|
HC MULTI-POST COLLAR
|
Facility
|
IP
|
$826.00
|
|
|
Service Code
|
CPT L0180
|
| Hospital Charge Code |
915350180
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$165.20 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$165.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$454.30
|
| Rate for Payer: Cash Price |
$454.30
|
| Rate for Payer: Cigna of CA HMO |
$578.20
|
| Rate for Payer: Cigna of CA PPO |
$578.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$330.40
|
| Rate for Payer: EPIC Health Plan Senior |
$330.40
|
| Rate for Payer: Galaxy Health WC |
$702.10
|
| Rate for Payer: Global Benefits Group Commercial |
$495.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$550.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$314.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$511.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$198.24
|
| Rate for Payer: Multiplan Commercial |
$660.80
|
| Rate for Payer: Networks By Design Commercial |
$413.00
|
| Rate for Payer: Prime Health Services Commercial |
$702.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$310.00
|
| Rate for Payer: United Healthcare All Other HMO |
$301.74
|
| Rate for Payer: United Healthcare HMO Rider |
$295.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$270.51
|
|
|
HC MULTI-POST COLLAR
|
Facility
|
OP
|
$826.00
|
|
|
Service Code
|
CPT L0180
|
| Hospital Charge Code |
905350180
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$198.24 |
| Max. Negotiated Rate |
$702.10 |
| Rate for Payer: Adventist Health Commercial |
$338.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$702.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$454.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$619.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$478.42
|
| Rate for Payer: Blue Shield of California Commercial |
$609.59
|
| Rate for Payer: Blue Shield of California EPN |
$401.44
|
| Rate for Payer: Cash Price |
$454.30
|
| Rate for Payer: Cash Price |
$454.30
|
| Rate for Payer: Cigna of CA HMO |
$578.20
|
| Rate for Payer: Cigna of CA PPO |
$578.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$702.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$702.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$702.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$330.40
|
| Rate for Payer: EPIC Health Plan Senior |
$330.40
|
| Rate for Payer: Galaxy Health WC |
$702.10
|
| Rate for Payer: Global Benefits Group Commercial |
$495.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$298.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$550.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$337.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$511.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$198.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$578.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$578.20
|
| Rate for Payer: Multiplan Commercial |
$660.80
|
| Rate for Payer: Networks By Design Commercial |
$413.00
|
| Rate for Payer: Prime Health Services Commercial |
$702.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$495.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$495.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$310.00
|
| Rate for Payer: United Healthcare All Other HMO |
$301.74
|
| Rate for Payer: United Healthcare HMO Rider |
$295.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$270.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$702.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$702.10
|
| Rate for Payer: Vantage Medical Group Senior |
$702.10
|
|
|
HC MULTI-POST COLLAR
|
Facility
|
OP
|
$826.00
|
|
|
Service Code
|
CPT L0180
|
| Hospital Charge Code |
915350180
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$198.24 |
| Max. Negotiated Rate |
$702.10 |
| Rate for Payer: Adventist Health Commercial |
$338.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$702.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$454.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$619.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$478.42
|
| Rate for Payer: Blue Shield of California Commercial |
$609.59
|
| Rate for Payer: Blue Shield of California EPN |
$401.44
|
| Rate for Payer: Cash Price |
$454.30
|
| Rate for Payer: Cash Price |
$454.30
|
| Rate for Payer: Cigna of CA HMO |
$578.20
|
| Rate for Payer: Cigna of CA PPO |
$578.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$702.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$702.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$702.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$330.40
|
| Rate for Payer: EPIC Health Plan Senior |
$330.40
|
| Rate for Payer: Galaxy Health WC |
$702.10
|
| Rate for Payer: Global Benefits Group Commercial |
$495.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$298.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$550.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$337.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$511.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$198.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$578.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$578.20
|
| Rate for Payer: Multiplan Commercial |
$660.80
|
| Rate for Payer: Networks By Design Commercial |
$413.00
|
| Rate for Payer: Prime Health Services Commercial |
$702.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$495.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$495.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$310.00
|
| Rate for Payer: United Healthcare All Other HMO |
$301.74
|
| Rate for Payer: United Healthcare HMO Rider |
$295.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$270.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$702.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$702.10
