|
HC BNDR ABD 3XL 82-100" 3 PANEL
|
Facility
|
IP
|
$69.13
|
|
| Hospital Charge Code |
901692021
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$13.83 |
| Max. Negotiated Rate |
$58.76 |
| Rate for Payer: Adventist Health Commercial |
$13.83
|
| Rate for Payer: Cash Price |
$31.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.65
|
| Rate for Payer: EPIC Health Plan Senior |
$27.65
|
| Rate for Payer: Galaxy Health WC |
$58.76
|
| Rate for Payer: Global Benefits Group Commercial |
$41.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$46.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.59
|
| Rate for Payer: Multiplan Commercial |
$55.30
|
| Rate for Payer: Networks By Design Commercial |
$44.93
|
| Rate for Payer: Prime Health Services Commercial |
$58.76
|
|
|
HC BNDR ABD 3XL 82-100" 3 PANEL
|
Facility
|
OP
|
$69.13
|
|
| Hospital Charge Code |
901692021
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$13.83 |
| Max. Negotiated Rate |
$58.76 |
| Rate for Payer: Adventist Health Commercial |
$13.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$45.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$58.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$51.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42.45
|
| Rate for Payer: Cash Price |
$31.11
|
| Rate for Payer: Cigna of CA HMO |
$44.24
|
| Rate for Payer: Cigna of CA PPO |
$51.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$58.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$58.76
|
| Rate for Payer: Dignity Health Medicare Advantage |
$58.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.65
|
| Rate for Payer: EPIC Health Plan Senior |
$27.65
|
| Rate for Payer: Galaxy Health WC |
$58.76
|
| Rate for Payer: Global Benefits Group Commercial |
$41.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$46.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$48.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48.39
|
| Rate for Payer: Multiplan Commercial |
$55.30
|
| Rate for Payer: Networks By Design Commercial |
$44.93
|
| Rate for Payer: Prime Health Services Commercial |
$58.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$41.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$41.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$34.56
|
| Rate for Payer: United Healthcare All Other HMO |
$34.56
|
| Rate for Payer: United Healthcare HMO Rider |
$34.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$58.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$58.76
|
| Rate for Payer: Vantage Medical Group Senior |
$58.76
|
|
|
HC BNDR ABD 3XL 82-100" 4 PANEL
|
Facility
|
OP
|
$86.56
|
|
| Hospital Charge Code |
901692020
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$17.31 |
| Max. Negotiated Rate |
$73.58 |
| Rate for Payer: Adventist Health Commercial |
$17.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$56.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$73.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$47.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$64.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$53.16
|
| Rate for Payer: Cash Price |
$38.95
|
| Rate for Payer: Cigna of CA HMO |
$55.40
|
| Rate for Payer: Cigna of CA PPO |
$64.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$73.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$73.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$73.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.62
|
| Rate for Payer: EPIC Health Plan Senior |
$34.62
|
| Rate for Payer: Galaxy Health WC |
$73.58
|
| Rate for Payer: Global Benefits Group Commercial |
$51.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$57.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$60.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60.59
|
| Rate for Payer: Multiplan Commercial |
$69.25
|
| Rate for Payer: Networks By Design Commercial |
$56.26
|
| Rate for Payer: Prime Health Services Commercial |
$73.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$43.28
|
| Rate for Payer: United Healthcare All Other HMO |
$43.28
|
| Rate for Payer: United Healthcare HMO Rider |
$43.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$73.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$73.58
|
| Rate for Payer: Vantage Medical Group Senior |
$73.58
|
|
|
HC BNDR ABD 3XL 82-100" 4 PANEL
|
Facility
|
IP
|
$86.56
|
|
| Hospital Charge Code |
901692020
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$17.31 |
| Max. Negotiated Rate |
$73.58 |
| Rate for Payer: Adventist Health Commercial |
$17.31
|
| Rate for Payer: Cash Price |
$38.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.62
|
| Rate for Payer: EPIC Health Plan Senior |
$34.62
|
| Rate for Payer: Galaxy Health WC |
$73.58
|
| Rate for Payer: Global Benefits Group Commercial |
$51.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$57.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.77
|
| Rate for Payer: Multiplan Commercial |
$69.25
|
| Rate for Payer: Networks By Design Commercial |
$56.26
|
| Rate for Payer: Prime Health Services Commercial |
$73.58
|
|
|
HC BNDR ABD 9" 3 PANEL 30-45"
|
Facility
|
IP
|
$50.10
|
|
| Hospital Charge Code |
901698686
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$10.02 |
| Max. Negotiated Rate |
$42.59 |
| Rate for Payer: Adventist Health Commercial |
