|
HC NURSE SPEC EVAL INTERVIN 30MIN
|
Facility
OP
|
$95.00
|
|
| Hospital Charge Code |
912154301
|
|
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 NURSE SPEC GRP TEACH SUPPORT
|
Facility
OP
|
$64.00
|
|
| Hospital Charge Code |
912154314
|
|
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 NURSE SPEC GRP TEACH SUPPORT
|
Facility
IP
|
$80.00
|
|
| Hospital Charge Code |
908600162
|
|
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 NURSE SPEC GRP TEACH SUPPORT
|
Facility
IP
|
$64.00
|
|
| Hospital Charge Code |
912154314
|
|
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 NURSE SPEC GRP TEACH SUPPORT
|
Facility
OP
|
$80.00
|
|
| Hospital Charge Code |
908600162
|
|
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 NURSE SPECIALIST CONF COORD
|
Facility
OP
|
$333.00
|
|
| Hospital Charge Code |
908600156
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$79.92 |
| Max. Negotiated Rate |
$283.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$218.41
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$283.05
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$183.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$183.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$198.40
|
| Rate for Payer: BCBS Transplant Transplant |
$199.80
|
| Rate for Payer: Blue Shield of California Commercial |
$245.42
|
| Rate for Payer: Blue Shield of California EPN |
$194.47
|
| Rate for Payer: Cash Price |
$149.85
|
| Rate for Payer: Cigna of CA HMO |
$213.12
|
| Rate for Payer: Cigna of CA PPO |
$246.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$283.05
|
| Rate for Payer: Dignity Health Media |
$283.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$133.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$133.20
|
| Rate for Payer: Galaxy Health WC |
$283.05
|
| Rate for Payer: Global Benefits Group Commercial |
$199.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$249.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$222.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$126.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.92
|
| Rate for Payer: Multiplan Commercial |
$266.40
|
| Rate for Payer: Networks By Design Commercial |
$216.45
|
| Rate for Payer: Prime Health Services Commercial |
$283.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$199.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$199.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$199.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$166.50
|
| Rate for Payer: United Healthcare All Other HMO |
$166.50
|
| Rate for Payer: United Healthcare HMO Rider |
$166.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$166.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$283.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.05
|
| Rate for Payer: Vantage Medical Group Senior |
$283.05
|
|
|
HC NURSE SPECIALIST CONF COORD
|
Facility
IP
|
$333.00
|
|
| Hospital Charge Code |
908600156
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$79.92 |
| Max. Negotiated Rate |
$283.05 |
| Rate for Payer: Cash Price |
$149.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$133.20
|
| Rate for Payer: Galaxy Health WC |
$283.05
|
| Rate for Payer: Global Benefits Group Commercial |
$199.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$222.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$126.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.92
|
| Rate for Payer: Multiplan Commercial |
$266.40
|
| Rate for Payer: Networks By Design Commercial |
$216.45
|
| Rate for Payer: Prime Health Services Commercial |
$283.05
|
|
|
HC NURSE SPEC PERIODIC CHRT REV
|
Facility
IP
|
$171.00
|
|
| Hospital Charge Code |
908600164
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$41.04 |
| Max. Negotiated Rate |
$145.35 |
| Rate for Payer: Cash Price |
$76.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.40
|
| Rate for Payer: Galaxy Health WC |
$145.35
|
| Rate for Payer: Global Benefits Group Commercial |
$102.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$114.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.04
|
| Rate for Payer: Multiplan Commercial |
$136.80
|
| Rate for Payer: Networks By Design Commercial |
$111.15
|
| Rate for Payer: Prime Health Services Commercial |
$145.35
|
|
|
HC NURSE SPEC PERIODIC CHRT REV
|
Facility
OP
|
$171.00
|
|
| Hospital Charge Code |
908600164
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$41.04 |
| Max. Negotiated Rate |
$145.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$112.16
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$145.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$94.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$94.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$101.88
|
| Rate for Payer: BCBS Transplant Transplant |
$102.60
|
| Rate for Payer: Blue Shield of California Commercial |
$126.03
|
| Rate for Payer: Blue Shield of California EPN |
$99.86
|
| Rate for Payer: Cash Price |
$76.95
|
| Rate for Payer: Cigna of CA HMO |
$109.44
|
| Rate for Payer: Cigna of CA PPO |
$126.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$145.35
|
| Rate for Payer: Dignity Health Media |
