|
HC NUCLEIC ACID ID VIM
|
Facility
|
OP
|
$172.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912476
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.25 |
| Max. Negotiated Rate |
$206.80 |
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$166.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$166.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$206.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$206.80
|
| Rate for Payer: Blue Shield of California Commercial |
$19.36
|
| Rate for Payer: Blue Shield of California Commercial |
$119.88
|
| Rate for Payer: Blue Shield of California Commercial |
$29.27
|
| Rate for Payer: Blue Shield of California Commercial |
$79.29
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cigna of CA HMO |
$26.88
|
| Rate for Payer: Cigna of CA HMO |
$110.08
|
| Rate for Payer: Cigna of CA PPO |
$127.28
|
| Rate for Payer: Cigna of CA PPO |
$31.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$120.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.08
|
| Rate for Payer: EPIC Health Plan Senior |
$22.05
|
| Rate for Payer: EPIC Health Plan Senior |
$22.05
|
| Rate for Payer: Galaxy Health WC |
$146.20
|
| Rate for Payer: Galaxy Health WC |
$35.70
|
| Rate for Payer: Global Benefits Group Commercial |
$103.20
|
| Rate for Payer: Global Benefits Group Commercial |
$25.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$32.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$32.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$27.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$27.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$109.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$26.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.87
|
| Rate for Payer: Multiplan Commercial |
$33.60
|
| Rate for Payer: Multiplan Commercial |
$137.60
|
| Rate for Payer: Networks By Design Commercial |
$27.30
|
| Rate for Payer: Networks By Design Commercial |
$111.80
|
| Rate for Payer: Prime Health Services Commercial |
$146.20
|
| Rate for Payer: Prime Health Services Commercial |
$35.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$103.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$103.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.25
|
| Rate for Payer: United Healthcare All Other HMO |
$16.25
|
| Rate for Payer: United Healthcare All Other HMO |
$16.25
|
| Rate for Payer: United Healthcare HMO Rider |
$16.25
|
| Rate for Payer: United Healthcare HMO Rider |
$16.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.25
|
| Rate for Payer: Upland Medical Group Pediatric |
$20.05
|
| Rate for Payer: Upland Medical Group Pediatric |
$20.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
|
|
HC NURSE SPEC CONF PARTICIP 15MIN
|
Facility
|
OP
|
$51.00
|
|
| Hospital Charge Code |
912154310
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$10.20 |
| Max. Negotiated Rate |
$43.35 |
| Rate for Payer: Adventist Health Commercial |
$10.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$33.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$43.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$38.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32.73
|
| Rate for Payer: Cash Price |
$22.95
|
| Rate for Payer: Cigna of CA HMO |
$32.64
|
| Rate for Payer: Cigna of CA PPO |
$37.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$43.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$43.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$43.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.40
|
| Rate for Payer: EPIC Health Plan Senior |
$20.40
|
| Rate for Payer: Galaxy Health WC |
$43.35
|
| Rate for Payer: Global Benefits Group Commercial |
$30.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$32.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$30.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35.70
|
| Rate for Payer: Multiplan Commercial |
$40.80
|
| Rate for Payer: Networks By Design Commercial |
$33.15
|
| Rate for Payer: Prime Health Services Commercial |
$43.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$25.50
|
| Rate for Payer: United Healthcare All Other HMO |
$25.50
|
| Rate for Payer: United Healthcare HMO Rider |
$25.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$43.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$43.35
|
| Rate for Payer: Vantage Medical Group Senior |
$43.35
|
|
|
HC NURSE SPEC CONF PARTICIP 15MIN
|
Facility
|
IP
|
$51.00
|
|
| Hospital Charge Code |
912154310
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$10.20 |
| Max. Negotiated Rate |
$43.35 |
| Rate for Payer: Adventist Health Commercial |
$10.20
|
| Rate for Payer: Cash Price |
$22.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.40
|
| Rate for Payer: EPIC Health Plan Senior |
$20.40
|
| Rate for Payer: Galaxy Health WC |
$43.35
|
| Rate for Payer: Global Benefits Group Commercial |
$30.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$32.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$30.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.24
|
| Rate for Payer: Multiplan Commercial |
$40.80
|
| Rate for Payer: Networks By Design Commercial |
$33.15
|
| Rate for Payer: Prime Health Services Commercial |
$43.35
|
|
|
HC NURSE SPEC CONF PARTICIP 15MIN
|
