|
HC DIETICIAN CONF PARTICIP 15MIN
|
Facility
IP
|
$50.00
|
|
| Hospital Charge Code |
912164312
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$42.50 |
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.00
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Multiplan Commercial |
$40.00
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
|
|
HC DIETICIAN CONF PARTICIP 15MIN
|
Facility
OP
|
$50.00
|
|
| Hospital Charge Code |
912164312
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$42.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32.80
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$42.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$27.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$27.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.79
|
| Rate for Payer: BCBS Transplant Transplant |
$30.00
|
| Rate for Payer: Blue Shield of California Commercial |
$36.85
|
| Rate for Payer: Blue Shield of California EPN |
$29.20
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cigna of CA HMO |
$32.00
|
| Rate for Payer: Cigna of CA PPO |
$37.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42.50
|
| Rate for Payer: Dignity Health Media |
$42.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$42.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$20.00
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$37.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Multiplan Commercial |
$40.00
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$25.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25.00
|
| Rate for Payer: United Healthcare HMO Rider |
$25.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42.50
|
| Rate for Payer: Vantage Medical Group Senior |
$42.50
|
|
|
HC DIETICIAN EVAL INTERVEN 30 MIN
|
Facility
IP
|
$99.00
|
|
| Hospital Charge Code |
908603048
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$23.76 |
| Max. Negotiated Rate |
$84.15 |
| Rate for Payer: Cash Price |
$44.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.60
|
| Rate for Payer: Galaxy Health WC |
$84.15
|
| Rate for Payer: Global Benefits Group Commercial |
$59.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.76
|
| 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
|
|
|
HC DIETICIAN EVAL INTERVEN 30 MIN
|
Facility
OP
|
$99.00
|
|
| Hospital Charge Code |
908603048
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$23.76 |
| Max. Negotiated Rate |
$84.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$64.93
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$84.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$54.45
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$54.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$58.98
|
| Rate for Payer: BCBS Transplant Transplant |
$59.40
|
| Rate for Payer: Blue Shield of California Commercial |
$72.96
|
| Rate for Payer: Blue Shield of California EPN |
$57.82
|
| 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 |
$84.15
|
| Rate for Payer: Dignity Health Media |
$84.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$84.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$39.60
|
| Rate for Payer: Galaxy Health WC |
$84.15
|
| Rate for Payer: Global Benefits Group Commercial |
$59.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$74.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.76
|
| 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: Redlands Yucaipa Medical Group Commercial/Senior |
$59.40
|
| 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 |
$49.50
|
| Rate for Payer: United Healthcare All Other HMO |
$49.50
|
| Rate for Payer: United Healthcare HMO Rider |
$49.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$84.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.15
|
| Rate for Payer: Vantage Medical Group Senior |
$84.15
|
|
|
HC DIETICIAN EVAL INTERVEN 30MIN
|
Facility
IP
|
$95.00
|
|
| Hospital Charge Code |
912164308
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$80.75 |
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.00
|
| Rate for Payer: Galaxy Health WC |
$80.75
|
| Rate for Payer: Global Benefits Group Commercial |
$57.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.80
|
| Rate for Payer: Multiplan Commercial |
$76.00
|
| Rate for Payer: Networks By Design Commercial |
$61.75
|
| Rate for Payer: Prime Health Services Commercial |
$80.75
|
|
|
HC DIETICIAN EVAL INTERVEN 30MIN
|
Facility
OP
|
$95.00
|
|
| Hospital Charge Code |
912164308
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$80.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$62.31
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$80.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$52.25
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$52.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$56.60
|
| Rate for Payer: BCBS Transplant Transplant |
$57.00
|
| Rate for Payer: Blue Shield of California Commercial |
$70.02
|
| Rate for Payer: Blue Shield of California EPN |
$55.48
|
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: Cigna of CA HMO |
$60.80
|
| Rate for Payer: Cigna of CA PPO |
$70.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$80.75
|
| Rate for Payer: Dignity Health Media |
$80.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$80.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$38.00
|
| Rate for Payer: Galaxy Health WC |
$80.75
|
| Rate for Payer: Global Benefits Group Commercial |
$57.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$71.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.80
|
| Rate for Payer: Multiplan Commercial |
$76.00
|
| Rate for Payer: Networks By Design Commercial |
$61.75
|
| Rate for Payer: Prime Health Services Commercial |
$80.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$57.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.50
|
| Rate for Payer: United Healthcare All Other HMO |