$10.02
|
| Rate for Payer: Cash Price |
$22.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.04
|
| Rate for Payer: EPIC Health Plan Senior |
$20.04
|
| Rate for Payer: Galaxy Health WC |
$42.59
|
| Rate for Payer: Global Benefits Group Commercial |
$30.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.02
|
| Rate for Payer: Multiplan Commercial |
$40.08
|
| Rate for Payer: Networks By Design Commercial |
$32.56
|
| Rate for Payer: Prime Health Services Commercial |
$42.59
|
|
|
HC BNDR ABD 9" 3 PANEL 30-45"
|
Facility
|
OP
|
$50.10
|
|
| Hospital Charge Code |
901698686
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$10.02 |
| Max. Negotiated Rate |
$42.59 |
| Rate for Payer: Adventist Health Commercial |
$10.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.77
|
| Rate for Payer: Cash Price |
$22.55
|
| Rate for Payer: Cigna of CA HMO |
$32.06
|
| Rate for Payer: Cigna of CA PPO |
$37.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$42.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$42.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.04
|
| Rate for Payer: EPIC Health Plan Senior |
$20.04
|
| Rate for Payer: Galaxy Health WC |
$42.59
|
| Rate for Payer: Global Benefits Group Commercial |
$30.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35.07
|
| Rate for Payer: Multiplan Commercial |
$40.08
|
| Rate for Payer: Networks By Design Commercial |
$32.56
|
| Rate for Payer: Prime Health Services Commercial |
$42.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$25.05
|
| Rate for Payer: United Healthcare All Other HMO |
$25.05
|
| Rate for Payer: United Healthcare HMO Rider |
$25.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42.59
|
| Rate for Payer: Vantage Medical Group Senior |
$42.59
|
|
|
HC BNDR ABD 9" 3PANEL 30-45" PROC
|
Facility
|
OP
|
$47.97
|
|
| Hospital Charge Code |
901698687
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.59 |
| Max. Negotiated Rate |
$40.77 |
| Rate for Payer: Adventist Health Commercial |
$9.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.46
|
| Rate for Payer: Cash Price |
$21.59
|
| Rate for Payer: Cigna of CA HMO |
$30.70
|
| Rate for Payer: Cigna of CA PPO |
$35.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.19
|
| Rate for Payer: EPIC Health Plan Senior |
$19.19
|
| Rate for Payer: Galaxy Health WC |
$40.77
|
| Rate for Payer: Global Benefits Group Commercial |
$28.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.58
|
| Rate for Payer: Multiplan Commercial |
$38.38
|
| Rate for Payer: Networks By Design Commercial |
$31.18
|
| Rate for Payer: Prime Health Services Commercial |
$40.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.78
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.98
|
| Rate for Payer: United Healthcare All Other HMO |
$23.98
|
| Rate for Payer: United Healthcare HMO Rider |
$23.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.77
|
| Rate for Payer: Vantage Medical Group Senior |
$40.77
|
|
|
HC BNDR ABD 9" 3PANEL 30-45" PROC
|
Facility
|
IP
|
$47.97
|
|
| Hospital Charge Code |
901698687
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.59 |
| Max. Negotiated Rate |
$40.77 |
| Rate for Payer: Adventist Health Commercial |
$9.59
|
| Rate for Payer: Cash Price |
$21.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.19
|
| Rate for Payer: EPIC Health Plan Senior |
$19.19
|
| Rate for Payer: Galaxy Health WC |
$40.77
|
| Rate for Payer: Global Benefits Group Commercial |
$28.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.51
|
| Rate for Payer: Multiplan Commercial |
$38.38
|
| Rate for Payer: Networks By Design Commercial |
$31.18
|
| Rate for Payer: Prime Health Services Commercial |
$40.77
|
|
|
HC BNDR ABD 9" 3PANEL 30-45"S/MED
|
Facility
|
OP
|
$86.26
|
|
| Hospital Charge Code |
901698688
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$17.25 |
| Max. Negotiated Rate |
$73.32 |
| Rate for Payer: Adventist Health Commercial |
$17.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$56.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$73.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$47.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$64.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.97
|
| Rate for Payer: Cash Price |
$38.82
|
| Rate for Payer: Cigna of CA HMO |
$55.21
|
| Rate for Payer: Cigna of CA PPO |
$63.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$73.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$73.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$73.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.50
|
| Rate for Payer: EPIC Health Plan Senior |
$34.50
|
| Rate for Payer: Galaxy Health WC |
$73.32
|
| Rate for Payer: Global Benefits Group Commercial |
$51.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$57.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$60.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60.38
|
| Rate for Payer: Multiplan Commercial |
$69.01
|
| Rate for Payer: Networks By Design Commercial |
$56.07
|
| Rate for Payer: Prime Health Services Commercial |
$73.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$43.13
|
| Rate for Payer: United Healthcare All Other HMO |
$43.13
|
| Rate for Payer: United Healthcare HMO Rider |
