|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$2,404.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
909000180
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$480.80 |
| Max. Negotiated Rate |
$2,163.60 |
| Rate for Payer: Cash Price |
$1,081.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,923.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$961.60
|
| Rate for Payer: Galaxy Health WC |
$2,043.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,442.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,163.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,603.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$915.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$480.80
|
| Rate for Payer: Multiplan Commercial |
$1,803.00
|
| Rate for Payer: Networks By Design Commercial |
$1,562.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,043.40
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$2,404.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
909000180
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$480.80 |
| Max. Negotiated Rate |
$2,163.60 |
| Rate for Payer: Cash Price |
$1,081.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,923.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$961.60
|
| Rate for Payer: Galaxy Health WC |
$2,043.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,442.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,163.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,603.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$915.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$480.80
|
| Rate for Payer: Multiplan Commercial |
$1,803.00
|
| Rate for Payer: Networks By Design Commercial |
$1,562.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,043.40
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$2,404.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
909000180
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$480.80 |
| Max. Negotiated Rate |
$2,163.60 |
| Rate for Payer: Cash Price |
$1,081.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,923.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$961.60
|
| Rate for Payer: Galaxy Health WC |
$2,043.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,442.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,163.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,603.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$915.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$480.80
|
| Rate for Payer: Multiplan Commercial |
$1,803.00
|
| Rate for Payer: Networks By Design Commercial |
$1,562.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,043.40
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$2,404.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
909000180
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$480.80 |
| Max. Negotiated Rate |
$2,163.60 |
| Rate for Payer: Cash Price |
$1,081.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,923.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$961.60
|
| Rate for Payer: Galaxy Health WC |
$2,043.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,442.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,163.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,603.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$915.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$480.80
|
| Rate for Payer: Multiplan Commercial |
$1,803.00
|
| Rate for Payer: Networks By Design Commercial |
$1,562.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,043.40
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$2,404.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
909000180
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$155.63 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$864.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,442.40
|
| Rate for Payer: Caremore Medicare Advantage |
$864.04
|
| Rate for Payer: Cash Price |
$1,081.80
|
| Rate for Payer: Cash Price |
$1,081.80
|
| Rate for Payer: Cash Price |
$1,081.80
|
| Rate for Payer: Cash Price |
$1,081.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,923.20
|
| Rate for Payer: Cigna of CA PPO |
$1,778.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Dignity Health Media |
$864.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$950.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,166.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$864.04
|
| Rate for Payer: EPIC Health Plan Transplant |
$864.04
|
| Rate for Payer: Galaxy Health WC |
$2,043.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,442.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,163.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,803.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,417.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$864.04
|
| Rate for Payer: InnovAge PACE Commercial |
$1,296.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,603.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$864.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$480.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,157.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,157.81
|
| Rate for Payer: Multiplan Commercial |
$1,803.00
|
| Rate for Payer: Networks By Design Commercial |
$1,562.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,043.40
|
| Rate for Payer: Prime Health Services Medicare |
$915.88
|
| Rate for Payer: Riverside University Health System MISP |
$950.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,442.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,202.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,202.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,202.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,202.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Vantage Medical Group Senior |
$864.04
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$2,404.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
906562270
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$155.63 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$864.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$864.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,442.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$864.04
|
| Rate for Payer: Cash Price |
$1,081.80
|
| Rate for Payer: Cash Price |
$1,081.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,923.20
|
| Rate for Payer: Cigna of CA PPO |
$1,778.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Dignity Health Media |