$47.50
|
| Rate for Payer: United Healthcare HMO Rider |
$47.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$80.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$80.75
|
| Rate for Payer: Vantage Medical Group Senior |
$80.75
|
|
|
HC DIETICIAN GRP TEACH SUPPORT
|
Facility
OP
|
$64.00
|
|
| Hospital Charge Code |
908603238
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$15.36 |
| Max. Negotiated Rate |
$54.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41.98
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$54.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$35.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$35.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38.13
|
| Rate for Payer: BCBS Transplant Transplant |
$38.40
|
| Rate for Payer: Blue Shield of California Commercial |
$47.17
|
| Rate for Payer: Blue Shield of California EPN |
$37.38
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cigna of CA HMO |
$40.96
|
| Rate for Payer: Cigna of CA PPO |
$47.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$54.40
|
| Rate for Payer: Dignity Health Media |
$54.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$54.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$25.60
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$48.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.36
|
| Rate for Payer: Multiplan Commercial |
$51.20
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$38.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.00
|
| Rate for Payer: United Healthcare All Other HMO |
$32.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$54.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$54.40
|
| Rate for Payer: Vantage Medical Group Senior |
$54.40
|
|
|
HC DIETICIAN GRP TEACH SUPPORT
|
Facility
OP
|
$80.00
|
|
| Hospital Charge Code |
908600138
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$68.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52.47
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$68.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$44.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$44.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.66
|
| Rate for Payer: BCBS Transplant Transplant |
$48.00
|
| Rate for Payer: Blue Shield of California Commercial |
$58.96
|
| Rate for Payer: Blue Shield of California EPN |
$46.72
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cigna of CA HMO |
$51.20
|
| Rate for Payer: Cigna of CA PPO |
$59.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$68.00
|
| Rate for Payer: Dignity Health Media |
$68.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$32.00
|
| Rate for Payer: Galaxy Health WC |
$68.00
|
| Rate for Payer: Global Benefits Group Commercial |
$48.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$60.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.20
|
| Rate for Payer: Multiplan Commercial |
$64.00
|
| Rate for Payer: Networks By Design Commercial |
$52.00
|
| Rate for Payer: Prime Health Services Commercial |
$68.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$48.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$48.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$48.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$40.00
|
| Rate for Payer: United Healthcare All Other HMO |
$40.00
|
| Rate for Payer: United Healthcare HMO Rider |
$40.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$40.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$68.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.00
|
| Rate for Payer: Vantage Medical Group Senior |
$68.00
|
|
|
HC DIETICIAN GRP TEACH SUPPORT
|
Facility
IP
|
$80.00
|
|
| Hospital Charge Code |
908600138
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$68.00 |
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.00
|
| Rate for Payer: Galaxy Health WC |
$68.00
|
| Rate for Payer: Global Benefits Group Commercial |
$48.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.20
|
| Rate for Payer: Multiplan Commercial |
$64.00
|
| Rate for Payer: Networks By Design Commercial |
$52.00
|
| Rate for Payer: Prime Health Services Commercial |
$68.00
|
|
|
HC DIETICIAN GRP TEACH SUPPORT
|
Facility
IP
|
$64.00
|
|
| Hospital Charge Code |
908603238
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$15.36 |
| Max. Negotiated Rate |
$54.40 |
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.36
|
| Rate for Payer: Multiplan Commercial |
$51.20
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
|
|
HC DIETICIAN PHONE CONSULT 15 MIN
|
Facility
OP
|
$23.00
|
|
| Hospital Charge Code |
908603052
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$5.52 |
| Max. Negotiated Rate |
$19.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$15.09
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.55
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.70
|
| Rate for Payer: BCBS Transplant Transplant |
$13.80
|
| Rate for Payer: Blue Shield of California Commercial |
$16.95
|
| Rate for Payer: Blue Shield of California EPN |
$13.43
|
| Rate for Payer: Cash Price |
$10.35
|
| Rate for Payer: Cigna of CA HMO |
$14.72
|
| Rate for Payer: Cigna of CA PPO |
$17.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.55
|
| Rate for Payer: Dignity Health Media |
$19.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.20
|
| Rate for Payer: Galaxy Health WC |
$19.55
|
| Rate for Payer: Global Benefits Group Commercial |
$13.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$17.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.52
|
| Rate for Payer: Multiplan Commercial |
$18.40
|
| Rate for Payer: Networks By Design Commercial |
$14.95
|
| Rate for Payer: Prime Health Services Commercial |
$19.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$13.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.50
|
| Rate for Payer: United Healthcare All Other HMO |