$145.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$145.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$68.40
|
| Rate for Payer: Galaxy Health WC |
$145.35
|
| Rate for Payer: Global Benefits Group Commercial |
$102.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$128.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$114.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.04
|
| Rate for Payer: Multiplan Commercial |
$136.80
|
| Rate for Payer: Networks By Design Commercial |
$111.15
|
| Rate for Payer: Prime Health Services Commercial |
$145.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$102.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$102.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$102.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$85.50
|
| Rate for Payer: United Healthcare All Other HMO |
$85.50
|
| Rate for Payer: United Healthcare HMO Rider |
$85.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$85.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$145.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$145.35
|
| Rate for Payer: Vantage Medical Group Senior |
$145.35
|
|
|
HC NURSE SPEC PHONE CONSULT 15 MI
|
Facility
IP
|
$24.00
|
|
| Hospital Charge Code |
908603063
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$5.76 |
| Max. Negotiated Rate |
$20.40 |
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.76
|
| Rate for Payer: Multiplan Commercial |
$19.20
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
|
|
HC NURSE SPEC PHONE CONSULT 15 MI
|
Facility
OP
|
$24.00
|
|
| Hospital Charge Code |
908603063
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$5.76 |
| Max. Negotiated Rate |
$20.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$15.74
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.30
|
| Rate for Payer: BCBS Transplant Transplant |
$14.40
|
| Rate for Payer: Blue Shield of California Commercial |
$17.69
|
| Rate for Payer: Blue Shield of California EPN |
$14.02
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cigna of CA HMO |
$15.36
|
| Rate for Payer: Cigna of CA PPO |
$17.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.40
|
| Rate for Payer: Dignity Health Media |
$20.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$18.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.76
|
| Rate for Payer: Multiplan Commercial |
$19.20
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$14.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.00
|
| Rate for Payer: United Healthcare All Other HMO |
$12.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.40
|
| Rate for Payer: Vantage Medical Group Senior |
$20.40
|
|
|
HC NUTRITION/METABOLIC ASSESS/TRA
|
Facility
OP
|
$508.00
|
|
| Hospital Charge Code |
902000202
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$121.92 |
| Max. Negotiated Rate |
$785.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$333.20
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$431.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$279.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$279.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$302.67
|
| Rate for Payer: BCBS Transplant Transplant |
$304.80
|
| Rate for Payer: Blue Shield of California Commercial |
$374.40
|
| Rate for Payer: Blue Shield of California EPN |
$296.67
|
| Rate for Payer: Cash Price |
$228.60
|
| Rate for Payer: Cash Price |
$228.60
|
| Rate for Payer: Cigna of CA HMO |
$325.12
|
| Rate for Payer: Cigna of CA PPO |
$375.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$431.80
|
| Rate for Payer: Dignity Health Media |
$431.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$203.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$203.20
|
| Rate for Payer: Galaxy Health WC |
$431.80
|
| Rate for Payer: Global Benefits Group Commercial |
$304.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$381.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$338.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$193.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.92
|
| Rate for Payer: Multiplan Commercial |
$406.40
|
| Rate for Payer: Networks By Design Commercial |
$330.20
|
| Rate for Payer: Prime Health Services Commercial |
$431.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$304.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$304.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$304.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$602.00
|
| Rate for Payer: United Healthcare All Other HMO |
$785.00
|
| Rate for Payer: United Healthcare HMO Rider |
$593.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$542.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$431.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.80
|
| Rate for Payer: Vantage Medical Group Senior |
$431.80
|
|
|
HC NUTRITION/METABOLIC ASSESS/TRA
|
Facility
IP
|
$508.00
|
|
| Hospital Charge Code |
902000202
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$121.92 |
| Max. Negotiated Rate |
$431.80 |
| Rate for Payer: Cash Price |
$228.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$203.20
|
| Rate for Payer: Galaxy Health WC |
$431.80
|
| Rate for Payer: Global Benefits Group Commercial |