|
| Rate for Payer: Vantage Medical Group Senior |
$702.10
|
|
|
HC MULTI-POST COLLAR
|
Facility
|
IP
|
$826.00
|
|
|
Service Code
|
CPT L0180
|
| Hospital Charge Code |
905350180
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$165.20 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$165.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$454.30
|
| Rate for Payer: Cash Price |
$454.30
|
| Rate for Payer: Cigna of CA HMO |
$578.20
|
| Rate for Payer: Cigna of CA PPO |
$578.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$330.40
|
| Rate for Payer: EPIC Health Plan Senior |
$330.40
|
| Rate for Payer: Galaxy Health WC |
$702.10
|
| Rate for Payer: Global Benefits Group Commercial |
$495.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$550.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$314.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$511.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$198.24
|
| Rate for Payer: Multiplan Commercial |
$660.80
|
| Rate for Payer: Networks By Design Commercial |
$413.00
|
| Rate for Payer: Prime Health Services Commercial |
$702.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$310.00
|
| Rate for Payer: United Healthcare All Other HMO |
$301.74
|
| Rate for Payer: United Healthcare HMO Rider |
$295.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$270.51
|
|
|
HC MUMPS AB
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
900913533
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$170.00 |
| Rate for Payer: Adventist Health Commercial |
$40.00
|
| Rate for Payer: Cash Price |
$110.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.00
|
| Rate for Payer: EPIC Health Plan Senior |
$80.00
|
| Rate for Payer: Galaxy Health WC |
$170.00
|
| Rate for Payer: Global Benefits Group Commercial |
$120.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$133.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$76.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$123.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.00
|
| Rate for Payer: Multiplan Commercial |
$160.00
|
| Rate for Payer: Networks By Design Commercial |
$130.00
|
| Rate for Payer: Prime Health Services Commercial |
$170.00
|
|
|
HC MUMPS AB
|
Facility
|
OP
|
$200.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
900913533
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.57 |
| Max. Negotiated Rate |
$170.00 |
| Rate for Payer: Adventist Health Commercial |
$40.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$131.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$130.27
|
| Rate for Payer: Blue Shield of California Commercial |
$133.80
|
| Rate for Payer: Blue Shield of California EPN |
$88.40
|
| Rate for Payer: Cash Price |
$110.00
|
| Rate for Payer: Cash Price |
$110.00
|
| Rate for Payer: Cigna of CA HMO |
$128.00
|
| Rate for Payer: Cigna of CA PPO |
$148.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.36
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.62
|
| Rate for Payer: EPIC Health Plan Senior |
$13.05
|
| Rate for Payer: Galaxy Health WC |
$170.00
|
| Rate for Payer: Global Benefits Group Commercial |
$120.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$21.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$133.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.49
|
| Rate for Payer: Multiplan Commercial |
$160.00
|
| Rate for Payer: Networks By Design Commercial |
$130.00
|
| Rate for Payer: Prime Health Services Commercial |
$170.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$120.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$120.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.57
|
| Rate for Payer: United Healthcare All Other HMO |
$10.57
|
| Rate for Payer: United Healthcare HMO Rider |
$10.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.57
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Vantage Medical Group Senior |
$13.05
|
|
|
HC MUMPS ANTIBODY
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
900913663
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.57 |
| Max. Negotiated Rate |
$130.27 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$87.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$130.27
|
| Rate for Payer: Blue Shield of California Commercial |
$89.65
|
| Rate for Payer: Blue Shield of California EPN |
$59.23
|
| Rate for Payer: Cash Price |
$73.70
|
| Rate for Payer: Cash Price |
$73.70
|
| Rate for Payer: Cigna of CA HMO |
$85.76
|
| Rate for Payer: Cigna of CA PPO |
$99.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.36
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.62
|
| Rate for Payer: EPIC Health Plan Senior |
$13.05
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$21.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$89.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.49
|
| Rate for Payer: Multiplan Commercial |
$107.20
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$80.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$80.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.57
|
| Rate for Payer: United Healthcare All Other HMO |
$10.57
|
| Rate for Payer: United Healthcare HMO Rider |
$10.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.57
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Vantage Medical Group Senior |
$13.05
|
|
|
HC MUMPS ANTIBODY
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
900913663
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$113.90 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Cash Price |
$73.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.60
|
| Rate for Payer: EPIC Health Plan Senior |
$53.60
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$89.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$51.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.16
