|
HC VEEG 21-12HR UNMNTRD
|
Facility
OP
|
$944.00
|
|
|
Service Code
|
CPT 95711
|
| Hospital Charge Code |
900605711
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$226.56 |
| Max. Negotiated Rate |
$1,935.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$794.15
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$392.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$562.44
|
| Rate for Payer: BCBS Transplant Transplant |
$566.40
|
| Rate for Payer: Blue Shield of California Commercial |
$557.90
|
| Rate for Payer: Blue Shield of California EPN |
$442.74
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cigna of CA HMO |
$604.16
|
| Rate for Payer: Cigna of CA PPO |
$698.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.26
|
| Rate for Payer: Dignity Health Media |
$392.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$529.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$392.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$392.17
|
| Rate for Payer: Galaxy Health WC |
$802.40
|
| Rate for Payer: Global Benefits Group Commercial |
$566.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$708.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$643.16
|
| Rate for Payer: Heritage Provider Network Transplant |
$643.16
|
| Rate for Payer: IEHP Medi-Cal |
$635.32
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$635.32
|
| Rate for Payer: IEHP Medicare Advantage |
$392.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$629.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$421.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$226.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$494.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$525.51
|
| Rate for Payer: Multiplan Commercial |
$755.20
|
| Rate for Payer: Networks By Design Commercial |
$613.60
|
| Rate for Payer: Prime Health Services Commercial |
$802.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$566.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$566.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$566.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,935.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,806.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,323.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Vantage Medical Group Senior |
$392.17
|
|
|
HC VEEG 2-12HR CONT MNTRD
|
Facility
IP
|
$1,812.00
|
|
|
Service Code
|
CPT 95713
|
| Hospital Charge Code |
900605713
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$434.88 |
| Max. Negotiated Rate |
$1,540.20 |
| Rate for Payer: Cash Price |
$815.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$724.80
|
| Rate for Payer: Galaxy Health WC |
$1,540.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,087.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,208.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$690.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$434.88
|
| Rate for Payer: Multiplan Commercial |
$1,449.60
|
| Rate for Payer: Networks By Design Commercial |
$1,177.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,540.20
|
|
|
HC VEEG 2-12HR CONT MNTRD
|
Facility
OP
|
$1,812.00
|
|
|
Service Code
|
CPT 95713
|
| Hospital Charge Code |
900605713
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$434.88 |
| Max. Negotiated Rate |
$3,976.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,976.03
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,004.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$736.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$669.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,079.59
|
| Rate for Payer: BCBS Transplant Transplant |
$1,087.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,070.89
|
| Rate for Payer: Blue Shield of California EPN |
$849.83
|
| Rate for Payer: Cash Price |
$815.40
|
| Rate for Payer: Cash Price |
$815.40
|
| Rate for Payer: Cash Price |
$815.40
|
| Rate for Payer: Cigna of CA HMO |
$1,159.68
|
| Rate for Payer: Cigna of CA PPO |
$1,340.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,004.52
|
| Rate for Payer: Dignity Health Media |
$669.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$736.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$904.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$669.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$669.68
|
| Rate for Payer: Galaxy Health WC |
$1,540.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,087.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,359.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,098.28
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,098.28
|
| Rate for Payer: IEHP Medi-Cal |
$1,084.88
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$1,084.88
|
| Rate for Payer: IEHP Medicare Advantage |
$669.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,208.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,386.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$669.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$434.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$843.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$897.37
|
| Rate for Payer: Multiplan Commercial |
$1,449.60
|
| Rate for Payer: Networks By Design Commercial |
$1,177.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,540.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,087.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,087.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,087.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,935.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,806.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,323.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,004.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$736.65
