|
HC BNDR ABD XL 62-74" 3 PANEL
|
Facility
|
IP
|
$52.23
|
|
| Hospital Charge Code |
901605881
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$10.45 |
| Max. Negotiated Rate |
$44.40 |
| Rate for Payer: Adventist Health Commercial |
$10.45
|
| Rate for Payer: Cash Price |
$23.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$36.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.89
|
| Rate for Payer: EPIC Health Plan Senior |
$20.89
|
| Rate for Payer: Galaxy Health WC |
$44.40
|
| Rate for Payer: Global Benefits Group Commercial |
$31.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$33.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$30.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.54
|
| Rate for Payer: Multiplan Commercial |
$41.78
|
| Rate for Payer: Networks By Design Commercial |
$33.95
|
| Rate for Payer: Prime Health Services Commercial |
$44.40
|
|
|
HC BNDR ABD XL 62-74" 3 PANEL
|
Facility
|
OP
|
$52.23
|
|
| Hospital Charge Code |
901605881
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$10.45 |
| Max. Negotiated Rate |
$44.40 |
| Rate for Payer: Adventist Health Commercial |
$10.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$44.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$39.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33.52
|
| Rate for Payer: Cash Price |
$23.50
|
| Rate for Payer: Cigna of CA HMO |
$33.43
|
| Rate for Payer: Cigna of CA PPO |
$38.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$44.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$44.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$36.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.89
|
| Rate for Payer: EPIC Health Plan Senior |
$20.89
|
| Rate for Payer: Galaxy Health WC |
$44.40
|
| Rate for Payer: Global Benefits Group Commercial |
$31.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$33.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$30.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36.56
|
| Rate for Payer: Multiplan Commercial |
$41.78
|
| Rate for Payer: Networks By Design Commercial |
$33.95
|
| Rate for Payer: Prime Health Services Commercial |
$44.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$26.11
|
| Rate for Payer: United Healthcare All Other HMO |
$26.11
|
| Rate for Payer: United Healthcare HMO Rider |
$26.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$44.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44.40
|
| Rate for Payer: Vantage Medical Group Senior |
$44.40
|
|
|
HC BNDR ABD XL 62-74" 4 PANEL
|
Facility
|
OP
|
$64.70
|
|
| Hospital Charge Code |
901605882
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$12.94 |
| Max. Negotiated Rate |
$54.99 |
| Rate for Payer: Adventist Health Commercial |
$12.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$54.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$35.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41.52
|
| Rate for Payer: Cash Price |
$29.12
|
| Rate for Payer: Cigna of CA HMO |
$41.41
|
| Rate for Payer: Cigna of CA PPO |
$47.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$54.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$54.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$54.99
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$45.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.88
|
| Rate for Payer: EPIC Health Plan Senior |
$25.88
|
| Rate for Payer: Galaxy Health WC |
$54.99
|
| Rate for Payer: Global Benefits Group Commercial |
$38.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45.29
|
| Rate for Payer: Multiplan Commercial |
$51.76
|
| Rate for Payer: Networks By Design Commercial |
$42.05
|
| Rate for Payer: Prime Health Services Commercial |
$54.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.35
|
| Rate for Payer: United Healthcare All Other HMO |
$32.35
|
| Rate for Payer: United Healthcare HMO Rider |
$32.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$54.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$54.99
|
| Rate for Payer: Vantage Medical Group Senior |
$54.99
|
|
|
HC BNDR ABD XL 62-74" 4 PANEL
|
Facility
|
IP
|
$64.70
|
|
| Hospital Charge Code |
901605882
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$12.94 |
| Max. Negotiated Rate |
$54.99 |
| Rate for Payer: Adventist Health Commercial |
$12.94
|
| Rate for Payer: Cash Price |
$29.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$45.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.88
|
| Rate for Payer: EPIC Health Plan Senior |
$25.88
|
| Rate for Payer: Galaxy Health WC |
$54.99
|
| Rate for Payer: Global Benefits Group Commercial |
$38.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.53
|
| Rate for Payer: Multiplan Commercial |
$51.76
|
| Rate for Payer: Networks By Design Commercial |
$42.05
|
| Rate for Payer: Prime Health Services Commercial |
$54.99
|
|
|
HC BODY JACKET CUSTOM FIT
|
Facility
|
IP
|
$3,410.00
|
|
|
Service Code
|
CPT L0430
|
| Hospital Charge Code |
905360430
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$682.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$682.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Cigna of CA HMO |
$2,387.00
|
| Rate for Payer: Cigna of CA PPO |
$2,387.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,387.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,364.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,364.00
|
| Rate for Payer: Galaxy Health WC |
$2,898.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,046.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,165.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,011.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$818.40
|
| Rate for Payer: Multiplan Commercial |
$2,728.00
|
| Rate for Payer: Networks By Design Commercial |