$304.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$338.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$193.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.92
|
| Rate for Payer: Multiplan Commercial |
$406.40
|
| Rate for Payer: Networks By Design Commercial |
$330.20
|
| Rate for Payer: Prime Health Services Commercial |
$431.80
|
|
|
HC NUTRITION/METABOLIC FOLLOWUP
|
Facility
IP
|
$260.00
|
|
| Hospital Charge Code |
902000203
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$62.40 |
| Max. Negotiated Rate |
$221.00 |
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$104.00
|
| Rate for Payer: Galaxy Health WC |
$221.00
|
| Rate for Payer: Global Benefits Group Commercial |
$156.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$173.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$99.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.40
|
| Rate for Payer: Multiplan Commercial |
$208.00
|
| Rate for Payer: Networks By Design Commercial |
$169.00
|
| Rate for Payer: Prime Health Services Commercial |
$221.00
|
|
|
HC NUTRITION/METABOLIC FOLLOWUP
|
Facility
OP
|
$260.00
|
|
| Hospital Charge Code |
902000203
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$62.40 |
| Max. Negotiated Rate |
$785.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$170.53
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$221.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$143.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$143.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$154.91
|
| Rate for Payer: BCBS Transplant Transplant |
$156.00
|
| Rate for Payer: Blue Shield of California Commercial |
$191.62
|
| Rate for Payer: Blue Shield of California EPN |
$151.84
|
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: Cigna of CA HMO |
$166.40
|
| Rate for Payer: Cigna of CA PPO |
$192.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$221.00
|
| Rate for Payer: Dignity Health Media |
$221.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$221.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$104.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$104.00
|
| Rate for Payer: Galaxy Health WC |
$221.00
|
| Rate for Payer: Global Benefits Group Commercial |
$156.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$195.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$173.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$99.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.40
|
| Rate for Payer: Multiplan Commercial |
$208.00
|
| Rate for Payer: Networks By Design Commercial |
$169.00
|
| Rate for Payer: Prime Health Services Commercial |
$221.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$156.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$156.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$156.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$602.00
|
| Rate for Payer: United Healthcare All Other HMO |
$785.00
|
| Rate for Payer: United Healthcare HMO Rider |
$593.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$542.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$221.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$221.00
|
| Rate for Payer: Vantage Medical Group Senior |
$221.00
|
|
|
HC NUTRITION THER GRP 30 MIN
|
Facility
OP
|
$213.00
|
|
|
Service Code
|
CPT 97804
|
| Hospital Charge Code |
902000205
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$26.43 |
| Max. Negotiated Rate |
$181.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$122.01
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$181.05
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$117.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$117.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$126.91
|
| Rate for Payer: BCBS Transplant Transplant |
$127.80
|
| Rate for Payer: Blue Shield of California Commercial |
$156.98
|
| Rate for Payer: Blue Shield of California EPN |
$124.39
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Cigna of CA HMO |
$136.32
|
| Rate for Payer: Cigna of CA PPO |
$157.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$181.05
|
| Rate for Payer: Dignity Health Media |
$181.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$181.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$85.20
|
| Rate for Payer: Galaxy Health WC |
$181.05
|
| Rate for Payer: Global Benefits Group Commercial |
$127.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$159.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$142.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.12
|
| Rate for Payer: Multiplan Commercial |
$170.40
|
| Rate for Payer: Networks By Design Commercial |
$138.45
|
| Rate for Payer: Prime Health Services Commercial |
$181.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$127.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$127.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$127.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$106.50
|
| Rate for Payer: United Healthcare All Other HMO |
$106.50
|
| Rate for Payer: United Healthcare HMO Rider |
$106.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$106.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$181.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$181.05
|
