|
HC NEDL BARD TRANS-SEPTAL
|
Facility
|
IP
|
$1,012.00
|
|
| Hospital Charge Code |
906812363
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.40 |
| Max. Negotiated Rate |
$860.20 |
| Rate for Payer: Adventist Health Commercial |
$202.40
|
| Rate for Payer: Cash Price |
$455.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$404.80
|
| Rate for Payer: EPIC Health Plan Senior |
$404.80
|
| Rate for Payer: Galaxy Health WC |
$860.20
|
| Rate for Payer: Global Benefits Group Commercial |
$607.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$675.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$385.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$626.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$242.88
|
| Rate for Payer: Multiplan Commercial |
$809.60
|
| Rate for Payer: Networks By Design Commercial |
$657.80
|
| Rate for Payer: Prime Health Services Commercial |
$860.20
|
|
|
HC NEDL BAYLIS RF TRANSEPTAL
|
Facility
|
OP
|
$2,277.00
|
|
| Hospital Charge Code |
906812470
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$455.40 |
| Max. Negotiated Rate |
$1,935.45 |
| Rate for Payer: Adventist Health Commercial |
$455.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,493.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,935.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,252.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,707.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,398.31
|
| Rate for Payer: Cash Price |
$1,024.65
|
| Rate for Payer: Cigna of CA HMO |
$1,457.28
|
| Rate for Payer: Cigna of CA PPO |
$1,684.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,935.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,935.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,935.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$910.80
|
| Rate for Payer: EPIC Health Plan Senior |
$910.80
|
| Rate for Payer: Galaxy Health WC |
$1,935.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,366.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,518.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$867.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,409.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$546.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,593.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,593.90
|
| Rate for Payer: Multiplan Commercial |
$1,821.60
|
| Rate for Payer: Networks By Design Commercial |
$1,480.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,935.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,366.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,366.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,138.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,138.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,138.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,138.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,935.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,935.45
|
| Rate for Payer: Vantage Medical Group Senior |
$1,935.45
|
|
|
HC NEDL BAYLIS RF TRANSEPTAL
|
Facility
|
IP
|
$2,277.00
|
|
| Hospital Charge Code |
906812470
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$455.40 |
| Max. Negotiated Rate |
$1,935.45 |
| Rate for Payer: Adventist Health Commercial |
$455.40
|
| Rate for Payer: Cash Price |
$1,024.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$910.80
|
| Rate for Payer: EPIC Health Plan Senior |
$910.80
|
| Rate for Payer: Galaxy Health WC |
$1,935.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,366.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,518.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$867.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,409.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$546.48
|
| Rate for Payer: Multiplan Commercial |
$1,821.60
|
| Rate for Payer: Networks By Design Commercial |
$1,480.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,935.45
|
|
|
HC NEDL COOK TRANSSEPTAL
|
Facility
|
IP
|
$288.00
|
|
| Hospital Charge Code |
906811779
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$244.80 |
| Rate for Payer: Adventist Health Commercial |
$57.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$192.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$178.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.12
|
| Rate for Payer: Multiplan Commercial |
$230.40
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
|
|
HC NEDL COOK TRANSSEPTAL
|
Facility
|
OP
|
$288.00
|
|
| Hospital Charge Code |
906811779
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$244.80 |
| Rate for Payer: Adventist Health Commercial |
$57.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$188.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$244.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$158.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$216.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$176.86
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cigna of CA HMO |
$184.32
|
| Rate for Payer: Cigna of CA PPO |
$213.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$244.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$244.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$244.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$192.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$178.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$201.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$201.60
|
| Rate for Payer: Multiplan Commercial |
$230.40
