|
HC THRPTC INTVN 1ST 15 MIN ST
|
Facility
IP
|
$60.00
|
|
|
Service Code
|
CPT 97129
|
| Hospital Charge Code |
905107132
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Central Health Plan Commercial |
$48.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.00
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$54.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Multiplan Commercial |
$45.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
|
|
HC THRPTC INTVN 1ST 15 MIN ST
|
Facility
OP
|
$60.00
|
|
|
Service Code
|
CPT 97129
|
| Hospital Charge Code |
905107132
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$99.71
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$51.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$33.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$33.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$36.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Central Health Plan Commercial |
$48.00
|
| Rate for Payer: Cigna of CA HMO |
$38.40
|
| Rate for Payer: Cigna of CA PPO |
$44.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$51.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$24.00
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$54.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$45.00
|
| Rate for Payer: IEHP medi-cal |
$21.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.60
|
| Rate for Payer: Multiplan Commercial |
$45.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$36.00
|
| Rate for Payer: Riverside University Health MISP |
$24.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$51.00
|
| Rate for Payer: Vantage Medical Group Senior |
$51.00
|
|
|
HC THRPTC INTVN EA ADD 15MIN
|
Facility
IP
|
$58.00
|
|
|
Service Code
|
CPT 97130
|
| Hospital Charge Code |
905107130
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$11.60 |
| Max. Negotiated Rate |
$52.20 |
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Central Health Plan Commercial |
$46.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.20
|
| Rate for Payer: Galaxy Health WC |
$49.30
|
| Rate for Payer: Global Benefits Group Commercial |
$34.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$52.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.60
|
| Rate for Payer: Multiplan Commercial |
$43.50
|
| Rate for Payer: Networks By Design Commercial |
$37.70
|
| Rate for Payer: Prime Health Services Commercial |
$49.30
|
|
|
HC THRPTC INTVN EA ADD 15MIN
|
Facility
OP
|
$58.00
|
|
|
Service Code
|
CPT 97130
|
| Hospital Charge Code |
905107130
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$20.30 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$96.70
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$49.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$31.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$31.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$34.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Central Health Plan Commercial |
$46.40
|
| Rate for Payer: Cigna of CA HMO |
$37.12
|
| Rate for Payer: Cigna of CA PPO |
$42.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$49.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$23.20
|
| Rate for Payer: Galaxy Health WC |
$49.30
|
| Rate for Payer: Global Benefits Group Commercial |
$34.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$52.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$43.50
|
| Rate for Payer: IEHP medi-cal |
$20.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.78
|
| Rate for Payer: Multiplan Commercial |
$43.50
|
| Rate for Payer: Networks By Design Commercial |
$37.70
|
| Rate for Payer: Prime Health Services Commercial |
$49.30
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$34.80
|
| Rate for Payer: Riverside University Health MISP |
$23.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$49.30
|
| Rate for Payer: Vantage Medical Group Senior |
$49.30
|
|
|
HC THRPTC INTVN EA ADD 15MIN OT
|
Facility
IP
|
$58.00
|
|
|
Service Code
|
CPT 97130
|
| Hospital Charge Code |
905107133
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$11.60 |
| Max. Negotiated Rate |
$52.20 |
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Central Health Plan Commercial |
$46.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.20
|
| Rate for Payer: Galaxy Health WC |
$49.30
|
| Rate for Payer: Global Benefits Group Commercial |
$34.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$52.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.60
|
| Rate for Payer: Multiplan Commercial |
$43.50
|
| Rate for Payer: Networks By Design Commercial |
$37.70
|
| Rate for Payer: Prime Health Services Commercial |
$49.30
|
|
|
HC THRPTC INTVN EA ADD 15MIN OT
|
Facility
OP
|
$58.00
|
|
|
Service Code
|
CPT 97130
|
| Hospital Charge Code |
905107133
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$20.30 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$96.70
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$49.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$31.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$31.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$34.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Central Health Plan Commercial |
$46.40
|
| Rate for Payer: Cigna of CA HMO |
$37.12
|
| Rate for Payer: Cigna of CA PPO |
$42.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$49.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$23.20
|
| Rate for Payer: Galaxy Health WC |
$49.30
|
| Rate for Payer: Global Benefits Group Commercial |
$34.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$52.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$43.50
|
| Rate for Payer: IEHP medi-cal |
$20.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.78
|
| Rate for Payer: Multiplan Commercial |
$43.50
|
| Rate for Payer: Networks By Design Commercial |
$37.70
|