$864.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$950.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,166.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$864.04
|
| Rate for Payer: EPIC Health Plan Transplant |
$864.04
|
| Rate for Payer: Galaxy Health WC |
$2,043.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,442.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,163.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,803.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,417.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,425.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$864.04
|
| Rate for Payer: InnovAge PACE Commercial |
$1,296.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,603.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$864.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$480.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,157.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,157.81
|
| Rate for Payer: Multiplan Commercial |
$1,803.00
|
| Rate for Payer: Networks By Design Commercial |
$1,562.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,043.40
|
| Rate for Payer: Prime Health Services Medicare |
$915.88
|
| Rate for Payer: Riverside University Health System MISP |
$950.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,442.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Vantage Medical Group Senior |
$864.04
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$2,404.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
909000180
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$155.63 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$864.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$864.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,442.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,512.12
|
| Rate for Payer: Blue Shield of California EPN |
$1,175.56
|
| Rate for Payer: Caremore Medicare Advantage |
$864.04
|
| Rate for Payer: Cash Price |
$1,081.80
|
| Rate for Payer: Cash Price |
$1,081.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,923.20
|
| Rate for Payer: Cigna of CA HMO |
$1,538.56
|
| Rate for Payer: Cigna of CA PPO |
$1,778.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Dignity Health Media |
$864.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$950.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,166.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$864.04
|
| Rate for Payer: EPIC Health Plan Transplant |
$864.04
|
| Rate for Payer: Galaxy Health WC |
$2,043.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,442.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,163.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,803.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,417.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,425.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$864.04
|
| Rate for Payer: InnovAge PACE Commercial |
$1,296.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,603.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$864.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$480.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,157.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,157.81
|
| Rate for Payer: Multiplan Commercial |
$1,803.00
|
| Rate for Payer: Networks By Design Commercial |
$1,562.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,043.40
|
| Rate for Payer: Prime Health Services Medicare |
$915.88
|
| Rate for Payer: Riverside University Health System MISP |
$950.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,442.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,442.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,202.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,202.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,202.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,202.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Vantage Medical Group Senior |
$864.04
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$2,404.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
909000180
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$155.63 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$864.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$864.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,442.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$864.04
|
| Rate for Payer: Cash Price |
$1,081.80
|
| Rate for Payer: Cash Price |
$1,081.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,923.20
|
| Rate for Payer: Cigna of CA PPO |
$1,778.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Dignity Health Media |
$864.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$950.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,166.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$864.04
|
| Rate for Payer: EPIC Health Plan Transplant |
$864.04
|
| Rate for Payer: Galaxy Health WC |
$2,043.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,442.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,163.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,803.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,417.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,425.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$864.04
|
| Rate for Payer: InnovAge PACE Commercial |
$1,296.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,603.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$864.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$480.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,157.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,157.81
|
| Rate for Payer: Multiplan Commercial |
$1,803.00
|
| Rate for Payer: Networks By Design Commercial |
$1,562.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,043.40
|
| Rate for Payer: Prime Health Services Medicare |
$915.88
|
| Rate for Payer: Riverside University Health System MISP |
$950.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,442.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Vantage Medical Group Senior |
$864.04
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$2,404.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
901200039
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$480.80 |
| Max. Negotiated Rate |
$2,163.60 |
| Rate for Payer: Cash Price |
$1,081.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,923.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$961.60
|
| Rate for Payer: Galaxy Health WC |
$2,043.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,442.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,163.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,603.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$915.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$480.80
