|
HC SPEECH LANG CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9174
|
| Hospital Charge Code |
900018139
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA 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 SPEECH LANG CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9174
|
| Hospital Charge Code |
900018239
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$447.00 |
| 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 |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| 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: 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: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA 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 SPEECH LANG CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9174
|
| Hospital Charge Code |
900018239
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA 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 SPEECH LANG CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9174
|
| Hospital Charge Code |
900018439
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA 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 SPEECH LANG D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9176
|
| Hospital Charge Code |
900018141
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$447.00 |
| 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 |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| 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: 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: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA 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 SPEECH LANG D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9176
|
| Hospital Charge Code |
900018241
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$447.00 |
| 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 |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| 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: 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: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA 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 SPEECH LANG D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9176
|
| Hospital Charge Code |
900018141
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA 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 SPEECH LANG D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9176
|
| Hospital Charge Code |
900018241
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA 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 SPEECH LANG D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9176
|
| Hospital Charge Code |
900018441
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$447.00 |
| 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 |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| 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: 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: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA 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 SPEECH LANG D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9176
|
| Hospital Charge Code |
900018441
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA 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 SPEECH LANG GOAL STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9175
|
| Hospital Charge Code |
900018240
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA 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 SPEECH LANG GOAL STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9175
|
| Hospital Charge Code |
900018440
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA 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 SPEECH LANG GOAL STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9175
|
| Hospital Charge Code |
900018440
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$447.00 |
| 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 |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| 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: 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: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA 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 SPEECH LANG GOAL STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9175
|
| Hospital Charge Code |
900018140
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA 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 SPEECH LANG GOAL STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9175
|
| Hospital Charge Code |
900018240
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$447.00 |
| 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 |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| 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: 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: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA 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 SPEECH LANG GOAL STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9175
|
| Hospital Charge Code |
900018140
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$447.00 |
| 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 |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| 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: 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: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA 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 SPEECH & LANG INDIV TRT
|
Facility
|
IP
|
$774.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
907000460
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$154.80 |
| Max. Negotiated Rate |
$696.60 |
| Rate for Payer: Adventist Health Commercial |
$154.80
|
| Rate for Payer: Cash Price |
$425.70
|
| Rate for Payer: Central Health Plan Commercial |
$619.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.60
|
| Rate for Payer: EPIC Health Plan Senior |
$309.60
|
| Rate for Payer: Galaxy Health WC |
$657.90
|
| Rate for Payer: Global Benefits Group Commercial |
$464.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$696.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$516.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$294.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$479.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.80
|
| Rate for Payer: Multiplan Commercial |
$580.50
|
| Rate for Payer: Networks By Design Commercial |
$503.10
|
| Rate for Payer: Prime Health Services Commercial |
$657.90
|
|
|
HC SPEECH & LANG INDIV TRT
|
Facility
|
OP
|
$774.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
907000460
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$51.12 |
| Max. Negotiated Rate |
$696.60 |
| Rate for Payer: Adventist Health Commercial |
$317.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$470.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$657.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$580.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$425.70
|
| Rate for Payer: Cash Price |
$425.70
|
| Rate for Payer: Cash Price |
$425.70
|
| Rate for Payer: Cash Price |
$425.70
|
| Rate for Payer: Central Health Plan Commercial |
$619.20
|
