|
HC DRES & OR DEB OF BURN INT/SUB LG
|
Facility
|
OP
|
$1,939.00
|
|
|
Service Code
|
CPT 16030
|
| Hospital Charge Code |
900501048
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$465.36 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$498.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,163.40
|
| Rate for Payer: Cash Price |
$872.55
|
| Rate for Payer: Cash Price |
$872.55
|
| Rate for Payer: Cash Price |
$872.55
|
| Rate for Payer: Cigna of CA PPO |
$1,434.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.30
|
| Rate for Payer: Dignity Health Media |
$498.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$548.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$672.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$498.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$498.20
|
| Rate for Payer: Galaxy Health WC |
$1,648.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,163.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,454.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$817.05
|
| Rate for Payer: Heritage Provider Network Transplant |
$817.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$498.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,293.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$498.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$465.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$627.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$667.59
|
| Rate for Payer: Multiplan Commercial |
$1,551.20
|
| Rate for Payer: Networks By Design Commercial |
$1,260.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,648.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,163.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$969.50
|
| Rate for Payer: United Healthcare All Other HMO |
$969.50
|
| Rate for Payer: United Healthcare HMO Rider |
$969.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$969.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Vantage Medical Group Senior |
$498.20
|
|
|
HC DRES & OR DEB OF BURN INT/SUB MED
|
Facility
|
OP
|
$1,631.00
|
|
|
Service Code
|
CPT 16025
|
| Hospital Charge Code |
900501047
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$114.59 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$250.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$978.60
|
| Rate for Payer: Cash Price |
$733.95
|
| Rate for Payer: Cash Price |
$733.95
|
| Rate for Payer: Cash Price |
$733.95
|
| Rate for Payer: Cigna of CA PPO |
$1,206.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: Dignity Health Media |
$250.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$275.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$250.14
|
| Rate for Payer: Galaxy Health WC |
$1,386.35
|
| Rate for Payer: Global Benefits Group Commercial |
$978.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,223.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$410.23
|
| Rate for Payer: Heritage Provider Network Transplant |
$410.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$250.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,087.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$114.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$391.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$315.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.19
|
| Rate for Payer: Multiplan Commercial |
$1,304.80
|
| Rate for Payer: Networks By Design Commercial |
$1,060.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,386.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$978.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$815.50
|
| Rate for Payer: United Healthcare All Other HMO |
$815.50
|
| Rate for Payer: United Healthcare HMO Rider |
$815.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$815.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
|
HC DRES & OR DEB OF BURN INT/SUB MED
|
Facility
|
IP
|
$1,631.00
|
|
|
Service Code
|
CPT 16025
|
| Hospital Charge Code |
900501047
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$391.44 |
| Max. Negotiated Rate |
$1,386.35 |
| Rate for Payer: Cash Price |
$733.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$652.40
|
| Rate for Payer: Galaxy Health WC |
$1,386.35
|
| Rate for Payer: Global Benefits Group Commercial |
$978.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,087.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$621.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$391.44
|
| Rate for Payer: Multiplan Commercial |
$1,304.80
|
| Rate for Payer: Networks By Design Commercial |
$1,060.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,386.35
|
|
|
HC DRES & OR DEB OF BURN INT/SUB SMALL
|
Facility
|
OP
|
$1,150.00
|
|
|
Service Code
|
CPT 16020
|
| Hospital Charge Code |
900501046
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$60.14 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$250.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$690.00
|
| Rate for Payer: Cash Price |
$517.50
|
| Rate for Payer: Cash Price |
$517.50
|
| Rate for Payer: Cash Price |
$517.50
|
| Rate for Payer: Cigna of CA PPO |
$851.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: Dignity Health Media |
$250.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$275.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$250.14
|
| Rate for Payer: Galaxy Health WC |
$977.50
|
| Rate for Payer: Global Benefits Group Commercial |
$690.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$862.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$410.23
|
| Rate for Payer: Heritage Provider Network Transplant |
$410.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$250.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$767.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$60.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$276.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$315.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.19
|
| Rate for Payer: Multiplan Commercial |
$920.00
|
| Rate for Payer: Networks By Design Commercial |
$747.50
|
| Rate for Payer: Prime Health Services Commercial |
$977.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$690.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$575.00
|
| Rate for Payer: United Healthcare All Other HMO |
$575.00
|
| Rate for Payer: United Healthcare HMO Rider |