|
| Rate for Payer: Vantage Medical Group Senior |
$669.68
|
|
|
HC VEEG EA 12-26HR CONT MNTRD
|
Facility
OP
|
$3,391.00
|
|
|
Service Code
|
CPT 95716
|
| Hospital Charge Code |
900605716
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$813.84 |
| Max. Negotiated Rate |
$7,952.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,952.69
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,959.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,436.96
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,306.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,020.36
|
| Rate for Payer: BCBS Transplant Transplant |
$2,034.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,004.08
|
| Rate for Payer: Blue Shield of California EPN |
$1,590.38
|
| Rate for Payer: Cash Price |
$1,525.95
|
| Rate for Payer: Cash Price |
$1,525.95
|
| Rate for Payer: Cash Price |
$1,525.95
|
| Rate for Payer: Cigna of CA HMO |
$2,170.24
|
| Rate for Payer: Cigna of CA PPO |
$2,509.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,959.50
|
| Rate for Payer: Dignity Health Media |
$1,306.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,436.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,763.55
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,306.33
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,306.33
|
| Rate for Payer: Galaxy Health WC |
$2,882.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,034.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,543.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,142.38
|
| Rate for Payer: Heritage Provider Network Transplant |
$2,142.38
|
| Rate for Payer: IEHP Medi-Cal |
$2,116.25
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$2,116.25
|
| Rate for Payer: IEHP Medicare Advantage |
$1,306.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,261.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,222.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,306.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$813.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,645.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,750.48
|
| Rate for Payer: Multiplan Commercial |
$2,712.80
|
| Rate for Payer: Networks By Design Commercial |
$2,204.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,882.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,034.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,034.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,034.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,935.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,806.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,323.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,959.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,436.96
|
| Rate for Payer: Vantage Medical Group Senior |
$1,306.33
|
|
|
HC VEEG EA 12-26HR CONT MNTRD
|
Facility
IP
|
$3,391.00
|
|
|
Service Code
|
CPT 95716
|
| Hospital Charge Code |
900605716
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$813.84 |
| Max. Negotiated Rate |
$2,882.35 |
| Rate for Payer: Cash Price |
$1,525.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,356.40
|
| Rate for Payer: Galaxy Health WC |
$2,882.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,034.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,261.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,291.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$813.84
|
| Rate for Payer: Multiplan Commercial |
$2,712.80
|
| Rate for Payer: Networks By Design Commercial |
$2,204.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,882.35
|
|
|
HC VEEG EA 12-26HR INTMT MNTRD
|
Facility
IP
|
$1,812.00
|
|
|
Service Code
|
CPT 95715
|
| Hospital Charge Code |
900605715
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$434.88 |
| Max. Negotiated Rate |
$1,540.20 |
| Rate for Payer: Cash Price |
$815.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$724.80
|
| Rate for Payer: Galaxy Health WC |
$1,540.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,087.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,208.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$690.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$434.88
|
| Rate for Payer: Multiplan Commercial |
$1,449.60
|
| Rate for Payer: Networks By Design Commercial |
$1,177.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,540.20
|
|
|
HC VEEG EA 12-26HR INTMT MNTRD
|
Facility
OP
|
$1,812.00
|
|
|
Service Code
|
CPT 95715
|
| Hospital Charge Code |
900605715
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$434.88 |
| Max. Negotiated Rate |
$6,361.47 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6,361.47
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,004.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$736.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$669.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,079.59
|
| Rate for Payer: BCBS Transplant Transplant |
$1,087.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,070.89
|
| Rate for Payer: Blue Shield of California EPN |
$849.83
|
| Rate for Payer: Cash Price |
$815.40
|
| Rate for Payer: Cash Price |
$815.40
|
| Rate for Payer: Cash Price |
$815.40
|
| Rate for Payer: Cigna of CA HMO |
$1,159.68
|
| Rate for Payer: Cigna of CA PPO |
$1,340.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,004.52
|
| Rate for Payer: Dignity Health Media |
$669.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$736.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$904.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$669.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$669.68
|
| Rate for Payer: Galaxy Health WC |
