|
HC CARDIAC MRI VELOCITY FLOW MAPPING
|
Facility
|
OP
|
$1,401.00
|
|
|
Service Code
|
CPT 75565
|
| Hospital Charge Code |
908875565
|
|
Hospital Revenue Code
|
614
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$1,190.85 |
| Rate for Payer: Adventist Health Commercial |
$280.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$918.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,190.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$770.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,050.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$860.35
|
| Rate for Payer: Blue Shield of California Commercial |
$857.41
|
| Rate for Payer: Blue Shield of California EPN |
$566.00
|
| Rate for Payer: Cash Price |
$630.45
|
| Rate for Payer: Cash Price |
$630.45
|
| Rate for Payer: Cigna of CA HMO |
$896.64
|
| Rate for Payer: Cigna of CA PPO |
$1,036.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,190.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,190.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,190.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$560.40
|
| Rate for Payer: EPIC Health Plan Senior |
$560.40
|
| Rate for Payer: Galaxy Health WC |
$1,190.85
|
| Rate for Payer: Global Benefits Group Commercial |
$840.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$76.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$934.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$86.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$867.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$336.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$980.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$980.70
|
| Rate for Payer: Multiplan Commercial |
$1,120.80
|
| Rate for Payer: Networks By Design Commercial |
$910.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,190.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$840.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$840.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$700.50
|
| Rate for Payer: United Healthcare All Other HMO |
$700.50
|
| Rate for Payer: United Healthcare HMO Rider |
$700.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$700.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,190.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,190.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,190.85
|
|
|
HC CARDIAC MRI VELOCITY FLOW MAPPING
|
Facility
|
IP
|
$1,401.00
|
|
|
Service Code
|
CPT 75565
|
| Hospital Charge Code |
908875565
|
|
Hospital Revenue Code
|
614
|
| Min. Negotiated Rate |
$280.20 |
| Max. Negotiated Rate |
$1,190.85 |
| Rate for Payer: Adventist Health Commercial |
$280.20
|
| Rate for Payer: Cash Price |
$630.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$560.40
|
| Rate for Payer: EPIC Health Plan Senior |
$560.40
|
| Rate for Payer: Galaxy Health WC |
$1,190.85
|
| Rate for Payer: Global Benefits Group Commercial |
$840.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$934.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$533.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$867.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$336.24
|
| Rate for Payer: Multiplan Commercial |
$1,120.80
|
| Rate for Payer: Networks By Design Commercial |
$910.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,190.85
|
|
|
HC CARDIAC STRESS TEST
|
Facility
|
IP
|
$3,214.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
906811397
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$642.80 |
| Max. Negotiated Rate |
$2,731.90 |
| Rate for Payer: Adventist Health Commercial |
$642.80
|
| Rate for Payer: Cash Price |
$1,446.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,285.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,285.60
|
| Rate for Payer: Galaxy Health WC |
$2,731.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,928.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,143.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,224.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,989.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$771.36
|
| Rate for Payer: Multiplan Commercial |
$2,571.20
|
| Rate for Payer: Networks By Design Commercial |
$2,089.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,731.90
|
|
|
HC CARDIAC STRESS TEST
|
Facility
|
OP
|
$3,214.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
906811397
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$88.20 |
| Max. Negotiated Rate |
$2,731.90 |
| Rate for Payer: Adventist Health Commercial |
$642.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,108.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,973.72
|
| Rate for Payer: Blue Shield of California Commercial |
$1,966.97
|
| Rate for Payer: Blue Shield of California EPN |
$1,298.46
|
| Rate for Payer: Cash Price |
$1,446.30
|
| Rate for Payer: Cash Price |
$1,446.30
|
| Rate for Payer: Cash Price |
$1,446.30
|
| Rate for Payer: Cigna of CA HMO |
$2,056.96
|
| Rate for Payer: Cigna of CA PPO |
$2,378.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.14
|
| Rate for Payer: EPIC Health Plan Senior |
$395.66
|
| Rate for Payer: Galaxy Health WC |
$2,731.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,928.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$648.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$88.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,143.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$99.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$771.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$498.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$530.18
|
| Rate for Payer: Multiplan Commercial |
$2,571.20
|
| Rate for Payer: Networks By Design Commercial |
$2,089.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,731.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,928.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,928.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,391.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,369.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,119.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,026.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$395.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC CARDIOLIPIN AB EAC IG CLASS