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$144.00
|
| Rate for Payer: United Healthcare All Other HMO |
$144.00
|
| Rate for Payer: United Healthcare HMO Rider |
$144.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$144.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$244.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$244.80
|
| Rate for Payer: Vantage Medical Group Senior |
$244.80
|
|
|
HC NEDL PD ACCESS DOPPLER
|
Facility
|
IP
|
$551.00
|
|
| Hospital Charge Code |
906811790
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$110.20 |
| Max. Negotiated Rate |
$468.35 |
| Rate for Payer: Adventist Health Commercial |
$110.20
|
| Rate for Payer: Cash Price |
$247.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.40
|
| Rate for Payer: EPIC Health Plan Senior |
$220.40
|
| Rate for Payer: Galaxy Health WC |
$468.35
|
| Rate for Payer: Global Benefits Group Commercial |
$330.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$367.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$341.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.24
|
| Rate for Payer: Multiplan Commercial |
$440.80
|
| Rate for Payer: Networks By Design Commercial |
$358.15
|
| Rate for Payer: Prime Health Services Commercial |
$468.35
|
|
|
HC NEDL PD ACCESS DOPPLER
|
Facility
|
OP
|
$551.00
|
|
| Hospital Charge Code |
906811790
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$110.20 |
| Max. Negotiated Rate |
$468.35 |
| Rate for Payer: Adventist Health Commercial |
$110.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$361.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$468.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$303.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$413.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$338.37
|
| Rate for Payer: Cash Price |
$247.95
|
| Rate for Payer: Cigna of CA HMO |
$352.64
|
| Rate for Payer: Cigna of CA PPO |
$407.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$468.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$468.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$468.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.40
|
| Rate for Payer: EPIC Health Plan Senior |
$220.40
|
| Rate for Payer: Galaxy Health WC |
$468.35
|
| Rate for Payer: Global Benefits Group Commercial |
$330.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$367.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$341.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$385.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$385.70
|
| Rate for Payer: Multiplan Commercial |
$440.80
|
| Rate for Payer: Networks By Design Commercial |
$358.15
|
| Rate for Payer: Prime Health Services Commercial |
$468.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$330.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$330.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$275.50
|
| Rate for Payer: United Healthcare All Other HMO |
$275.50
|
| Rate for Payer: United Healthcare HMO Rider |
$275.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$275.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$468.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$468.35
|
| Rate for Payer: Vantage Medical Group Senior |
$468.35
|
|
|
HC NEDL PERI-CARD CENTISIS COOK
|
Facility
|
IP
|
$527.56
|
|
| Hospital Charge Code |
906811776
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.51 |
| Max. Negotiated Rate |
$448.43 |
| Rate for Payer: Adventist Health Commercial |
$105.51
|
| Rate for Payer: Cash Price |
$237.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$211.02
|
| Rate for Payer: EPIC Health Plan Senior |
$211.02
|
| Rate for Payer: Galaxy Health WC |
$448.43
|
| Rate for Payer: Global Benefits Group Commercial |
$316.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$351.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$201.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$326.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.61
|
| Rate for Payer: Multiplan Commercial |
$422.05
|
| Rate for Payer: Networks By Design Commercial |
$342.91
|
| Rate for Payer: Prime Health Services Commercial |
$448.43
|
|
|
HC NEDL PERI-CARD CENTISIS COOK
|
Facility
|
OP
|
$527.56
|
|
| Hospital Charge Code |
906811776
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.51 |
| Max. Negotiated Rate |
$448.43 |
| Rate for Payer: Adventist Health Commercial |
$105.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$346.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$448.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$290.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$323.97
|
| Rate for Payer: Cash Price |
$237.40
|
| Rate for Payer: Cigna of CA HMO |
$337.64
|
| Rate for Payer: Cigna of CA PPO |
$390.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$448.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$448.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$211.02
|
| Rate for Payer: EPIC Health Plan Senior |
$211.02
|
| Rate for Payer: Galaxy Health WC |
$448.43
|
| Rate for Payer: Global Benefits Group Commercial |
$316.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$351.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$201.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$326.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$369.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$369.29
|
| Rate for Payer: Multiplan Commercial |
$422.05
|
| Rate for Payer: Networks By Design Commercial |
$342.91
|