| Rate for Payer: Vantage Medical Group Senior |
$181.05
|
|
|
HC NUTRITION THER GRP 30 MIN
|
Facility
IP
|
$213.00
|
|
|
Service Code
|
CPT 97804
|
| Hospital Charge Code |
902000205
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$51.12 |
| Max. Negotiated Rate |
$181.05 |
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.20
|
| Rate for Payer: Galaxy Health WC |
$181.05
|
| Rate for Payer: Global Benefits Group Commercial |
$127.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$142.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.12
|
| Rate for Payer: Multiplan Commercial |
$170.40
|
| Rate for Payer: Networks By Design Commercial |
$138.45
|
| Rate for Payer: Prime Health Services Commercial |
$181.05
|
|
|
HC NUTRITION THER GRP 30 MIN
|
Facility
IP
|
$213.00
|
|
|
Service Code
|
CPT 97804
|
| Hospital Charge Code |
902000205
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$51.12 |
| Max. Negotiated Rate |
$181.05 |
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.20
|
| Rate for Payer: Galaxy Health WC |
$181.05
|
| Rate for Payer: Global Benefits Group Commercial |
$127.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$142.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.12
|
| Rate for Payer: Multiplan Commercial |
$170.40
|
| Rate for Payer: Networks By Design Commercial |
$138.45
|
| Rate for Payer: Prime Health Services Commercial |
$181.05
|
|
|
HC NUTRITION THER GRP 30 MIN
|
Facility
OP
|
$213.00
|
|
|
Service Code
|
CPT 97804
|
| Hospital Charge Code |
902000205
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$26.43 |
| Max. Negotiated Rate |
$785.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$122.01
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$181.05
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$117.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$117.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$126.91
|
| Rate for Payer: BCBS Transplant Transplant |
$127.80
|
| Rate for Payer: Blue Shield of California Commercial |
$156.98
|
| Rate for Payer: Blue Shield of California EPN |
$124.39
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Cigna of CA HMO |
$136.32
|
| Rate for Payer: Cigna of CA PPO |
$157.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$181.05
|
| Rate for Payer: Dignity Health Media |
$181.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$181.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$85.20
|
| Rate for Payer: Galaxy Health WC |
$181.05
|
| Rate for Payer: Global Benefits Group Commercial |
$127.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$159.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$142.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.12
|
| Rate for Payer: Multiplan Commercial |
$170.40
|
| Rate for Payer: Networks By Design Commercial |
$138.45
|
| Rate for Payer: Prime Health Services Commercial |
$181.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$127.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$127.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$127.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$602.00
|
| Rate for Payer: United Healthcare All Other HMO |
$785.00
|
| Rate for Payer: United Healthcare HMO Rider |
$593.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$542.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$181.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$181.05
|
| Rate for Payer: Vantage Medical Group Senior |
$181.05
|
|
|
HC NUTR THER INIT EVAL 15 MIN
|
Facility
OP
|
$254.00
|
|
|
Service Code
|
CPT 97802
|
| Hospital Charge Code |
902000200
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$57.66 |
| Max. Negotiated Rate |
$785.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$260.78
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$215.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$139.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$139.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$151.33
|
| Rate for Payer: BCBS Transplant Transplant |
$152.40
|
| Rate for Payer: Blue Shield of California Commercial |
$187.20
|
| Rate for Payer: Blue Shield of California EPN |
$148.34
|
| Rate for Payer: Cash Price |
$114.30
|
| Rate for Payer: Cash Price |
$114.30
|
| Rate for Payer: Cash Price |
$114.30
|
| Rate for Payer: Cigna of CA HMO |
$162.56
|
| Rate for Payer: Cigna of CA PPO |
$187.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$215.90
|
| Rate for Payer: Dignity Health Media |
$215.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$215.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$101.60
|
| Rate for Payer: Galaxy Health WC |
$215.90
|
| Rate for Payer: Global Benefits Group Commercial |
$152.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$190.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$169.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.96
|
| Rate for Payer: Multiplan Commercial |
$203.20
|
| Rate for Payer: Networks By Design Commercial |
$165.10
|
| Rate for Payer: Prime Health Services Commercial |
$215.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$152.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$152.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$152.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$602.00