Facility
|
OP
|
$51.00
|
|
| Hospital Charge Code |
908600161
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$10.20 |
| Max. Negotiated Rate |
$43.35 |
| Rate for Payer: Adventist Health Commercial |
$10.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$33.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$43.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$38.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32.73
|
| Rate for Payer: Cash Price |
$22.95
|
| Rate for Payer: Cigna of CA HMO |
$32.64
|
| Rate for Payer: Cigna of CA PPO |
$37.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$43.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$43.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$43.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.40
|
| Rate for Payer: EPIC Health Plan Senior |
$20.40
|
| Rate for Payer: Galaxy Health WC |
$43.35
|
| Rate for Payer: Global Benefits Group Commercial |
$30.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$32.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$30.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35.70
|
| Rate for Payer: Multiplan Commercial |
$40.80
|
| Rate for Payer: Networks By Design Commercial |
$33.15
|
| Rate for Payer: Prime Health Services Commercial |
$43.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$25.50
|
| Rate for Payer: United Healthcare All Other HMO |
$25.50
|
| Rate for Payer: United Healthcare HMO Rider |
$25.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$43.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$43.35
|
| Rate for Payer: Vantage Medical Group Senior |
$43.35
|
|
|
HC NURSE SPEC CONF PARTICIP 15MIN
|
Facility
|
IP
|
$51.00
|
|
| Hospital Charge Code |
908600161
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$10.20 |
| Max. Negotiated Rate |
$43.35 |
| Rate for Payer: Adventist Health Commercial |
$10.20
|
| Rate for Payer: Cash Price |
$22.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.40
|
| Rate for Payer: EPIC Health Plan Senior |
$20.40
|
| Rate for Payer: Galaxy Health WC |
$43.35
|
| Rate for Payer: Global Benefits Group Commercial |
$30.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$32.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$30.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.24
|
| Rate for Payer: Multiplan Commercial |
$40.80
|
| Rate for Payer: Networks By Design Commercial |
$33.15
|
| Rate for Payer: Prime Health Services Commercial |
$43.35
|
|
|
HC NURSE SPEC EVAL INTERVEN 30MIN
|
Facility
|
IP
|
$92.00
|
|
| Hospital Charge Code |
908600154
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$78.20 |
| Rate for Payer: Adventist Health Commercial |
$18.40
|
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$64.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.80
|
| Rate for Payer: EPIC Health Plan Senior |
$36.80
|
| Rate for Payer: Galaxy Health WC |
$78.20
|
| Rate for Payer: Global Benefits Group Commercial |
$55.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$58.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$54.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.08
|
| Rate for Payer: Multiplan Commercial |
$73.60
|
| Rate for Payer: Networks By Design Commercial |
$59.80
|
| Rate for Payer: Prime Health Services Commercial |
$78.20
|
|
|
HC NURSE SPEC EVAL INTERVEN 30MIN
|
Facility
|
OP
|
$92.00
|
|
| Hospital Charge Code |
908600154
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$78.20 |
| Rate for Payer: Adventist Health Commercial |
$18.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$60.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$78.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$50.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$69.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.04
|
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Cigna of CA HMO |
$58.88
|
| Rate for Payer: Cigna of CA PPO |
$68.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$78.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$78.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$78.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$64.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.80
|
| Rate for Payer: EPIC Health Plan Senior |
$36.80
|
| Rate for Payer: Galaxy Health WC |
$78.20
|
| Rate for Payer: Global Benefits Group Commercial |
$55.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$58.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$33.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$54.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$64.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$64.40
|
| Rate for Payer: Multiplan Commercial |
$73.60
|
| Rate for Payer: Networks By Design Commercial |
$59.80
|
| Rate for Payer: Prime Health Services Commercial |
$78.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$55.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$55.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$46.00
|
| Rate for Payer: United Healthcare All Other HMO |
$46.00
|
| Rate for Payer: United Healthcare HMO Rider |
$46.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$46.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$78.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$78.20