|
Facility
|
OP
|
$99.00
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
900913559
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.80 |
| Max. Negotiated Rate |
$142.64 |
| Rate for Payer: Adventist Health Commercial |
$19.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$64.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$38.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$142.64
|
| Rate for Payer: Blue Shield of California Commercial |
$66.23
|
| Rate for Payer: Blue Shield of California EPN |
$43.76
|
| Rate for Payer: Cash Price |
$44.55
|
| Rate for Payer: Cash Price |
$44.55
|
| Rate for Payer: Cigna of CA HMO |
$63.36
|
| Rate for Payer: Cigna of CA PPO |
$73.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.36
|
| Rate for Payer: EPIC Health Plan Senior |
$25.45
|
| Rate for Payer: Galaxy Health WC |
$84.15
|
| Rate for Payer: Global Benefits Group Commercial |
$59.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$41.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$29.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.10
|
| Rate for Payer: Multiplan Commercial |
$79.20
|
| Rate for Payer: Networks By Design Commercial |
$64.35
|
| Rate for Payer: Prime Health Services Commercial |
$84.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$59.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$59.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.62
|
| Rate for Payer: United Healthcare All Other HMO |
$20.62
|
| Rate for Payer: United Healthcare HMO Rider |
$20.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.62
|
| Rate for Payer: Upland Medical Group Pediatric |
$25.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$38.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.00
|
| Rate for Payer: Vantage Medical Group Senior |
$25.45
|
|
|
HC CARDIOLIPIN AB EAC IG CLASS
|
Facility
|
IP
|
$221.00
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
900913559
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.20 |
| Max. Negotiated Rate |
$187.85 |
| Rate for Payer: Adventist Health Commercial |
$44.20
|
| Rate for Payer: Cash Price |
$99.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$88.40
|
| Rate for Payer: EPIC Health Plan Senior |
$88.40
|
| Rate for Payer: Galaxy Health WC |
$187.85
|
| Rate for Payer: Global Benefits Group Commercial |
$132.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$147.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$84.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$136.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.04
|
| Rate for Payer: Multiplan Commercial |
$176.80
|
| Rate for Payer: Networks By Design Commercial |
$143.65
|
| Rate for Payer: Prime Health Services Commercial |
$187.85
|
|
|
HC CARDIOLITE PERFUSION SCAN
|
Facility
|
OP
|
$3,036.00
|
|
|
Service Code
|
CPT 78451
|
| Hospital Charge Code |
909301560
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$339.24 |
| Max. Negotiated Rate |
$2,720.33 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,824.61
|
| Rate for Payer: Adventist Health Commercial |
$607.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,991.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,488.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,824.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,658.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,864.41
|
| Rate for Payer: Blue Shield of California Commercial |
$1,858.03
|
| Rate for Payer: Blue Shield of California EPN |
$1,226.54
|
| Rate for Payer: Cash Price |
$1,366.20
|
| Rate for Payer: Cash Price |
$1,366.20
|
| Rate for Payer: Cigna of CA HMO |
$1,943.04
|
| Rate for Payer: Cigna of CA PPO |
$2,246.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,488.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,824.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,658.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,239.30
|
| Rate for Payer: EPIC Health Plan Senior |
$1,658.74
|
| Rate for Payer: Galaxy Health WC |
$2,580.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,821.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,720.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$339.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,658.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,025.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$383.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,658.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$728.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,090.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,222.71
|
| Rate for Payer: Multiplan Commercial |
$2,428.80
|
| Rate for Payer: Networks By Design Commercial |
$1,973.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,580.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,821.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,821.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,721.55
|
| Rate for Payer: United Healthcare All Other HMO |
$1,721.55
|
| Rate for Payer: United Healthcare HMO Rider |
$1,721.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,721.55
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,658.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,488.11
|
| Rate for Payer: Vantage Medical Group Senior |
$1,658.74
|
|
|
HC CARDIOLITE PERFUSION SCAN
|
Facility
|
IP
|
$3,036.00
|
|
|
Service Code
|
CPT 78451
|
| Hospital Charge Code |
909301560
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$607.20 |
| Max. Negotiated Rate |
$2,580.60 |
| Rate for Payer: Adventist Health Commercial |
$607.20
|
| Rate for Payer: Cash Price |
$1,366.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,214.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,214.40
|
| Rate for Payer: Galaxy Health WC |