$575.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
|
HC DRES & OR DEB OF BURN INT/SUB SMALL
|
Facility
|
IP
|
$1,150.00
|
|
|
Service Code
|
CPT 16020
|
| Hospital Charge Code |
900501046
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$276.00 |
| Max. Negotiated Rate |
$977.50 |
| Rate for Payer: Cash Price |
$517.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$460.00
|
| Rate for Payer: Galaxy Health WC |
$977.50
|
| Rate for Payer: Global Benefits Group Commercial |
$690.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$767.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$438.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$276.00
|
| Rate for Payer: Multiplan Commercial |
$920.00
|
| Rate for Payer: Networks By Design Commercial |
$747.50
|
| Rate for Payer: Prime Health Services Commercial |
$977.50
|
|
|
HC DRESSING CHANGE UNDER ANESTH
|
Facility
|
IP
|
$656.00
|
|
|
Service Code
|
CPT 15852
|
| Hospital Charge Code |
907201139
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$157.44 |
| Max. Negotiated Rate |
$557.60 |
| Rate for Payer: Cash Price |
$295.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$262.40
|
| Rate for Payer: Galaxy Health WC |
$557.60
|
| Rate for Payer: Global Benefits Group Commercial |
$393.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$437.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$249.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$157.44
|
| Rate for Payer: Multiplan Commercial |
$524.80
|
| Rate for Payer: Networks By Design Commercial |
$426.40
|
| Rate for Payer: Prime Health Services Commercial |
$557.60
|
|
|
HC DRESSING CHANGE UNDER ANESTH
|
Facility
|
OP
|
$656.00
|
|
|
Service Code
|
CPT 15852
|
| Hospital Charge Code |
907201139
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$157.44 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,177.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$863.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$784.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$393.60
|
| Rate for Payer: Cash Price |
$295.20
|
| Rate for Payer: Cash Price |
$295.20
|
| Rate for Payer: Cash Price |
$295.20
|
| Rate for Payer: Cigna of CA PPO |
$485.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,177.06
|
| Rate for Payer: Dignity Health Media |
$784.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$863.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,059.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$784.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$784.71
|
| Rate for Payer: Galaxy Health WC |
$557.60
|
| Rate for Payer: Global Benefits Group Commercial |
$393.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$492.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,286.92
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,286.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$784.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$437.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$249.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$157.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$988.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,051.51
|
| Rate for Payer: Multiplan Commercial |
$524.80
|
| Rate for Payer: Networks By Design Commercial |
$426.40
|
| Rate for Payer: Prime Health Services Commercial |
$557.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$393.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$328.00
|
| Rate for Payer: United Healthcare All Other HMO |
$328.00
|
| Rate for Payer: United Healthcare HMO Rider |
$328.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$328.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,177.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.18
|
| Rate for Payer: Vantage Medical Group Senior |
$784.71
|
|
|
HC DRILL SKULL FOR IMPLANTATION
|
Facility
|
IP
|
$7,191.00
|
|
|
Service Code
|
CPT 61107
|
| Hospital Charge Code |
900501647
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,725.84 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$3,235.95
|
| Rate for Payer: Cash Price |
$3,235.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,876.40
|
| Rate for Payer: Galaxy Health WC |
$6,112.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,314.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,796.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,739.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,725.84
|
| Rate for Payer: Multiplan Commercial |
$5,752.80
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,112.35
|
|
|
HC DRILL SKULL FOR IMPLANTATION
|
Facility
|
OP
|
$7,191.00
|
|
|
Service Code
|
CPT 61107
|
| Hospital Charge Code |
900501647
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$594.19 |
| Max. Negotiated Rate |
$7,282.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,809.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,112.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,955.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,955.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,314.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$3,235.95
|
| Rate for Payer: Cash Price |
$3,235.95
|
| Rate for Payer: Cigna of CA PPO |
$5,321.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,112.35
|
| Rate for Payer: Dignity Health Media |
$6,112.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,112.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,876.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,876.40
|
| Rate for Payer: Galaxy Health WC |
$6,112.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,314.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,393.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,796.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$594.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,725.84
|
| Rate for Payer: Multiplan Commercial |
$5,752.80
|
| Rate for Payer: Networks By Design Commercial |
$4,674.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,112.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,314.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,112.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,112.35
|
| Rate for Payer: Vantage Medical Group Senior |
$6,112.35
|
|
|
HC DRSNG SLVR AQUACEL AG 3.5X8"
|
Facility
|
IP
|
$241.57
|
|
| Hospital Charge Code |