| Rate for Payer: Prime Health Services Commercial |
$448.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$316.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$316.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$263.78
|
| Rate for Payer: United Healthcare All Other HMO |
$263.78
|
| Rate for Payer: United Healthcare HMO Rider |
$263.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$263.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$448.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$448.43
|
| Rate for Payer: Vantage Medical Group Senior |
$448.43
|
|
|
HC NEEDLE ELEC CRANI NERVE UNI
|
Facility
|
OP
|
$496.00
|
|
|
Service Code
|
CPT 95867
|
| Hospital Charge Code |
900600252
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$81.03 |
| Max. Negotiated Rate |
$1,297.00 |
| Rate for Payer: Adventist Health Commercial |
$99.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$325.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$304.59
|
| Rate for Payer: Blue Shield of California Commercial |
$303.55
|
| Rate for Payer: Blue Shield of California EPN |
$200.38
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Cigna of CA HMO |
$317.44
|
| Rate for Payer: Cigna of CA PPO |
$367.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.14
|
| Rate for Payer: EPIC Health Plan Senior |
$395.66
|
| Rate for Payer: Galaxy Health WC |
$421.60
|
| Rate for Payer: Global Benefits Group Commercial |
$297.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$648.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$81.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$330.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$91.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$498.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$530.18
|
| Rate for Payer: Multiplan Commercial |
$396.80
|
| Rate for Payer: Networks By Design Commercial |
$322.40
|
| Rate for Payer: Prime Health Services Commercial |
$421.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$297.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$297.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,297.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,024.00
|
| Rate for Payer: United Healthcare HMO Rider |
$776.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$711.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$395.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC NEEDLE ELEC CRANI NERVE UNI
|
Facility
|
IP
|
$496.00
|
|
|
Service Code
|
CPT 95867
|
| Hospital Charge Code |
900600252
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$99.20 |
| Max. Negotiated Rate |
$421.60 |
| Rate for Payer: Adventist Health Commercial |
$99.20
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$198.40
|
| Rate for Payer: EPIC Health Plan Senior |
$198.40
|
| Rate for Payer: Galaxy Health WC |
$421.60
|
| Rate for Payer: Global Benefits Group Commercial |
$297.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$330.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$188.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$307.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.04
|
| Rate for Payer: Multiplan Commercial |
$396.80
|
| Rate for Payer: Networks By Design Commercial |
$322.40
|
| Rate for Payer: Prime Health Services Commercial |
$421.60
|
|
|
HC NEEDLE ELEC LIMIT STUDY 1 SITE
|
Facility
|
OP
|
$287.00
|
|
|
Service Code
|
CPT 95870
|
| Hospital Charge Code |
900600255
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$34.02 |
| Max. Negotiated Rate |
$2,039.00 |
| Rate for Payer: Adventist Health Commercial |
$57.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$188.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$176.25
|
| Rate for Payer: Blue Shield of California Commercial |
$175.64
|
| Rate for Payer: Blue Shield of California EPN |
$115.95
|
| Rate for Payer: Cash Price |
$129.15
|
| Rate for Payer: Cash Price |
$129.15
|
| Rate for Payer: Cash Price |
$129.15
|
| Rate for Payer: Cigna of CA HMO |
$183.68
|
| Rate for Payer: Cigna of CA PPO |
$212.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$243.95
|
| Rate for Payer: Global Benefits Group Commercial |
$172.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$34.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$191.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$206.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$229.60
|
| Rate for Payer: Networks By Design Commercial |
$186.55
|
| Rate for Payer: Prime Health Services Commercial |
$243.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC NEEDLE ELEC LIMIT STUDY 1 SITE
|
Facility
|
IP
|
$287.00
|
|
|
Service Code
|
CPT 95870
|
| Hospital Charge Code |
900600255
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$57.40 |
| Max. Negotiated Rate |
$243.95 |
| Rate for Payer: Adventist Health Commercial |
$57.40
|
| Rate for Payer: Cash Price |
$129.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$114.80
|
| Rate for Payer: EPIC Health Plan Senior |
$114.80
|
| Rate for Payer: Galaxy Health WC |
$243.95
|
| Rate for Payer: Global Benefits Group Commercial |
$172.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$191.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$177.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.88
|
| Rate for Payer: Multiplan Commercial |
$229.60
|
| Rate for Payer: Networks By Design Commercial |
$186.55
|
| Rate for Payer: Prime Health Services Commercial |
$243.95
|
|
|
HC NEEDLE ELECT CRANI NERVE BI
|
Facility
|