|
| Rate for Payer: Vantage Medical Group Senior |
$78.20
|
|
|
HC NURSE SPEC EVAL INTERVIN 30MIN
|
Facility
|
IP
|
$97.00
|
|
| Hospital Charge Code |
912154301
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.40 |
| Max. Negotiated Rate |
$82.45 |
| Rate for Payer: Adventist Health Commercial |
$19.40
|
| Rate for Payer: Cash Price |
$43.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$67.90
|
| 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 Foundation Hospitals Commercial/Self Funded |
$61.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$57.23
|
| 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 NURSE SPEC EVAL INTERVIN 30MIN
|
Facility
|
OP
|
$97.00
|
|
| Hospital Charge Code |
912154301
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.40 |
| Max. Negotiated Rate |
$82.45 |
| 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 |
$62.24
|
| Rate for Payer: Cash Price |
$43.65
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$67.90
|
| 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 Foundation Hospitals Commercial/Self Funded |
$61.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$35.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$57.23
|
| 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 |
$48.50
|
| Rate for Payer: United Healthcare All Other HMO |
$48.50
|
| Rate for Payer: United Healthcare HMO Rider |
$48.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$48.50
|
| 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 NURSE SPEC GRP TEACH SUPPORT
|
Facility
|
IP
|
$82.00
|
|
| Hospital Charge Code |
908600162
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$69.70 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.68
|
| Rate for Payer: Multiplan Commercial |
$65.60
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
|
|
HC NURSE SPEC GRP TEACH SUPPORT
|
Facility
|
IP
|
$65.00
|
|
| Hospital Charge Code |
912154314
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$13.00 |
| Max. Negotiated Rate |
$55.25 |
| Rate for Payer: Adventist Health Commercial |
$13.00
|
| Rate for Payer: Cash Price |
$29.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$45.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.00
|
| Rate for Payer: EPIC Health Plan Senior |
$26.00
|
| Rate for Payer: Galaxy Health WC |
$55.25
|
| Rate for Payer: Global Benefits Group Commercial |
$39.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.60
|
| Rate for Payer: Multiplan Commercial |
$52.00
|
| Rate for Payer: Networks By Design Commercial |
$42.25
|
| Rate for Payer: Prime Health Services Commercial |
$55.25
|
|
|
HC NURSE SPEC GRP TEACH SUPPORT
|
Facility
|
OP
|
$65.00
|
|
| Hospital Charge Code |
912154314
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$13.00 |
| Max. Negotiated Rate |
$55.25 |
| Rate for Payer: Adventist Health Commercial |
$13.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$35.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41.71
|
| Rate for Payer: Cash Price |
$29.25
|
| Rate for Payer: Cigna of CA HMO |
$41.60
|
| Rate for Payer: Cigna of CA PPO |
$48.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$55.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$55.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$45.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.00
|
| Rate for Payer: EPIC Health Plan Senior |
$26.00
|
| Rate for Payer: Galaxy Health WC |
$55.25
|
| Rate for Payer: Global Benefits Group Commercial |
$39.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45.50
|
| Rate for Payer: Multiplan Commercial |
$52.00
|
| Rate for Payer: Networks By Design Commercial |
$42.25
|
| Rate for Payer: Prime Health Services Commercial |
$55.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.50
|
| Rate for Payer: United Healthcare All Other HMO |
$32.50
|
| Rate for Payer: United Healthcare HMO Rider |
$32.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$55.25
|
| Rate for Payer: Vantage Medical Group Senior |
$55.25
|
|
|
HC NURSE SPEC GRP TEACH SUPPORT
|
Facility
|
OP
|
$82.00
|
|
| Hospital Charge Code |
908600162
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$69.70 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$53.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.62
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$69.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$69.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$29.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57.40
|
| Rate for Payer: Multiplan Commercial |
$65.60
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41.00
|
| Rate for Payer: United Healthcare HMO Rider |
$41.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69.70
|
| Rate for Payer: Vantage Medical Group Senior |
$69.70
|
|
|
HC NURSE SPECIALIST CONF COORD
|
Facility
|
OP
|
$342.00
|
|
| Hospital Charge Code |
908600156
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$68.40 |
| Max. Negotiated Rate |
$290.70 |
| Rate for Payer: Adventist Health Commercial |
$68.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$224.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$290.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$256.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$219.46
|