| Rate for Payer: Prime Health Services Commercial |
$49.30
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$34.80
|
| Rate for Payer: Riverside University Health MISP |
$23.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$49.30
|
| Rate for Payer: Vantage Medical Group Senior |
$49.30
|
|
|
HC THRPTC INTVN EA ADD 15MIN ST
|
Facility
OP
|
$58.00
|
|
|
Service Code
|
CPT 97130
|
| Hospital Charge Code |
905107134
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$20.30 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$96.70
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$49.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$31.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$31.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$34.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Central Health Plan Commercial |
$46.40
|
| Rate for Payer: Cigna of CA HMO |
$37.12
|
| Rate for Payer: Cigna of CA PPO |
$42.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$49.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$23.20
|
| Rate for Payer: Galaxy Health WC |
$49.30
|
| Rate for Payer: Global Benefits Group Commercial |
$34.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$52.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$43.50
|
| Rate for Payer: IEHP medi-cal |
$20.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.78
|
| Rate for Payer: Multiplan Commercial |
$43.50
|
| Rate for Payer: Networks By Design Commercial |
$37.70
|
| Rate for Payer: Prime Health Services Commercial |
$49.30
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$34.80
|
| Rate for Payer: Riverside University Health MISP |
$23.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$49.30
|
| Rate for Payer: Vantage Medical Group Senior |
$49.30
|
|
|
HC THRPTC INTVN EA ADD 15MIN ST
|
Facility
IP
|
$58.00
|
|
|
Service Code
|
CPT 97130
|
| Hospital Charge Code |
905107134
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$11.60 |
| Max. Negotiated Rate |
$52.20 |
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Central Health Plan Commercial |
$46.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.20
|
| Rate for Payer: Galaxy Health WC |
$49.30
|
| Rate for Payer: Global Benefits Group Commercial |
$34.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$52.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.60
|
| Rate for Payer: Multiplan Commercial |
$43.50
|
| Rate for Payer: Networks By Design Commercial |
$37.70
|
| Rate for Payer: Prime Health Services Commercial |
$49.30
|
|
|
HC THRPTC SPNL PNCTR CSF FLUOR/CT
|
Facility
IP
|
$2,331.00
|
|
|
Service Code
|
CPT 62329
|
| Hospital Charge Code |
909002329
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$466.20 |
| Max. Negotiated Rate |
$2,097.90 |
| Rate for Payer: Cash Price |
$1,048.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,864.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$932.40
|
| Rate for Payer: Galaxy Health WC |
$1,981.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,398.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,097.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,554.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$466.20
|
| Rate for Payer: Multiplan Commercial |
$1,748.25
|
| Rate for Payer: Networks By Design Commercial |
$1,515.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,981.35
|
|
|
HC THRPTC SPNL PNCTR CSF FLUOR/CT
|
Facility
OP
|
$2,331.00
|
|
|
Service Code
|
CPT 62329
|
| Hospital Charge Code |
909002329
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$466.20 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$864.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$864.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,398.60
|
| 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 |
$1,048.95
|
| Rate for Payer: Cash Price |
$1,048.95
|
| Rate for Payer: Cash Price |
$1,048.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,864.80
|
| Rate for Payer: Cigna of CA PPO |
$1,724.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,296.06
|
| 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 |
$1,981.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,398.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,097.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,748.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,417.03
|
| Rate for Payer: IEHP medi-cal |
$1,425.67
|
| Rate for Payer: IEHP Medicare Advantage |
$864.04
|
| Rate for Payer: Innovage PACE Commercial |
$1,296.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,554.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$864.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$466.20
|
| 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 |
$1,748.25
|
| Rate for Payer: Networks By Design Commercial |
$1,515.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,981.35
|
| Rate for Payer: Prime Health Services Medicare |
$915.88
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,398.60
|
| Rate for Payer: Riverside University Health MISP |
$950.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,398.60
|
| 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 THUMB ABDUCTION C BAR
|
Facility
OP
|
$180.00
|
|
| Hospital Charge Code |
903203810
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$162.00 |
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$153.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$99.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$99.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$87.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$106.34
|
| Rate for Payer: BCBS Transplant Transplant |
$108.00
|
| Rate for Payer: Blue Shield of California Commercial |
$135.00
|
| Rate for Payer: Blue Shield of California EPN |
$97.92
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Central Health Plan Commercial |
