|
HC SVC MENTAL HEALTH EDUCATION
|
Facility
|
OP
|
$374.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804035
|
|
Hospital Revenue Code
|
912
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$800.00 |
| Rate for Payer: Adventist Health Commercial |
$74.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$130.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$251.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$195.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$143.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$130.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$181.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$217.56
|
| Rate for Payer: Blue Shield of California Commercial |
$237.12
|
| Rate for Payer: Blue Shield of California EPN |
$149.23
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Central Health Plan Commercial |
$299.20
|
| Rate for Payer: Cigna of CA HMO |
$239.36
|
| Rate for Payer: Cigna of CA PPO |
$276.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$195.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$143.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$130.66
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$261.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.59
|
| Rate for Payer: EPIC Health Plan Senior |
$143.73
|
| Rate for Payer: Galaxy Health WC |
$317.90
|
| Rate for Payer: Global Benefits Group Commercial |
$224.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$336.60
|
| Rate for Payer: Health Net Behavioral |
$800.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$214.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$41.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$130.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$237.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$45.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$182.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$175.08
|
| Rate for Payer: Multiplan Commercial |
$280.50
|
| Rate for Payer: Networks By Design Commercial |
$243.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$130.66
|
| Rate for Payer: Prime Health Services Commercial |
$317.90
|
| Rate for Payer: Prime Health Services Medicare |
$138.50
|
| Rate for Payer: Riverside University Health System MISP |
$143.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$224.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$224.40
|
| Rate for Payer: Upland Medical Group Pediatric |
$130.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$195.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$143.73
|
| Rate for Payer: Vantage Medical Group Senior |
$130.66
|
|
|
HC SVC MENTAL HEALTH EDUCATION
|
Facility
|
IP
|
$374.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804035
|
|
Hospital Revenue Code
|
912
|
| Min. Negotiated Rate |
$74.80 |
| Max. Negotiated Rate |
$336.60 |
| Rate for Payer: Adventist Health Commercial |
$74.80
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Central Health Plan Commercial |
$299.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$261.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.60
|
| Rate for Payer: EPIC Health Plan Senior |
$149.60
|
| Rate for Payer: Galaxy Health WC |
$317.90
|
| Rate for Payer: Global Benefits Group Commercial |
$224.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$336.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$237.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$220.66
|
| Rate for Payer: Multiplan Commercial |
$280.50
|
| Rate for Payer: Networks By Design Commercial |
$243.10
|
| Rate for Payer: Prime Health Services Commercial |
$317.90
|
|
|
HC SVC STRESS MANAGEMENT
|
Facility
|
IP
|
$374.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804015
|
|
Hospital Revenue Code
|
912
|
| Min. Negotiated Rate |
$74.80 |
| Max. Negotiated Rate |
$336.60 |
| Rate for Payer: Adventist Health Commercial |
$74.80
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Central Health Plan Commercial |
$299.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$261.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.60
|
| Rate for Payer: EPIC Health Plan Senior |
$149.60
|
| Rate for Payer: Galaxy Health WC |
$317.90
|
| Rate for Payer: Global Benefits Group Commercial |
$224.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$336.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$237.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$220.66
|
| Rate for Payer: Multiplan Commercial |
$280.50
|
| Rate for Payer: Networks By Design Commercial |
$243.10
|
| Rate for Payer: Prime Health Services Commercial |
$317.90
|
|
|
HC SVC STRESS MANAGEMENT
|
Facility
|
OP
|
$374.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804015
|
|
Hospital Revenue Code
|
912
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$800.00 |
| Rate for Payer: Adventist Health Commercial |
$74.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$130.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$251.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$195.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$143.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$130.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$181.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$217.56
|
| Rate for Payer: Blue Shield of California Commercial |
$237.12
|
| Rate for Payer: Blue Shield of California EPN |
$149.23
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Central Health Plan Commercial |
$299.20
|
| Rate for Payer: Cigna of CA HMO |
$239.36
|
| Rate for Payer: Cigna of CA PPO |
$276.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$195.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$143.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$130.66
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$261.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.59
|
| Rate for Payer: EPIC Health Plan Senior |
$143.73
|
| Rate for Payer: Galaxy Health WC |
$317.90
|
| Rate for Payer: Global Benefits Group Commercial |
$224.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$336.60
|
| Rate for Payer: Health Net Behavioral |
