|
HC OPIATES CONF & ID
|
Facility
OP
|
$225.00
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
900910516
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$191.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.07
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$191.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$123.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$123.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.27
|
| Rate for Payer: BCBS Transplant Transplant |
$135.00
|
| Rate for Payer: Blue Shield of California Commercial |
$145.35
|
| Rate for Payer: Blue Shield of California EPN |
$115.20
|
| Rate for Payer: Cash Price |
$101.25
|
| Rate for Payer: Cash Price |
$101.25
|
| Rate for Payer: Cigna of CA HMO |
$144.00
|
| Rate for Payer: Cigna of CA PPO |
$166.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$191.25
|
| Rate for Payer: Dignity Health Media |
$191.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$191.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$90.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$90.00
|
| Rate for Payer: Galaxy Health WC |
$191.25
|
| Rate for Payer: Global Benefits Group Commercial |
$135.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$168.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$150.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$85.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.00
|
| Rate for Payer: Multiplan Commercial |
$180.00
|
| Rate for Payer: Networks By Design Commercial |
$146.25
|
| Rate for Payer: Prime Health Services Commercial |
$191.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$135.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$135.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$135.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$112.50
|
| Rate for Payer: United Healthcare All Other HMO |
$112.50
|
| Rate for Payer: United Healthcare HMO Rider |
$112.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$112.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$191.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$191.25
|
| Rate for Payer: Vantage Medical Group Senior |
$191.25
|
|
|
HC OPN FEM ART DELV END PRO, UNI
|
Facility
IP
|
$6,556.00
|
|
|
Service Code
|
CPT 34812
|
| Hospital Charge Code |
900034812
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,573.44 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$2,950.20
|
| Rate for Payer: Cash Price |
$2,950.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,622.40
|
| Rate for Payer: Galaxy Health WC |
$5,572.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,933.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,372.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,497.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,573.44
|
| Rate for Payer: Multiplan Commercial |
$5,244.80
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,572.60
|
|
|
HC OPN FEM ART DELV END PRO, UNI
|
Facility
OP
|
$6,556.00
|
|
|
Service Code
|
CPT 34812
|
| Hospital Charge Code |
900034812
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$120.95 |
| Max. Negotiated Rate |
$8,049.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,073.22
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,572.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,605.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,605.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,049.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,933.60
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$2,950.20
|
| Rate for Payer: Cash Price |
$2,950.20
|
| Rate for Payer: Cash Price |
$2,950.20
|
| Rate for Payer: Cigna of CA PPO |
$4,851.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,572.60
|
| Rate for Payer: Dignity Health Media |
$5,572.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,572.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,622.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,622.40
|
| Rate for Payer: Galaxy Health WC |
$5,572.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,933.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,917.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,372.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$120.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,573.44
|
| Rate for Payer: Multiplan Commercial |
$5,244.80
|
| Rate for Payer: Networks By Design Commercial |
$4,261.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,572.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,933.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,933.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,572.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,572.60
|
| Rate for Payer: Vantage Medical Group Senior |
$5,572.60
|
|
|
HC OPTIC FORAMINA
|
Facility
IP
|
$570.00
|
|
|
Service Code
|
CPT 70190
|
| Hospital Charge Code |
909001112
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$136.80 |
| Max. Negotiated Rate |
$484.50 |
| Rate for Payer: Cash Price |
$256.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$228.00
|
| Rate for Payer: Galaxy Health WC |
$484.50
|
| Rate for Payer: Global Benefits Group Commercial |
$342.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$380.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$217.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$136.80
|
| Rate for Payer: Multiplan Commercial |
$456.00
|