$2,580.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,821.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,025.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,156.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,879.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$728.64
|
| Rate for Payer: Multiplan Commercial |
$2,428.80
|
| Rate for Payer: Networks By Design Commercial |
$1,973.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,580.60
|
|
|
HC CARDIOLITE PERFUSION SCAN 1 DY
|
Facility
|
OP
|
$5,966.00
|
|
|
Service Code
|
CPT 78452
|
| Hospital Charge Code |
909301562
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$584.84 |
| Max. Negotiated Rate |
$5,071.10 |
| Rate for Payer: Adventist Health Commercial |
$1,193.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,913.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,488.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,824.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,658.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,663.72
|
| Rate for Payer: Blue Shield of California Commercial |
$3,651.19
|
| Rate for Payer: Blue Shield of California EPN |
$2,410.26
|
| Rate for Payer: Cash Price |
$2,684.70
|
| Rate for Payer: Cash Price |
$2,684.70
|
| Rate for Payer: Cigna of CA HMO |
$3,818.24
|
| Rate for Payer: Cigna of CA PPO |
$4,414.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,488.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,824.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,658.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,239.30
|
| Rate for Payer: EPIC Health Plan Senior |
$1,658.74
|
| Rate for Payer: Galaxy Health WC |
$5,071.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,579.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,720.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$584.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,658.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,979.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$661.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,658.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,431.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,090.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,222.71
|
| Rate for Payer: Multiplan Commercial |
$4,772.80
|
| Rate for Payer: Networks By Design Commercial |
$3,877.90
|
| Rate for Payer: Prime Health Services Commercial |
$5,071.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,579.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,579.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,721.55
|
| Rate for Payer: United Healthcare All Other HMO |
$1,721.55
|
| Rate for Payer: United Healthcare HMO Rider |
$1,721.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,721.55
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,658.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,488.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,824.61
|
| Rate for Payer: Vantage Medical Group Senior |
$1,658.74
|
|
|
HC CARDIOLITE PERFUSION SCAN 1 DY
|
Facility
|
IP
|
$5,966.00
|
|
|
Service Code
|
CPT 78452
|
| Hospital Charge Code |
909301562
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,193.20 |
| Max. Negotiated Rate |
$5,071.10 |
| Rate for Payer: Adventist Health Commercial |
$1,193.20
|
| Rate for Payer: Cash Price |
$2,684.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,386.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,386.40
|
| Rate for Payer: Galaxy Health WC |
$5,071.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,579.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,979.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,273.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,692.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,431.84
|
| Rate for Payer: Multiplan Commercial |
$4,772.80
|
| Rate for Payer: Networks By Design Commercial |
$3,877.90
|
| Rate for Payer: Prime Health Services Commercial |
$5,071.10
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
OP
|
$4,076.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906812198
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$193.20 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$815.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$1,834.20
|
| Rate for Payer: Cash Price |
$1,834.20
|
| Rate for Payer: Cash Price |
$1,834.20
|
| Rate for Payer: Cigna of CA HMO |
$2,649.40
|
| Rate for Payer: Cigna of CA PPO |
$3,016.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.14
|
| Rate for Payer: EPIC Health Plan Senior |
$395.66
|
| Rate for Payer: Galaxy Health WC |
$3,464.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,445.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$648.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$193.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,718.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$978.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$498.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$530.18
|
| Rate for Payer: Multiplan Commercial |
$3,260.80
|
| Rate for Payer: Networks By Design Commercial |
$2,649.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,464.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,445.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,445.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$395.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
IP
|
$4,076.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906812198
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$815.20 |
| Max. Negotiated Rate |
$3,464.60 |
| Rate for Payer: Adventist Health Commercial |
$815.20
|
| Rate for Payer: Cash Price |
$1,834.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,630.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,630.40
|
| Rate for Payer: Galaxy Health WC |
$3,464.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,445.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,718.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,552.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,523.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$978.24