$800.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$214.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$41.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$130.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$237.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$45.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$182.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$175.08
|
| Rate for Payer: Multiplan Commercial |
$280.50
|
| Rate for Payer: Networks By Design Commercial |
$243.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$130.66
|
| Rate for Payer: Prime Health Services Commercial |
$317.90
|
| Rate for Payer: Prime Health Services Medicare |
$138.50
|
| Rate for Payer: Riverside University Health System MISP |
$143.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$224.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$224.40
|
| Rate for Payer: Upland Medical Group Pediatric |
$130.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$195.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$143.73
|
| Rate for Payer: Vantage Medical Group Senior |
$130.66
|
|
|
HC SVS AIRWAY SZNG KIT W/BLN CATH
|
Facility
|
IP
|
$145.00
|
|
|
Service Code
|
CPT C1726
|
| Hospital Charge Code |
900831821
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.00 |
| Max. Negotiated Rate |
$130.50 |
| Rate for Payer: Adventist Health Commercial |
$29.00
|
| Rate for Payer: Cash Price |
$65.25
|
| Rate for Payer: Central Health Plan Commercial |
$116.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$101.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$58.00
|
| Rate for Payer: EPIC Health Plan Senior |
$58.00
|
| Rate for Payer: Galaxy Health WC |
$123.25
|
| Rate for Payer: Global Benefits Group Commercial |
$87.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$130.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$92.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$85.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.00
|
| Rate for Payer: Multiplan Commercial |
$108.75
|
| Rate for Payer: Networks By Design Commercial |
$94.25
|
| Rate for Payer: Prime Health Services Commercial |
$123.25
|
|
|
HC SVS AIRWAY SZNG KIT W/BLN CATH
|
Facility
|
OP
|
$145.00
|
|
|
Service Code
|
CPT C1726
|
| Hospital Charge Code |
900831821
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.00 |
| Max. Negotiated Rate |
$431.40 |
| Rate for Payer: Adventist Health Commercial |
$29.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$431.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$123.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$79.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$108.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$70.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$84.35
|
| Rate for Payer: Blue Shield of California Commercial |
$91.93
|
| Rate for Payer: Blue Shield of California EPN |
$57.85
|
| Rate for Payer: Cash Price |
$65.25
|
| Rate for Payer: Cash Price |
$65.25
|
| Rate for Payer: Central Health Plan Commercial |
$116.00
|
| Rate for Payer: Cigna of CA HMO |
$92.80
|
| Rate for Payer: Cigna of CA PPO |
$107.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$123.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$123.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$101.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$58.00
|
| Rate for Payer: EPIC Health Plan Senior |
$58.00
|
| Rate for Payer: Galaxy Health WC |
$123.25
|
| Rate for Payer: Global Benefits Group Commercial |
$87.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$130.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$92.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$52.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$85.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$101.50
|
| Rate for Payer: Multiplan Commercial |
$108.75
|
| Rate for Payer: Networks By Design Commercial |
$94.25
|
| Rate for Payer: Prime Health Services Commercial |
$123.25
|
| Rate for Payer: Riverside University Health System MISP |
$58.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$87.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$87.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$72.50
|
| Rate for Payer: United Healthcare All Other HMO |
$72.50
|
| Rate for Payer: United Healthcare HMO Rider |
$72.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$72.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$123.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.25
|
| Rate for Payer: Vantage Medical Group Senior |
$123.25
|
|
|
HC SVS DEPLOYMENT CATH AND LOADER
|
Facility
|
IP
|
$390.00
|
|
| Hospital Charge Code |
900831820
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$351.00 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Central Health Plan Commercial |
$312.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$273.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$156.00
|
| Rate for Payer: EPIC Health Plan Senior |
$156.00
|
| Rate for Payer: Galaxy Health WC |
$331.50
|
| Rate for Payer: Global Benefits Group Commercial |
$234.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$351.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$247.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$230.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: Networks By Design Commercial |
$253.50
|
| Rate for Payer: Prime Health Services Commercial |
$331.50
|
|
|
HC SVS DEPLOYMENT CATH AND LOADER
|
Facility
|
OP
|
$390.00
|
|
| Hospital Charge Code |
900831820
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$351.00 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$236.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$331.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$214.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$292.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$188.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$226.86
|
| Rate for Payer: Blue Shield of California Commercial |
$247.26
|
| Rate for Payer: Blue Shield of California EPN |
$155.61