901698804
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.98 |
| Max. Negotiated Rate |
$205.33 |
| Rate for Payer: Cash Price |
$108.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.63
|
| Rate for Payer: Galaxy Health WC |
$205.33
|
| Rate for Payer: Global Benefits Group Commercial |
$144.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$161.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$92.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.98
|
| Rate for Payer: Multiplan Commercial |
$193.26
|
| Rate for Payer: Networks By Design Commercial |
$157.02
|
| Rate for Payer: Prime Health Services Commercial |
$205.33
|
|
|
HC DRSNG SLVR AQUACEL AG 3.5X8"
|
Facility
|
OP
|
$241.57
|
|
| Hospital Charge Code |
901698804
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.98 |
| Max. Negotiated Rate |
$205.33 |
| Rate for Payer: Aetna of CA HMO/PPO |
$158.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$205.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$132.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$132.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$143.93
|
| Rate for Payer: Blue Distinction Transplant |
$144.94
|
| Rate for Payer: Blue Shield of California Commercial |
$178.04
|
| Rate for Payer: Blue Shield of California EPN |
$141.08
|
| Rate for Payer: Cash Price |
$108.71
|
| Rate for Payer: Cigna of CA HMO |
$154.60
|
| Rate for Payer: Cigna of CA PPO |
$178.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$205.33
|
| Rate for Payer: Dignity Health Media |
$205.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$205.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.63
|
| Rate for Payer: EPIC Health Plan Transplant |
$96.63
|
| Rate for Payer: Galaxy Health WC |
$205.33
|
| Rate for Payer: Global Benefits Group Commercial |
$144.94
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$181.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$161.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$92.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.98
|
| Rate for Payer: Multiplan Commercial |
$193.26
|
| Rate for Payer: Networks By Design Commercial |
$157.02
|
| Rate for Payer: Prime Health Services Commercial |
$205.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$144.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$144.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$120.78
|
| Rate for Payer: United Healthcare All Other HMO |
$120.78
|
| Rate for Payer: United Healthcare HMO Rider |
$120.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$120.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$205.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$205.33
|
| Rate for Payer: Vantage Medical Group Senior |
$205.33
|
|
|
HC DRUGS ABUSE SCREEN,URINE(7)COC
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900912159
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$562.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$471.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$562.21
|
| Rate for Payer: Blue Distinction Transplant |
$63.00
|
| Rate for Payer: Blue Shield of California Commercial |
$67.83
|
| Rate for Payer: Blue Shield of California EPN |
$53.76
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cigna of CA HMO |
$67.20
|
| Rate for Payer: Cigna of CA PPO |
$77.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Media |
$62.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$83.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$62.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$62.14
|
| Rate for Payer: Galaxy Health WC |
$89.25
|
| Rate for Payer: Global Benefits Group Commercial |
$63.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$78.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$101.91
|
| Rate for Payer: Heritage Provider Network Transplant |
$101.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$100.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$100.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$83.27
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: Networks By Design Commercial |
$68.25
|
| Rate for Payer: Prime Health Services Commercial |
$89.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
| Rate for Payer: United Healthcare All Other HMO |
$50.34
|
| Rate for Payer: United Healthcare HMO Rider |
$50.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
|
HC DRUG SCREEN AMPHETAMINES
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900911077
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$562.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$471.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$562.21
|
| Rate for Payer: Blue Distinction Transplant |
$63.00
|
| Rate for Payer: Blue Shield of California Commercial |
$67.83
|
| Rate for Payer: Blue Shield of California EPN |
$53.76
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cigna of CA HMO |
$67.20
|
| Rate for Payer: Cigna of CA PPO |
$77.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Media |
$62.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$83.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$62.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$62.14
|
| Rate for Payer: Galaxy Health WC |
$89.25
|
| Rate for Payer: Global Benefits Group Commercial |
$63.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$78.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$101.91
|
| Rate for Payer: Heritage Provider Network Transplant |
$101.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$100.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$100.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$83.27
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: Networks By Design Commercial |
$68.25
|
| Rate for Payer: Prime Health Services Commercial |
$89.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
| Rate for Payer: United Healthcare All Other HMO |
$50.34
|
| Rate for Payer: United Healthcare HMO Rider |
$50.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
|
HC DRUG SCREEN BARBITUATES
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900910325
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$562.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$471.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$562.21
|
| Rate for Payer: Blue Distinction Transplant |