|
| Rate for Payer: Multiplan Commercial |
$107.20
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
|
|
HC MUSCLE BIOPSY, PERCUTANEOUS
|
Facility
|
OP
|
$2,792.00
|
|
|
Service Code
|
CPT 20206
|
| Hospital Charge Code |
909000105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$110.71 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$558.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$1,535.60
|
| Rate for Payer: Cash Price |
$1,535.60
|
| Rate for Payer: Cash Price |
$1,535.60
|
| Rate for Payer: Cigna of CA HMO |
$1,786.88
|
| Rate for Payer: Cigna of CA PPO |
$2,066.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,779.22
|
| Rate for Payer: EPIC Health Plan Senior |
$2,058.68
|
| Rate for Payer: Galaxy Health WC |
$2,373.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,675.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$110.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,862.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$125.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$670.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,593.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,758.63
|
| Rate for Payer: Multiplan Commercial |
$2,233.60
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$1,814.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,373.20
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,675.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,058.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
HC MUSCLE BIOPSY, PERCUTANEOUS
|
Facility
|
IP
|
$2,792.00
|
|
|
Service Code
|
CPT 20206
|
| Hospital Charge Code |
909000105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$558.40 |
| Max. Negotiated Rate |
$2,373.20 |
| Rate for Payer: Adventist Health Commercial |
$558.40
|
| Rate for Payer: Cash Price |
$1,535.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,116.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,116.80
|
| Rate for Payer: Galaxy Health WC |
$2,373.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,675.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,862.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,063.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,728.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$670.08
|
| Rate for Payer: Multiplan Commercial |
$2,233.60
|
| Rate for Payer: Networks By Design Commercial |
$1,814.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,373.20
|
|
|
HC MUSCLE TEST MANUAL W RPT
|
Facility
|
IP
|
$97.00
|
|
|
Service Code
|
CPT 95831
|
| Hospital Charge Code |
900895831
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$19.40 |
| Max. Negotiated Rate |
$82.45 |
| Rate for Payer: Adventist Health Commercial |
$19.40
|
| Rate for Payer: Cash Price |
$53.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.80
|
| Rate for Payer: EPIC Health Plan Senior |
$38.80
|
| Rate for Payer: Galaxy Health WC |
$82.45
|
| Rate for Payer: Global Benefits Group Commercial |
$58.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$64.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.28
|
| Rate for Payer: Multiplan Commercial |
$77.60
|
| Rate for Payer: Networks By Design Commercial |
$63.05
|
| Rate for Payer: Prime Health Services Commercial |
$82.45
|
|
|
HC MUSCLE TEST MANUAL W RPT
|
Facility
|
OP
|
$97.00
|
|
|
Service Code
|
CPT 95831
|
| Hospital Charge Code |
900895831
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$19.40 |
| Max. Negotiated Rate |
$1,021.00 |
| Rate for Payer: Adventist Health Commercial |
$19.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$82.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$53.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$72.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.57
|
| Rate for Payer: Blue Shield of California Commercial |
$59.36
|
| Rate for Payer: Blue Shield of California EPN |
$39.19
|
| Rate for Payer: Cash Price |
$53.35
|
| Rate for Payer: Cash Price |
$53.35
|
| Rate for Payer: Cigna of CA HMO |
$62.08
|
| Rate for Payer: Cigna of CA PPO |
$71.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$82.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$82.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$82.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.80
|
| Rate for Payer: EPIC Health Plan Senior |
$38.80
|
| Rate for Payer: Galaxy Health WC |
$82.45
|
| Rate for Payer: Global Benefits Group Commercial |
$58.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$64.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$67.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$67.90
|
| Rate for Payer: Multiplan Commercial |
$77.60
|
| Rate for Payer: Networks By Design Commercial |
$63.05
|
| Rate for Payer: Prime Health Services Commercial |
$82.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,021.00
|
| Rate for Payer: United Healthcare All Other HMO |
$803.00
|
| Rate for Payer: United Healthcare HMO Rider |
$608.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$558.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$82.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$82.45
|
| Rate for Payer: Vantage Medical Group Senior |
$82.45
|
|
|
HC MYELOGRAM, CERVICAL
|
Facility
|
IP
|
$2,497.00
|
|
|
Service Code
|
CPT 72240
|
| Hospital Charge Code |
909001363
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$499.40 |
| Max. Negotiated Rate |
$2,122.45 |
| Rate for Payer: Adventist Health Commercial |
$499.40
|
| Rate for Payer: Cash Price |
$1,373.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$998.80
|
| Rate for Payer: EPIC Health Plan Senior |
$998.80
|
| Rate for Payer: Galaxy Health WC |
$2,122.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,498.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,665.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$951.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,545.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$599.28