| Rate for Payer: Networks By Design Commercial |
$370.50
|
| Rate for Payer: Prime Health Services Commercial |
$484.50
|
|
|
HC OPTIC FORAMINA
|
Facility
OP
|
$570.00
|
|
|
Service Code
|
CPT 70190
|
| Hospital Charge Code |
909001112
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$49.36 |
| Max. Negotiated Rate |
$484.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$161.29
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$113.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$162.28
|
| Rate for Payer: BCBS Transplant Transplant |
$342.00
|
| Rate for Payer: Blue Shield of California Commercial |
$336.87
|
| Rate for Payer: Blue Shield of California EPN |
$267.33
|
| Rate for Payer: Cash Price |
$256.50
|
| Rate for Payer: Cash Price |
$256.50
|
| Rate for Payer: Cigna of CA HMO |
$364.80
|
| Rate for Payer: Cigna of CA PPO |
$421.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$170.31
|
| Rate for Payer: Dignity Health Media |
$113.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$124.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$153.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$113.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$113.54
|
| Rate for Payer: Galaxy Health WC |
$484.50
|
| Rate for Payer: Global Benefits Group Commercial |
$342.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$427.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$186.21
|
| Rate for Payer: Heritage Provider Network Transplant |
$186.21
|
| Rate for Payer: IEHP Medi-Cal |
$183.93
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$183.93
|
| Rate for Payer: IEHP Medicare Advantage |
$113.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$380.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$113.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$136.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$143.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$152.14
|
| Rate for Payer: Multiplan Commercial |
$456.00
|
| Rate for Payer: Networks By Design Commercial |
$370.50
|
| Rate for Payer: Prime Health Services Commercial |
$484.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$342.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$342.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$342.00
|
| 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: Vantage Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Vantage Medical Group Senior |
$113.54
|
|
|
HC ORBITS
|
Facility
IP
|
$1,327.00
|
|
|
Service Code
|
CPT 70200
|
| Hospital Charge Code |
909001111
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$318.48 |
| Max. Negotiated Rate |
$1,127.95 |
| Rate for Payer: Cash Price |
$597.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$530.80
|
| Rate for Payer: Galaxy Health WC |
$1,127.95
|
| Rate for Payer: Global Benefits Group Commercial |
$796.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$885.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$505.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$318.48
|
| Rate for Payer: Multiplan Commercial |
$1,061.60
|
| Rate for Payer: Networks By Design Commercial |
$862.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,127.95
|
|
|
HC ORBITS
|
Facility
OP
|
$1,327.00
|
|
|
Service Code
|
CPT 70200
|
| Hospital Charge Code |
909001111
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$71.99 |
| Max. Negotiated Rate |
$1,127.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$193.76
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$206.20
|
| Rate for Payer: BCBS Transplant Transplant |
$796.20
|
| Rate for Payer: Blue Shield of California Commercial |
$784.26
|
| Rate for Payer: Blue Shield of California EPN |
$622.36
|
| Rate for Payer: Cash Price |
$597.15
|
| Rate for Payer: Cash Price |
$597.15
|
| Rate for Payer: Cigna of CA HMO |
$849.28
|
| Rate for Payer: Cigna of CA PPO |
$981.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Media |
$137.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
| Rate for Payer: Galaxy Health WC |
$1,127.95
|
| Rate for Payer: Global Benefits Group Commercial |
$796.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$995.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$225.27
|
| Rate for Payer: Heritage Provider Network Transplant |
$225.27
|
| Rate for Payer: IEHP Medi-Cal |
$222.52
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$222.52
|
| Rate for Payer: IEHP Medicare Advantage |
$137.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$885.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$71.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$318.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$173.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
| Rate for Payer: Multiplan Commercial |
$1,061.60
|
| Rate for Payer: Networks By Design Commercial |
$862.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,127.95
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$796.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$796.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$796.20
|
| 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: Vantage Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC ORTHOTIC FITTING TRAINING 15 MIN MCAL
|
Facility
OP
|
$287.00
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
900400049
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$68.88 |
| Max. Negotiated Rate |