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Central Health Plan Commercial |
$312.00
|
| Rate for Payer: Cigna of CA HMO |
$249.60
|
| Rate for Payer: Cigna of CA PPO |
$288.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$331.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$331.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$331.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$273.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$156.00
|
| Rate for Payer: EPIC Health Plan Senior |
$156.00
|
| Rate for Payer: Galaxy Health WC |
$331.50
|
| Rate for Payer: Global Benefits Group Commercial |
$234.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$351.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$247.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$141.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$230.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$273.00
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: Networks By Design Commercial |
$253.50
|
| Rate for Payer: Prime Health Services Commercial |
$331.50
|
| Rate for Payer: Riverside University Health System MISP |
$156.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$234.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$234.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$195.00
|
| Rate for Payer: United Healthcare All Other HMO |
$195.00
|
| Rate for Payer: United Healthcare HMO Rider |
$195.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$195.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$331.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$331.50
|
| Rate for Payer: Vantage Medical Group Senior |
$331.50
|
|
|
HC SVS VALVE IN CARTRIDGE 5MM
|
Facility
|
OP
|
$675.00
|
|
|
Service Code
|
CPT C1889
|
| Hospital Charge Code |
900831822
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$607.50 |
| Rate for Payer: Adventist Health Commercial |
$135.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$573.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$371.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$506.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$308.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$370.17
|
| Rate for Payer: Blue Shield of California Commercial |
$541.35
|
| Rate for Payer: Blue Shield of California EPN |
$340.20
|
| Rate for Payer: Cash Price |
$303.75
|
| Rate for Payer: Central Health Plan Commercial |
$540.00
|
| Rate for Payer: Cigna of CA HMO |
$472.50
|
| Rate for Payer: Cigna of CA PPO |
$472.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$573.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$573.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$573.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$472.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$270.00
|
| Rate for Payer: EPIC Health Plan Senior |
$270.00
|
| Rate for Payer: Galaxy Health WC |
$573.75
|
| Rate for Payer: Global Benefits Group Commercial |
$405.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$607.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$428.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$245.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$398.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$472.50
|
| Rate for Payer: Multiplan Commercial |
$506.25
|
| Rate for Payer: Networks By Design Commercial |
$337.50
|
| Rate for Payer: Prime Health Services Commercial |
$573.75
|
| Rate for Payer: Riverside University Health System MISP |
$270.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$405.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$405.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$253.33
|
| Rate for Payer: United Healthcare All Other HMO |
$246.58
|
| Rate for Payer: United Healthcare HMO Rider |
$241.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$221.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$573.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$573.75
|
| Rate for Payer: Vantage Medical Group Senior |
$573.75
|
|
|
HC SVS VALVE IN CARTRIDGE 5MM
|
Facility
|
IP
|
$675.00
|
|
|
Service Code
|
CPT C1889
|
| Hospital Charge Code |
900831822
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$607.50 |
| Rate for Payer: Adventist Health Commercial |
$135.00
|
| Rate for Payer: Blue Shield of California Commercial |
$541.35
|
| Rate for Payer: Blue Shield of California EPN |
$340.20
|
| Rate for Payer: Cash Price |
$303.75
|
| Rate for Payer: Central Health Plan Commercial |
$540.00
|
| Rate for Payer: Cigna of CA HMO |
$472.50
|
| Rate for Payer: Cigna of CA PPO |
$472.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$472.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$270.00
|
| Rate for Payer: EPIC Health Plan Senior |
$270.00
|
| Rate for Payer: Galaxy Health WC |
$573.75
|
| Rate for Payer: Global Benefits Group Commercial |
$405.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$607.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$428.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$398.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.00
|
| Rate for Payer: Multiplan Commercial |
$506.25
|
| Rate for Payer: Networks By Design Commercial |
$337.50
|
| Rate for Payer: Prime Health Services Commercial |
$573.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$253.33
|
| Rate for Payer: United Healthcare All Other HMO |
$246.58
|
| Rate for Payer: United Healthcare HMO Rider |
$241.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$221.06
|
|
|
HC SVS VALVE IN CARTRIDGE 6MM
|
Facility
|
IP
|
$675.00
|
|
|
Service Code
|
CPT C1889
|
| Hospital Charge Code |
900831823
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$607.50 |
| Rate for Payer: Adventist Health Commercial |
$135.00
|
| Rate for Payer: Blue Shield of California Commercial |
$541.35
|
| Rate for Payer: Blue Shield of California EPN |
$340.20
|
| Rate for Payer: Cash Price |
$303.75
|
| Rate for Payer: Central Health Plan Commercial |
$540.00
|
| Rate for Payer: Cigna of CA HMO |
$472.50
|
| Rate for Payer: Cigna of CA PPO |
$472.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$472.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$270.00