|
| Rate for Payer: Multiplan Commercial |
$1,997.60
|
| Rate for Payer: Networks By Design Commercial |
$1,623.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,122.45
|
|
|
HC MYELOGRAM, CERVICAL
|
Facility
|
OP
|
$2,497.00
|
|
|
Service Code
|
CPT 72240
|
| Hospital Charge Code |
909001363
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$147.08 |
| Max. Negotiated Rate |
$2,122.45 |
| Rate for Payer: Adventist Health Commercial |
$499.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,637.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,003.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,334.59
|
| Rate for Payer: Blue Shield of California Commercial |
$1,528.16
|
| Rate for Payer: Blue Shield of California EPN |
$1,008.79
|
| Rate for Payer: Cash Price |
$1,373.35
|
| Rate for Payer: Cash Price |
$1,373.35
|
| Rate for Payer: Cigna of CA HMO |
$1,598.08
|
| Rate for Payer: Cigna of CA PPO |
$1,847.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,104.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,003.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,355.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,003.85
|
| Rate for Payer: Galaxy Health WC |
$2,122.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,498.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,646.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$147.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,003.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,665.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$166.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,003.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$599.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,264.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,345.16
|
| Rate for Payer: Multiplan Commercial |
$1,997.60
|
| Rate for Payer: Networks By Design Commercial |
$1,623.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,122.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,498.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,498.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,265.49
|
| Rate for Payer: United Healthcare All Other HMO |
$1,265.49
|
| Rate for Payer: United Healthcare HMO Rider |
$1,265.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,265.49
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,003.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Vantage Medical Group Senior |
$1,003.85
|
|
|
HC MYELOGRAM, COMPLETE
|
Facility
|
OP
|
$2,750.00
|
|
|
Service Code
|
CPT 72270
|
| Hospital Charge Code |
909001364
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$189.71 |
| Max. Negotiated Rate |
$2,337.50 |
| Rate for Payer: Adventist Health Commercial |
$550.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,803.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,003.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,714.89
|
| Rate for Payer: Blue Shield of California Commercial |
$1,683.00
|
| Rate for Payer: Blue Shield of California EPN |
$1,111.00
|
| Rate for Payer: Cash Price |
$1,512.50
|
| Rate for Payer: Cash Price |
$1,512.50
|
| Rate for Payer: Cigna of CA HMO |
$1,760.00
|
| Rate for Payer: Cigna of CA PPO |
$2,035.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,104.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,003.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,355.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,003.85
|
| Rate for Payer: Galaxy Health WC |
$2,337.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,650.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,646.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$189.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,003.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,834.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$214.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,003.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$660.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,264.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,345.16
|
| Rate for Payer: Multiplan Commercial |
$2,200.00
|
| Rate for Payer: Networks By Design Commercial |
$1,787.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,337.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,650.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,650.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,265.49
|
| Rate for Payer: United Healthcare All Other HMO |
$1,265.49
|
| Rate for Payer: United Healthcare HMO Rider |
$1,265.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,265.49
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,003.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Vantage Medical Group Senior |
$1,003.85
|
|
|
HC MYELOGRAM, COMPLETE
|
Facility
|
IP
|
$2,750.00
|
|
|
Service Code
|
CPT 72270
|
| Hospital Charge Code |
909001364
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$550.00 |
| Max. Negotiated Rate |
$2,337.50 |
| Rate for Payer: Adventist Health Commercial |
$550.00
|
| Rate for Payer: Cash Price |
$1,512.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,100.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,100.00
|
| Rate for Payer: Galaxy Health WC |
$2,337.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,650.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,834.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,047.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,702.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$660.00
|
| Rate for Payer: Multiplan Commercial |
$2,200.00
|
| Rate for Payer: Networks By Design Commercial |