$63.00
|
| Rate for Payer: Blue Shield of California Commercial |
$67.83
|
| Rate for Payer: Blue Shield of California EPN |
$53.76
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cigna of CA HMO |
$67.20
|
| Rate for Payer: Cigna of CA PPO |
$77.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Media |
$62.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$83.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$62.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$62.14
|
| Rate for Payer: Galaxy Health WC |
$89.25
|
| Rate for Payer: Global Benefits Group Commercial |
$63.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$78.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$101.91
|
| Rate for Payer: Heritage Provider Network Transplant |
$101.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$100.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$100.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$83.27
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: Networks By Design Commercial |
$68.25
|
| Rate for Payer: Prime Health Services Commercial |
$89.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
| Rate for Payer: United Healthcare All Other HMO |
$50.34
|
| Rate for Payer: United Healthcare HMO Rider |
$50.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
|
HC DRUG SCREEN BENZODIAZPINES
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900911101
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$562.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$471.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$562.21
|
| Rate for Payer: Blue Distinction Transplant |
$63.00
|
| Rate for Payer: Blue Shield of California Commercial |
$67.83
|
| Rate for Payer: Blue Shield of California EPN |
$53.76
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cigna of CA HMO |
$67.20
|
| Rate for Payer: Cigna of CA PPO |
$77.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Media |
$62.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$83.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$62.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$62.14
|
| Rate for Payer: Galaxy Health WC |
$89.25
|
| Rate for Payer: Global Benefits Group Commercial |
$63.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$78.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$101.91
|
| Rate for Payer: Heritage Provider Network Transplant |
$101.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$100.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$100.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$83.27
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: Networks By Design Commercial |
$68.25
|
| Rate for Payer: Prime Health Services Commercial |
$89.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
| Rate for Payer: United Healthcare All Other HMO |
$50.34
|
| Rate for Payer: United Healthcare HMO Rider |
$50.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
|
HC DRUG SCREEN CANNABINOIDS
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900911238
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$562.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$471.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$562.21
|
| Rate for Payer: Blue Distinction Transplant |
$63.00
|
| Rate for Payer: Blue Shield of California Commercial |
$67.83
|
| Rate for Payer: Blue Shield of California EPN |
$53.76
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cigna of CA HMO |
$67.20
|
| Rate for Payer: Cigna of CA PPO |
$77.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Media |
$62.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$83.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$62.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$62.14
|
| Rate for Payer: Galaxy Health WC |
$89.25
|
| Rate for Payer: Global Benefits Group Commercial |
$63.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$78.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$101.91
|
| Rate for Payer: Heritage Provider Network Transplant |
$101.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$100.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$100.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$83.27
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: Networks By Design Commercial |
$68.25
|
| Rate for Payer: Prime Health Services Commercial |
$89.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
| Rate for Payer: United Healthcare All Other HMO |
$50.34
|
| Rate for Payer: United Healthcare HMO Rider |
$50.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
|
HC DRUG SCREEN COCAINE
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900910390
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$562.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$471.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$562.21
|
| Rate for Payer: Blue Distinction Transplant |
$63.00
|
| Rate for Payer: Blue Shield of California Commercial |
$67.83
|
| Rate for Payer: Blue Shield of California EPN |
$53.76
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cigna of CA HMO |
$67.20
|
| Rate for Payer: Cigna of CA PPO |
$77.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Media |
$62.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$83.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$62.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$62.14
|
| Rate for Payer: Galaxy Health WC |
$89.25
|
| Rate for Payer: Global Benefits Group Commercial |
$63.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$78.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$101.91
|
| Rate for Payer: Heritage Provider Network Transplant |
$101.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$100.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$100.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$83.27
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: Networks By Design Commercial |
$68.25
|
| Rate for Payer: Prime Health Services Commercial |
$89.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
| Rate for Payer: United Healthcare All Other HMO |
$50.34
|
| Rate for Payer: United Healthcare HMO Rider |
$50.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
|
HC DRUG SCREEN OPIATES
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900911145