| Rate for Payer: Cash Price |
$153.90
|
| Rate for Payer: Cigna of CA HMO |
$218.88
|
| Rate for Payer: Cigna of CA PPO |
$253.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$290.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$290.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$290.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$239.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$136.80
|
| Rate for Payer: EPIC Health Plan Senior |
$136.80
|
| Rate for Payer: Galaxy Health WC |
$290.70
|
| Rate for Payer: Global Benefits Group Commercial |
$205.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$217.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$124.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$201.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$239.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$239.40
|
| Rate for Payer: Multiplan Commercial |
$273.60
|
| Rate for Payer: Networks By Design Commercial |
$222.30
|
| Rate for Payer: Prime Health Services Commercial |
$290.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$205.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$205.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$171.00
|
| Rate for Payer: United Healthcare All Other HMO |
$171.00
|
| Rate for Payer: United Healthcare HMO Rider |
$171.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$171.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$290.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$290.70
|
| Rate for Payer: Vantage Medical Group Senior |
$290.70
|
|
|
HC NURSE SPECIALIST CONF COORD
|
Facility
|
IP
|
$342.00
|
|
| Hospital Charge Code |
908600156
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$68.40 |
| Max. Negotiated Rate |
$290.70 |
| Rate for Payer: Adventist Health Commercial |
$68.40
|
| Rate for Payer: Cash Price |
$153.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$239.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$136.80
|
| Rate for Payer: EPIC Health Plan Senior |
$136.80
|
| Rate for Payer: Galaxy Health WC |
$290.70
|
| Rate for Payer: Global Benefits Group Commercial |
$205.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$217.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$201.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.08
|
| Rate for Payer: Multiplan Commercial |
$273.60
|
| Rate for Payer: Networks By Design Commercial |
$222.30
|
| Rate for Payer: Prime Health Services Commercial |
$290.70
|
|
|
HC NURSE SPEC PERIODIC CHRT REV
|
Facility
|
OP
|
$176.00
|
|
| Hospital Charge Code |
908600164
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$35.20 |
| Max. Negotiated Rate |
$149.60 |
| Rate for Payer: Adventist Health Commercial |
$35.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$149.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$96.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$132.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$112.94
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cigna of CA HMO |
$112.64
|
| Rate for Payer: Cigna of CA PPO |
$130.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$149.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$149.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$149.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$123.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$70.40
|
| Rate for Payer: EPIC Health Plan Senior |
$70.40
|
| Rate for Payer: Galaxy Health WC |
$149.60
|
| Rate for Payer: Global Benefits Group Commercial |
$105.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$111.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$63.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$103.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$123.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$123.20
|
| Rate for Payer: Multiplan Commercial |
$140.80
|
| Rate for Payer: Networks By Design Commercial |
$114.40
|
| Rate for Payer: Prime Health Services Commercial |
$149.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$105.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$105.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$88.00
|
| Rate for Payer: United Healthcare All Other HMO |
$88.00
|
| Rate for Payer: United Healthcare HMO Rider |
$88.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$88.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$149.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$149.60
|
| Rate for Payer: Vantage Medical Group Senior |
$149.60
|
|
|
HC NURSE SPEC PERIODIC CHRT REV
|
Facility
|
IP
|
$176.00
|
|
| Hospital Charge Code |
908600164
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$35.20 |
| Max. Negotiated Rate |
$149.60 |
| Rate for Payer: Adventist Health Commercial |
$35.20
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$123.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$70.40
|
| Rate for Payer: EPIC Health Plan Senior |
$70.40
|
| Rate for Payer: Galaxy Health WC |
$149.60
|
| Rate for Payer: Global Benefits Group Commercial |
$105.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$111.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$103.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.24
|
| Rate for Payer: Multiplan Commercial |
$140.80
|