$43.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$73.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$73.32
|
| Rate for Payer: Vantage Medical Group Senior |
$73.32
|
|
|
HC BNDR ABD 9" 3PANEL 30-45"S/MED
|
Facility
|
IP
|
$86.26
|
|
| Hospital Charge Code |
901698688
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$17.25 |
| Max. Negotiated Rate |
$73.32 |
| Rate for Payer: Adventist Health Commercial |
$17.25
|
| Rate for Payer: Cash Price |
$38.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.50
|
| Rate for Payer: EPIC Health Plan Senior |
$34.50
|
| Rate for Payer: Galaxy Health WC |
$73.32
|
| Rate for Payer: Global Benefits Group Commercial |
$51.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$57.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.70
|
| Rate for Payer: Multiplan Commercial |
$69.01
|
| Rate for Payer: Networks By Design Commercial |
$56.07
|
| Rate for Payer: Prime Health Services Commercial |
$73.32
|
|
|
HC BNDR ABD 9IN XL 75-84" 3 PANEL
|
Facility
|
OP
|
$105.26
|
|
| Hospital Charge Code |
901698833
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$21.05 |
| Max. Negotiated Rate |
$89.47 |
| Rate for Payer: Adventist Health Commercial |
$21.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$69.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$89.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$57.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$78.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$64.64
|
| Rate for Payer: Cash Price |
$47.37
|
| Rate for Payer: Cigna of CA HMO |
$67.37
|
| Rate for Payer: Cigna of CA PPO |
$77.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$89.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$89.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$89.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.10
|
| Rate for Payer: EPIC Health Plan Senior |
$42.10
|
| Rate for Payer: Galaxy Health WC |
$89.47
|
| Rate for Payer: Global Benefits Group Commercial |
$63.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$65.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$73.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$73.68
|
| Rate for Payer: Multiplan Commercial |
$84.21
|
| Rate for Payer: Networks By Design Commercial |
$68.42
|
| Rate for Payer: Prime Health Services Commercial |
$89.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$52.63
|
| Rate for Payer: United Healthcare All Other HMO |
$52.63
|
| Rate for Payer: United Healthcare HMO Rider |
$52.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$89.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$89.47
|
| Rate for Payer: Vantage Medical Group Senior |
$89.47
|
|
|
HC BNDR ABD 9IN XL 75-84" 3 PANEL
|
Facility
|
IP
|
$105.26
|
|
| Hospital Charge Code |
901698833
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$21.05 |
| Max. Negotiated Rate |
$89.47 |
| Rate for Payer: Adventist Health Commercial |
$21.05
|
| Rate for Payer: Cash Price |
$47.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.10
|
| Rate for Payer: EPIC Health Plan Senior |
$42.10
|
| Rate for Payer: Galaxy Health WC |
$89.47
|
| Rate for Payer: Global Benefits Group Commercial |
$63.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$65.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.26
|
| Rate for Payer: Multiplan Commercial |
$84.21
|
| Rate for Payer: Networks By Design Commercial |
$68.42
|
| Rate for Payer: Prime Health Services Commercial |
$89.47
|
|
|
HC BNDR ABD UNIV 9" WIDE 45-62"
|
Facility
|
IP
|
$42.72
|
|
| Hospital Charge Code |
901698644
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$8.54 |
| Max. Negotiated Rate |
$36.31 |
| Rate for Payer: Adventist Health Commercial |
$8.54
|
| Rate for Payer: Cash Price |
$19.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.09
|
| Rate for Payer: EPIC Health Plan Senior |
$17.09
|
| Rate for Payer: Galaxy Health WC |
$36.31
|
| Rate for Payer: Global Benefits Group Commercial |
$25.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.25
|
| Rate for Payer: Multiplan Commercial |
$34.18
|
| Rate for Payer: Networks By Design Commercial |
$27.77
|
| Rate for Payer: Prime Health Services Commercial |
$36.31
|
|
|
HC BNDR ABD UNIV 9" WIDE 45-62"
|
Facility
|
OP
|
$42.72
|
|
| Hospital Charge Code |
901698644
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$8.54 |
| Max. Negotiated Rate |
$36.31 |
| Rate for Payer: Adventist Health Commercial |
$8.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$28.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$23.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$32.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26.23
|
| Rate for Payer: Cash Price |
$19.22
|
| Rate for Payer: Cigna of CA HMO |
$27.34
|
| Rate for Payer: Cigna of CA PPO |
$31.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$36.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$36.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.09
|
| Rate for Payer: EPIC Health Plan Senior |
$17.09
|
| Rate for Payer: Galaxy Health WC |
$36.31
|
| Rate for Payer: Global Benefits Group Commercial |
$25.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29.90
|
| Rate for Payer: Multiplan Commercial |
$34.18
|
| Rate for Payer: Networks By Design Commercial |
$27.77
|
| Rate for Payer: Prime Health Services Commercial |
