan Commercial |
$51.20
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
|
|
HC THRPTC SPNL PNCTR CSF FLUOR/CT
|
Facility
|
OP
|
$2,278.00
|
|
|
Service Code
|
CPT 62329
|
| Hospital Charge Code |
909002329
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$455.60 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$455.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$998.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$907.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$1,025.10
|
| Rate for Payer: Cash Price |
$1,025.10
|
| Rate for Payer: Cash Price |
$1,025.10
|
| Rate for Payer: Cigna of CA HMO |
$1,457.92
|
| Rate for Payer: Cigna of CA PPO |
$1,685.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$998.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$907.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,594.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,498.00
|
| Rate for Payer: EPIC Health Plan Senior |
$998.67
|
| Rate for Payer: Galaxy Health WC |
$1,936.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,366.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,488.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$494.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$907.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,446.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$558.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,271.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$546.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,143.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,216.56
|
| Rate for Payer: Multiplan Commercial |
$1,822.40
|
| Rate for Payer: Multiplan WC |
$1,402.00
|
| Rate for Payer: Networks By Design Commercial |
$1,480.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,936.30
|
| Rate for Payer: Prime Health Services WC |
$1,387.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,366.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,139.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$907.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$998.67
|
| Rate for Payer: Vantage Medical Group Senior |
$907.88
|
|
|
HC THRPTC SPNL PNCTR CSF FLUOR/CT
|
Facility
|
IP
|
$2,278.00
|
|
|
Service Code
|
CPT 62329
|
| Hospital Charge Code |
909002329
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$455.60 |
| Max. Negotiated Rate |
$1,936.30 |
| Rate for Payer: Adventist Health Commercial |
$455.60
|
| Rate for Payer: Cash Price |
$1,025.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,594.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$911.20
|
| Rate for Payer: EPIC Health Plan Senior |
$911.20
|
| Rate for Payer: Galaxy Health WC |
$1,936.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,366.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,446.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,344.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$546.72
|
| Rate for Payer: Multiplan Commercial |
$1,822.40
|
| Rate for Payer: Networks By Design Commercial |
$1,480.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,936.30
|
|
|
HC THYROGEN 1.1MG
|
Facility
|
OP
|
$5,235.00
|
|
|
Service Code
|
CPT J3240
|
| Hospital Charge Code |
909301498
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,047.00 |
| Max. Negotiated Rate |
$13,074.01 |
| Rate for Payer: Adventist Health Commercial |
$1,047.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13,074.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,698.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,374.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,374.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,270.09
|
| Rate for Payer: Blue Shield of California Commercial |
$2,372.69
|
| Rate for Payer: Cash Price |
$2,355.75
|
| Rate for Payer: Cash Price |
$2,355.75
|
| Rate for Payer: Cigna of CA HMO |
$3,664.50
|
| Rate for Payer: Cigna of CA PPO |
$3,664.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,698.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,374.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,374.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,664.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,561.79
|
| Rate for Payer: EPIC Health Plan Senior |
$2,374.53
|
| Rate for Payer: Galaxy Health WC |
$4,449.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,141.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,540.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2,158.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,158.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,324.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,047.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,022.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,256.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,719.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,892.60
|
| Rate for Payer: Multiplan Commercial |
$4,188.00
|
| Rate for Payer: Networks By Design Commercial |
$2,617.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,449.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,141.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,141.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,964.70
|
| Rate for Payer: United Healthcare All Other HMO |
$1,912.35
|
| Rate for Payer: United Healthcare HMO Rider |
$1,870.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,714.46
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,158.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,698.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,374.53
|
| Rate for Payer: Vantage Medical Group Senior |
$2,374.53
|
|
|
HC THYROGEN 1.1MG
|
Facility
|
IP
|
$5,235.00
|
|
|
Service Code
|
CPT J3240
|
| Hospital Charge Code |