$421.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$163.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$243.95
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$157.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$157.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$421.00
|
| Rate for Payer: BCBS Transplant Transplant |
$172.20
|
| Rate for Payer: Blue Shield of California Commercial |
$407.00
|
| Rate for Payer: Blue Shield of California EPN |
$293.00
|
| Rate for Payer: Cash Price |
$129.15
|
| Rate for Payer: Cash Price |
$129.15
|
| Rate for Payer: Cash Price |
$129.15
|
| Rate for Payer: Cash Price |
$129.15
|
| Rate for Payer: Cigna of CA HMO |
$183.68
|
| Rate for Payer: Cigna of CA PPO |
$212.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$243.95
|
| Rate for Payer: Dignity Health Media |
$243.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$243.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$114.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$114.80
|
| Rate for Payer: Galaxy Health WC |
$243.95
|
| Rate for Payer: Global Benefits Group Commercial |
$172.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$215.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$191.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.88
|
| Rate for Payer: Multiplan Commercial |
$229.60
|
| Rate for Payer: Networks By Design Commercial |
$186.55
|
| Rate for Payer: Prime Health Services Commercial |
$243.95
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$172.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$243.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$243.95
|
| Rate for Payer: Vantage Medical Group Senior |
$243.95
|
|
|
HC ORTHOTIC FITTING TRAINING 15 MIN MCAL
|
Facility
IP
|
$287.00
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
900400049
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$68.88 |
| Max. Negotiated Rate |
$243.95 |
| Rate for Payer: Cash Price |
$129.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$114.80
|
| Rate for Payer: Galaxy Health WC |
$243.95
|
| Rate for Payer: Global Benefits Group Commercial |
$172.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$191.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.88
|
| Rate for Payer: Multiplan Commercial |
$229.60
|
| Rate for Payer: Networks By Design Commercial |
$186.55
|
| Rate for Payer: Prime Health Services Commercial |
$243.95
|
|
|
HC ORTHOTIC TRAINING 15 MIN MCAL
|
Facility
OP
|
$287.00
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
901300078
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$68.88 |
| Max. Negotiated Rate |
$421.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$163.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$243.95
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$157.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$157.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$421.00
|
| Rate for Payer: BCBS Transplant Transplant |
$172.20
|
| Rate for Payer: Blue Shield of California Commercial |
$407.00
|
| Rate for Payer: Blue Shield of California EPN |
$293.00
|
| Rate for Payer: Cash Price |
$129.15
|
| Rate for Payer: Cash Price |
$129.15
|
| Rate for Payer: Cash Price |
$129.15
|
| Rate for Payer: Cash Price |
$129.15
|
| Rate for Payer: Cigna of CA HMO |
$183.68
|
| Rate for Payer: Cigna of CA PPO |
$212.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$243.95
|
| Rate for Payer: Dignity Health Media |
$243.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$243.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$114.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$114.80
|
| Rate for Payer: Galaxy Health WC |
$243.95
|
| Rate for Payer: Global Benefits Group Commercial |
$172.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$215.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$191.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.88
|
| Rate for Payer: Multiplan Commercial |
$229.60
|
| Rate for Payer: Networks By Design Commercial |
$186.55
|
| Rate for Payer: Prime Health Services Commercial |
$243.95
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$172.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$243.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$243.95
|
| Rate for Payer: Vantage Medical Group Senior |
$243.95
|
|
|
HC ORTHOTIC TRAINING 15 MIN MCAL
|
Facility
IP
|
$287.00
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
901300078
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$68.88 |
| Max. Negotiated Rate |
$243.95 |
| Rate for Payer: Cash Price |
$129.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$114.80
|
| Rate for Payer: Galaxy Health WC |
$243.95
|
| Rate for Payer: Global Benefits Group Commercial |
$172.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$191.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.88
|
| Rate for Payer: Multiplan Commercial |
$229.60
|
| Rate for Payer: Networks By Design Commercial |
$186.55
|
| Rate for Payer: Prime Health Services Commercial |
$243.95
|
|
|
HC OSCALSIS (HEEL)
|
Facility
OP
|
$706.00
|
|
|
Service Code
|
CPT 73650
|
| Hospital Charge Code |
909001633
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$36.14 |
| Max. Negotiated Rate |
$600.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$126.60
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$113.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$123.59
|
| Rate for Payer: BCBS Transplant Transplant |
$423.60
|