$2,216.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,898.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,279.77
|
| Rate for Payer: United Healthcare All Other HMO |
$1,245.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,218.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,116.78
|
|
|
HC BODY JACKET CUSTOM FIT
|
Facility
|
OP
|
$3,410.00
|
|
|
Service Code
|
CPT L0430
|
| Hospital Charge Code |
905360430
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$818.40 |
| Max. Negotiated Rate |
$2,898.50 |
| Rate for Payer: Adventist Health Commercial |
$1,398.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,898.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,875.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,557.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,064.07
|
| Rate for Payer: Blue Shield of California Commercial |
$1,728.87
|
| Rate for Payer: Blue Shield of California Commercial |
$2,622.29
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Cigna of CA HMO |
$2,387.00
|
| Rate for Payer: Cigna of CA PPO |
$2,387.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,898.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,898.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,898.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,387.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,364.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,364.00
|
| Rate for Payer: Galaxy Health WC |
$2,898.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,046.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,165.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,237.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,011.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$818.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,387.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,387.00
|
| Rate for Payer: Multiplan Commercial |
$2,728.00
|
| Rate for Payer: Networks By Design Commercial |
$1,705.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,898.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,046.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,046.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,279.77
|
| Rate for Payer: United Healthcare All Other HMO |
$1,245.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,218.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,116.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,898.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,898.50
|
| Rate for Payer: Vantage Medical Group Senior |
$2,898.50
|
|
|
HC BODY MUSCLE TESTING MANUAL MCAL
|
Facility
|
OP
|
$339.00
|
|
|
Service Code
|
CPT 95833
|
| Hospital Charge Code |
901300027
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$81.36 |
| Max. Negotiated Rate |
$478.00 |
| Rate for Payer: Adventist Health Commercial |
$138.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$222.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$288.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$186.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$254.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$478.00
|
| Rate for Payer: Blue Shield of California Commercial |
$439.00
|
| Rate for Payer: Blue Shield of California Commercial |
$291.00
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Cigna of CA HMO |
$216.96
|
| Rate for Payer: Cigna of CA PPO |
$250.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$288.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$288.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$288.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$237.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$135.60
|
| Rate for Payer: EPIC Health Plan Senior |
$135.60
|
| Rate for Payer: Galaxy Health WC |
$288.15
|
| Rate for Payer: Global Benefits Group Commercial |
$203.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$215.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$123.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$200.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$237.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$237.30
|
| Rate for Payer: Multiplan Commercial |
$271.20
|
| Rate for Payer: Networks By Design Commercial |
$220.35
|
| Rate for Payer: Prime Health Services Commercial |
$288.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$203.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$203.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$288.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$288.15
|
| Rate for Payer: Vantage Medical Group Senior |
$288.15
|
|
|
HC BODY MUSCLE TESTING MANUAL MCAL
|
Facility
|
OP
|
$339.00
|
|
|
Service Code
|
CPT 95833
|
| Hospital Charge Code |
900400012
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$81.36 |
| Max. Negotiated Rate |
$478.00 |
| Rate for Payer: Adventist Health Commercial |
$138.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$222.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$288.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$186.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$254.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$478.00
|
| Rate for Payer: Blue Shield of California Commercial |
$439.00
|
| Rate for Payer: Blue Shield of California Commercial |
$291.00
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Cigna of CA HMO |
$216.96
|
| Rate for Payer: Cigna of CA PPO |
$250.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$288.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$288.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$288.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$237.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$135.60
|
| Rate for Payer: EPIC Health Plan Senior |