$144.00
|
| Rate for Payer: Cigna of CA HMO |
$126.00
|
| Rate for Payer: Cigna of CA PPO |
$126.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$153.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$72.00
|
| Rate for Payer: Galaxy Health WC |
$153.00
|
| Rate for Payer: Global Benefits Group Commercial |
$108.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$162.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$135.00
|
| Rate for Payer: IEHP medi-cal |
$63.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$120.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.80
|
| Rate for Payer: Multiplan Commercial |
$135.00
|
| Rate for Payer: Networks By Design Commercial |
$90.00
|
| Rate for Payer: Prime Health Services Commercial |
$153.00
|
| Rate for Payer: Riverside University Health MISP |
$72.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$108.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$108.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$90.00
|
| Rate for Payer: United Healthcare All Other HMO |
$90.00
|
| Rate for Payer: United Healthcare HMO Rider |
$90.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$90.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$153.00
|
| Rate for Payer: Vantage Medical Group Senior |
$153.00
|
|
|
HC THUMB ABDUCTION C BAR
|
Facility
IP
|
$180.00
|
|
| Hospital Charge Code |
903203810
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$162.00 |
| Rate for Payer: Blue Shield of California EPN |
$96.12
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Central Health Plan Commercial |
$144.00
|
| Rate for Payer: Cigna of CA HMO |
$126.00
|
| Rate for Payer: Cigna of CA PPO |
$126.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$72.00
|
| Rate for Payer: Galaxy Health WC |
$153.00
|
| Rate for Payer: Global Benefits Group Commercial |
$108.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$162.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$120.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.00
|
| Rate for Payer: Multiplan Commercial |
$135.00
|
| Rate for Payer: Networks By Design Commercial |
$90.00
|
| Rate for Payer: Prime Health Services Commercial |
$153.00
|
|
|
HC THYROGEN 1.1MG
|
Facility
OP
|
$5,235.00
|
|
|
Service Code
|
CPT J3240
|
| Hospital Charge Code |
909301498
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$983.87 |
| Max. Negotiated Rate |
$12,525.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,021.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,525.30
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,526.46
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,223.29
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,223.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$983.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,077.24
|
| Rate for Payer: BCBS Transplant Transplant |
$3,141.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,231.46
|
| Rate for Payer: Blue Shield of California EPN |
$2,028.60
|
| Rate for Payer: Caremore Medicare Advantage |
$2,021.17
|
| Rate for Payer: Cash Price |
$2,355.75
|
| Rate for Payer: Cash Price |
$2,355.75
|
| Rate for Payer: Central Health Plan Commercial |
$4,188.00
|
| Rate for Payer: Cigna of CA HMO |
$3,664.50
|
| Rate for Payer: Cigna of CA PPO |
$3,664.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,031.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,728.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,021.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,021.17
|
| Rate for Payer: Galaxy Health WC |
$4,449.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,141.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,711.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,926.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,314.72
|
| Rate for Payer: IEHP medi-cal |
$3,334.93
|
| Rate for Payer: IEHP Medicare Advantage |
$2,021.17
|
| Rate for Payer: Innovage PACE Commercial |
$3,031.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,491.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,021.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,047.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,708.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,708.37
|
| Rate for Payer: Multiplan Commercial |
$3,926.25
|
| Rate for Payer: Networks By Design Commercial |
$2,617.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,449.75
|
| Rate for Payer: Prime Health Services Medicare |
$2,142.44
|
| Rate for Payer: Riverside University Health MISP |
$2,223.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,141.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,141.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,617.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,617.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,617.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,617.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,031.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,223.29
|
| Rate for Payer: Vantage Medical Group Senior |
$2,021.17
|
|
|
HC THYROGEN 1.1MG
|
Facility
IP
|
$5,235.00
|
|
|
Service Code
|
CPT J3240
|
| Hospital Charge Code |
909301498
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,047.00 |
| Max. Negotiated Rate |
$4,711.50 |
| Rate for Payer: Blue Shield of California Commercial |
$3,926.25
|
| Rate for Payer: Blue Shield of California EPN |
$2,795.49
|
| Rate for Payer: Cash Price |
$2,355.75
|
| Rate for Payer: Central Health Plan Commercial |
$4,188.00
|
| Rate for Payer: Cigna of CA HMO |
$3,664.50
|
| Rate for Payer: Cigna of CA PPO |
$3,664.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,094.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,094.00
|
| Rate for Payer: Galaxy Health WC |