| Rate for Payer: Cigna of CA HMO |
$495.36
|
| Rate for Payer: Cigna of CA PPO |
$572.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$657.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$657.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$657.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.60
|
| Rate for Payer: EPIC Health Plan Senior |
$309.60
|
| Rate for Payer: Galaxy Health WC |
$657.90
|
| Rate for Payer: Global Benefits Group Commercial |
$464.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$696.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$51.12
|
| Rate for Payer: InnovAge PACE Commercial |
$387.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$516.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$479.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$317.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$541.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$541.80
|
| Rate for Payer: Multiplan Commercial |
$580.50
|
| Rate for Payer: Networks By Design Commercial |
$503.10
|
| Rate for Payer: Prime Health Services Commercial |
$657.90
|
| Rate for Payer: Riverside University Health System MISP |
$309.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$464.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$464.40
|
| 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 |
$657.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$657.90
|
| Rate for Payer: Vantage Medical Group Senior |
$657.90
|
|
|
HC SPEECH & LANG TRT
|
Facility
|
IP
|
$619.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
905600430
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$123.80 |
| Max. Negotiated Rate |
$557.10 |
| Rate for Payer: Adventist Health Commercial |
$123.80
|
| Rate for Payer: Cash Price |
$340.45
|
| Rate for Payer: Central Health Plan Commercial |
$495.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$247.60
|
| Rate for Payer: EPIC Health Plan Senior |
$247.60
|
| Rate for Payer: Galaxy Health WC |
$526.15
|
| Rate for Payer: Global Benefits Group Commercial |
$371.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$557.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$412.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$235.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$383.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.80
|
| Rate for Payer: Multiplan Commercial |
$464.25
|
| Rate for Payer: Networks By Design Commercial |
$402.35
|
| Rate for Payer: Prime Health Services Commercial |
$526.15
|
|
|
HC SPEECH & LANG TRT
|
Facility
|
OP
|
$619.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
905600430
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$51.12 |
| Max. Negotiated Rate |
$557.10 |
| Rate for Payer: Adventist Health Commercial |
$253.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$375.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$526.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$340.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$464.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$340.45
|
| Rate for Payer: Cash Price |
$340.45
|
| Rate for Payer: Cash Price |
$340.45
|
| Rate for Payer: Cash Price |
$340.45
|
| Rate for Payer: Central Health Plan Commercial |
$495.20
|
| Rate for Payer: Cigna of CA HMO |
$396.16
|
| Rate for Payer: Cigna of CA PPO |
$458.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$526.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$526.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$526.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$247.60
|
| Rate for Payer: EPIC Health Plan Senior |
$247.60
|
| Rate for Payer: Galaxy Health WC |
$526.15
|
| Rate for Payer: Global Benefits Group Commercial |
$371.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$557.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$51.12
|
| Rate for Payer: InnovAge PACE Commercial |
$309.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$412.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$383.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$433.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$433.30
|
| Rate for Payer: Multiplan Commercial |
$464.25
|
| Rate for Payer: Networks By Design Commercial |
$402.35
|
| Rate for Payer: Prime Health Services Commercial |
$526.15
|
| Rate for Payer: Riverside University Health System MISP |
$247.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$371.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$371.40
|
| 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 |
$526.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$526.15
|
| Rate for Payer: Vantage Medical Group Senior |
$526.15
|
|
|
HC SPHINCTEROTOME 0.021IN 5-4FRX20MM
|
Facility
|
OP
|
$506.00
|
|
| Hospital Charge Code |
900100360
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$101.20 |
| Max. Negotiated Rate |
$455.40 |
| Rate for Payer: Adventist Health Commercial |
$101.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$307.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$430.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$278.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$379.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$245.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$297.17
|
| Rate for Payer: Blue Shield of California Commercial |
$309.17
|
| Rate for Payer: Blue Shield of California EPN |
$201.89
|
| Rate for Payer: Cash Price |
$278.30
|
| Rate for Payer: Central Health Plan Commercial |
$404.80
|
| Rate for Payer: Cigna of CA HMO |
$323.84
|
| Rate for Payer: Cigna of CA PPO |
$374.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$430.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$430.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$430.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$202.40
|
| Rate for Payer: EPIC Health Plan Senior |
$202.40
|
| Rate for Payer: Galaxy Health WC |
$430.10
|
| Rate for Payer: Global Benefits Group Commercial |
$303.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$455.40
|
| Rate for Payer: InnovAge PACE Commercial |
$253.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$337.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$192.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$313.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$101.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$354.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$354.20
|
| Rate for Payer: Multiplan Commercial |
$379.50
|
| Rate for Payer: Networks By Design Commercial |
$328.90
|
| Rate for Payer: Prime Health Services Commercial |
$430.10
|
| Rate for Payer: Riverside University Health System MISP |
$202.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$303.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$303.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$253.00
|
| Rate for Payer: United Healthcare All Other HMO |
$253.00
|
| Rate for Payer: United Healthcare HMO Rider |
$253.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$253.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$430.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$430.10
|
| Rate for Payer: Vantage Medical Group Senior |
$430.10