909301498
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,047.00 |
| Max. Negotiated Rate |
$4,449.75 |
| Rate for Payer: Adventist Health Commercial |
$1,047.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,654.14
|
| Rate for Payer: Blue Shield of California Commercial |
$4,025.72
|
| Rate for Payer: Cash Price |
$2,355.75
|
| Rate for Payer: Cigna of CA HMO |
$3,664.50
|
| Rate for Payer: Cigna of CA PPO |
$3,664.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,664.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,094.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,094.00
|
| Rate for Payer: Galaxy Health WC |
$4,449.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,141.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,324.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,088.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,256.40
|
| Rate for Payer: Multiplan Commercial |
$4,188.00
|
| Rate for Payer: Networks By Design Commercial |
$2,617.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,449.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,964.70
|
| Rate for Payer: United Healthcare All Other HMO |
$1,912.35
|
| Rate for Payer: United Healthcare HMO Rider |
$1,870.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,714.46
|
|
|
HC THYROID BIOPSY PERCUTANEOUS
|
Facility
|
OP
|
$1,969.00
|
|
|
Service Code
|
CPT 60100
|
| Hospital Charge Code |
909000178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$89.44 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$393.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Cash Price |
$886.05
|
| Rate for Payer: Cash Price |
$886.05
|
| Rate for Payer: Cash Price |
$886.05
|
| Rate for Payer: Cigna of CA HMO |
$1,260.16
|
| Rate for Payer: Cigna of CA PPO |
$1,457.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,378.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$1,673.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,181.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$89.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,250.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$101.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,275.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$472.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,147.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$1,575.20
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$1,279.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,673.65
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,181.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$984.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC THYROID BIOPSY PERCUTANEOUS
|
Facility
|
IP
|
$1,969.00
|
|
|
Service Code
|
CPT 60100
|
| Hospital Charge Code |
909000178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$393.80 |
| Max. Negotiated Rate |
$1,673.65 |
| Rate for Payer: Adventist Health Commercial |
$393.80
|
| Rate for Payer: Cash Price |
$886.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,378.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$787.60
|
| Rate for Payer: EPIC Health Plan Senior |
$787.60
|
| Rate for Payer: Galaxy Health WC |
$1,673.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,181.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,250.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,161.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$472.56
|
| Rate for Payer: Multiplan Commercial |
$1,575.20
|
| Rate for Payer: Networks By Design Commercial |
$1,279.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,673.65
|
|
|
HC THYROID BIOPSY PERCUTANEOUS
|
Facility
|
IP
|
$1,969.00
|
|
|
Service Code
|
CPT 60100
|
| Hospital Charge Code |
909000178
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$393.80 |
| Max. Negotiated Rate |
$1,673.65 |
| Rate for Payer: Adventist Health Commercial |
$393.80
|
| Rate for Payer: Cash Price |
$886.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,378.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$787.60
|
| Rate for Payer: EPIC Health Plan Senior |
$787.60
|
| Rate for Payer: Galaxy Health WC |
$1,673.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,181.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,250.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,161.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$472.56
|
| Rate for Payer: Multiplan Commercial |
$1,575.20
|
| Rate for Payer: Networks By Design Commercial |
$1,279.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,673.65
|
|
|
HC THYROID BIOPSY PERCUTANEOUS
|
Facility
|
OP
|
$1,969.00
|
|
|
Service Code
|
CPT 60100
|
| Hospital Charge Code |
909000178
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$101.16 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$807.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$507.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$886.05
|
| Rate for Payer: Cash Price |
$886.05
|
| Rate for Payer: Cash Price |
$886.05
|
| Rate for Payer: Cigna of CA HMO |
$1,260.16
|
| Rate for Payer: Cigna of CA PPO |
$1,457.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,378.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$1,673.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,181.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,250.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$101.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$979.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$472.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,147.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$1,575.20
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$1,279.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,673.65