$1,787.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,337.50
|
|
|
HC MYELOGRAPHY LUMBAR INJECT T-SPINE
|
Facility
|
OP
|
$2,676.00
|
|
|
Service Code
|
CPT 62303
|
| Hospital Charge Code |
909062303
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$184.51 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$535.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,003.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$1,471.80
|
| Rate for Payer: Cash Price |
$1,471.80
|
| Rate for Payer: Cash Price |
$1,471.80
|
| Rate for Payer: Cigna of CA HMO |
$1,712.64
|
| Rate for Payer: Cigna of CA PPO |
$1,980.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,104.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,003.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,355.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,003.85
|
| Rate for Payer: Galaxy Health WC |
$2,274.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,605.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,646.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$184.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,003.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,784.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$208.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,003.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$642.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,264.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,345.16
|
| Rate for Payer: Multiplan Commercial |
$2,140.80
|
| Rate for Payer: Multiplan WC |
$1,599.45
|
| Rate for Payer: Networks By Design Commercial |
$1,739.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,274.60
|
| Rate for Payer: Prime Health Services WC |
$1,583.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,605.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,003.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Vantage Medical Group Senior |
$1,003.85
|
|
|
HC MYELOGRAPHY LUMBAR INJECT T-SPINE
|
Facility
|
IP
|
$2,676.00
|
|
|
Service Code
|
CPT 62303
|
| Hospital Charge Code |
909062303
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$535.20 |
| Max. Negotiated Rate |
$2,274.60 |
| Rate for Payer: Adventist Health Commercial |
$535.20
|
| Rate for Payer: Cash Price |
$1,471.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,070.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,070.40
|
| Rate for Payer: Galaxy Health WC |
$2,274.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,605.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,784.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,019.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,656.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$642.24
|
| Rate for Payer: Multiplan Commercial |
$2,140.80
|
| Rate for Payer: Networks By Design Commercial |
$1,739.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,274.60
|
|
|
HC MYELOGRAPHY, LUMBOSACRAL
|
Facility
|
IP
|
$2,497.00
|
|
|
Service Code
|
CPT 72265
|
| Hospital Charge Code |
909001372
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$499.40 |
| Max. Negotiated Rate |
$2,122.45 |
| Rate for Payer: Adventist Health Commercial |
$499.40
|
| Rate for Payer: Cash Price |
$1,373.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$998.80
|
| Rate for Payer: EPIC Health Plan Senior |
$998.80
|
| Rate for Payer: Galaxy Health WC |
$2,122.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,498.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,665.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$951.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,545.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$599.28
|
| Rate for Payer: Multiplan Commercial |
$1,997.60
|
| Rate for Payer: Networks By Design Commercial |
$1,623.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,122.45
|
|
|
HC MYELOGRAPHY, LUMBOSACRAL
|
Facility
|
OP
|
$2,497.00
|
|
|
Service Code
|
CPT 72265
|
| Hospital Charge Code |
909001372
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$137.73 |
| Max. Negotiated Rate |
$2,122.45 |
| Rate for Payer: Adventist Health Commercial |
$499.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,637.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,003.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,146.01
|
| Rate for Payer: Blue Shield of California Commercial |
$1,528.16
|
| Rate for Payer: Blue Shield of California EPN |
$1,008.79
|
| Rate for Payer: Cash Price |
$1,373.35
|
| Rate for Payer: Cash Price |
$1,373.35
|
| Rate for Payer: Cigna of CA HMO |
$1,598.08
|
| Rate for Payer: Cigna of CA PPO |
$1,847.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,104.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,003.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,355.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,003.85
|
| Rate for Payer: Galaxy Health WC |
$2,122.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,498.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,646.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$137.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,003.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,665.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,003.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$599.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,264.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,345.16
|
| Rate for Payer: Multiplan Commercial |
$1,997.60
|
| Rate for Payer: Networks By Design Commercial |
$1,623.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,122.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,498.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,498.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,265.49
|
| Rate for Payer: United Healthcare All Other HMO |
$1,265.49
|