$135.60
|
| Rate for Payer: Galaxy Health WC |
$288.15
|
| Rate for Payer: Global Benefits Group Commercial |
$203.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$215.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$123.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$200.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$237.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$237.30
|
| Rate for Payer: Multiplan Commercial |
$271.20
|
| Rate for Payer: Networks By Design Commercial |
$220.35
|
| Rate for Payer: Prime Health Services Commercial |
$288.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$203.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$203.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$288.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$288.15
|
| Rate for Payer: Vantage Medical Group Senior |
$288.15
|
|
|
HC BODY MUSCLE TESTING MANUAL MCAL
|
Facility
|
IP
|
$339.00
|
|
|
Service Code
|
CPT 95833
|
| Hospital Charge Code |
901300027
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$67.80 |
| Max. Negotiated Rate |
$288.15 |
| Rate for Payer: Adventist Health Commercial |
$67.80
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$237.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$135.60
|
| Rate for Payer: EPIC Health Plan Senior |
$135.60
|
| Rate for Payer: Galaxy Health WC |
$288.15
|
| Rate for Payer: Global Benefits Group Commercial |
$203.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$215.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$200.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.36
|
| Rate for Payer: Multiplan Commercial |
$271.20
|
| Rate for Payer: Networks By Design Commercial |
$220.35
|
| Rate for Payer: Prime Health Services Commercial |
$288.15
|
|
|
HC BODY MUSCLE TESTING MANUAL MCAL
|
Facility
|
IP
|
$339.00
|
|
|
Service Code
|
CPT 95833
|
| Hospital Charge Code |
900400012
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$67.80 |
| Max. Negotiated Rate |
$288.15 |
| Rate for Payer: Adventist Health Commercial |
$67.80
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$237.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$135.60
|
| Rate for Payer: EPIC Health Plan Senior |
$135.60
|
| Rate for Payer: Galaxy Health WC |
$288.15
|
| Rate for Payer: Global Benefits Group Commercial |
$203.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$215.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$200.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.36
|
| Rate for Payer: Multiplan Commercial |
$271.20
|
| Rate for Payer: Networks By Design Commercial |
$220.35
|
| Rate for Payer: Prime Health Services Commercial |
$288.15
|
|
|
HC BODY MUSCLE TEST MANUAL W HAND MCAL
|
Facility
|
IP
|
$339.00
|
|
|
Service Code
|
CPT 95834
|
| Hospital Charge Code |
901300029
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$67.80 |
| Max. Negotiated Rate |
$288.15 |
| Rate for Payer: Adventist Health Commercial |
$67.80
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$237.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$135.60
|
| Rate for Payer: EPIC Health Plan Senior |
$135.60
|
| Rate for Payer: Galaxy Health WC |
$288.15
|
| Rate for Payer: Global Benefits Group Commercial |
$203.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$215.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$200.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.36
|
| Rate for Payer: Multiplan Commercial |
$271.20
|
| Rate for Payer: Networks By Design Commercial |
$220.35
|
| Rate for Payer: Prime Health Services Commercial |
$288.15
|
|
|
HC BODY MUSCLE TEST MANUAL W HAND MCAL
|
Facility
|
OP
|
$339.00
|
|
|
Service Code
|
CPT 95834
|
| Hospital Charge Code |
901300029
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$81.36 |
| Max. Negotiated Rate |
$478.00 |
| Rate for Payer: Adventist Health Commercial |
$138.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$222.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$288.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$186.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$254.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$478.00
|
| Rate for Payer: Blue Shield of California Commercial |
$439.00
|
| Rate for Payer: Blue Shield of California Commercial |
$291.00
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Cigna of CA HMO |
$216.96
|
| Rate for Payer: Cigna of CA PPO |
$250.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$288.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$288.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$288.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$237.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$135.60
|
| Rate for Payer: EPIC Health Plan Senior |
$135.60
|
| Rate for Payer: Galaxy Health WC |
$288.15
|
| Rate for Payer: Global Benefits Group Commercial |
$203.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$215.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$123.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$200.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$237.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$237.30
|
| Rate for Payer: Multiplan Commercial |
$271.20
|
| Rate for Payer: Networks By Design Commercial |
$220.35
|
| Rate for Payer: Prime Health Services Commercial |
$288.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$203.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$203.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$288.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$288.15
|
| Rate for Payer: Vantage Medical Group Senior |
$288.15
|
|
|
HC BODY MUSCLE TEST MANUAL W/HAND MCAL
|
Facility
|
OP
|
$339.00
|
|
|
Service Code
|
CPT 95834
|
| Hospital Charge Code |
900400014