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,181.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,181.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC THYROID HORMONE T3
|
Facility
|
OP
|
$120.00
|
|
|
Service Code
|
CPT 84480
|
| Hospital Charge Code |
900910827
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$146.27 |
| Rate for Payer: Adventist Health Commercial |
$24.00
|
| Rate for Payer: Adventist Health Commercial |
$57.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$117.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$117.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$146.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$146.27
|
| Rate for Payer: Blue Shield of California Commercial |
$132.77
|
| Rate for Payer: Blue Shield of California Commercial |
$55.32
|
| Rate for Payer: Blue Shield of California Commercial |
$200.74
|
| Rate for Payer: Blue Shield of California Commercial |
$83.64
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Cigna of CA HMO |
$184.32
|
| Rate for Payer: Cigna of CA HMO |
$76.80
|
| Rate for Payer: Cigna of CA PPO |
$88.80
|
| Rate for Payer: Cigna of CA PPO |
$213.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$84.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$201.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.40
|
| Rate for Payer: EPIC Health Plan Senior |
$15.60
|
| Rate for Payer: EPIC Health Plan Senior |
$15.60
|
| Rate for Payer: Galaxy Health WC |
$102.00
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$72.00
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.26
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$21.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$21.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$76.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$182.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.00
|
| Rate for Payer: Multiplan Commercial |
$230.40
|
| Rate for Payer: Multiplan Commercial |
$96.00
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Networks By Design Commercial |
$78.00
|
| Rate for Payer: Prime Health Services Commercial |
$102.00
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$72.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$72.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.48
|
| Rate for Payer: United Healthcare All Other HMO |
$11.48
|
| Rate for Payer: United Healthcare All Other HMO |
$11.48
|
| Rate for Payer: United Healthcare HMO Rider |
$11.48
|
| Rate for Payer: United Healthcare HMO Rider |
$11.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.48
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.18
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.60
|
| Rate for Payer: Vantage Medical Group Senior |
$14.18
|
| Rate for Payer: Vantage Medical Group Senior |
$14.18
|
|
|
HC THYROID HORMONE T3
|
Facility
|
IP
|
$288.00
|
|
|
Service Code
|
CPT 84480
|
| Hospital Charge Code |
900910827
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$244.80 |
| Rate for Payer: Adventist Health Commercial |
$57.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$201.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$182.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$169.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.12
|
| Rate for Payer: Multiplan Commercial |
$230.40
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
|
|
HC THYROID SCAN
|
Facility
|
IP
|
$1,275.00
|
|
|
Service Code
|
CPT 78013
|
| Hospital Charge Code |
909301316
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$255.00 |
| Max. Negotiated Rate |
$1,083.75 |
| Rate for Payer: Adventist Health Commercial |
$255.00
|
| Rate for Payer: Cash Price |
$573.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$892.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$510.00
|
| Rate for Payer: EPIC Health Plan Senior |
$510.00
|
| Rate for Payer: Galaxy Health WC |
$1,083.75
|
| Rate for Payer: Global Benefits Group Commercial |
$765.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$809.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$752.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$306.00
|
| Rate for Payer: Multiplan Commercial |
$1,020.00
|
| Rate for Payer: Networks By Design Commercial |
$828.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,083.75
|
|
|
HC THYROID SCAN
|
Facility
|
OP
|
$1,275.00
|
|
|
Service Code
|
CPT 78013
|
| Hospital Charge Code |
909301316
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$255.00 |
| Max. Negotiated Rate |
$1,083.75 |
| Rate for Payer: Adventist Health Commercial |
$255.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,021.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$514.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$818.17
|
| Rate for Payer: Blue Shield of California Commercial |
$813.45
|
| Rate for Payer: Blue Shield of California Commercial |
$536.77
|
| Rate for Payer: Cash Price |
$573.75
|
| Rate for Payer: Cash Price |
$573.75
|
| Rate for Payer: Cigna of CA HMO |
$816.00
|
| Rate for Payer: Cigna of CA PPO |
$943.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$771.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$565.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$514.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$892.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$848.38
|
| Rate for Payer: EPIC Health Plan Senior |
$565.59
|
| Rate for Payer: Galaxy Health WC |
$1,083.75
|
| Rate for Payer: Global Benefits Group Commercial |