|
| Rate for Payer: Multiplan Commercial |
$3,260.80
|
| Rate for Payer: Networks By Design Commercial |
$2,649.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,464.60
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
OP
|
$3,962.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906820082
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$193.20 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$792.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$1,782.90
|
| Rate for Payer: Cash Price |
$1,782.90
|
| Rate for Payer: Cash Price |
$1,782.90
|
| Rate for Payer: Cigna of CA HMO |
$2,575.30
|
| Rate for Payer: Cigna of CA PPO |
$2,931.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.14
|
| Rate for Payer: EPIC Health Plan Senior |
$395.66
|
| Rate for Payer: Galaxy Health WC |
$3,367.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,377.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$648.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$193.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,642.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$950.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$498.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$530.18
|
| Rate for Payer: Multiplan Commercial |
$3,169.60
|
| Rate for Payer: Networks By Design Commercial |
$2,575.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,367.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,377.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,377.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$395.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
IP
|
$4,076.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906812198
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$815.20 |
| Max. Negotiated Rate |
$3,464.60 |
| Rate for Payer: Adventist Health Commercial |
$815.20
|
| Rate for Payer: Cash Price |
$1,834.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,630.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,630.40
|
| Rate for Payer: Galaxy Health WC |
$3,464.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,445.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,718.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,552.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,523.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$978.24
|
| Rate for Payer: Multiplan Commercial |
$3,260.80
|
| Rate for Payer: Networks By Design Commercial |
$2,649.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,464.60
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
OP
|
$4,076.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906812198
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$193.20 |
| Max. Negotiated Rate |
$6,906.11 |
| Rate for Payer: Adventist Health Commercial |
$815.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,673.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$1,834.20
|
| Rate for Payer: Cash Price |
$1,834.20
|
| Rate for Payer: Cash Price |
$1,834.20
|
| Rate for Payer: Cigna of CA HMO |
$2,608.64
|
| Rate for Payer: Cigna of CA PPO |
$3,016.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.14
|
| Rate for Payer: EPIC Health Plan Senior |
$395.66
|
| Rate for Payer: Galaxy Health WC |
$3,464.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,445.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$648.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$193.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,718.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$978.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$498.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$530.18
|
| Rate for Payer: Multiplan Commercial |
$3,260.80
|
| Rate for Payer: Networks By Design Commercial |
$2,649.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,464.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,445.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,445.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$395.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
IP
|
$3,962.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906820082
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$792.40 |
| Max. Negotiated Rate |
$3,367.70 |
| Rate for Payer: Adventist Health Commercial |
$792.40
|
| Rate for Payer: Cash Price |
$1,782.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,584.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,584.80
|
| Rate for Payer: Galaxy Health WC |
$3,367.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,377.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,642.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,509.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,452.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$950.88
|
| Rate for Payer: Multiplan Commercial |
$3,169.60
|
| Rate for Payer: Networks By Design Commercial |
$2,575.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,367.70
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
OP
|
$4,076.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
900802005
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$193.20 |
| Max. Negotiated Rate |
$6,906.11 |
| Rate for Payer: Adventist Health Commercial |
$815.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,673.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$1,834.20
|
| Rate for Payer: Cash Price |
$1,834.20
|
| Rate for Payer: Cash Price |
$1,834.20
|
| Rate for Payer: Cigna of CA HMO |
$2,608.64
|
| Rate for Payer: Cigna of CA PPO |
$3,016.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.14
|
| Rate for Payer: EPIC Health Plan Senior |
$395.66
|
| Rate for Payer: Galaxy Health WC |
$3,464.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,445.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$648.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$193.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,718.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$978.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$498.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$530.18