|
| Rate for Payer: Multiplan Commercial |
$1,803.00
|
| Rate for Payer: Networks By Design Commercial |
$1,562.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,043.40
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$2,404.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
901200039
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$155.63 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$864.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$864.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,442.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$864.04
|
| Rate for Payer: Cash Price |
$1,081.80
|
| Rate for Payer: Cash Price |
$1,081.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,923.20
|
| Rate for Payer: Cigna of CA PPO |
$1,778.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Dignity Health Media |
$864.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$950.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,166.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$864.04
|
| Rate for Payer: EPIC Health Plan Transplant |
$864.04
|
| Rate for Payer: Galaxy Health WC |
$2,043.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,442.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,163.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,803.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,417.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,425.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$864.04
|
| Rate for Payer: InnovAge PACE Commercial |
$1,296.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,603.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$864.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$480.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,157.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,157.81
|
| Rate for Payer: Multiplan Commercial |
$1,803.00
|
| Rate for Payer: Networks By Design Commercial |
$1,562.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,043.40
|
| Rate for Payer: Prime Health Services Medicare |
$915.88
|
| Rate for Payer: Riverside University Health System MISP |
$950.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,442.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Vantage Medical Group Senior |
$864.04
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$2,404.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
906562270
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$480.80 |
| Max. Negotiated Rate |
$2,163.60 |
| Rate for Payer: Cash Price |
$1,081.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,923.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$961.60
|
| Rate for Payer: Galaxy Health WC |
$2,043.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,442.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,163.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,603.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$915.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$480.80
|
| Rate for Payer: Multiplan Commercial |
$1,803.00
|
| Rate for Payer: Networks By Design Commercial |
$1,562.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,043.40
|
|
|
HC SPINAL PUNCTURE DRAIN FLUID
|
Facility
|
IP
|
$1,386.00
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
900501458
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$277.20 |
| Max. Negotiated Rate |
$1,247.40 |
| Rate for Payer: Cash Price |
$623.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,108.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$554.40
|
| Rate for Payer: Galaxy Health WC |
$1,178.10
|
| Rate for Payer: Global Benefits Group Commercial |
$831.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,247.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$924.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$528.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.20
|
| Rate for Payer: Multiplan Commercial |
$1,039.50
|
| Rate for Payer: Networks By Design Commercial |
$900.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,178.10
|
|
|
HC SPINAL PUNCTURE DRAIN FLUID
|
Facility
|
IP
|
$1,386.00
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
900501458
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$277.20 |
| Max. Negotiated Rate |
$1,247.40 |
| Rate for Payer: Cash Price |
$623.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,108.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$554.40
|
| Rate for Payer: Galaxy Health WC |
$1,178.10
|
| Rate for Payer: Global Benefits Group Commercial |
$831.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,247.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$924.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$528.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.20
|
| Rate for Payer: Multiplan Commercial |
$1,039.50
|
| Rate for Payer: Networks By Design Commercial |
$900.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,178.10
|
|
|
HC SPINAL PUNCTURE DRAIN FLUID
|
Facility
|
OP
|
$1,386.00
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
900501458
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$156.33 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$864.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$864.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$831.60
|
| Rate for Payer: Blue Shield of California Commercial |
$871.79
|
| Rate for Payer: Blue Shield of California EPN |
$677.75
|
| Rate for Payer: Caremore Medicare Advantage |
$864.04
|
| Rate for Payer: Cash Price |
$623.70
|
| Rate for Payer: Cash Price |
$623.70
|
| Rate for Payer: Cash Price |
$623.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,108.80
|
| Rate for Payer: Cigna of CA HMO |
$887.04
|
| Rate for Payer: Cigna of CA PPO |
$1,025.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Dignity Health Media |
$864.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$950.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,166.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$864.04
|
| Rate for Payer: EPIC Health Plan Transplant |
$864.04
|
| Rate for Payer: Galaxy Health WC |
$1,178.10
|
| Rate for Payer: Global Benefits Group Commercial |
$831.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,247.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,039.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,417.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,425.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$864.04
|