$765.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$843.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$292.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$514.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$809.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$330.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$719.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$306.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$647.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$688.99
|
| Rate for Payer: Multiplan Commercial |
$1,020.00
|
| Rate for Payer: Networks By Design Commercial |
$828.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,083.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$765.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$765.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$384.10
|
| Rate for Payer: United Healthcare All Other HMO |
$384.10
|
| Rate for Payer: United Healthcare HMO Rider |
$384.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$384.10
|
| Rate for Payer: Upland Medical Group Pediatric |
$514.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Vantage Medical Group Senior |
$514.17
|
|
|
HC THYROID UPTAKE MULT
|
Facility
|
IP
|
$853.00
|
|
|
Service Code
|
CPT 78012
|
| Hospital Charge Code |
909301311
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$170.60 |
| Max. Negotiated Rate |
$725.05 |
| Rate for Payer: Adventist Health Commercial |
$170.60
|
| Rate for Payer: Cash Price |
$383.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$597.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$341.20
|
| Rate for Payer: EPIC Health Plan Senior |
$341.20
|
| Rate for Payer: Galaxy Health WC |
$725.05
|
| Rate for Payer: Global Benefits Group Commercial |
$511.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$541.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$503.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.72
|
| Rate for Payer: Multiplan Commercial |
$682.40
|
| Rate for Payer: Networks By Design Commercial |
$554.45
|
| Rate for Payer: Prime Health Services Commercial |
$725.05
|
|
|
HC THYROID UPTAKE MULT
|
Facility
|
OP
|
$853.00
|
|
|
Service Code
|
CPT 78012
|
| Hospital Charge Code |
909301311
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$170.60 |
| Max. Negotiated Rate |
$848.38 |
| Rate for Payer: Adventist Health Commercial |
$170.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$502.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$514.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$547.37
|
| Rate for Payer: Blue Shield of California Commercial |
$544.21
|
| Rate for Payer: Blue Shield of California Commercial |
$359.11
|
| Rate for Payer: Cash Price |
$383.85
|
| Rate for Payer: Cash Price |
$383.85
|
| Rate for Payer: Cigna of CA HMO |
$545.92
|
| Rate for Payer: Cigna of CA PPO |
$631.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$771.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$565.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$514.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$597.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$848.38
|
| Rate for Payer: EPIC Health Plan Senior |
$565.59
|
| Rate for Payer: Galaxy Health WC |
$725.05
|
| Rate for Payer: Global Benefits Group Commercial |
$511.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$843.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$514.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$541.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$309.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$719.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$647.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$688.99
|
| Rate for Payer: Multiplan Commercial |
$682.40
|
| Rate for Payer: Networks By Design Commercial |
$554.45
|
| Rate for Payer: Prime Health Services Commercial |
$725.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$511.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$511.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$291.92
|
| Rate for Payer: United Healthcare All Other HMO |
$291.92
|
| Rate for Payer: United Healthcare HMO Rider |
$291.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$291.92
|
| Rate for Payer: Upland Medical Group Pediatric |
$514.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Vantage Medical Group Senior |
$514.17
|
|
|
HC THYROID UPTAKE/SCAN
|
Facility
|
IP
|
$2,414.00
|
|
|
Service Code
|
CPT 78014
|
| Hospital Charge Code |
909301315
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$482.80 |
| Max. Negotiated Rate |
$2,051.90 |
| Rate for Payer: Adventist Health Commercial |
$482.80
|
| Rate for Payer: Cash Price |
$1,086.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,689.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$965.60
|
| Rate for Payer: EPIC Health Plan Senior |
$965.60
|
| Rate for Payer: Galaxy Health WC |
$2,051.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,448.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,532.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,424.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$579.36
|
| Rate for Payer: Multiplan Commercial |
$1,931.20
|
| Rate for Payer: Networks By Design Commercial |
$1,569.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,051.90
|
|
|
HC THYROID UPTAKE/SCAN
|
Facility
|
OP
|
$2,414.00
|
|
|
Service Code
|
CPT 78014
|
| Hospital Charge Code |
909301315
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$358.68 |
| Max. Negotiated Rate |
$2,051.90 |
| Rate for Payer: Adventist Health Commercial |
$482.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,488.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$514.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,549.06
|
| Rate for Payer: Blue Shield of California Commercial |
$1,540.13
|
| Rate for Payer: Blue Shield of California Commercial |
$1,016.29
|
| Rate for Payer: Cash Price |
$1,086.30
|