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$562.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$471.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$562.21
|
| Rate for Payer: Blue Distinction Transplant |
$63.00
|
| Rate for Payer: Blue Shield of California Commercial |
$67.83
|
| Rate for Payer: Blue Shield of California EPN |
$53.76
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cigna of CA HMO |
$67.20
|
| Rate for Payer: Cigna of CA PPO |
$77.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Media |
$62.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$83.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$62.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$62.14
|
| Rate for Payer: Galaxy Health WC |
$89.25
|
| Rate for Payer: Global Benefits Group Commercial |
$63.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$78.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$101.91
|
| Rate for Payer: Heritage Provider Network Transplant |
$101.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$100.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$100.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$83.27
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: Networks By Design Commercial |
$68.25
|
| Rate for Payer: Prime Health Services Commercial |
$89.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
| Rate for Payer: United Healthcare All Other HMO |
$50.34
|
| Rate for Payer: United Healthcare HMO Rider |
$50.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
|
HC DRUG SCREEN PHENCYCLIDINE
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900911147
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$562.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$471.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$562.21
|
| Rate for Payer: Blue Distinction Transplant |
$63.00
|
| Rate for Payer: Blue Shield of California Commercial |
$67.83
|
| Rate for Payer: Blue Shield of California EPN |
$53.76
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cigna of CA HMO |
$67.20
|
| Rate for Payer: Cigna of CA PPO |
$77.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Media |
$62.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$83.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$62.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$62.14
|
| Rate for Payer: Galaxy Health WC |
$89.25
|
| Rate for Payer: Global Benefits Group Commercial |
$63.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$78.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$101.91
|
| Rate for Payer: Heritage Provider Network Transplant |
$101.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$100.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$100.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$83.27
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: Networks By Design Commercial |
$68.25
|
| Rate for Payer: Prime Health Services Commercial |
$89.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
| Rate for Payer: United Healthcare All Other HMO |
$50.34
|
| Rate for Payer: United Healthcare HMO Rider |
$50.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
|
HC DRUG SCREEN, PRE-EMPLOYMENT
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900912158
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$562.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$471.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$562.21
|
| Rate for Payer: Blue Distinction Transplant |
$63.00
|
| Rate for Payer: Blue Shield of California Commercial |
$67.83
|
| Rate for Payer: Blue Shield of California EPN |
$53.76
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cigna of CA HMO |
$67.20
|
| Rate for Payer: Cigna of CA PPO |
$77.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Media |
$62.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$83.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$62.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$62.14
|
| Rate for Payer: Galaxy Health WC |
$89.25
|
| Rate for Payer: Global Benefits Group Commercial |
$63.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$78.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$101.91
|
| Rate for Payer: Heritage Provider Network Transplant |
$101.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$100.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$100.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$83.27
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: Networks By Design Commercial |
$68.25
|
| Rate for Payer: Prime Health Services Commercial |
$89.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
| Rate for Payer: United Healthcare All Other HMO |
$50.34
|
| Rate for Payer: United Healthcare HMO Rider |
$50.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
|
HC DRUGS OF ABUSE SCREEN,URINE(5)
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900912160
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$562.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$471.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$562.21
|
| Rate for Payer: Blue Distinction Transplant |
$63.00
|
| Rate for Payer: Blue Shield of California Commercial |
$67.83
|
| Rate for Payer: Blue Shield of California EPN |
$53.76
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cigna of CA HMO |
$67.20
|
| Rate for Payer: Cigna of CA PPO |
$77.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Media |
$62.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$83.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$62.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$62.14
|
| Rate for Payer: Galaxy Health WC |
$89.25
|
| Rate for Payer: Global Benefits Group Commercial |
$63.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$78.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$101.91
|
| Rate for Payer: Heritage Provider Network Transplant |
$101.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$100.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$100.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$83.27
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: Networks By Design Commercial |
$68.25
|
| Rate for Payer: Prime Health Services Commercial |
$89.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
| Rate for Payer: United Healthcare All Other HMO |
$50.34
|