|
| Rate for Payer: Multiplan Commercial |
$3,260.80
|
| Rate for Payer: Networks By Design Commercial |
$2,649.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,464.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,445.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,445.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$395.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
IP
|
$4,076.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906812198
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$815.20 |
| Max. Negotiated Rate |
$3,464.60 |
| Rate for Payer: Adventist Health Commercial |
$815.20
|
| Rate for Payer: Cash Price |
$1,834.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,630.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,630.40
|
| Rate for Payer: Galaxy Health WC |
$3,464.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,445.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,718.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,552.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,523.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$978.24
|
| Rate for Payer: Multiplan Commercial |
$3,260.80
|
| Rate for Payer: Networks By Design Commercial |
$2,649.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,464.60
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
OP
|
$4,076.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906812198
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$218.50 |
| Max. Negotiated Rate |
$5,398.00 |
| Rate for Payer: Adventist Health Commercial |
$815.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$1,834.20
|
| Rate for Payer: Cash Price |
$1,834.20
|
| Rate for Payer: Cash Price |
$1,834.20
|
| Rate for Payer: Cigna of CA HMO |
$2,608.64
|
| Rate for Payer: Cigna of CA PPO |
$3,016.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.14
|
| Rate for Payer: EPIC Health Plan Senior |
$395.66
|
| Rate for Payer: Galaxy Health WC |
$3,464.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,445.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$648.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,718.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$978.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$498.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$530.18
|
| Rate for Payer: Multiplan Commercial |
$3,260.80
|
| Rate for Payer: Multiplan WC |
$630.41
|
| Rate for Payer: Networks By Design Commercial |
$2,649.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,464.60
|
| Rate for Payer: Prime Health Services WC |
$623.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,445.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,038.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,038.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,038.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,038.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$395.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
IP
|
$4,076.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
900802005
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$815.20 |
| Max. Negotiated Rate |
$3,464.60 |
| Rate for Payer: Adventist Health Commercial |
$815.20
|
| Rate for Payer: Cash Price |
$1,834.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,630.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,630.40
|
| Rate for Payer: Galaxy Health WC |
$3,464.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,445.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,718.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,552.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,523.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$978.24
|
| Rate for Payer: Multiplan Commercial |
$3,260.80
|
| Rate for Payer: Networks By Design Commercial |
$2,649.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,464.60
|
|
|
HC CARDIOVERSION EXTERNAL ELECTIVE
|
Facility
|
OP
|
$5,137.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
900200140
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$232.67 |
| Max. Negotiated Rate |
$5,398.00 |
| Rate for Payer: Adventist Health Commercial |
$1,027.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$914.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$831.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$2,311.65
|
| Rate for Payer: Cash Price |
$2,311.65
|
| Rate for Payer: Cash Price |
$2,311.65
|
| Rate for Payer: Cigna of CA HMO |
$3,287.68
|
| Rate for Payer: Cigna of CA PPO |
$3,801.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$914.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$831.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,122.47
|
| Rate for Payer: EPIC Health Plan Senior |
$831.46
|
| Rate for Payer: Galaxy Health WC |
$4,366.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,082.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,363.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$831.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,426.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$232.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$831.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,232.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,047.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,114.16
|
| Rate for Payer: Multiplan Commercial |
$4,109.60
|
| Rate for Payer: Multiplan WC |
$1,324.78
|
| Rate for Payer: Networks By Design Commercial |
$3,339.05
|
| Rate for Payer: Prime Health Services Commercial |
$4,366.45
|
| Rate for Payer: Prime Health Services WC |
$1,311.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,082.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,568.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,568.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,568.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,568.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$831.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$914.61