$1,540.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,087.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,359.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,098.28
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,098.28
|
| Rate for Payer: IEHP Medi-Cal |
$1,084.88
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$1,084.88
|
| Rate for Payer: IEHP Medicare Advantage |
$669.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,208.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,241.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$669.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$434.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$843.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$897.37
|
| Rate for Payer: Multiplan Commercial |
$1,449.60
|
| Rate for Payer: Networks By Design Commercial |
$1,177.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,540.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,087.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,087.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,087.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,935.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,806.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,323.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,004.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$736.65
|
| Rate for Payer: Vantage Medical Group Senior |
$669.68
|
|
|
HC VEEG EA 12-26HR UNMNTRD
|
Facility
IP
|
$1,812.00
|
|
|
Service Code
|
CPT 95714
|
| Hospital Charge Code |
900605714
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$434.88 |
| Max. Negotiated Rate |
$1,540.20 |
| Rate for Payer: Cash Price |
$815.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$724.80
|
| Rate for Payer: Galaxy Health WC |
$1,540.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,087.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,208.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$690.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$434.88
|
| Rate for Payer: Multiplan Commercial |
$1,449.60
|
| Rate for Payer: Networks By Design Commercial |
$1,177.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,540.20
|
|
|
HC VEEG EA 12-26HR UNMNTRD
|
Facility
OP
|
$1,812.00
|
|
|
Service Code
|
CPT 95714
|
| Hospital Charge Code |
900605714
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$434.88 |
| Max. Negotiated Rate |
$1,935.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,272.53
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,004.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$736.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$669.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,079.59
|
| Rate for Payer: BCBS Transplant Transplant |
$1,087.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,070.89
|
| Rate for Payer: Blue Shield of California EPN |
$849.83
|
| Rate for Payer: Cash Price |
$815.40
|
| Rate for Payer: Cash Price |
$815.40
|
| Rate for Payer: Cash Price |
$815.40
|
| Rate for Payer: Cigna of CA HMO |
$1,159.68
|
| Rate for Payer: Cigna of CA PPO |
$1,340.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,004.52
|
| Rate for Payer: Dignity Health Media |
$669.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$736.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$904.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$669.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$669.68
|
| Rate for Payer: Galaxy Health WC |
$1,540.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,087.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,359.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,098.28
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,098.28
|
| Rate for Payer: IEHP Medi-Cal |
$1,084.88
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$1,084.88
|
| Rate for Payer: IEHP Medicare Advantage |
$669.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,208.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$503.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$669.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$434.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$843.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$897.37
|
| Rate for Payer: Multiplan Commercial |
$1,449.60
|
| Rate for Payer: Networks By Design Commercial |
$1,177.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,540.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,087.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,087.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,087.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,935.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,806.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,323.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,004.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$736.65
|
| Rate for Payer: Vantage Medical Group Senior |
$669.68
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
OP
|
$405.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$49.51 |
| Max. Negotiated Rate |
$6,668.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$57.98
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$344.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$222.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$222.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: BCBS Transplant Transplant |
$243.00
|
| 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 |
$182.25
|
| Rate for Payer: Cash Price |
$182.25
|
| Rate for Payer: Cash Price |
$182.25
|
| Rate for Payer: Cigna of CA PPO |
$299.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$344.25
|
| Rate for Payer: Dignity Health Media |