| Rate for Payer: United Healthcare HMO Rider |
$50.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
|
HC DRUGS OF ABUSE SCREEN,URINE(7)
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900912161
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$562.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$471.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$562.21
|
| Rate for Payer: Blue Distinction Transplant |
$63.00
|
| Rate for Payer: Blue Shield of California Commercial |
$67.83
|
| Rate for Payer: Blue Shield of California EPN |
$53.76
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cigna of CA HMO |
$67.20
|
| Rate for Payer: Cigna of CA PPO |
$77.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Media |
$62.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$83.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$62.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$62.14
|
| Rate for Payer: Galaxy Health WC |
$89.25
|
| Rate for Payer: Global Benefits Group Commercial |
$63.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$78.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$101.91
|
| Rate for Payer: Heritage Provider Network Transplant |
$101.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$100.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$100.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$83.27
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: Networks By Design Commercial |
$68.25
|
| Rate for Payer: Prime Health Services Commercial |
$89.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
| Rate for Payer: United Healthcare All Other HMO |
$50.34
|
| Rate for Payer: United Healthcare HMO Rider |
$50.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
|
HC DRVVT
|
Facility
|
OP
|
$37.00
|
|
|
Service Code
|
CPT 85613
|
| Hospital Charge Code |
900912008
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.76 |
| Max. Negotiated Rate |
$87.28 |
| Rate for Payer: Aetna of CA HMO/PPO |
$79.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.28
|
| Rate for Payer: Blue Distinction Transplant |
$22.20
|
| Rate for Payer: Blue Shield of California Commercial |
$23.90
|
| Rate for Payer: Blue Shield of California EPN |
$18.94
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cigna of CA HMO |
$23.68
|
| Rate for Payer: Cigna of CA PPO |
$27.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.37
|
| Rate for Payer: Dignity Health Media |
$9.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.93
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.58
|
| Rate for Payer: Galaxy Health WC |
$31.45
|
| Rate for Payer: Global Benefits Group Commercial |
$22.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$27.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$15.71
|
| Rate for Payer: Heritage Provider Network Transplant |
$15.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$15.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$15.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.84
|
| Rate for Payer: Multiplan Commercial |
$29.60
|
| Rate for Payer: Networks By Design Commercial |
$24.05
|
| Rate for Payer: Prime Health Services Commercial |
$31.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.76
|
| Rate for Payer: United Healthcare All Other HMO |
$7.76
|
| Rate for Payer: United Healthcare HMO Rider |
$7.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.54
|
| Rate for Payer: Vantage Medical Group Senior |
$9.58
|
|
|
HC DSCHG RCP EDU TRAINING EA 30MN
|
Facility
|
OP
|
$94.00
|
|
|
Service Code
|
CPT 98960
|
| Hospital Charge Code |
900898960
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$22.56 |
| Max. Negotiated Rate |
$509.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$179.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$79.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$51.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$51.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$421.00
|
| Rate for Payer: Blue Distinction Transplant |
$56.40
|
| Rate for Payer: Blue Shield of California Commercial |
$407.00
|
| Rate for Payer: Blue Shield of California EPN |
$293.00
|
| Rate for Payer: Cash Price |
$42.30
|
| Rate for Payer: Cash Price |
$42.30
|
| Rate for Payer: Cash Price |
$42.30
|
| Rate for Payer: Cash Price |
$42.30
|
| Rate for Payer: Cigna of CA HMO |
$60.16
|
| Rate for Payer: Cigna of CA PPO |
$69.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$79.90
|
| Rate for Payer: Dignity Health Media |
$79.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$79.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$37.60
|
| Rate for Payer: Galaxy Health WC |
$79.90
|
| Rate for Payer: Global Benefits Group Commercial |
$56.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$70.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$62.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.56
|
| Rate for Payer: Multiplan Commercial |
$75.20
|
| Rate for Payer: Networks By Design Commercial |
$61.10
|
| Rate for Payer: Prime Health Services Commercial |
$79.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$56.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$56.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$509.00
|
| Rate for Payer: United Healthcare All Other HMO |
$478.00
|
| Rate for Payer: United Healthcare HMO Rider |
$428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$391.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$79.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$79.90
|
| Rate for Payer: Vantage Medical Group Senior |
$79.90
|
|
|
HC DSCHG RCP EDU TRAINING EA 30MN
|
Facility
|
IP
|
$94.00
|
|
|
Service Code
|
CPT 98960
|
| Hospital Charge Code |
900898960
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$22.56 |
| Max. Negotiated Rate |
$79.90 |
| Rate for Payer: Cash Price |
$42.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.60
|
| Rate for Payer: Galaxy Health WC |
$79.90
|
| Rate for Payer: Global Benefits Group Commercial |
$56.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$62.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$35.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.56
|
| Rate for Payer: Multiplan Commercial |
$75.20
|
| Rate for Payer: Networks By Design Commercial |
$61.10
|
| Rate for Payer: Prime Health Services Commercial |
$79.90
|
|