| Rate for Payer: Cash Price |
$1,086.30
|
| Rate for Payer: Cigna of CA HMO |
$1,544.96
|
| Rate for Payer: Cigna of CA PPO |
$1,786.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$771.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$565.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$514.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,689.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$848.38
|
| Rate for Payer: EPIC Health Plan Senior |
$565.59
|
| Rate for Payer: Galaxy Health WC |
$2,051.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,448.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$843.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$358.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$514.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,532.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$405.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$719.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$579.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$647.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$688.99
|
| Rate for Payer: Multiplan Commercial |
$1,931.20
|
| Rate for Payer: Networks By Design Commercial |
$1,569.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,051.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,448.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,448.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$596.32
|
| Rate for Payer: United Healthcare All Other HMO |
$596.32
|
| Rate for Payer: United Healthcare HMO Rider |
$596.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$596.32
|
| Rate for Payer: Upland Medical Group Pediatric |
$514.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Vantage Medical Group Senior |
$514.17
|
|
|
HC THYROXIN T4
|
Facility
|
OP
|
$153.00
|
|
|
Service Code
|
CPT 84436
|
| Hospital Charge Code |
900910835
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.56 |
| Max. Negotiated Rate |
$130.05 |
| Rate for Payer: Adventist Health Commercial |
$30.60
|
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70.95
|
| Rate for Payer: Blue Shield of California Commercial |
$27.66
|
| Rate for Payer: Blue Shield of California Commercial |
$106.64
|
| Rate for Payer: Blue Shield of California Commercial |
$41.82
|
| Rate for Payer: Blue Shield of California Commercial |
$70.53
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Cigna of CA HMO |
$38.40
|
| Rate for Payer: Cigna of CA HMO |
$97.92
|
| Rate for Payer: Cigna of CA PPO |
$113.22
|
| Rate for Payer: Cigna of CA PPO |
$44.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.87
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$107.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.34
|
| Rate for Payer: EPIC Health Plan Senior |
$7.56
|
| Rate for Payer: EPIC Health Plan Senior |
$7.56
|
| Rate for Payer: Galaxy Health WC |
$130.05
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$91.80
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11.27
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$97.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.21
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Multiplan Commercial |
$122.40
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Networks By Design Commercial |
$99.45
|
| Rate for Payer: Prime Health Services Commercial |
$130.05
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$91.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.56
|
| Rate for Payer: United Healthcare All Other HMO |
$5.56
|
| Rate for Payer: United Healthcare All Other HMO |
$5.56
|
| Rate for Payer: United Healthcare HMO Rider |
$5.56
|
| Rate for Payer: United Healthcare HMO Rider |
$5.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.56
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.87
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.56
|
| Rate for Payer: Vantage Medical Group Senior |
$6.87
|
| Rate for Payer: Vantage Medical Group Senior |
$6.87
|
|
|
HC THYROXIN T4
|
Facility
|
IP
|
$153.00
|
|
|
Service Code
|
CPT 84436
|
| Hospital Charge Code |
900910835
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$130.05 |
| Rate for Payer: Adventist Health Commercial |
$30.60
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$107.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.20
|
| Rate for Payer: EPIC Health Plan Senior |
$61.20
|
| Rate for Payer: Galaxy Health WC |
$130.05
|
| Rate for Payer: Global Benefits Group Commercial |
$91.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$97.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$90.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.72
|
| Rate for Payer: Multiplan Commercial |
$122.40
|
| Rate for Payer: Networks By Design Commercial |
$99.45
|
| Rate for Payer: Prime Health Services Commercial |
$130.05
|
|
|
HC TIBIA FIBULA
|
Facility
|
IP
|
$713.00
|
|
|
Service Code
|
CPT 73590
|
| Hospital Charge Code |
909001638
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$142.60 |
| Max. Negotiated Rate |
$606.05 |
| Rate for Payer: Adventist Health Commercial |
$142.60
|
| Rate for Payer: Cash Price |
$320.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$499.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$285.20
|
| Rate for Payer: EPIC Health Plan Senior |
$285.20
|
| Rate for Payer: Galaxy Health WC |
$606.05
|
| Rate for Payer: Global Benefits Group Commercial |
$427.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$452.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$420.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$171.12
|
| Rate for Payer: Multiplan Commercial |
$570.40
|
| Rate for Payer: Networks By Design Commercial |
$463.45
|
| Rate for Payer: Prime Health Services Commercial |
$606.05
|
|