$344.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$344.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$162.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$162.00
|
| Rate for Payer: Galaxy Health WC |
$344.25
|
| Rate for Payer: Global Benefits Group Commercial |
$243.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$303.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$270.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.20
|
| Rate for Payer: Multiplan Commercial |
$324.00
|
| Rate for Payer: Networks By Design Commercial |
$263.25
|
| Rate for Payer: Prime Health Services Commercial |
$344.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$243.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$243.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$344.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$344.25
|
| Rate for Payer: Vantage Medical Group Senior |
$344.25
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
IP
|
$405.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$97.20 |
| Max. Negotiated Rate |
$344.25 |
| Rate for Payer: Cash Price |
$182.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$162.00
|
| Rate for Payer: Galaxy Health WC |
$344.25
|
| Rate for Payer: Global Benefits Group Commercial |
$243.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$270.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$154.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.20
|
| Rate for Payer: Multiplan Commercial |
$324.00
|
| Rate for Payer: Networks By Design Commercial |
$263.25
|
| Rate for Payer: Prime Health Services Commercial |
$344.25
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
OP
|
$405.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$49.51 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$344.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$222.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$222.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: BCBS Transplant Transplant |
$243.00
|
| Rate for Payer: Cash Price |
$182.25
|
| Rate for Payer: Cash Price |
$182.25
|
| Rate for Payer: Cash Price |
$182.25
|
| Rate for Payer: Cigna of CA PPO |
$299.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$344.25
|
| Rate for Payer: Dignity Health Media |
$344.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$344.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$162.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$162.00
|
| Rate for Payer: Galaxy Health WC |
$344.25
|
| Rate for Payer: Global Benefits Group Commercial |
$243.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$303.75
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$270.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.20
|
| Rate for Payer: Multiplan Commercial |
$324.00
|
| Rate for Payer: Networks By Design Commercial |
$263.25
|
| Rate for Payer: Prime Health Services Commercial |
$344.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$243.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$243.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$202.50
|
| Rate for Payer: United Healthcare All Other HMO |
$202.50
|
| Rate for Payer: United Healthcare HMO Rider |
$202.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$202.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$344.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$344.25
|
| Rate for Payer: Vantage Medical Group Senior |
$344.25
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
IP
|
$405.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$97.20 |
| Max. Negotiated Rate |
$344.25 |
| Rate for Payer: Cash Price |
$182.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$162.00
|
| Rate for Payer: Galaxy Health WC |
$344.25
|
| Rate for Payer: Global Benefits Group Commercial |
$243.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$270.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$154.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.20
|
| Rate for Payer: Multiplan Commercial |
$324.00
|
| Rate for Payer: Networks By Design Commercial |
$263.25
|
| Rate for Payer: Prime Health Services Commercial |
$344.25
|
|
|
HC VELOPHARYNGEAL STUDY
|
Facility
OP
|
$934.00
|
|
|
Service Code
|
CPT 70371
|
| Hospital Charge Code |
909001252
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$224.16 |
| Max. Negotiated Rate |
$793.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$340.94
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$459.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$336.78
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$306.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$541.08
|
| Rate for Payer: BCBS Transplant Transplant |
$560.40
|
| Rate for Payer: Blue Shield of California Commercial |
$551.99
|
| Rate for Payer: Blue Shield of California EPN |
$438.05
|
| Rate for Payer: Cash Price |
$420.30
|
| Rate for Payer: Cash Price |
$420.30
|
| Rate for Payer: Cigna of CA HMO |
$597.76
|
| Rate for Payer: Cigna of CA PPO |
$691.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$459.24
|
| Rate for Payer: Dignity Health Media |
$306.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$336.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$413.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$306.16
|
| Rate for Payer: EPIC Health Plan Transplant |
$306.16
|
| Rate for Payer: Galaxy Health WC |
$793.90
|
| Rate for Payer: Global Benefits Group Commercial |
$560.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$700.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$502.10
|
| Rate for Payer: Heritage Provider Network Transplant |
$502.10
|
| Rate for Payer: IEHP Medi-Cal |
$495.98
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$495.98
|