$4,449.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,141.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,711.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,491.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,047.00
|
| Rate for Payer: Multiplan Commercial |
$3,926.25
|
| Rate for Payer: Networks By Design Commercial |
$2,617.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,449.75
|
|
|
HC THYROID BIOPSY PERCUTANEOUS
|
Facility
IP
|
$1,752.00
|
|
|
Service Code
|
CPT 60100
|
| Hospital Charge Code |
909000178
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$350.40 |
| Max. Negotiated Rate |
$1,576.80 |
| Rate for Payer: Cash Price |
$788.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,401.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$700.80
|
| Rate for Payer: Galaxy Health WC |
$1,489.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,051.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,576.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,168.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$350.40
|
| Rate for Payer: Multiplan Commercial |
$1,314.00
|
| Rate for Payer: Networks By Design Commercial |
$1,138.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,489.20
|
|
|
HC THYROID BIOPSY PERCUTANEOUS
|
Facility
OP
|
$1,752.00
|
|
|
Service Code
|
CPT 60100
|
| Hospital Charge Code |
909000178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$350.40 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$879.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$879.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,051.20
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$879.07
|
| Rate for Payer: Cash Price |
$788.40
|
| Rate for Payer: Cash Price |
$788.40
|
| Rate for Payer: Cash Price |
$788.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,401.60
|
| Rate for Payer: Cigna of CA PPO |
$1,296.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,186.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.07
|
| Rate for Payer: Galaxy Health WC |
$1,489.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,051.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,576.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,314.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,441.67
|
| Rate for Payer: IEHP medi-cal |
$1,450.47
|
| Rate for Payer: IEHP Medicare Advantage |
$879.07
|
| Rate for Payer: Innovage PACE Commercial |
$1,318.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,168.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$350.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,177.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,177.95
|
| Rate for Payer: Multiplan Commercial |
$1,314.00
|
| Rate for Payer: Networks By Design Commercial |
$1,138.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,489.20
|
| Rate for Payer: Prime Health Services Medicare |
$931.81
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,051.20
|
| Rate for Payer: Riverside University Health MISP |
$966.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,051.20
|
| 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 |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
|
HC THYROID BIOPSY PERCUTANEOUS
|
Facility
IP
|
$1,752.00
|
|
|
Service Code
|
CPT 60100
|
| Hospital Charge Code |
909000178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$350.40 |
| Max. Negotiated Rate |
$1,576.80 |
| Rate for Payer: Cash Price |
$788.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,401.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$700.80
|
| Rate for Payer: Galaxy Health WC |
$1,489.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,051.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,576.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,168.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$350.40
|
| Rate for Payer: Multiplan Commercial |
$1,314.00
|
| Rate for Payer: Networks By Design Commercial |
$1,138.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,489.20
|
|
|
HC THYROID BIOPSY PERCUTANEOUS
|
Facility
OP
|
$1,752.00
|
|
|
Service Code
|
CPT 60100
|
| Hospital Charge Code |
909000178
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$350.40 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$879.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$879.07
|
| 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: BCBS Transplant Transplant |
$1,051.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,102.01
|
| Rate for Payer: Blue Shield of California EPN |
$856.73
|
| Rate for Payer: Caremore Medicare Advantage |
$879.07
|
| Rate for Payer: Cash Price |
$788.40
|
| Rate for Payer: Cash Price |
$788.40
|
| Rate for Payer: Cash Price |
$788.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,401.60
|
| Rate for Payer: Cigna of CA HMO |
$1,121.28
|
| Rate for Payer: Cigna of CA PPO |
$1,296.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,186.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.07
|
| Rate for Payer: Galaxy Health WC |
$1,489.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,051.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,576.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,314.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,441.67
|
| Rate for Payer: IEHP medi-cal |
$1,450.47
|
| Rate for Payer: IEHP Medicare Advantage |
$879.07
|
| Rate for Payer: Innovage PACE Commercial |
$1,318.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,168.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$350.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,177.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,177.95
|
| Rate for Payer: Multiplan Commercial |
$1,314.00
|
| Rate for Payer: Networks By Design Commercial |
$1,138.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,489.20
|
| Rate for Payer: Prime Health Services Medicare |
$931.81