$36.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.63
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.36
|
| Rate for Payer: United Healthcare All Other HMO |
$21.36
|
| Rate for Payer: United Healthcare HMO Rider |
$21.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$36.31
|
| Rate for Payer: Vantage Medical Group Senior |
$36.31
|
|
|
HC BNDR ABD XL 62-74" 3 PANEL
|
Facility
|
IP
|
$52.23
|
|
| Hospital Charge Code |
901605881
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$10.45 |
| Max. Negotiated Rate |
$44.40 |
| Rate for Payer: Adventist Health Commercial |
$10.45
|
| Rate for Payer: Cash Price |
$23.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.89
|
| Rate for Payer: EPIC Health Plan Senior |
$20.89
|
| Rate for Payer: Galaxy Health WC |
$44.40
|
| Rate for Payer: Global Benefits Group Commercial |
$31.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.54
|
| Rate for Payer: Multiplan Commercial |
$41.78
|
| Rate for Payer: Networks By Design Commercial |
$33.95
|
| Rate for Payer: Prime Health Services Commercial |
$44.40
|
|
|
HC BNDR ABD XL 62-74" 3 PANEL
|
Facility
|
OP
|
$52.23
|
|
| Hospital Charge Code |
901605881
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$10.45 |
| Max. Negotiated Rate |
$44.40 |
| Rate for Payer: Adventist Health Commercial |
$10.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$44.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$39.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32.07
|
| Rate for Payer: Cash Price |
$23.50
|
| Rate for Payer: Cigna of CA HMO |
$33.43
|
| Rate for Payer: Cigna of CA PPO |
$38.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$44.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$44.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.89
|
| Rate for Payer: EPIC Health Plan Senior |
$20.89
|
| Rate for Payer: Galaxy Health WC |
$44.40
|
| Rate for Payer: Global Benefits Group Commercial |
$31.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36.56
|
| Rate for Payer: Multiplan Commercial |
$41.78
|
| Rate for Payer: Networks By Design Commercial |
$33.95
|
| Rate for Payer: Prime Health Services Commercial |
$44.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$26.11
|
| Rate for Payer: United Healthcare All Other HMO |
$26.11
|
| Rate for Payer: United Healthcare HMO Rider |
$26.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$44.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44.40
|
| Rate for Payer: Vantage Medical Group Senior |
$44.40
|
|
|
HC BNDR ABD XL 62-74" 4 PANEL
|
Facility
|
IP
|
$64.70
|
|
| Hospital Charge Code |
901605882
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$12.94 |
| Max. Negotiated Rate |
$54.99 |
| Rate for Payer: Adventist Health Commercial |
$12.94
|
| Rate for Payer: Cash Price |
$29.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.88
|
| Rate for Payer: EPIC Health Plan Senior |
$25.88
|
| Rate for Payer: Galaxy Health WC |
$54.99
|
| Rate for Payer: Global Benefits Group Commercial |
$38.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.53
|
| Rate for Payer: Multiplan Commercial |
$51.76
|
| Rate for Payer: Networks By Design Commercial |
$42.05
|
| Rate for Payer: Prime Health Services Commercial |
$54.99
|
|
|
HC BNDR ABD XL 62-74" 4 PANEL
|
Facility
|
OP
|
$64.70
|
|
| Hospital Charge Code |
901605882
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$12.94 |
| Max. Negotiated Rate |
$54.99 |
| Rate for Payer: Adventist Health Commercial |
$12.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$54.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$35.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$39.73
|
| Rate for Payer: Cash Price |
$29.12
|
| Rate for Payer: Cigna of CA HMO |
$41.41
|
| Rate for Payer: Cigna of CA PPO |
$47.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$54.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$54.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$54.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.88
|
| Rate for Payer: EPIC Health Plan Senior |
$25.88
|
| Rate for Payer: Galaxy Health WC |
$54.99
|
| Rate for Payer: Global Benefits Group Commercial |
$38.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45.29
|
| Rate for Payer: Multiplan Commercial |
$51.76
|
| Rate for Payer: Networks By Design Commercial |
$42.05
|
| Rate for Payer: Prime Health Services Commercial |
$54.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.35
|
| Rate for Payer: United Healthcare All Other HMO |
$32.35
|
| Rate for Payer: United Healthcare HMO Rider |
$32.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$54.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$54.99
|
| Rate for Payer: Vantage Medical Group Senior |
$54.99
|
|
|
HC BODY JACKET CUSTOM FIT
|
Facility
|
OP
|
$3,410.00
|
|
|
Service Code
|
CPT L0430
|
| Hospital Charge Code |
905360430
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$818.40 |
| Max. Negotiated Rate |
$2,898.50 |
| Rate for Payer: Adventist Health Commercial |
$1,398.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,898.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,875.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,557.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,975.07
|
| Rate for Payer: Blue Shield of California Commercial |