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$81.36 |
| Max. Negotiated Rate |
$478.00 |
| Rate for Payer: Adventist Health Commercial |
$138.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$222.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$288.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$186.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$254.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$478.00
|
| Rate for Payer: Blue Shield of California Commercial |
$439.00
|
| Rate for Payer: Blue Shield of California Commercial |
$291.00
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Cigna of CA HMO |
$216.96
|
| Rate for Payer: Cigna of CA PPO |
$250.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$288.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$288.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$288.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$237.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$135.60
|
| Rate for Payer: EPIC Health Plan Senior |
$135.60
|
| Rate for Payer: Galaxy Health WC |
$288.15
|
| Rate for Payer: Global Benefits Group Commercial |
$203.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$215.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$123.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$200.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$237.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$237.30
|
| Rate for Payer: Multiplan Commercial |
$271.20
|
| Rate for Payer: Networks By Design Commercial |
$220.35
|
| Rate for Payer: Prime Health Services Commercial |
$288.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$203.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$203.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$288.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$288.15
|
| Rate for Payer: Vantage Medical Group Senior |
$288.15
|
|
|
HC BODY MUSCLE TEST MANUAL W/HAND MCAL
|
Facility
|
IP
|
$339.00
|
|
|
Service Code
|
CPT 95834
|
| Hospital Charge Code |
900400014
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$67.80 |
| Max. Negotiated Rate |
$288.15 |
| Rate for Payer: Adventist Health Commercial |
$67.80
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$237.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$135.60
|
| Rate for Payer: EPIC Health Plan Senior |
$135.60
|
| Rate for Payer: Galaxy Health WC |
$288.15
|
| Rate for Payer: Global Benefits Group Commercial |
$203.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$215.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$200.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.36
|
| Rate for Payer: Multiplan Commercial |
$271.20
|
| Rate for Payer: Networks By Design Commercial |
$220.35
|
| Rate for Payer: Prime Health Services Commercial |
$288.15
|
|
|
HC BODY PLETHYSMOGRAPHY
|
Facility
|
IP
|
$572.00
|
|
|
Service Code
|
CPT 94726
|
| Hospital Charge Code |
900801003
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$114.40 |
| Max. Negotiated Rate |
$486.20 |
| Rate for Payer: Adventist Health Commercial |
$114.40
|
| Rate for Payer: Cash Price |
$257.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$400.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$228.80
|
| Rate for Payer: EPIC Health Plan Senior |
$228.80
|
| Rate for Payer: Galaxy Health WC |
$486.20
|
| Rate for Payer: Global Benefits Group Commercial |
$343.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$363.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$337.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$137.28
|
| Rate for Payer: Multiplan Commercial |
$457.60
|
| Rate for Payer: Networks By Design Commercial |
$371.80
|
| Rate for Payer: Prime Health Services Commercial |
$486.20
|
|
|
HC BODY PLETHYSMOGRAPHY
|
Facility
|
OP
|
$572.00
|
|
|
Service Code
|
CPT 94726
|
| Hospital Charge Code |
900801003
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$80.79 |
| Max. Negotiated Rate |
$791.90 |
| Rate for Payer: Adventist Health Commercial |
$114.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$287.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$479.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$367.05
|
| Rate for Payer: Blue Shield of California Commercial |
$240.81
|
| Rate for Payer: Blue Shield of California Commercial |
$364.94
|
| Rate for Payer: Cash Price |
$257.40
|
| Rate for Payer: Cash Price |
$257.40
|
| Rate for Payer: Cash Price |
$257.40
|
| Rate for Payer: Cigna of CA HMO |
$366.08
|
| Rate for Payer: Cigna of CA PPO |
$423.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$719.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$527.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$479.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$400.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$791.90
|
| Rate for Payer: EPIC Health Plan Senior |
$527.93
|
| Rate for Payer: Galaxy Health WC |
$486.20
|
| Rate for Payer: Global Benefits Group Commercial |
$343.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$787.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$80.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$479.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$363.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$91.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$671.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$137.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$604.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$643.12
|
| Rate for Payer: Multiplan Commercial |
$457.60
|
| Rate for Payer: Networks By Design Commercial |
$371.80
|
| Rate for Payer: Prime Health Services Commercial |