$11.50
|
| Rate for Payer: United Healthcare HMO Rider |
$11.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.55
|
| Rate for Payer: Vantage Medical Group Senior |
$19.55
|
|
|
HC DIETICIAN PHONE CONSULT 15 MIN
|
Facility
IP
|
$23.00
|
|
| Hospital Charge Code |
908603052
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$5.52 |
| Max. Negotiated Rate |
$19.55 |
| Rate for Payer: Cash Price |
$10.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.20
|
| Rate for Payer: Galaxy Health WC |
$19.55
|
| Rate for Payer: Global Benefits Group Commercial |
$13.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.52
|
| Rate for Payer: Multiplan Commercial |
$18.40
|
| Rate for Payer: Networks By Design Commercial |
$14.95
|
| Rate for Payer: Prime Health Services Commercial |
$19.55
|
|
|
HC DIETITIAN ASSESS/EVAL
|
Facility
OP
|
$73.00
|
|
| Hospital Charge Code |
912900116
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$17.52 |
| Max. Negotiated Rate |
$62.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$62.05
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$40.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$40.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$43.49
|
| Rate for Payer: BCBS Transplant Transplant |
$43.80
|
| Rate for Payer: Blue Shield of California Commercial |
$53.80
|
| Rate for Payer: Blue Shield of California EPN |
$42.63
|
| Rate for Payer: Cash Price |
$32.85
|
| Rate for Payer: Cigna of CA HMO |
$46.72
|
| Rate for Payer: Cigna of CA PPO |
$54.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$62.05
|
| Rate for Payer: Dignity Health Media |
$62.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$62.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$29.20
|
| Rate for Payer: Galaxy Health WC |
$62.05
|
| Rate for Payer: Global Benefits Group Commercial |
$43.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$54.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$48.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.52
|
| Rate for Payer: Multiplan Commercial |
$58.40
|
| Rate for Payer: Networks By Design Commercial |
$47.45
|
| Rate for Payer: Prime Health Services Commercial |
$62.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$43.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$43.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$43.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$36.50
|
| Rate for Payer: United Healthcare All Other HMO |
$36.50
|
| Rate for Payer: United Healthcare HMO Rider |
$36.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$36.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$62.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$62.05
|
| Rate for Payer: Vantage Medical Group Senior |
$62.05
|
|
|
HC DIETITIAN ASSESS/EVAL
|
Facility
IP
|
$73.00
|
|
| Hospital Charge Code |
912900116
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$17.52 |
| Max. Negotiated Rate |
$62.05 |
| Rate for Payer: Cash Price |
$32.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.20
|
| Rate for Payer: Galaxy Health WC |
$62.05
|
| Rate for Payer: Global Benefits Group Commercial |
$43.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$48.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.52
|
| Rate for Payer: Multiplan Commercial |
$58.40
|
| Rate for Payer: Networks By Design Commercial |
$47.45
|
| Rate for Payer: Prime Health Services Commercial |
$62.05
|
|
|
HC DIETITIAN CONF PARTICIPATION
|
Facility
IP
|
$50.00
|
|
| Hospital Charge Code |
912900119
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$42.50 |
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.00
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Multiplan Commercial |
$40.00
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
|
|
HC DIETITIAN CONF PARTICIPATION
|
Facility
OP
|
$50.00
|
|
| Hospital Charge Code |
912900119
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$42.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32.80
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$42.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$27.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$27.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.79
|
| Rate for Payer: BCBS Transplant Transplant |
$30.00
|
| Rate for Payer: Blue Shield of California Commercial |
$36.85
|
| Rate for Payer: Blue Shield of California EPN |
$29.20
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cigna of CA HMO |
$32.00
|
| Rate for Payer: Cigna of CA PPO |
$37.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42.50
|
| Rate for Payer: Dignity Health Media |
$42.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$42.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$20.00
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$37.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Multiplan Commercial |
$40.00
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$25.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25.00
|
| Rate for Payer: United Healthcare HMO Rider |
$25.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42.50
|
| Rate for Payer: Vantage Medical Group Senior |
$42.50
|
|
|
HC DIETITIAN GROUP TEACHING
|
Facility
IP
|
$36.00
|
|
| Hospital Charge Code |
912900001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8.64 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.40
|
| Rate for Payer: Galaxy Health WC |
$30.60
|
| Rate for Payer: Global Benefits Group Commercial |
$21.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.64
|
| Rate for Payer: Multiplan Commercial |
$28.80
|
| Rate for Payer: Networks By Design Commercial |
$23.40
|
| Rate for Payer: Prime Health Services Commercial |
$30.60
|
|
|
HC DIETITIAN GROUP TEACHING
|
Facility
OP
|
$36.00
|
|
| Hospital Charge Code |
912900001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8.64 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23.61