$2,516.58
|
| Rate for Payer: Blue Shield of California EPN |
$1,657.26
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Cigna of CA HMO |
$2,387.00
|
| Rate for Payer: Cigna of CA PPO |
$2,387.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,898.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,898.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,898.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,364.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,364.00
|
| Rate for Payer: Galaxy Health WC |
$2,898.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,046.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,274.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,299.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,110.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$818.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,387.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,387.00
|
| Rate for Payer: Multiplan Commercial |
$2,728.00
|
| Rate for Payer: Networks By Design Commercial |
$1,705.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,898.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,046.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,046.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,279.77
|
| Rate for Payer: United Healthcare All Other HMO |
$1,245.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,218.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,116.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,898.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,898.50
|
| Rate for Payer: Vantage Medical Group Senior |
$2,898.50
|
|
|
HC BODY JACKET CUSTOM FIT
|
Facility
|
IP
|
$3,410.00
|
|
|
Service Code
|
CPT L0430
|
| Hospital Charge Code |
905360430
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$682.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$682.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Cigna of CA HMO |
$2,387.00
|
| Rate for Payer: Cigna of CA PPO |
$2,387.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,364.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,364.00
|
| Rate for Payer: Galaxy Health WC |
$2,898.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,046.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,274.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,299.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,110.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$818.40
|
| Rate for Payer: Multiplan Commercial |
$2,728.00
|
| Rate for Payer: Networks By Design Commercial |
$1,705.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,898.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,279.77
|
| Rate for Payer: United Healthcare All Other HMO |
$1,245.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,218.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,116.78
|
|
|
HC BODY MUSCLE TESTING MANUAL MCAL
|
Facility
|
IP
|
$339.00
|
|
|
Service Code
|
CPT 95833
|
| Hospital Charge Code |
901300027
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$67.80 |
| Max. Negotiated Rate |
$288.15 |
| Rate for Payer: Adventist Health Commercial |
$67.80
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$135.60
|
| Rate for Payer: EPIC Health Plan Senior |
$135.60
|
| Rate for Payer: Galaxy Health WC |
$288.15
|
| Rate for Payer: Global Benefits Group Commercial |
$203.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$226.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$129.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$209.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.36
|
| Rate for Payer: Multiplan Commercial |
$271.20
|
| Rate for Payer: Networks By Design Commercial |
$220.35
|
| Rate for Payer: Prime Health Services Commercial |
$288.15
|
|
|
HC BODY MUSCLE TESTING MANUAL MCAL
|
Facility
|
OP
|
$339.00
|
|
|
Service Code
|
CPT 95833
|
| Hospital Charge Code |
901300027
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$81.36 |
| Max. Negotiated Rate |
$457.00 |
| Rate for Payer: Adventist Health Commercial |
$138.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$222.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$288.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$186.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$254.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$457.00
|
| Rate for Payer: Blue Shield of California Commercial |
$421.00
|
| Rate for Payer: Blue Shield of California EPN |
$279.00
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Cigna of CA HMO |
$216.96
|
| Rate for Payer: Cigna of CA PPO |
$250.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$288.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$288.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$288.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$135.60
|
| Rate for Payer: EPIC Health Plan Senior |
$135.60
|
| Rate for Payer: Galaxy Health WC |
$288.15
|
| Rate for Payer: Global Benefits Group Commercial |
$203.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$226.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$129.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$209.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$237.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$237.30
|
| Rate for Payer: Multiplan Commercial |