|
| Rate for Payer: Vantage Medical Group Senior |
$831.46
|
|
|
HC CARDIOVERSION EXTERNAL ELECTIVE
|
Facility
|
IP
|
$5,137.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
900802140
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,027.40 |
| Max. Negotiated Rate |
$4,366.45 |
| Rate for Payer: Adventist Health Commercial |
$1,027.40
|
| Rate for Payer: Cash Price |
$2,311.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,054.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,054.80
|
| Rate for Payer: Galaxy Health WC |
$4,366.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,082.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,426.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,957.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,179.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,232.88
|
| Rate for Payer: Multiplan Commercial |
$4,109.60
|
| Rate for Payer: Networks By Design Commercial |
$3,339.05
|
| Rate for Payer: Prime Health Services Commercial |
$4,366.45
|
|
|
HC CARDIOVERSION EXTERNAL ELECTIVE
|
Facility
|
OP
|
$5,137.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
900802140
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$205.73 |
| Max. Negotiated Rate |
$6,906.11 |
| Rate for Payer: Adventist Health Commercial |
$1,027.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,369.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$914.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$831.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$2,311.65
|
| Rate for Payer: Cash Price |
$2,311.65
|
| Rate for Payer: Cash Price |
$2,311.65
|
| Rate for Payer: Cigna of CA HMO |
$3,287.68
|
| Rate for Payer: Cigna of CA PPO |
$3,801.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$914.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$831.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,122.47
|
| Rate for Payer: EPIC Health Plan Senior |
$831.46
|
| Rate for Payer: Galaxy Health WC |
$4,366.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,082.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,363.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$205.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$831.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,426.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$232.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$831.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,232.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,047.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,114.16
|
| Rate for Payer: Multiplan Commercial |
$4,109.60
|
| Rate for Payer: Networks By Design Commercial |
$3,339.05
|
| Rate for Payer: Prime Health Services Commercial |
$4,366.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,082.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,082.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$831.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$914.61
|
| Rate for Payer: Vantage Medical Group Senior |
$831.46
|
|
|
HC CARDIOVERSION EXTERNAL ELECTIVE
|
Facility
|
IP
|
$5,137.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
900802000
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,027.40 |
| Max. Negotiated Rate |
$4,366.45 |
| Rate for Payer: Adventist Health Commercial |
$1,027.40
|
| Rate for Payer: Cash Price |
$2,311.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,054.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,054.80
|
| Rate for Payer: Galaxy Health WC |
$4,366.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,082.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,426.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,957.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,179.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,232.88
|
| Rate for Payer: Multiplan Commercial |
$4,109.60
|
| Rate for Payer: Networks By Design Commercial |
$3,339.05
|
| Rate for Payer: Prime Health Services Commercial |
$4,366.45
|
|
|
HC CARDIOVERSION EXTERNAL ELECTIVE
|
Facility
|
OP
|
$5,137.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
900200140
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$205.73 |
| Max. Negotiated Rate |
$6,906.11 |
| Rate for Payer: Adventist Health Commercial |
$1,027.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,369.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$914.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$831.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$2,311.65
|
| Rate for Payer: Cash Price |
$2,311.65
|
| Rate for Payer: Cash Price |
$2,311.65
|
| Rate for Payer: Cigna of CA HMO |
$3,287.68
|
| Rate for Payer: Cigna of CA PPO |
$3,801.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$914.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$831.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,122.47
|
| Rate for Payer: EPIC Health Plan Senior |
$831.46
|
| Rate for Payer: Galaxy Health WC |
$4,366.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,082.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,363.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$205.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$831.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,426.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$232.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$831.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,232.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,047.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,114.16
|
| Rate for Payer: Multiplan Commercial |
$4,109.60
|
| Rate for Payer: Networks By Design Commercial |
$3,339.05
|
| Rate for Payer: Prime Health Services Commercial |
$4,366.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,082.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,082.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$831.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$914.61
|
| Rate for Payer: Vantage Medical Group Senior |
$831.46
|
|