| Rate for Payer: Networks By Design Commercial |
$114.40
|
| Rate for Payer: Prime Health Services Commercial |
$149.60
|
|
|
HC NURSE SPEC PHONE CONSULT 15 MI
|
Facility
|
IP
|
$24.00
|
|
| Hospital Charge Code |
908603063
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$20.40 |
| Rate for Payer: Adventist Health Commercial |
$4.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.76
|
| Rate for Payer: Multiplan Commercial |
$19.20
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
|
|
HC NURSE SPEC PHONE CONSULT 15 MI
|
Facility
|
OP
|
$24.00
|
|
| Hospital Charge Code |
908603063
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$20.40 |
| Rate for Payer: Adventist Health Commercial |
$4.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.40
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cigna of CA HMO |
$15.36
|
| Rate for Payer: Cigna of CA PPO |
$17.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.80
|
| Rate for Payer: Multiplan Commercial |
$19.20
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.00
|
| Rate for Payer: United Healthcare All Other HMO |
$12.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.40
|
| Rate for Payer: Vantage Medical Group Senior |
$20.40
|
|
|
HC NUTRITION/METABOLIC ASSESS/TRA
|
Facility
|
IP
|
$523.00
|
|
| Hospital Charge Code |
902000202
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$104.60 |
| Max. Negotiated Rate |
$444.55 |
| Rate for Payer: Adventist Health Commercial |
$104.60
|
| Rate for Payer: Cash Price |
$235.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$366.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$209.20
|
| Rate for Payer: EPIC Health Plan Senior |
$209.20
|
| Rate for Payer: Galaxy Health WC |
$444.55
|
| Rate for Payer: Global Benefits Group Commercial |
$313.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$332.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$308.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$125.52
|
| Rate for Payer: Multiplan Commercial |
$418.40
|
| Rate for Payer: Networks By Design Commercial |
$339.95
|
| Rate for Payer: Prime Health Services Commercial |
$444.55
|
|
|
HC NUTRITION/METABOLIC ASSESS/TRA
|
Facility
|
OP
|
$523.00
|
|
| Hospital Charge Code |
902000202
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$125.52 |
| Max. Negotiated Rate |
$824.00 |
| Rate for Payer: Adventist Health Commercial |
$214.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$343.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$444.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$287.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$392.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$335.61
|
| Rate for Payer: Cash Price |
$235.35
|
| Rate for Payer: Cash Price |
$235.35
|
| Rate for Payer: Cigna of CA HMO |
$334.72
|
| Rate for Payer: Cigna of CA PPO |
$387.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$444.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$444.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$444.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$366.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$209.20
|
| Rate for Payer: EPIC Health Plan Senior |
$209.20
|
| Rate for Payer: Galaxy Health WC |
$444.55
|
| Rate for Payer: Global Benefits Group Commercial |
$313.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$332.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$189.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$308.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$125.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$366.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$366.10
|
| Rate for Payer: Multiplan Commercial |
$418.40
|
| Rate for Payer: Networks By Design Commercial |
$339.95
|
| Rate for Payer: Prime Health Services Commercial |
$444.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$313.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$313.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$634.00
|
| Rate for Payer: United Healthcare All Other HMO |
$824.00
|
| Rate for Payer: United Healthcare HMO Rider |
$623.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$570.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$444.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$444.55
|
| Rate for Payer: Vantage Medical Group Senior |
$444.55
|
|
|
HC NUTRITION/METABOLIC FOLLOWUP
|
Facility
|
OP
|
$267.00
|
|
| Hospital Charge Code |
902000203
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$64.08 |
| Max. Negotiated Rate |
$824.00 |
| Rate for Payer: Adventist Health Commercial |
$109.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$175.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$226.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$146.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$200.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$171.33
|
| Rate for Payer: Cash Price |
$120.15
|
| Rate for Payer: Cash Price |
$120.15
|
| Rate for Payer: Cigna of CA HMO |
$170.88
|
| Rate for Payer: Cigna of CA PPO |
$197.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$226.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$226.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$226.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$186.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.80