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$30.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$19.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$19.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.45
|
| Rate for Payer: BCBS Transplant Transplant |
$21.60
|
| Rate for Payer: Blue Shield of California Commercial |
$26.53
|
| Rate for Payer: Blue Shield of California EPN |
$21.02
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cigna of CA HMO |
$23.04
|
| Rate for Payer: Cigna of CA PPO |
$26.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.60
|
| Rate for Payer: Dignity Health Media |
$30.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$14.40
|
| Rate for Payer: Galaxy Health WC |
$30.60
|
| Rate for Payer: Global Benefits Group Commercial |
$21.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$27.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.64
|
| Rate for Payer: Multiplan Commercial |
$28.80
|
| Rate for Payer: Networks By Design Commercial |
$23.40
|
| Rate for Payer: Prime Health Services Commercial |
$30.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$21.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.00
|
| Rate for Payer: United Healthcare All Other HMO |
$18.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.60
|
| Rate for Payer: Vantage Medical Group Senior |
$30.60
|
|
|
HC DIETITIAN PHONE CONF 15 MINS
|
Facility
OP
|
$23.00
|
|
| Hospital Charge Code |
912900005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5.52 |
| Max. Negotiated Rate |
$19.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$15.09
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.55
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.70
|
| Rate for Payer: BCBS Transplant Transplant |
$13.80
|
| Rate for Payer: Blue Shield of California Commercial |
$16.95
|
| Rate for Payer: Blue Shield of California EPN |
$13.43
|
| Rate for Payer: Cash Price |
$10.35
|
| Rate for Payer: Cigna of CA HMO |
$14.72
|
| Rate for Payer: Cigna of CA PPO |
$17.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.55
|
| Rate for Payer: Dignity Health Media |
$19.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.20
|
| Rate for Payer: Galaxy Health WC |
$19.55
|
| Rate for Payer: Global Benefits Group Commercial |
$13.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$17.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.52
|
| Rate for Payer: Multiplan Commercial |
$18.40
|
| Rate for Payer: Networks By Design Commercial |
$14.95
|
| Rate for Payer: Prime Health Services Commercial |
$19.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$13.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.50
|
| Rate for Payer: United Healthcare All Other HMO |
$11.50
|
| Rate for Payer: United Healthcare HMO Rider |
$11.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.55
|
| Rate for Payer: Vantage Medical Group Senior |
$19.55
|
|
|
HC DIETITIAN PHONE CONF 15 MINS
|
Facility
IP
|
$23.00
|
|
| Hospital Charge Code |
912900005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5.52 |
| Max. Negotiated Rate |
$19.55 |
| Rate for Payer: Cash Price |
$10.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.20
|
| Rate for Payer: Galaxy Health WC |
$19.55
|
| Rate for Payer: Global Benefits Group Commercial |
$13.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.52
|
| Rate for Payer: Multiplan Commercial |
$18.40
|
| Rate for Payer: Networks By Design Commercial |
$14.95
|
| Rate for Payer: Prime Health Services Commercial |
$19.55
|
|
|
HC DIFFERENTIAL LUNG SCAN
|
Facility
IP
|
$3,775.00
|
|
|
Service Code
|
CPT 78597
|
| Hospital Charge Code |
909301404
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$906.00 |
| Max. Negotiated Rate |
$3,208.75 |
| Rate for Payer: Cash Price |
$1,698.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,510.00
|
| Rate for Payer: Galaxy Health WC |
$3,208.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,265.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,517.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,438.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$906.00
|
| Rate for Payer: Multiplan Commercial |
$3,020.00
|
| Rate for Payer: Networks By Design Commercial |
$2,453.75
|
| Rate for Payer: Prime Health Services Commercial |
$3,208.75
|
|
|
HC DIFFERENTIAL LUNG SCAN
|
Facility
OP
|
$3,775.00
|
|
|
Service Code
|
CPT 78597
|
| Hospital Charge Code |
909301404
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$337.42 |
| Max. Negotiated Rate |
$3,208.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,038.80
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$772.98
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$566.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$515.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,225.47
|
| Rate for Payer: BCBS Transplant Transplant |
$2,265.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,231.02
|
| Rate for Payer: Blue Shield of California EPN |
$1,770.48
|
| Rate for Payer: Cash Price |
$1,698.75
|
| Rate for Payer: Cash Price |
$1,698.75
|
| Rate for Payer: Cigna of CA HMO |
$2,416.00
|
| Rate for Payer: Cigna of CA PPO |
$2,793.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$772.98
|
| Rate for Payer: Dignity Health Media |
$515.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$566.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$695.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$515.32
|
| Rate for Payer: EPIC Health Plan Transplant |
$515.32
|
| Rate for Payer: Galaxy Health WC |
$3,208.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,265.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,831.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$845.12
|
| Rate for Payer: Heritage Provider Network Transplant |
$845.12
|
| Rate for Payer: IEHP Medi-Cal |
$834.82