| Rate for Payer: Blue Shield of California Commercial |
$417.25
|
| Rate for Payer: Blue Shield of California EPN |
$331.11
|
| Rate for Payer: Cash Price |
$317.70
|
| Rate for Payer: Cash Price |
$317.70
|
| Rate for Payer: Cigna of CA HMO |
$451.84
|
| Rate for Payer: Cigna of CA PPO |
$522.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$170.31
|
| Rate for Payer: Dignity Health Media |
$113.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$124.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$153.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$113.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$113.54
|
| Rate for Payer: Galaxy Health WC |
$600.10
|
| Rate for Payer: Global Benefits Group Commercial |
$423.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$529.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$186.21
|
| Rate for Payer: Heritage Provider Network Transplant |
$186.21
|
| Rate for Payer: IEHP Medi-Cal |
$183.93
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$183.93
|
| Rate for Payer: IEHP Medicare Advantage |
$113.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$470.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$113.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$169.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$143.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$152.14
|
| Rate for Payer: Multiplan Commercial |
$564.80
|
| Rate for Payer: Networks By Design Commercial |
$458.90
|
| Rate for Payer: Prime Health Services Commercial |
$600.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$423.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$423.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$423.60
|
| 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: Vantage Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Vantage Medical Group Senior |
$113.54
|
|
|
HC OSCALSIS (HEEL)
|
Facility
IP
|
$706.00
|
|
|
Service Code
|
CPT 73650
|
| Hospital Charge Code |
909001633
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$169.44 |
| Max. Negotiated Rate |
$600.10 |
| Rate for Payer: Cash Price |
$317.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.40
|
| Rate for Payer: Galaxy Health WC |
$600.10
|
| Rate for Payer: Global Benefits Group Commercial |
$423.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$470.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$268.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$169.44
|
| Rate for Payer: Multiplan Commercial |
$564.80
|
| Rate for Payer: Networks By Design Commercial |
$458.90
|
| Rate for Payer: Prime Health Services Commercial |
$600.10
|
|
|
HC OSMOLALITY STOOL
|
Facility
OP
|
$26.00
|
|
|
Service Code
|
CPT 83935
|
| Hospital Charge Code |
900910358
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.53 |
| Max. Negotiated Rate |
$62.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56.66
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.23
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.22
|
| Rate for Payer: BCBS Transplant Transplant |
$15.60
|
| Rate for Payer: Blue Shield of California Commercial |
$16.80
|
| Rate for Payer: Blue Shield of California EPN |
$13.31
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cigna of CA HMO |
$16.64
|
| Rate for Payer: Cigna of CA PPO |
$19.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.23
|
| Rate for Payer: Dignity Health Media |
$6.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.82
|
| Rate for Payer: Galaxy Health WC |
$22.10
|
| Rate for Payer: Global Benefits Group Commercial |
$15.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$19.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.18
|
| Rate for Payer: Heritage Provider Network Transplant |
$11.18
|
| Rate for Payer: IEHP Medi-Cal |
$11.05
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$11.05
|
| Rate for Payer: IEHP Medicare Advantage |
$6.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.14
|
| Rate for Payer: Multiplan Commercial |
$20.80
|
| Rate for Payer: Networks By Design Commercial |
$16.90
|
| Rate for Payer: Prime Health Services Commercial |
$22.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.53
|
| Rate for Payer: United Healthcare All Other HMO |
$5.53
|
| Rate for Payer: United Healthcare HMO Rider |
$5.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.50
|
| Rate for Payer: Vantage Medical Group Senior |
$6.82
|
|
|
HC OSMOLALITY URINE
|
Facility
OP
|
$26.00
|
|
|
Service Code
|
CPT 83935
|
| Hospital Charge Code |
900910214
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.53 |
| Max. Negotiated Rate |
$62.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56.66
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.23
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.22
|
| Rate for Payer: BCBS Transplant Transplant |
$15.60
|
| Rate for Payer: Blue Shield of California Commercial |
$16.80
|
| Rate for Payer: Blue Shield of California EPN |
$13.31
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cigna of CA HMO |
$16.64
|
| Rate for Payer: Cigna of CA PPO |
$19.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.23
|
| Rate for Payer: Dignity Health Media |
$6.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.82
|
| Rate for Payer: Galaxy Health WC |
$22.10
|
| Rate for Payer: Global Benefits Group Commercial |
$15.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$19.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.18