|
| Rate for Payer: United Healthcare All Other HMO |
$785.00
|
| Rate for Payer: United Healthcare HMO Rider |
$593.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$542.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$215.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$215.90
|
| Rate for Payer: Vantage Medical Group Senior |
$215.90
|
|
|
HC NUTR THER INIT EVAL 15 MIN
|
Facility
IP
|
$254.00
|
|
|
Service Code
|
CPT 97802
|
| Hospital Charge Code |
902000200
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$60.96 |
| Max. Negotiated Rate |
$215.90 |
| Rate for Payer: Cash Price |
$114.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.60
|
| Rate for Payer: Galaxy Health WC |
$215.90
|
| Rate for Payer: Global Benefits Group Commercial |
$152.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$169.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$96.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.96
|
| Rate for Payer: Multiplan Commercial |
$203.20
|
| Rate for Payer: Networks By Design Commercial |
$165.10
|
| Rate for Payer: Prime Health Services Commercial |
$215.90
|
|
|
HC NUTR THER INIT EVAL 30 MN MCAL
|
Facility
IP
|
$132.00
|
|
| Hospital Charge Code |
902000206
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$31.68 |
| Max. Negotiated Rate |
$112.20 |
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.80
|
| Rate for Payer: Galaxy Health WC |
$112.20
|
| Rate for Payer: Global Benefits Group Commercial |
$79.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$88.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.68
|
| Rate for Payer: Multiplan Commercial |
$105.60
|
| Rate for Payer: Networks By Design Commercial |
$85.80
|
| Rate for Payer: Prime Health Services Commercial |
$112.20
|
|
|
HC NUTR THER INIT EVAL 30 MN MCAL
|
Facility
OP
|
$132.00
|
|
| Hospital Charge Code |
902000206
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$31.68 |
| Max. Negotiated Rate |
$112.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$86.58
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$112.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$72.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$72.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.65
|
| Rate for Payer: BCBS Transplant Transplant |
$79.20
|
| Rate for Payer: Blue Shield of California Commercial |
$97.28
|
| Rate for Payer: Blue Shield of California EPN |
$77.09
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Cigna of CA HMO |
$84.48
|
| Rate for Payer: Cigna of CA PPO |
$97.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$112.20
|
| Rate for Payer: Dignity Health Media |
$112.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$112.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$52.80
|
| Rate for Payer: Galaxy Health WC |
$112.20
|
| Rate for Payer: Global Benefits Group Commercial |
$79.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$99.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$88.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.68
|
| Rate for Payer: Multiplan Commercial |
$105.60
|
| Rate for Payer: Networks By Design Commercial |
$85.80
|
| Rate for Payer: Prime Health Services Commercial |
$112.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$79.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$79.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$79.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$66.00
|
| Rate for Payer: United Healthcare All Other HMO |
$66.00
|
| Rate for Payer: United Healthcare HMO Rider |
$66.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$66.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$112.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$112.20
|
| Rate for Payer: Vantage Medical Group Senior |
$112.20
|
|
|
HC NUTR THER-RE EVAL 15 MIN
|
Facility
IP
|
$213.00
|
|
|
Service Code
|
CPT 97803
|
| Hospital Charge Code |
902000201
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$51.12 |
| Max. Negotiated Rate |
$181.05 |
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.20
|
| Rate for Payer: Galaxy Health WC |
$181.05
|
| Rate for Payer: Global Benefits Group Commercial |
$127.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$142.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.12
|
| Rate for Payer: Multiplan Commercial |
$170.40
|
| Rate for Payer: Networks By Design Commercial |
$138.45
|
| Rate for Payer: Prime Health Services Commercial |
$181.05
|
|
|
HC NUTR THER-RE EVAL 15 MIN
|
Facility
IP
|
$213.00
|
|
|
Service Code
|
CPT 97803
|
| Hospital Charge Code |
902000201
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$51.12 |
| Max. Negotiated Rate |
$181.05 |
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.20
|
| Rate for Payer: Galaxy Health WC |
$181.05
|
| Rate for Payer: Global Benefits Group Commercial |
$127.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$142.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.12
|
| Rate for Payer: Multiplan Commercial |
$170.40
|
| Rate for Payer: Networks By Design Commercial |
$138.45
|
| Rate for Payer: Prime Health Services Commercial |
$181.05
|
|