IP
|
$744.00
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
900600253
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$148.80 |
| Max. Negotiated Rate |
$632.40 |
| Rate for Payer: Adventist Health Commercial |
$148.80
|
| Rate for Payer: Cash Price |
$334.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$297.60
|
| Rate for Payer: EPIC Health Plan Senior |
$297.60
|
| Rate for Payer: Galaxy Health WC |
$632.40
|
| Rate for Payer: Global Benefits Group Commercial |
$446.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$496.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$283.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$460.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.56
|
| Rate for Payer: Multiplan Commercial |
$595.20
|
| Rate for Payer: Networks By Design Commercial |
$483.60
|
| Rate for Payer: Prime Health Services Commercial |
$632.40
|
|
|
HC NEEDLE ELECT CRANI NERVE BI
|
Facility
|
OP
|
$744.00
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
900600253
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$136.77 |
| Max. Negotiated Rate |
$2,039.00 |
| Rate for Payer: Adventist Health Commercial |
$148.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$487.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$456.89
|
| Rate for Payer: Blue Shield of California Commercial |
$455.33
|
| Rate for Payer: Blue Shield of California EPN |
$300.58
|
| Rate for Payer: Cash Price |
$334.80
|
| Rate for Payer: Cash Price |
$334.80
|
| Rate for Payer: Cash Price |
$334.80
|
| Rate for Payer: Cigna of CA HMO |
$476.16
|
| Rate for Payer: Cigna of CA PPO |
$550.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.14
|
| Rate for Payer: EPIC Health Plan Senior |
$395.66
|
| Rate for Payer: Galaxy Health WC |
$632.40
|
| Rate for Payer: Global Benefits Group Commercial |
$446.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$648.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$136.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$496.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$154.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$498.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$530.18
|
| Rate for Payer: Multiplan Commercial |
$595.20
|
| Rate for Payer: Networks By Design Commercial |
$483.60
|
| Rate for Payer: Prime Health Services Commercial |
$632.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$446.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$446.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$395.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC NEEDLE ELEC THOR/SPINAL MUSC
|
Facility
|
IP
|
$360.00
|
|
|
Service Code
|
CPT 95869
|
| Hospital Charge Code |
900600254
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$72.00 |
| Max. Negotiated Rate |
$306.00 |
| Rate for Payer: Adventist Health Commercial |
$72.00
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$144.00
|
| Rate for Payer: EPIC Health Plan Senior |
$144.00
|
| Rate for Payer: Galaxy Health WC |
$306.00
|
| Rate for Payer: Global Benefits Group Commercial |
$216.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$240.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$222.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.40
|
| Rate for Payer: Multiplan Commercial |
$288.00
|
| Rate for Payer: Networks By Design Commercial |
$234.00
|
| Rate for Payer: Prime Health Services Commercial |
$306.00
|
|
|
HC NEEDLE ELEC THOR/SPINAL MUSC
|
Facility
|
OP
|
$360.00
|
|
|
Service Code
|
CPT 95869
|
| Hospital Charge Code |
900600254
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$44.08 |
| Max. Negotiated Rate |
$2,039.00 |
| Rate for Payer: Adventist Health Commercial |
$72.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$236.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$221.08
|
| Rate for Payer: Blue Shield of California Commercial |
$220.32
|
| Rate for Payer: Blue Shield of California EPN |
$145.44
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cigna of CA HMO |
$230.40
|
| Rate for Payer: Cigna of CA PPO |
$266.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.14
|
| Rate for Payer: EPIC Health Plan Senior |
$395.66
|
| Rate for Payer: Galaxy Health WC |
$306.00
|
| Rate for Payer: Global Benefits Group Commercial |
$216.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$648.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$44.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$240.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$498.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$530.18
|
| Rate for Payer: Multiplan Commercial |
$288.00
|
| Rate for Payer: Networks By Design Commercial |
$234.00
|
| Rate for Payer: Prime Health Services Commercial |
$306.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$216.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$216.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$395.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC NEEDLE EMG 1 EXT W/ WO PARASP
|
Facility
|
IP
|
$2,740.00
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
900600233
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$548.00 |
| Max. Negotiated Rate |
$2,329.00 |
| Rate for Payer: Adventist Health Commercial |
$548.00
|
| Rate for Payer: Cash Price |
$1,233.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,096.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,096.00
|
| Rate for Payer: Galaxy Health WC |