|
| Rate for Payer: Heritage Provider Network Transplant |
$11.18
|
| Rate for Payer: IEHP Medi-Cal |
$11.05
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$11.05
|
| Rate for Payer: IEHP Medicare Advantage |
$6.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.14
|
| Rate for Payer: Multiplan Commercial |
$20.80
|
| Rate for Payer: Networks By Design Commercial |
$16.90
|
| Rate for Payer: Prime Health Services Commercial |
$22.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.53
|
| Rate for Payer: United Healthcare All Other HMO |
$5.53
|
| Rate for Payer: United Healthcare HMO Rider |
$5.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.50
|
| Rate for Payer: Vantage Medical Group Senior |
$6.82
|
|
|
HC OSMOTIC FRAGILITY
|
Facility
OP
|
$54.00
|
|
|
Service Code
|
CPT 85555
|
| Hospital Charge Code |
900910039
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.05 |
| Max. Negotiated Rate |
$60.99 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55.62
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.22
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$60.99
|
| Rate for Payer: BCBS Transplant Transplant |
$32.40
|
| Rate for Payer: Blue Shield of California Commercial |
$34.88
|
| Rate for Payer: Blue Shield of California EPN |
$27.65
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cigna of CA HMO |
$34.56
|
| Rate for Payer: Cigna of CA PPO |
$39.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.20
|
| Rate for Payer: Dignity Health Media |
$7.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.08
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7.47
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.47
|
| Rate for Payer: Galaxy Health WC |
$45.90
|
| Rate for Payer: Global Benefits Group Commercial |
$32.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$40.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.25
|
| Rate for Payer: Heritage Provider Network Transplant |
$12.25
|
| Rate for Payer: IEHP Medi-Cal |
$12.10
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$12.10
|
| Rate for Payer: IEHP Medicare Advantage |
$7.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.01
|
| Rate for Payer: Multiplan Commercial |
$43.20
|
| Rate for Payer: Networks By Design Commercial |
$35.10
|
| Rate for Payer: Prime Health Services Commercial |
$45.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$32.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$32.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.05
|
| Rate for Payer: United Healthcare All Other HMO |
$6.05
|
| Rate for Payer: United Healthcare HMO Rider |
$6.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.22
|
| Rate for Payer: Vantage Medical Group Senior |
$7.47
|
|
|
HC OSMOTIC FRAGILITY (INC)
|
Facility
OP
|
$52.00
|
|
|
Service Code
|
CPT 85557
|
| Hospital Charge Code |
900910077
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$10.82 |
| Max. Negotiated Rate |
$121.87 |
| Rate for Payer: Aetna of CA HMO/PPO |
$111.10
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$121.87
|
| Rate for Payer: BCBS Transplant Transplant |
$31.20
|
| Rate for Payer: Blue Shield of California Commercial |
$33.59
|
| Rate for Payer: Blue Shield of California EPN |
$26.62
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cigna of CA HMO |
$33.28
|
| Rate for Payer: Cigna of CA PPO |
$38.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.04
|
| Rate for Payer: Dignity Health Media |
$13.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.04
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.36
|
| Rate for Payer: Galaxy Health WC |
$44.20
|
| Rate for Payer: Global Benefits Group Commercial |
$31.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$39.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$21.91
|
| Rate for Payer: Heritage Provider Network Transplant |
$21.91
|
| Rate for Payer: IEHP Medi-Cal |
$21.64
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$21.64
|
| Rate for Payer: IEHP Medicare Advantage |
$13.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.90
|
| Rate for Payer: Multiplan Commercial |
$41.60
|
| Rate for Payer: Networks By Design Commercial |
$33.80
|
| Rate for Payer: Prime Health Services Commercial |
$44.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$31.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.82
|
| Rate for Payer: United Healthcare All Other HMO |
$10.82
|
| Rate for Payer: United Healthcare HMO Rider |
$10.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.70
|
| Rate for Payer: Vantage Medical Group Senior |
$13.36
|
|
|
HC OT EVALUATION EA ADDL 15 MIN
|
Facility
OP
|
$64.00
|
|
| Hospital Charge Code |
908600171
|
|
Hospital Revenue Code
|
434
|
| Min. Negotiated Rate |
$15.36 |
| Max. Negotiated Rate |
$421.00 |
| 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 |
$421.00
|
| Rate for Payer: BCBS Transplant Transplant |
$38.40
|
| Rate for Payer: Blue Shield of California Commercial |
$407.00
|
| Rate for Payer: Blue Shield of California EPN |
$293.00
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| 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 |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| 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 OT EVALUATION EA ADDL 15 MIN
|
Facility
IP
|
$64.00
|
|
| Hospital Charge Code |
908600171
|
|
Hospital Revenue Code
|
434
|
| 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 OTHER ALLIED CONF PARTCP 15MIN