| Rate for Payer: United Healthcare HMO Rider |
$1,265.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,265.49
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,003.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Vantage Medical Group Senior |
$1,003.85
|
|
|
HC MYELOGRAPHY, THORACIC
|
Facility
|
OP
|
$2,498.00
|
|
|
Service Code
|
CPT 72255
|
| Hospital Charge Code |
909001371
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$146.19 |
| Max. Negotiated Rate |
$2,123.30 |
| Rate for Payer: Adventist Health Commercial |
$499.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,638.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,003.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,218.23
|
| Rate for Payer: Blue Shield of California Commercial |
$1,528.78
|
| Rate for Payer: Blue Shield of California EPN |
$1,009.19
|
| Rate for Payer: Cash Price |
$1,373.90
|
| Rate for Payer: Cash Price |
$1,373.90
|
| Rate for Payer: Cigna of CA HMO |
$1,598.72
|
| Rate for Payer: Cigna of CA PPO |
$1,848.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,104.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,003.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,355.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,003.85
|
| Rate for Payer: Galaxy Health WC |
$2,123.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,498.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,646.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$146.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,003.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,666.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$165.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,003.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$599.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,264.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,345.16
|
| Rate for Payer: Multiplan Commercial |
$1,998.40
|
| Rate for Payer: Networks By Design Commercial |
$1,623.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,123.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,498.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,498.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,265.49
|
| Rate for Payer: United Healthcare All Other HMO |
$1,265.49
|
| Rate for Payer: United Healthcare HMO Rider |
$1,265.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,265.49
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,003.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Vantage Medical Group Senior |
$1,003.85
|
|
|
HC MYELOGRAPHY, THORACIC
|
Facility
|
IP
|
$2,498.00
|
|
|
Service Code
|
CPT 72255
|
| Hospital Charge Code |
909001371
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$499.60 |
| Max. Negotiated Rate |
$2,123.30 |
| Rate for Payer: Adventist Health Commercial |
$499.60
|
| Rate for Payer: Cash Price |
$1,373.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$999.20
|
| Rate for Payer: EPIC Health Plan Senior |
$999.20
|
| Rate for Payer: Galaxy Health WC |
$2,123.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,498.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,666.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$951.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,546.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$599.52
|
| Rate for Payer: Multiplan Commercial |
$1,998.40
|
| Rate for Payer: Networks By Design Commercial |
$1,623.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,123.30
|
|
|
HC MYLOPEROXIDASE AB
|
Facility
|
OP
|
$78.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913678
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$231.08 |
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$51.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$231.08
|
| Rate for Payer: Blue Shield of California Commercial |
$52.18
|
| Rate for Payer: Blue Shield of California EPN |
$34.48
|
| Rate for Payer: Cash Price |
$42.90
|
| Rate for Payer: Cash Price |
$42.90
|
| Rate for Payer: Cigna of CA HMO |
$49.92
|
| Rate for Payer: Cigna of CA PPO |
$57.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.57
|
| Rate for Payer: EPIC Health Plan Senior |
$11.53
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$18.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.45
|
| Rate for Payer: Multiplan Commercial |
$62.40
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
|
|
HC MYLOPEROXIDASE AB
|
Facility
|
IP
|
$78.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913678
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Cash Price |
$42.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.20
|
| Rate for Payer: EPIC Health Plan Senior |
$31.20
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.72
|
| Rate for Payer: Multiplan Commercial |
$62.40
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
|
|
HC MYOCARDIAL PERFUSION MULTIPLE TEST
|
Facility
|
IP
|
$2,504.00
|
|
|
Service Code
|
CPT 78454
|
| Hospital Charge Code |
909301383
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$500.80 |
| Max. Negotiated Rate |
$2,128.40 |
| Rate for Payer: Adventist Health Commercial |
$500.80
|
| Rate for Payer: Cash Price |
$1,377.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,001.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.60
|
| Rate for Payer: Galaxy Health WC |
$2,128.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,502.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,670.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$954.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,549.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$600.96
|
| Rate for Payer: Multiplan Commercial |
$2,003.20
|
| Rate for Payer: Networks By Design Commercial |
$1,627.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,128.40
|
|