$2,329.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,644.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,827.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,043.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,696.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$657.60
|
| Rate for Payer: Multiplan Commercial |
$2,192.00
|
| Rate for Payer: Networks By Design Commercial |
$1,781.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,329.00
|
|
|
HC NEEDLE EMG 1 EXT W/ WO PARASP
|
Facility
|
OP
|
$2,740.00
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
900600233
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$110.21 |
| Max. Negotiated Rate |
$2,329.00 |
| Rate for Payer: Adventist Health Commercial |
$548.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,797.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,682.63
|
| Rate for Payer: Blue Shield of California Commercial |
$1,676.88
|
| Rate for Payer: Blue Shield of California EPN |
$1,106.96
|
| Rate for Payer: Cash Price |
$1,233.00
|
| Rate for Payer: Cash Price |
$1,233.00
|
| Rate for Payer: Cash Price |
$1,233.00
|
| Rate for Payer: Cigna of CA HMO |
$1,753.60
|
| Rate for Payer: Cigna of CA PPO |
$2,027.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$2,329.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,644.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$110.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,827.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$124.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$657.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$206.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$2,192.00
|
| Rate for Payer: Networks By Design Commercial |
$1,781.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,329.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,644.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,644.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,297.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,024.00
|
| Rate for Payer: United Healthcare HMO Rider |
$776.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$711.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC NEEDLE EMG 2 EXT W/WO PARASP
|
Facility
|
OP
|
$1,875.00
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
900600232
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$163.78 |
| Max. Negotiated Rate |
$1,593.75 |
| Rate for Payer: Adventist Health Commercial |
$375.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,229.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,151.44
|
| Rate for Payer: Blue Shield of California Commercial |
$1,147.50
|
| Rate for Payer: Blue Shield of California EPN |
$757.50
|
| Rate for Payer: Cash Price |
$843.75
|
| Rate for Payer: Cash Price |
$843.75
|
| Rate for Payer: Cash Price |
$843.75
|
| Rate for Payer: Cigna of CA HMO |
$1,200.00
|
| Rate for Payer: Cigna of CA PPO |
$1,387.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$1,593.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,125.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$165.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,250.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$186.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$450.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$206.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$1,500.00
|
| Rate for Payer: Networks By Design Commercial |
$1,218.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,593.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,125.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,125.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,297.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,024.00
|
| Rate for Payer: United Healthcare HMO Rider |
$776.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$711.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC NEEDLE EMG 2 EXT W/WO PARASP
|
Facility
|
IP
|
$1,875.00
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
900600232
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$375.00 |
| Max. Negotiated Rate |
$1,593.75 |
| Rate for Payer: Adventist Health Commercial |
$375.00
|
| Rate for Payer: Cash Price |
$843.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$750.00
|
| Rate for Payer: EPIC Health Plan Senior |
$750.00
|
| Rate for Payer: Galaxy Health WC |
$1,593.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,125.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,250.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$714.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,160.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$450.00
|
| Rate for Payer: Multiplan Commercial |
$1,500.00
|
| Rate for Payer: Networks By Design Commercial |
$1,218.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,593.75
|
|
|
HC NEEDLE EMG 3 EXT W WO PARASP
|
Facility
|
OP
|
$2,882.00
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
900600250
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$187.24 |
| Max. Negotiated Rate |
$2,449.70 |
| Rate for Payer: Adventist Health Commercial |
$576.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,890.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$198.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,769.84
|
| Rate for Payer: Blue Shield of California Commercial |
$1,763.78
|
| Rate for Payer: Blue Shield of California EPN |
$1,164.33
|
| Rate for Payer: Cash Price |
$1,296.90
|
| Rate for Payer: Cash Price |
$1,296.90
|
| Rate for Payer: Cash Price |