| Rate for Payer: InnovAge PACE Commercial |
$1,296.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$924.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$156.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$864.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,157.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,157.81
|
| Rate for Payer: Multiplan Commercial |
$1,039.50
|
| Rate for Payer: Networks By Design Commercial |
$900.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,178.10
|
| Rate for Payer: Prime Health Services Medicare |
$915.88
|
| Rate for Payer: Riverside University Health System MISP |
$950.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$831.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$831.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,036.00
|
| Rate for Payer: United Healthcare All Other HMO |
$799.00
|
| Rate for Payer: United Healthcare HMO Rider |
$605.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$552.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Vantage Medical Group Senior |
$864.04
|
|
|
HC SPINAL PUNCTURE DRAIN FLUID
|
Facility
|
IP
|
$1,386.00
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
900501458
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$277.20 |
| Max. Negotiated Rate |
$1,247.40 |
| Rate for Payer: Cash Price |
$623.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,108.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$554.40
|
| Rate for Payer: Galaxy Health WC |
$1,178.10
|
| Rate for Payer: Global Benefits Group Commercial |
$831.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,247.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$924.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$528.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.20
|
| Rate for Payer: Multiplan Commercial |
$1,039.50
|
| Rate for Payer: Networks By Design Commercial |
$900.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,178.10
|
|
|
HC SPINAL PUNCTURE DRAIN FLUID
|
Facility
|
OP
|
$1,386.00
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
900501458
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$156.33 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$864.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$831.60
|
| Rate for Payer: Caremore Medicare Advantage |
$864.04
|
| Rate for Payer: Cash Price |
$623.70
|
| Rate for Payer: Cash Price |
$623.70
|
| Rate for Payer: Cash Price |
$623.70
|
| Rate for Payer: Cash Price |
$623.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,108.80
|
| Rate for Payer: Cigna of CA PPO |
$1,025.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Dignity Health Media |
$864.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$950.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,166.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$864.04
|
| Rate for Payer: EPIC Health Plan Transplant |
$864.04
|
| Rate for Payer: Galaxy Health WC |
$1,178.10
|
| Rate for Payer: Global Benefits Group Commercial |
$831.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,247.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,039.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,417.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$864.04
|
| Rate for Payer: InnovAge PACE Commercial |
$1,296.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$924.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$156.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$864.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,157.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,157.81
|
| Rate for Payer: Multiplan Commercial |
$1,039.50
|
| Rate for Payer: Networks By Design Commercial |
$900.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,178.10
|
| Rate for Payer: Prime Health Services Medicare |
$915.88
|
| Rate for Payer: Riverside University Health System MISP |
$950.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$831.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$693.00
|
| Rate for Payer: United Healthcare All Other HMO |
$693.00
|
| Rate for Payer: United Healthcare HMO Rider |
$693.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$693.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Vantage Medical Group Senior |
$864.04
|
|
|
HC SPINAL PUNCTURE DRAIN FLUID
|
Facility
|
OP
|
$1,386.00
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
900501458
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$156.33 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$864.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$864.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$831.60
|
| Rate for Payer: Blue Shield of California Commercial |
$871.79
|
| Rate for Payer: Blue Shield of California EPN |
$677.75
|
| Rate for Payer: Caremore Medicare Advantage |
$864.04
|
| Rate for Payer: Cash Price |
$623.70
|
| Rate for Payer: Cash Price |
$623.70
|
| Rate for Payer: Cash Price |
$623.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,108.80
|
| Rate for Payer: Cigna of CA HMO |
$887.04
|
| Rate for Payer: Cigna of CA PPO |
$1,025.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Dignity Health Media |
$864.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$950.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,166.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$864.04
|
| Rate for Payer: EPIC Health Plan Transplant |
$864.04
|
| Rate for Payer: Galaxy Health WC |
$1,178.10
|
| Rate for Payer: Global Benefits Group Commercial |
$831.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,247.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,039.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,417.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,425.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$864.04
|
| Rate for Payer: InnovAge PACE Commercial |
$1,296.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$924.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$156.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$864.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,157.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,157.81
|
| Rate for Payer: Multiplan Commercial |
$1,039.50
|
| Rate for Payer: Networks By Design Commercial |
$900.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,178.10
|
| Rate for Payer: Prime Health Services Medicare |
$915.88
|
| Rate for Payer: Riverside University Health System MISP |
$950.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$831.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$831.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$693.00
|