|
| Rate for Payer: EPIC Health Plan Senior |
$106.80
|
| Rate for Payer: Galaxy Health WC |
$226.95
|
| Rate for Payer: Global Benefits Group Commercial |
$160.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$169.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$96.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$157.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$186.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$186.90
|
| Rate for Payer: Multiplan Commercial |
$213.60
|
| Rate for Payer: Networks By Design Commercial |
$173.55
|
| Rate for Payer: Prime Health Services Commercial |
$226.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$160.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$160.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$634.00
|
| Rate for Payer: United Healthcare All Other HMO |
$824.00
|
| Rate for Payer: United Healthcare HMO Rider |
$623.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$570.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$226.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$226.95
|
| Rate for Payer: Vantage Medical Group Senior |
$226.95
|
|
|
HC NUTRITION/METABOLIC FOLLOWUP
|
Facility
|
IP
|
$267.00
|
|
| Hospital Charge Code |
902000203
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$53.40 |
| Max. Negotiated Rate |
$226.95 |
| Rate for Payer: Adventist Health Commercial |
$53.40
|
| Rate for Payer: Cash Price |
$120.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$186.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.80
|
| Rate for Payer: EPIC Health Plan Senior |
$106.80
|
| Rate for Payer: Galaxy Health WC |
$226.95
|
| Rate for Payer: Global Benefits Group Commercial |
$160.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$169.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$157.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.08
|
| Rate for Payer: Multiplan Commercial |
$213.60
|
| Rate for Payer: Networks By Design Commercial |
$173.55
|
| Rate for Payer: Prime Health Services Commercial |
$226.95
|
|
|
HC NUTRITION THER GRP 30 MIN
|
Facility
|
OP
|
$207.00
|
|
|
Service Code
|
CPT 97804
|
| Hospital Charge Code |
902000205
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$23.37 |
| Max. Negotiated Rate |
$824.00 |
| Rate for Payer: Adventist Health Commercial |
$84.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$123.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$175.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$113.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$155.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$132.83
|
| Rate for Payer: Cash Price |
$93.15
|
| Rate for Payer: Cash Price |
$93.15
|
| Rate for Payer: Cash Price |
$93.15
|
| Rate for Payer: Cigna of CA HMO |
$132.48
|
| Rate for Payer: Cigna of CA PPO |
$153.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$175.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$175.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$144.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$82.80
|
| Rate for Payer: EPIC Health Plan Senior |
$82.80
|
| Rate for Payer: Galaxy Health WC |
$175.95
|
| Rate for Payer: Global Benefits Group Commercial |
$124.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$23.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$131.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$26.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$122.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$144.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$144.90
|
| Rate for Payer: Multiplan Commercial |
$165.60
|
| Rate for Payer: Networks By Design Commercial |
$134.55
|
| Rate for Payer: Prime Health Services Commercial |
$175.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$124.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$124.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$634.00
|
| Rate for Payer: United Healthcare All Other HMO |
$824.00
|
| Rate for Payer: United Healthcare HMO Rider |
$623.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$570.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$175.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.95
|
| Rate for Payer: Vantage Medical Group Senior |
$175.95
|
|
|
HC NUTRITION THER GRP 30 MIN
|
Facility
|
IP
|
$207.00
|
|
|
Service Code
|
CPT 97804
|
| Hospital Charge Code |
902000205
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$41.40 |
| Max. Negotiated Rate |
$175.95 |
| Rate for Payer: Adventist Health Commercial |
$41.40
|
| Rate for Payer: Cash Price |
$93.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$144.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$82.80
|
| Rate for Payer: EPIC Health Plan Senior |
$82.80
|
| Rate for Payer: Galaxy Health WC |
$175.95
|
| Rate for Payer: Global Benefits Group Commercial |
$124.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$131.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$122.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.68
|
| Rate for Payer: Multiplan Commercial |
$165.60
|
| Rate for Payer: Networks By Design Commercial |
$134.55
|
| Rate for Payer: Prime Health Services Commercial |
$175.95
|
|