|
|
|
HC SPHINCTEROTOME 0.021IN 5-4FRX20MM
|
Facility
|
IP
|
$506.00
|
|
| Hospital Charge Code |
900100360
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$101.20 |
| Max. Negotiated Rate |
$455.40 |
| Rate for Payer: Adventist Health Commercial |
$101.20
|
| Rate for Payer: Cash Price |
$278.30
|
| Rate for Payer: Central Health Plan Commercial |
$404.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$202.40
|
| Rate for Payer: EPIC Health Plan Senior |
$202.40
|
| Rate for Payer: Galaxy Health WC |
$430.10
|
| Rate for Payer: Global Benefits Group Commercial |
$303.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$455.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$337.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$192.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$313.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$101.20
|
| Rate for Payer: Multiplan Commercial |
$379.50
|
| Rate for Payer: Networks By Design Commercial |
$328.90
|
| Rate for Payer: Prime Health Services Commercial |
$430.10
|
|
|
HC SPHINCTEROTOME 0.021IN 5.5FR
|
Facility
|
OP
|
$943.00
|
|
| Hospital Charge Code |
900100364
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$188.60 |
| Max. Negotiated Rate |
$848.70 |
| Rate for Payer: Adventist Health Commercial |
$188.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$572.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$801.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$518.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$707.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$456.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$553.82
|
| Rate for Payer: Blue Shield of California Commercial |
$576.17
|
| Rate for Payer: Blue Shield of California EPN |
$376.26
|
| Rate for Payer: Cash Price |
$518.65
|
| Rate for Payer: Central Health Plan Commercial |
$754.40
|
| Rate for Payer: Cigna of CA HMO |
$603.52
|
| Rate for Payer: Cigna of CA PPO |
$697.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$801.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$801.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$801.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$377.20
|
| Rate for Payer: EPIC Health Plan Senior |
$377.20
|
| Rate for Payer: Galaxy Health WC |
$801.55
|
| Rate for Payer: Global Benefits Group Commercial |
$565.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$848.70
|
| Rate for Payer: InnovAge PACE Commercial |
$471.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$628.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$359.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$583.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$188.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$660.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$660.10
|
| Rate for Payer: Multiplan Commercial |
$707.25
|
| Rate for Payer: Networks By Design Commercial |
$612.95
|
| Rate for Payer: Prime Health Services Commercial |
$801.55
|
| Rate for Payer: Riverside University Health System MISP |
$377.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$565.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$565.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$471.50
|
| Rate for Payer: United Healthcare All Other HMO |
$471.50
|
| Rate for Payer: United Healthcare HMO Rider |
$471.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$471.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$801.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$801.55
|
| Rate for Payer: Vantage Medical Group Senior |
$801.55
|
|
|
HC SPHINCTEROTOME 0.021IN 5.5FR
|
Facility
|
IP
|
$943.00
|
|
| Hospital Charge Code |
900100364
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$188.60 |
| Max. Negotiated Rate |
$848.70 |
| Rate for Payer: Adventist Health Commercial |
$188.60
|
| Rate for Payer: Cash Price |
$518.65
|
| Rate for Payer: Central Health Plan Commercial |
$754.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$377.20
|
| Rate for Payer: EPIC Health Plan Senior |
$377.20
|
| Rate for Payer: Galaxy Health WC |
$801.55
|
| Rate for Payer: Global Benefits Group Commercial |
$565.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$848.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$628.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$359.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$583.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$188.60
|
| Rate for Payer: Multiplan Commercial |
$707.25
|
| Rate for Payer: Networks By Design Commercial |
$612.95
|
| Rate for Payer: Prime Health Services Commercial |
$801.55
|
|
|
HC SPHINCTEROTOME 0.021INX480 5.5FR
|
Facility
|
OP
|
$1,375.40
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
900100362
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$275.08 |
| Max. Negotiated Rate |
$1,237.86 |
| Rate for Payer: Adventist Health Commercial |
$275.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$835.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,169.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$756.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,031.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$665.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$807.77
|
| Rate for Payer: Blue Shield of California Commercial |
$840.37
|
| Rate for Payer: Blue Shield of California EPN |
$548.78
|
| Rate for Payer: Cash Price |
$756.47
|
| Rate for Payer: Central Health Plan Commercial |
$1,100.32
|
| Rate for Payer: Cigna of CA HMO |
$880.26
|
| Rate for Payer: Cigna of CA PPO |
$1,017.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,169.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,169.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,169.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$550.16
|
| Rate for Payer: EPIC Health Plan Senior |
$550.16
|
| Rate for Payer: Galaxy Health WC |
$1,169.09
|
| Rate for Payer: Global Benefits Group Commercial |
$825.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,237.86
|
| Rate for Payer: InnovAge PACE Commercial |
$687.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$917.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$524.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$851.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$275.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$962.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$962.78
|
| Rate for Payer: Multiplan Commercial |
$1,031.55
|
| Rate for Payer: Networks By Design Commercial |
$894.01
|
| Rate for Payer: Prime Health Services Commercial |
$1,169.09
|
| Rate for Payer: Riverside University Health System MISP |
$550.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$825.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$825.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$687.70
|
| Rate for Payer: United Healthcare All Other HMO |
$687.70
|
| Rate for Payer: United Healthcare HMO Rider |
$687.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$687.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,169.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,169.09
|
| Rate for Payer: Vantage Medical Group Senior |
$1,169.09
|
|