| Rate for Payer: United Healthcare All Other HMO |
$693.00
|
| Rate for Payer: United Healthcare HMO Rider |
$693.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$693.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Vantage Medical Group Senior |
$864.04
|
|
|
HC SPINAL PUNCTURE DRAIN FLUID
|
Facility
|
IP
|
$1,386.00
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
900501458
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$277.20 |
| Max. Negotiated Rate |
$1,247.40 |
| Rate for Payer: Cash Price |
$623.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,108.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$554.40
|
| Rate for Payer: Galaxy Health WC |
$1,178.10
|
| Rate for Payer: Global Benefits Group Commercial |
$831.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,247.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$924.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$528.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.20
|
| Rate for Payer: Multiplan Commercial |
$1,039.50
|
| Rate for Payer: Networks By Design Commercial |
$900.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,178.10
|
|
|
HC SPINAL PUNCTURE DRAIN FLUID
|
Facility
|
OP
|
$1,386.00
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
900501458
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$156.33 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$864.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$864.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$831.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$864.04
|
| Rate for Payer: Cash Price |
$623.70
|
| Rate for Payer: Cash Price |
$623.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,108.80
|
| Rate for Payer: Cigna of CA PPO |
$1,025.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Dignity Health Media |
$864.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$950.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,166.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$864.04
|
| Rate for Payer: EPIC Health Plan Transplant |
$864.04
|
| Rate for Payer: Galaxy Health WC |
$1,178.10
|
| Rate for Payer: Global Benefits Group Commercial |
$831.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,247.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,039.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,417.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,425.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$864.04
|
| Rate for Payer: InnovAge PACE Commercial |
$1,296.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$924.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$156.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$864.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,157.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,157.81
|
| Rate for Payer: Multiplan Commercial |
$1,039.50
|
| Rate for Payer: Networks By Design Commercial |
$900.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,178.10
|
| Rate for Payer: Prime Health Services Medicare |
$915.88
|
| Rate for Payer: Riverside University Health System MISP |
$950.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$831.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Vantage Medical Group Senior |
$864.04
|
|
|
HC SPINE 2-3 VIEWS
|
Facility
|
OP
|
$1,020.00
|
|
|
Service Code
|
CPT 72040
|
| Hospital Charge Code |
909001302
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$49.36 |
| Max. Negotiated Rate |
$918.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$113.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$153.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$113.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$125.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$152.81
|
| Rate for Payer: Blue Distinction Transplant |
$612.00
|
| Rate for Payer: Blue Shield of California Commercial |
$630.36
|
| Rate for Payer: Blue Shield of California EPN |
$495.72
|
| Rate for Payer: Caremore Medicare Advantage |
$113.54
|
| Rate for Payer: Cash Price |
$459.00
|
| Rate for Payer: Cash Price |
$459.00
|
| Rate for Payer: Central Health Plan Commercial |
$816.00
|
| Rate for Payer: Cigna of CA HMO |
$652.80
|
| Rate for Payer: Cigna of CA PPO |
$754.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$170.31
|
| Rate for Payer: Dignity Health Media |
$113.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$124.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$153.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$113.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$113.54
|
| Rate for Payer: Galaxy Health WC |
$867.00
|
| Rate for Payer: Global Benefits Group Commercial |
$612.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$918.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$765.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$186.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$187.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$113.54
|
| Rate for Payer: InnovAge PACE Commercial |
$170.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$680.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$113.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$152.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$152.14
|
| Rate for Payer: Multiplan Commercial |
$765.00
|
| Rate for Payer: Networks By Design Commercial |
$663.00
|
| Rate for Payer: Prime Health Services Commercial |
$867.00
|
| Rate for Payer: Prime Health Services Medicare |
$120.35
|
| Rate for Payer: Riverside University Health System MISP |
$124.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$612.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$612.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Vantage Medical Group Senior |
$113.54
|
|
|
HC SPINE 2-3 VIEWS
|
Facility
|
IP
|
$1,020.00
|
|
|
Service Code
|
CPT 72040
|
| Hospital Charge Code |
909001302
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$204.00 |
| Max. Negotiated Rate |
$918.00 |
| Rate for Payer: Cash Price |
$459.00
|
| Rate for Payer: Central Health Plan Commercial |
$816.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$408.00
|
| Rate for Payer: Galaxy Health WC |
$867.00
|
| Rate for Payer: Global Benefits Group Commercial |
$612.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$918.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$680.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$388.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.00
|
| Rate for Payer: Multiplan Commercial |
$765.00
|
| Rate for Payer: Networks By Design Commercial |
$663.00
|