| Rate for Payer: IEHP Medicare Advantage |
$306.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$622.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$355.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$306.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$224.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$385.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$410.25
|
| Rate for Payer: Multiplan Commercial |
$747.20
|
| Rate for Payer: Networks By Design Commercial |
$607.10
|
| Rate for Payer: Prime Health Services Commercial |
$793.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$560.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$560.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$560.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$225.63
|
| Rate for Payer: United Healthcare All Other HMO |
$225.63
|
| Rate for Payer: United Healthcare HMO Rider |
$225.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$225.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$459.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$336.78
|
| Rate for Payer: Vantage Medical Group Senior |
$306.16
|
|
|
HC VELOPHARYNGEAL STUDY
|
Facility
IP
|
$934.00
|
|
|
Service Code
|
CPT 70371
|
| Hospital Charge Code |
909001252
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$224.16 |
| Max. Negotiated Rate |
$793.90 |
| Rate for Payer: Cash Price |
$420.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$373.60
|
| Rate for Payer: Galaxy Health WC |
$793.90
|
| Rate for Payer: Global Benefits Group Commercial |
$560.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$622.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$355.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$224.16
|
| Rate for Payer: Multiplan Commercial |
$747.20
|
| Rate for Payer: Networks By Design Commercial |
$607.10
|
| Rate for Payer: Prime Health Services Commercial |
$793.90
|
|
|
HC VENIPUNCTURECUTDOWN GT 1YR
|
Facility
IP
|
$615.00
|
|
|
Service Code
|
CPT 36425
|
| Hospital Charge Code |
900501336
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$147.60 |
| Max. Negotiated Rate |
$522.75 |
| Rate for Payer: Cash Price |
$276.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$246.00
|
| Rate for Payer: Galaxy Health WC |
$522.75
|
| Rate for Payer: Global Benefits Group Commercial |
$369.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$410.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$234.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.60
|
| Rate for Payer: Multiplan Commercial |
$492.00
|
| Rate for Payer: Networks By Design Commercial |
$399.75
|
| Rate for Payer: Prime Health Services Commercial |
$522.75
|
|
|
HC VENIPUNCTURECUTDOWN GT 1YR
|
Facility
OP
|
$615.00
|
|
|
Service Code
|
CPT 36425
|
| Hospital Charge Code |
900501336
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$113.89 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$746.73
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$547.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$497.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: BCBS Transplant Transplant |
$369.00
|
| Rate for Payer: Cash Price |
$276.75
|
| Rate for Payer: Cash Price |
$276.75
|
| Rate for Payer: Cash Price |
$276.75
|
| Rate for Payer: Cigna of CA PPO |
$455.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$746.73
|
| Rate for Payer: Dignity Health Media |
$497.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$547.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$672.06
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$497.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$497.82
|
| Rate for Payer: Galaxy Health WC |
$522.75
|
| Rate for Payer: Global Benefits Group Commercial |
$369.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$461.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$816.42
|
| Rate for Payer: Heritage Provider Network Transplant |
$816.42
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$497.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$410.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$113.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$497.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$627.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$667.08
|
| Rate for Payer: Multiplan Commercial |
$492.00
|
| Rate for Payer: Networks By Design Commercial |
$399.75
|
| Rate for Payer: Prime Health Services Commercial |
$522.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$369.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$369.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$307.50
|
| Rate for Payer: United Healthcare All Other HMO |
$307.50
|
| Rate for Payer: United Healthcare HMO Rider |
$307.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$307.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$746.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$547.60
|
| Rate for Payer: Vantage Medical Group Senior |
$497.82
|
|
|
HC VENIPUNCTURE GT 3 YRS OLD
|
Facility
IP
|
$154.00
|
|
|
Service Code
|
CPT 36410
|
| Hospital Charge Code |
910100005
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.96 |
| Max. Negotiated Rate |
$130.90 |
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.60
|
| Rate for Payer: Galaxy Health WC |
$130.90
|
| Rate for Payer: Global Benefits Group Commercial |
$92.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$102.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$58.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.96
|
| Rate for Payer: Multiplan Commercial |
$123.20
|
| Rate for Payer: Networks By Design Commercial |
$100.10
|
| Rate for Payer: Prime Health Services Commercial |
$130.90
|
|
|