|
| Rate for Payer: EPIC Health Plan Senior |
$270.00
|
| Rate for Payer: Galaxy Health WC |
$573.75
|
| Rate for Payer: Global Benefits Group Commercial |
$405.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$607.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$428.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$398.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.00
|
| Rate for Payer: Multiplan Commercial |
$506.25
|
| Rate for Payer: Networks By Design Commercial |
$337.50
|
| Rate for Payer: Prime Health Services Commercial |
$573.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$253.33
|
| Rate for Payer: United Healthcare All Other HMO |
$246.58
|
| Rate for Payer: United Healthcare HMO Rider |
$241.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$221.06
|
|
|
HC SVS VALVE IN CARTRIDGE 6MM
|
Facility
|
OP
|
$675.00
|
|
|
Service Code
|
CPT C1889
|
| Hospital Charge Code |
900831823
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$607.50 |
| Rate for Payer: Adventist Health Commercial |
$135.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$573.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$371.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$506.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$308.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$370.17
|
| Rate for Payer: Blue Shield of California Commercial |
$541.35
|
| Rate for Payer: Blue Shield of California EPN |
$340.20
|
| Rate for Payer: Cash Price |
$303.75
|
| Rate for Payer: Central Health Plan Commercial |
$540.00
|
| Rate for Payer: Cigna of CA HMO |
$472.50
|
| Rate for Payer: Cigna of CA PPO |
$472.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$573.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$573.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$573.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$472.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$270.00
|
| Rate for Payer: EPIC Health Plan Senior |
$270.00
|
| Rate for Payer: Galaxy Health WC |
$573.75
|
| Rate for Payer: Global Benefits Group Commercial |
$405.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$607.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$428.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$245.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$398.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$472.50
|
| Rate for Payer: Multiplan Commercial |
$506.25
|
| Rate for Payer: Networks By Design Commercial |
$337.50
|
| Rate for Payer: Prime Health Services Commercial |
$573.75
|
| Rate for Payer: Riverside University Health System MISP |
$270.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$405.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$405.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$253.33
|
| Rate for Payer: United Healthcare All Other HMO |
$246.58
|
| Rate for Payer: United Healthcare HMO Rider |
$241.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$221.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$573.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$573.75
|
| Rate for Payer: Vantage Medical Group Senior |
$573.75
|
|
|
HC SVS VALVE IN CARTRIDGE 7MM
|
Facility
|
IP
|
$675.00
|
|
|
Service Code
|
CPT C1889
|
| Hospital Charge Code |
900831824
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$607.50 |
| Rate for Payer: Adventist Health Commercial |
$135.00
|
| Rate for Payer: Blue Shield of California Commercial |
$541.35
|
| Rate for Payer: Blue Shield of California EPN |
$340.20
|
| Rate for Payer: Cash Price |
$303.75
|
| Rate for Payer: Central Health Plan Commercial |
$540.00
|
| Rate for Payer: Cigna of CA HMO |
$472.50
|
| Rate for Payer: Cigna of CA PPO |
$472.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$472.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$270.00
|
| Rate for Payer: EPIC Health Plan Senior |
$270.00
|
| Rate for Payer: Galaxy Health WC |
$573.75
|
| Rate for Payer: Global Benefits Group Commercial |
$405.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$607.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$428.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$398.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.00
|
| Rate for Payer: Multiplan Commercial |
$506.25
|
| Rate for Payer: Networks By Design Commercial |
$337.50
|
| Rate for Payer: Prime Health Services Commercial |
$573.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$253.33
|
| Rate for Payer: United Healthcare All Other HMO |
$246.58
|
| Rate for Payer: United Healthcare HMO Rider |
$241.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$221.06
|
|
|
HC SVS VALVE IN CARTRIDGE 7MM
|
Facility
|
OP
|
$675.00
|
|
|
Service Code
|
CPT C1889
|
| Hospital Charge Code |
900831824
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$607.50 |
| Rate for Payer: Adventist Health Commercial |
$135.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$573.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$371.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$506.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$308.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$370.17
|
| Rate for Payer: Blue Shield of California Commercial |
$541.35
|
| Rate for Payer: Blue Shield of California EPN |
$340.20
|
| Rate for Payer: Cash Price |
$303.75
|
| Rate for Payer: Central Health Plan Commercial |
$540.00
|
| Rate for Payer: Cigna of CA HMO |
$472.50
|
| Rate for Payer: Cigna of CA PPO |
$472.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$573.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$573.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$573.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$472.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$270.00
|
| Rate for Payer: EPIC Health Plan Senior |
$270.00
|
| Rate for Payer: Galaxy Health WC |
$573.75
|
| Rate for Payer: Global Benefits Group Commercial |
$405.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$607.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$428.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$245.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$398.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$472.50