$271.20
|
| Rate for Payer: Networks By Design Commercial |
$220.35
|
| Rate for Payer: Prime Health Services Commercial |
$288.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$203.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$203.40
|
| 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 |
$288.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$288.15
|
| Rate for Payer: Vantage Medical Group Senior |
$288.15
|
|
|
HC BODY MUSCLE TESTING MANUAL MCAL
|
Facility
|
OP
|
$339.00
|
|
|
Service Code
|
CPT 95833
|
| Hospital Charge Code |
900400012
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$81.36 |
| Max. Negotiated Rate |
$457.00 |
| Rate for Payer: Adventist Health Commercial |
$138.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$222.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$288.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$186.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$254.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$457.00
|
| Rate for Payer: Blue Shield of California Commercial |
$421.00
|
| Rate for Payer: Blue Shield of California EPN |
$279.00
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Cigna of CA HMO |
$216.96
|
| Rate for Payer: Cigna of CA PPO |
$250.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$288.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$288.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$288.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$135.60
|
| Rate for Payer: EPIC Health Plan Senior |
$135.60
|
| Rate for Payer: Galaxy Health WC |
$288.15
|
| Rate for Payer: Global Benefits Group Commercial |
$203.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$226.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$129.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$209.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$237.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$237.30
|
| Rate for Payer: Multiplan Commercial |
$271.20
|
| Rate for Payer: Networks By Design Commercial |
$220.35
|
| Rate for Payer: Prime Health Services Commercial |
$288.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$203.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$203.40
|
| 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 |
$288.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$288.15
|
| Rate for Payer: Vantage Medical Group Senior |
$288.15
|
|
|
HC BODY MUSCLE TESTING MANUAL MCAL
|
Facility
|
IP
|
$339.00
|
|
|
Service Code
|
CPT 95833
|
| Hospital Charge Code |
900400012
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$67.80 |
| Max. Negotiated Rate |
$288.15 |
| Rate for Payer: Adventist Health Commercial |
$67.80
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$135.60
|
| Rate for Payer: EPIC Health Plan Senior |
$135.60
|
| Rate for Payer: Galaxy Health WC |
$288.15
|
| Rate for Payer: Global Benefits Group Commercial |
$203.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$226.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$129.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$209.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.36
|
| Rate for Payer: Multiplan Commercial |
$271.20
|
| Rate for Payer: Networks By Design Commercial |
$220.35
|
| Rate for Payer: Prime Health Services Commercial |
$288.15
|
|
|
HC BODY MUSCLE TEST MANUAL W HAND MCAL
|
Facility
|
OP
|
$339.00
|
|
|
Service Code
|
CPT 95834
|
| Hospital Charge Code |
901300029
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$81.36 |
| Max. Negotiated Rate |
$457.00 |
| Rate for Payer: Adventist Health Commercial |
$138.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$222.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$288.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$186.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$254.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$457.00
|
| Rate for Payer: Blue Shield of California Commercial |
$421.00
|
| Rate for Payer: Blue Shield of California EPN |
$279.00
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Cigna of CA HMO |
$216.96
|
| Rate for Payer: Cigna of CA PPO |
$250.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$288.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$288.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$288.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$135.60
|
| Rate for Payer: EPIC Health Plan Senior |
$135.60
|
| Rate for Payer: Galaxy Health WC |
$288.15
|
| Rate for Payer: Global Benefits Group Commercial |
$203.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$226.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$129.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$209.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$237.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$237.30
|
| Rate for Payer: Multiplan Commercial |
$271.20
|
| Rate for Payer: Networks By Design Commercial |
$220.35
|
| Rate for Payer: Prime Health Services Commercial |
$288.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$203.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$203.40
|
| 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 |
$288.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$288.15
|
| Rate for Payer: Vantage Medical Group Senior |
$288.15
|
|