HC VENIPUNCTURE GT 3 YRS OLD
|
Facility
OP
|
$154.00
|
|
|
Service Code
|
CPT 36410
|
| Hospital Charge Code |
910100005
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.52 |
| Max. Negotiated Rate |
$130.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55.83
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$130.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$84.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$84.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$91.75
|
| Rate for Payer: BCBS Transplant Transplant |
$92.40
|
| Rate for Payer: Blue Shield of California Commercial |
$99.48
|
| Rate for Payer: Blue Shield of California EPN |
$78.85
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Cigna of CA HMO |
$98.56
|
| Rate for Payer: Cigna of CA PPO |
$113.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$130.90
|
| Rate for Payer: Dignity Health Media |
$130.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$130.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$61.60
|
| Rate for Payer: Galaxy Health WC |
$130.90
|
| Rate for Payer: Global Benefits Group Commercial |
$92.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$115.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$102.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.96
|
| Rate for Payer: Multiplan Commercial |
$123.20
|
| Rate for Payer: Networks By Design Commercial |
$100.10
|
| Rate for Payer: Prime Health Services Commercial |
$130.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$92.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$92.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$92.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$77.00
|
| Rate for Payer: United Healthcare All Other HMO |
$77.00
|
| Rate for Payer: United Healthcare HMO Rider |
$77.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$77.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$130.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$130.90
|
| Rate for Payer: Vantage Medical Group Senior |
$130.90
|
|
|
HC VENIPUNCTURE W SPECIMEN
|
Facility
OP
|
$58.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
900510279
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.43 |
| Max. Negotiated Rate |
$49.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17.94
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.86
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.43
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.53
|
| Rate for Payer: BCBS Transplant Transplant |
$34.80
|
| Rate for Payer: Blue Shield of California Commercial |
$37.47
|
| Rate for Payer: Blue Shield of California EPN |
$29.70
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cigna of CA HMO |
$37.12
|
| Rate for Payer: Cigna of CA PPO |
$42.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.86
|
| Rate for Payer: Dignity Health Media |
$8.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.57
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.57
|
| Rate for Payer: Galaxy Health WC |
$49.30
|
| Rate for Payer: Global Benefits Group Commercial |
$34.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$43.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.05
|
| Rate for Payer: Heritage Provider Network Transplant |
$14.05
|
| Rate for Payer: IEHP Medi-Cal |
$13.88
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$13.88
|
| Rate for Payer: IEHP Medicare Advantage |
$8.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.48
|
| Rate for Payer: Multiplan Commercial |
$46.40
|
| Rate for Payer: Networks By Design Commercial |
$37.70
|
| Rate for Payer: Prime Health Services Commercial |
$49.30
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$34.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.43
|
| Rate for Payer: United Healthcare All Other HMO |
$2.43
|
| Rate for Payer: United Healthcare HMO Rider |
$2.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.43
|
| Rate for Payer: Vantage Medical Group Senior |
$8.57
|
|
|
HC VENIPUNCTURE W/SPECIMEN
|
Facility
OP
|
$58.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
900910099
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.43 |
| Max. Negotiated Rate |
$49.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17.94
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.86
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.43
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.53
|
| Rate for Payer: BCBS Transplant Transplant |
$34.80
|
| Rate for Payer: Blue Shield of California Commercial |
$37.47
|
| Rate for Payer: Blue Shield of California EPN |
$29.70
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cigna of CA HMO |
$37.12
|
| Rate for Payer: Cigna of CA PPO |
$42.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.86
|
| Rate for Payer: Dignity Health Media |
$8.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.57
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.57
|
| Rate for Payer: Galaxy Health WC |
$49.30
|
| Rate for Payer: Global Benefits Group Commercial |
$34.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$43.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.05
|
| Rate for Payer: Heritage Provider Network Transplant |
$14.05
|
| Rate for Payer: IEHP Medi-Cal |
$13.88
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$13.88
|
| Rate for Payer: IEHP Medicare Advantage |
$8.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.48
|
| Rate for Payer: Multiplan Commercial |
$46.40
|
| Rate for Payer: Networks By Design Commercial |
$37.70
|
| Rate for Payer: Prime Health Services Commercial |
$49.30
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$34.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.43
|