$486.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$343.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$343.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$764.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$731.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$669.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$479.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Vantage Medical Group Senior |
$479.94
|
|
|
HC BODY POS CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8981
|
| Hospital Charge Code |
900018303
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$478.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$478.00
|
| Rate for Payer: Blue Shield of California Commercial |
$291.00
|
| Rate for Payer: Blue Shield of California Commercial |
$439.00
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC BODY POS CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8981
|
| Hospital Charge Code |
900018303
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC BODY POS D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8983
|
| Hospital Charge Code |
900018305
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$478.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$478.00
|
| Rate for Payer: Blue Shield of California Commercial |
$291.00
|
| Rate for Payer: Blue Shield of California Commercial |
$439.00
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC BODY POS D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8983
|
| Hospital Charge Code |
900018305
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC BODY POS GOAL STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8982
|
| Hospital Charge Code |
900018304
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC BODY POS GOAL STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8982
|
| Hospital Charge Code |
900018304
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$478.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$478.00
|
| Rate for Payer: Blue Shield of California Commercial |
$291.00
|
| Rate for Payer: Blue Shield of California Commercial |
$439.00
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC BONE AGE
|
Facility
|
OP
|
$585.00
|
|
|
Service Code
|
CPT 77072
|
| Hospital Charge Code |
909001602
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$33.05 |
| Max. Negotiated Rate |
$497.25 |
| Rate for Payer: Adventist Health Commercial |
$117.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$101.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$154.13
|
| Rate for Payer: Blue Shield of California Commercial |
$246.28
|
| Rate for Payer: Blue Shield of California Commercial |
$373.23
|
| Rate for Payer: Cash Price |
$263.25
|
| Rate for Payer: Cash Price |
$263.25
|
| Rate for Payer: Cigna of CA HMO |
$374.40
|
| Rate for Payer: Cigna of CA PPO |
$432.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$409.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: Galaxy Health WC |
$497.25
|
| Rate for Payer: Global Benefits Group Commercial |
$351.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$33.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$371.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$37.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$140.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$169.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$468.00
|
| Rate for Payer: Networks By Design Commercial |
$380.25
|
| Rate for Payer: Prime Health Services Commercial |
$497.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$351.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$351.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC BONE AGE
|
Facility
|
IP
|
$585.00
|
|
|
Service Code
|
CPT 77072
|
| Hospital Charge Code |
909001602
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$117.00 |
| Max. Negotiated Rate |
$497.25 |
| Rate for Payer: Adventist Health Commercial |
$117.00
|
| Rate for Payer: Cash Price |
$263.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$409.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$234.00
|
| Rate for Payer: EPIC Health Plan Senior |
$234.00
|
| Rate for Payer: Galaxy Health WC |
$497.25
|
| Rate for Payer: Global Benefits Group Commercial |
$351.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$371.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$345.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$140.40
|
| Rate for Payer: Multiplan Commercial |
$468.00
|
| Rate for Payer: Networks By Design Commercial |
$380.25
|
| Rate for Payer: Prime Health Services Commercial |
$497.25
|
|
|
HC BONE BIOPSY DEEP, PERCUTAN
|
Facility
|
OP
|
$5,824.00
|
|
|
Service Code
|
CPT 20225
|
| Hospital Charge Code |
909000107
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$250.19 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,164.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Cigna of CA HMO |
$3,727.36
|
| Rate for Payer: Cigna of CA PPO |
$4,309.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,076.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Galaxy Health WC |
$4,950.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,494.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$250.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,698.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$282.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,973.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,397.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,676.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$4,659.20
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$3,785.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,950.40
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,494.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,912.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