|
Facility
IP
|
$47.00
|
|
| Hospital Charge Code |
908602559
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$11.28 |
| Max. Negotiated Rate |
$39.95 |
| Rate for Payer: Cash Price |
$21.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.80
|
| Rate for Payer: Galaxy Health WC |
$39.95
|
| Rate for Payer: Global Benefits Group Commercial |
$28.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.28
|
| Rate for Payer: Multiplan Commercial |
$37.60
|
| Rate for Payer: Networks By Design Commercial |
$30.55
|
| Rate for Payer: Prime Health Services Commercial |
$39.95
|
|
|
HC OTHER ALLIED CONF PARTCP 15MIN
|
Facility
IP
|
$50.00
|
|
| Hospital Charge Code |
908600159
|
|
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 OTHER ALLIED CONF PARTCP 15MIN
|
Facility
OP
|
$47.00
|
|
| Hospital Charge Code |
908602559
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$11.28 |
| Max. Negotiated Rate |
$39.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30.83
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$39.95
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$25.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$25.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.00
|
| Rate for Payer: BCBS Transplant Transplant |
$28.20
|
| Rate for Payer: Blue Shield of California Commercial |
$34.64
|
| Rate for Payer: Blue Shield of California EPN |
$27.45
|
| Rate for Payer: Cash Price |
$21.15
|
| Rate for Payer: Cigna of CA HMO |
$30.08
|
| Rate for Payer: Cigna of CA PPO |
$34.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$39.95
|
| Rate for Payer: Dignity Health Media |
$39.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$39.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.80
|
| Rate for Payer: Galaxy Health WC |
$39.95
|
| Rate for Payer: Global Benefits Group Commercial |
$28.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$35.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.28
|
| Rate for Payer: Multiplan Commercial |
$37.60
|
| Rate for Payer: Networks By Design Commercial |
$30.55
|
| Rate for Payer: Prime Health Services Commercial |
$39.95
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$28.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.50
|
| Rate for Payer: United Healthcare All Other HMO |
$23.50
|
| Rate for Payer: United Healthcare HMO Rider |
$23.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$39.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$39.95
|
| Rate for Payer: Vantage Medical Group Senior |
$39.95
|
|
|
HC OTHER ALLIED CONF PARTCP 15MIN
|
Facility
OP
|
$50.00
|
|
| Hospital Charge Code |
908600159
|
|
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 OTHER ALLIED HLTH CONF COORD
|
Facility
IP
|
$270.00
|
|
| Hospital Charge Code |
908600155
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$64.80 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Cash Price |
$121.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$108.00
|
| Rate for Payer: Galaxy Health WC |
$229.50
|
| Rate for Payer: Global Benefits Group Commercial |
$162.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$180.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.80
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Networks By Design Commercial |
$175.50
|
| Rate for Payer: Prime Health Services Commercial |
$229.50
|
|
|
HC OTHER ALLIED HLTH CONF COORD
|
Facility
OP
|
$270.00
|
|
| Hospital Charge Code |
908600155
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$64.80 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$177.09
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$229.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$148.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$148.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$160.87
|
| Rate for Payer: BCBS Transplant Transplant |
$162.00
|
| Rate for Payer: Blue Shield of California Commercial |
$198.99
|
| Rate for Payer: Blue Shield of California EPN |
$157.68
|
| Rate for Payer: Cash Price |
$121.50
|
| Rate for Payer: Cigna of CA HMO |
$172.80
|
| Rate for Payer: Cigna of CA PPO |
$199.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$229.50
|
| Rate for Payer: Dignity Health Media |
$229.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$229.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$108.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$108.00
|
| Rate for Payer: Galaxy Health WC |
$229.50
|
| Rate for Payer: Global Benefits Group Commercial |
$162.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$202.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$180.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.80
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Networks By Design Commercial |
$175.50
|
| Rate for Payer: Prime Health Services Commercial |
$229.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$162.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$162.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$162.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$135.00
|
| Rate for Payer: United Healthcare All Other HMO |
$135.00
|
| Rate for Payer: United Healthcare HMO Rider |
$135.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$135.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$229.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$229.50
|
| Rate for Payer: Vantage Medical Group Senior |
$229.50
|
|