| Rate for Payer: United Healthcare All Other HMO |
$2.43
|
| Rate for Payer: United Healthcare HMO Rider |
$2.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.43
|
| Rate for Payer: Vantage Medical Group Senior |
$8.57
|
|
|
HC VENOGRAM ADRENAL BILAT
|
Facility
OP
|
$11,597.00
|
|
|
Service Code
|
CPT 75842
|
| Hospital Charge Code |
909081638
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$275.60 |
| Max. Negotiated Rate |
$11,260.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,074.67
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6,866.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,289.19
|
| Rate for Payer: BCBS Transplant Transplant |
$6,958.20
|
| Rate for Payer: Blue Shield of California Commercial |
$6,853.83
|
| Rate for Payer: Blue Shield of California EPN |
$5,438.99
|
| Rate for Payer: Cash Price |
$5,218.65
|
| Rate for Payer: Cash Price |
$5,218.65
|
| Rate for Payer: Cigna of CA HMO |
$7,422.08
|
| Rate for Payer: Cigna of CA PPO |
$8,581.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Dignity Health Media |
$6,866.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,552.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,269.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6,866.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,866.07
|
| Rate for Payer: Galaxy Health WC |
$9,857.45
|
| Rate for Payer: Global Benefits Group Commercial |
$6,958.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8,697.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,260.35
|
| Rate for Payer: Heritage Provider Network Transplant |
$11,260.35
|
| Rate for Payer: IEHP Medi-Cal |
$11,123.03
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$11,123.03
|
| Rate for Payer: IEHP Medicare Advantage |
$6,866.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,735.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$275.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,866.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,783.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,651.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,200.53
|
| Rate for Payer: Multiplan Commercial |
$9,277.60
|
| Rate for Payer: Networks By Design Commercial |
$7,538.05
|
| Rate for Payer: Prime Health Services Commercial |
$9,857.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6,958.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,958.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,958.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: Vantage Medical Group Senior |
$6,866.07
|
|
|
HC VENOGRAM ADRENAL BILAT
|
Facility
IP
|
$11,597.00
|
|
|
Service Code
|
CPT 75842
|
| Hospital Charge Code |
909081638
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,783.28 |
| Max. Negotiated Rate |
$9,857.45 |
| Rate for Payer: Cash Price |
$5,218.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,638.80
|
| Rate for Payer: Galaxy Health WC |
$9,857.45
|
| Rate for Payer: Global Benefits Group Commercial |
$6,958.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,735.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,418.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,783.28
|
| Rate for Payer: Multiplan Commercial |
$9,277.60
|
| Rate for Payer: Networks By Design Commercial |
$7,538.05
|
| Rate for Payer: Prime Health Services Commercial |
$9,857.45
|
|
|
HC VENOGRAM ADRENAL UNILAT
|
Facility
OP
|
$7,731.00
|
|
|
Service Code
|
CPT 75840
|
| Hospital Charge Code |
909081579
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$957.74 |
| Max. Negotiated Rate |
$6,571.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$957.74
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,289.19
|
| Rate for Payer: BCBS Transplant Transplant |
$4,638.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4,569.02
|
| Rate for Payer: Blue Shield of California EPN |
$3,625.84
|
| Rate for Payer: Cash Price |
$3,478.95
|
| Rate for Payer: Cash Price |
$3,478.95
|
| Rate for Payer: Cigna of CA HMO |
$4,947.84
|
| Rate for Payer: Cigna of CA PPO |
$5,720.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$6,571.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,638.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,798.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,531.38
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,531.38
|
| Rate for Payer: IEHP Medi-Cal |
$6,451.73
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$6,451.73
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,156.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,855.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$6,184.80
|
| Rate for Payer: Networks By Design Commercial |
$5,025.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,571.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,638.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,638.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,638.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC VENOGRAM ADRENAL UNILAT
|
Facility
IP
|
$7,731.00
|
|
|
Service Code
|
CPT 75840
|
| Hospital Charge Code |
909081579
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,855.44 |
| Max. Negotiated Rate |
$6,571.35 |
| Rate for Payer: Cash Price |
$3,478.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,092.40
|
| Rate for Payer: Galaxy Health WC |
$6,571.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,638.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,156.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,945.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,855.44
|
| Rate for Payer: Multiplan Commercial |
$6,184.80
|
| Rate for Payer: Networks By Design Commercial |
$5,025.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,571.35
|
|