|
| Rate for Payer: Multiplan Commercial |
$506.25
|
| Rate for Payer: Networks By Design Commercial |
$337.50
|
| Rate for Payer: Prime Health Services Commercial |
$573.75
|
| Rate for Payer: Riverside University Health System MISP |
$270.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$405.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$405.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$253.33
|
| Rate for Payer: United Healthcare All Other HMO |
$246.58
|
| Rate for Payer: United Healthcare HMO Rider |
$241.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$221.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$573.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$573.75
|
| Rate for Payer: Vantage Medical Group Senior |
$573.75
|
|
|
HC SVS VALVE IN CARTRIDGE 9MM
|
Facility
|
IP
|
$675.00
|
|
|
Service Code
|
CPT C1889
|
| Hospital Charge Code |
900831825
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$607.50 |
| Rate for Payer: Adventist Health Commercial |
$135.00
|
| Rate for Payer: Blue Shield of California Commercial |
$541.35
|
| Rate for Payer: Blue Shield of California EPN |
$340.20
|
| Rate for Payer: Cash Price |
$303.75
|
| Rate for Payer: Central Health Plan Commercial |
$540.00
|
| Rate for Payer: Cigna of CA HMO |
$472.50
|
| Rate for Payer: Cigna of CA PPO |
$472.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$472.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$270.00
|
| Rate for Payer: EPIC Health Plan Senior |
$270.00
|
| Rate for Payer: Galaxy Health WC |
$573.75
|
| Rate for Payer: Global Benefits Group Commercial |
$405.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$607.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$428.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$398.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.00
|
| Rate for Payer: Multiplan Commercial |
$506.25
|
| Rate for Payer: Networks By Design Commercial |
$337.50
|
| Rate for Payer: Prime Health Services Commercial |
$573.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$253.33
|
| Rate for Payer: United Healthcare All Other HMO |
$246.58
|
| Rate for Payer: United Healthcare HMO Rider |
$241.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$221.06
|
|
|
HC SVS VALVE IN CARTRIDGE 9MM
|
Facility
|
OP
|
$675.00
|
|
|
Service Code
|
CPT C1889
|
| Hospital Charge Code |
900831825
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$607.50 |
| Rate for Payer: Adventist Health Commercial |
$135.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$573.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$371.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$506.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$308.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$370.17
|
| Rate for Payer: Blue Shield of California Commercial |
$541.35
|
| Rate for Payer: Blue Shield of California EPN |
$340.20
|
| Rate for Payer: Cash Price |
$303.75
|
| Rate for Payer: Central Health Plan Commercial |
$540.00
|
| Rate for Payer: Cigna of CA HMO |
$472.50
|
| Rate for Payer: Cigna of CA PPO |
$472.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$573.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$573.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$573.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$472.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$270.00
|
| Rate for Payer: EPIC Health Plan Senior |
$270.00
|
| Rate for Payer: Galaxy Health WC |
$573.75
|
| Rate for Payer: Global Benefits Group Commercial |
$405.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$607.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$428.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$245.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$398.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$472.50
|
| Rate for Payer: Multiplan Commercial |
$506.25
|
| Rate for Payer: Networks By Design Commercial |
$337.50
|
| Rate for Payer: Prime Health Services Commercial |
$573.75
|
| Rate for Payer: Riverside University Health System MISP |
$270.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$405.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$405.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$253.33
|
| Rate for Payer: United Healthcare All Other HMO |
$246.58
|
| Rate for Payer: United Healthcare HMO Rider |
$241.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$221.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$573.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$573.75
|
| Rate for Payer: Vantage Medical Group Senior |
$573.75
|
|
|
HC SWALLOW CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8996
|
| Hospital Charge Code |
900018418
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC SWALLOW CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8996
|
| Hospital Charge Code |
900018418
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC SWALLOW CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8996
|
| Hospital Charge Code |
900018118
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC SWALLOW CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8996
|
| Hospital Charge Code |
900018218
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC SWALLOW CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8996
|
| Hospital Charge Code |
900018218
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC SWALLOW CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8996
|
| Hospital Charge Code |
900018118
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC SWALLOW D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8998
|
| Hospital Charge Code |
900018220
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC SWALLOW D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8998
|
| Hospital Charge Code |
900018120
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC SWALLOW D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8998
|
| Hospital Charge Code |
900018220
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