$1,296.90
|
| Rate for Payer: Cigna of CA HMO |
$1,844.48
|
| Rate for Payer: Cigna of CA PPO |
$2,132.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$298.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$218.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$198.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$268.38
|
| Rate for Payer: EPIC Health Plan Senior |
$198.80
|
| Rate for Payer: Galaxy Health WC |
$2,449.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,729.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$326.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$187.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$198.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,922.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$211.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$198.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$691.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$250.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$266.39
|
| Rate for Payer: Multiplan Commercial |
$2,305.60
|
| Rate for Payer: Networks By Design Commercial |
$1,873.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,449.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,729.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,729.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$198.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Vantage Medical Group Senior |
$198.80
|
|
|
HC NEEDLE EMG 3 EXT W WO PARASP
|
Facility
|
IP
|
$2,882.00
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
900600250
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$576.40 |
| Max. Negotiated Rate |
$2,449.70 |
| Rate for Payer: Adventist Health Commercial |
$576.40
|
| Rate for Payer: Cash Price |
$1,296.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,152.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,152.80
|
| Rate for Payer: Galaxy Health WC |
$2,449.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,729.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,922.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,098.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,783.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$691.68
|
| Rate for Payer: Multiplan Commercial |
$2,305.60
|
| Rate for Payer: Networks By Design Commercial |
$1,873.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,449.70
|
|
|
HC NEEDLE EMG 4 EXT W WO PARASP
|
Facility
|
IP
|
$2,882.00
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
900600251
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$576.40 |
| Max. Negotiated Rate |
$2,449.70 |
| Rate for Payer: Adventist Health Commercial |
$576.40
|
| Rate for Payer: Cash Price |
$1,296.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,152.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,152.80
|
| Rate for Payer: Galaxy Health WC |
$2,449.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,729.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,922.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,098.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,783.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$691.68
|
| Rate for Payer: Multiplan Commercial |
$2,305.60
|
| Rate for Payer: Networks By Design Commercial |
$1,873.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,449.70
|
|
|
HC NEEDLE EMG 4 EXT W WO PARASP
|
Facility
|
OP
|
$2,882.00
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
900600251
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$198.80 |
| Max. Negotiated Rate |
$2,449.70 |
| Rate for Payer: Adventist Health Commercial |
$576.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,890.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$198.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,769.84
|
| Rate for Payer: Blue Shield of California Commercial |
$1,763.78
|
| Rate for Payer: Blue Shield of California EPN |
$1,164.33
|
| Rate for Payer: Cash Price |
$1,296.90
|
| Rate for Payer: Cash Price |
$1,296.90
|
| Rate for Payer: Cash Price |
$1,296.90
|
| Rate for Payer: Cigna of CA HMO |
$1,844.48
|
| Rate for Payer: Cigna of CA PPO |
$2,132.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$298.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$218.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$198.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$268.38
|
| Rate for Payer: EPIC Health Plan Senior |
$198.80
|
| Rate for Payer: Galaxy Health WC |
$2,449.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,729.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$326.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$275.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$198.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,922.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$311.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$198.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$691.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$250.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$266.39
|
| Rate for Payer: Multiplan Commercial |
$2,305.60
|
| Rate for Payer: Networks By Design Commercial |
$1,873.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,449.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,729.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,729.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$198.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Vantage Medical Group Senior |
$198.80
|
|