| Rate for Payer: Prime Health Services Commercial |
$867.00
|
|
|
HC SPINE MINIMUM 4 VIEWS
|
Facility
|
OP
|
$1,584.00
|
|
|
Service Code
|
CPT 72050
|
| Hospital Charge Code |
909001301
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$76.00 |
| Max. Negotiated Rate |
$1,425.60 |
| Rate for Payer: Adventist Health Medi-Cal |
$137.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$209.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$186.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$228.03
|
| Rate for Payer: Blue Distinction Transplant |
$950.40
|
| Rate for Payer: Blue Shield of California Commercial |
$978.91
|
| Rate for Payer: Blue Shield of California EPN |
$769.82
|
| Rate for Payer: Caremore Medicare Advantage |
$137.36
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,267.20
|
| Rate for Payer: Cigna of CA HMO |
$1,013.76
|
| Rate for Payer: Cigna of CA PPO |
$1,172.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Media |
$137.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
| Rate for Payer: Galaxy Health WC |
$1,346.40
|
| Rate for Payer: Global Benefits Group Commercial |
$950.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,425.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,188.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$225.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$226.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$137.36
|
| Rate for Payer: InnovAge PACE Commercial |
$206.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,056.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$76.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$316.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$184.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
| Rate for Payer: Multiplan Commercial |
$1,188.00
|
| Rate for Payer: Networks By Design Commercial |
$1,029.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,346.40
|
| Rate for Payer: Prime Health Services Medicare |
$145.60
|
| Rate for Payer: Riverside University Health System MISP |
$151.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$950.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$950.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$193.23
|
| Rate for Payer: United Healthcare All Other HMO |
$193.23
|
| Rate for Payer: United Healthcare HMO Rider |
$193.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$193.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC SPINE MINIMUM 4 VIEWS
|
Facility
|
IP
|
$1,584.00
|
|
|
Service Code
|
CPT 72050
|
| Hospital Charge Code |
909001301
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$316.80 |
| Max. Negotiated Rate |
$1,425.60 |
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,267.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$633.60
|
| Rate for Payer: Galaxy Health WC |
$1,346.40
|
| Rate for Payer: Global Benefits Group Commercial |
$950.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,425.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,056.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$603.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$316.80
|
| Rate for Payer: Multiplan Commercial |
$1,188.00
|
| Rate for Payer: Networks By Design Commercial |
$1,029.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,346.40
|
|
|
HC SPINE SCAN
|
Facility
|
OP
|
$2,162.00
|
|
|
Service Code
|
CPT 76800
|
| Hospital Charge Code |
906601401
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$137.36 |
| Max. Negotiated Rate |
$1,945.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$137.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$442.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$299.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,277.31
|
| Rate for Payer: Blue Distinction Transplant |
$1,297.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,336.12
|
| Rate for Payer: Blue Shield of California EPN |
$1,050.73
|
| Rate for Payer: Caremore Medicare Advantage |
$137.36
|
| Rate for Payer: Cash Price |
$972.90
|
| Rate for Payer: Cash Price |
$972.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,729.60
|
| Rate for Payer: Cigna of CA HMO |
$1,383.68
|
| Rate for Payer: Cigna of CA PPO |
$1,599.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Media |
$137.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
| Rate for Payer: Galaxy Health WC |
$1,837.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,297.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,945.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,621.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$225.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$226.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$137.36
|
| Rate for Payer: InnovAge PACE Commercial |
$206.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,442.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$153.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$432.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$184.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
| Rate for Payer: Multiplan Commercial |
$1,621.50
|
| Rate for Payer: Networks By Design Commercial |
$1,405.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,837.70
|
| Rate for Payer: Prime Health Services Medicare |
$145.60
|
| Rate for Payer: Riverside University Health System MISP |
$151.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,297.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,297.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$246.56
|
| Rate for Payer: United Healthcare All Other HMO |
$246.56
|
| Rate for Payer: United Healthcare HMO Rider |
$246.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$246.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC SPINE SCAN
|
Facility
|
IP
|
$2,162.00
|
|
|
Service Code
|
CPT 76800
|
| Hospital Charge Code |
906601401
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$432.40 |
| Max. Negotiated Rate |
$1,945.80 |
| Rate for Payer: Cash Price |
$972.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,729.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$864.80
|
| Rate for Payer: Galaxy Health WC |
$1,837.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,297.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,945.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,442.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$823.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$432.40
|
| Rate for Payer: Multiplan Commercial |
$1,621.50
|
| Rate for Payer: Networks By Design Commercial |
$1,405.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,837.70
|
|