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$834.82
|
| Rate for Payer: IEHP Medicare Advantage |
$515.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,517.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$337.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$515.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$906.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$649.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$690.53
|
| Rate for Payer: Multiplan Commercial |
$3,020.00
|
| Rate for Payer: Networks By Design Commercial |
$2,453.75
|
| Rate for Payer: Prime Health Services Commercial |
$3,208.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,265.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,265.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,265.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$518.19
|
| Rate for Payer: United Healthcare All Other HMO |
$518.19
|
| Rate for Payer: United Healthcare HMO Rider |
$518.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$518.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$772.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$566.85
|
| Rate for Payer: Vantage Medical Group Senior |
$515.32
|
|
|
HC DIGITAL-SCREENING MAMMO, BILAT
|
Facility
IP
|
$703.00
|
|
|
Service Code
|
CPT 77067
|
| Hospital Charge Code |
909002010
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$168.72 |
| Max. Negotiated Rate |
$597.55 |
| Rate for Payer: Cash Price |
$316.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$281.20
|
| Rate for Payer: Galaxy Health WC |
$597.55
|
| Rate for Payer: Global Benefits Group Commercial |
$421.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$468.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$267.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.72
|
| Rate for Payer: Multiplan Commercial |
$562.40
|
| Rate for Payer: Networks By Design Commercial |
$456.95
|
| Rate for Payer: Prime Health Services Commercial |
$597.55
|
|
|
HC DIGITAL-SCREENING MAMMO, BILAT
|
Facility
OP
|
$703.00
|
|
|
Service Code
|
CPT 77067
|
| Hospital Charge Code |
909002010
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$168.72 |
| Max. Negotiated Rate |
$639.74 |
| Rate for Payer: Aetna of CA HMO/PPO |
$639.74
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$597.55
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$386.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$386.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$418.85
|
| Rate for Payer: BCBS Transplant Transplant |
$421.80
|
| Rate for Payer: Blue Shield of California Commercial |
$415.47
|
| Rate for Payer: Blue Shield of California EPN |
$329.71
|
| Rate for Payer: Cash Price |
$316.35
|
| Rate for Payer: Cash Price |
$316.35
|
| Rate for Payer: Cigna of CA HMO |
$449.92
|
| Rate for Payer: Cigna of CA PPO |
$520.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$597.55
|
| Rate for Payer: Dignity Health Media |
$597.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$597.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$281.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$281.20
|
| Rate for Payer: Galaxy Health WC |
$597.55
|
| Rate for Payer: Global Benefits Group Commercial |
$421.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$527.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$468.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$226.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.72
|
| Rate for Payer: Multiplan Commercial |
$562.40
|
| Rate for Payer: Networks By Design Commercial |
$456.95
|
| Rate for Payer: Prime Health Services Commercial |
$597.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$421.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$421.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$421.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$269.26
|
| Rate for Payer: United Healthcare All Other HMO |
$269.26
|
| Rate for Payer: United Healthcare HMO Rider |
$269.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$269.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$597.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$597.55
|
| Rate for Payer: Vantage Medical Group Senior |
$597.55
|
|
|
HC DIGOXIN
|
Facility
OP
|
$50.00
|
|
|
Service Code
|
CPT 80162
|
| Hospital Charge Code |
900910816
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.76 |
| Max. Negotiated Rate |
$121.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$110.47
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.92
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.61
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$121.13
|
| Rate for Payer: BCBS Transplant Transplant |
$30.00
|
| Rate for Payer: Blue Shield of California Commercial |
$32.30
|
| Rate for Payer: Blue Shield of California EPN |
$25.60
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cigna of CA HMO |
$32.00
|
| Rate for Payer: Cigna of CA PPO |
$37.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.92
|
| Rate for Payer: Dignity Health Media |
$13.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.93
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.28
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$37.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$21.78
|
| Rate for Payer: Heritage Provider Network Transplant |
$21.78
|
| Rate for Payer: IEHP Medi-Cal |
$21.51
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$21.51
|
| Rate for Payer: IEHP Medicare Advantage |
$13.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.80
|
| Rate for Payer: Multiplan Commercial |
$40.00
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.76
|
| Rate for Payer: United Healthcare All Other HMO |
$10.76
|
| Rate for Payer: United Healthcare HMO Rider |
$10.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.61
|
| Rate for Payer: Vantage Medical Group Senior |
$13.28
|
|