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,051.20
|
| Rate for Payer: Riverside University Health MISP |
$966.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,051.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,051.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$876.00
|
| Rate for Payer: United Healthcare All Other HMO |
$876.00
|
| Rate for Payer: United Healthcare HMO Rider |
$876.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$876.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
|
HC THYROID HORMONE T3
|
Facility
IP
|
$260.00
|
|
|
Service Code
|
CPT 84480
|
| Hospital Charge Code |
900910827
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$52.00 |
| Max. Negotiated Rate |
$234.00 |
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: Central Health Plan Commercial |
$208.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$104.00
|
| Rate for Payer: Galaxy Health WC |
$221.00
|
| Rate for Payer: Global Benefits Group Commercial |
$156.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$234.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$173.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.00
|
| Rate for Payer: Multiplan Commercial |
$195.00
|
| Rate for Payer: Networks By Design Commercial |
$169.00
|
| Rate for Payer: Prime Health Services Commercial |
$221.00
|
|
|
HC THYROID HORMONE T3
|
Facility
OP
|
$54.00
|
|
|
Service Code
|
CPT 84480
|
| Hospital Charge Code |
900910827
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$125.75 |
| Rate for Payer: Adventist Health Medi-Cal |
$14.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$104.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21.27
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$103.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$125.75
|
| Rate for Payer: BCBS Transplant Transplant |
$32.40
|
| Rate for Payer: Blue Shield of California Commercial |
$33.37
|
| Rate for Payer: Blue Shield of California EPN |
$26.24
|
| Rate for Payer: Caremore Medicare Advantage |
$14.18
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Central Health Plan Commercial |
$43.20
|
| Rate for Payer: Cigna of CA HMO |
$34.56
|
| Rate for Payer: Cigna of CA PPO |
$39.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$14.18
|
| Rate for Payer: Galaxy Health WC |
$45.90
|
| Rate for Payer: Global Benefits Group Commercial |
$32.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$48.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$40.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.26
|
| Rate for Payer: IEHP medi-cal |
$23.40
|
| Rate for Payer: IEHP Medicare Advantage |
$14.18
|
| Rate for Payer: Innovage PACE Commercial |
$21.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.00
|
| Rate for Payer: Multiplan Commercial |
$40.50
|
| Rate for Payer: Networks By Design Commercial |
$35.10
|
| Rate for Payer: Prime Health Services Commercial |
$45.90
|
| Rate for Payer: Prime Health Services Medicare |
$15.03
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$32.40
|
| Rate for Payer: Riverside University Health MISP |
$15.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$32.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.48
|
| Rate for Payer: United Healthcare All Other HMO |
$11.48
|
| Rate for Payer: United Healthcare HMO Rider |
$11.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.60
|
| Rate for Payer: Vantage Medical Group Senior |
$14.18
|
|
|
HC THYROID SCAN
|
Facility
IP
|
$1,425.00
|
|
|
Service Code
|
CPT 78013
|
| Hospital Charge Code |
909301316
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$285.00 |
| Max. Negotiated Rate |
$1,282.50 |
| Rate for Payer: Cash Price |
$641.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,140.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$570.00
|
| Rate for Payer: Galaxy Health WC |
$1,211.25
|
| Rate for Payer: Global Benefits Group Commercial |
$855.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,282.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$950.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$285.00
|
| Rate for Payer: Multiplan Commercial |
$1,068.75
|
| Rate for Payer: Networks By Design Commercial |
$926.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,211.25
|
|
|
HC THYROID SCAN
|
Facility
OP
|
$1,425.00
|
|
|
Service Code
|
CPT 78013
|
| Hospital Charge Code |
909301316
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$285.00 |
| Max. Negotiated Rate |
$1,282.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$515.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$847.16
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$772.98
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$566.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$515.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$903.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$841.89
|
| Rate for Payer: BCBS Transplant Transplant |
$855.00
|
| Rate for Payer: Blue Shield of California Commercial |
$880.65
|
| Rate for Payer: Blue Shield of California EPN |
$692.55
|
| Rate for Payer: Caremore Medicare Advantage |
$515.32
|
| Rate for Payer: Cash Price |
$641.25
|
| Rate for Payer: Cash Price |
$641.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,140.00
|
| Rate for Payer: Cigna of CA HMO |
$912.00
|
| Rate for Payer: Cigna of CA PPO |
$1,054.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$772.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$695.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$515.32
|
| Rate for Payer: EPIC Health Plan Transplant |
$515.32
|
| Rate for Payer: Galaxy Health WC |
$1,211.25
|
| Rate for Payer: Global Benefits Group Commercial |
$855.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,282.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,068.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$845.12
|
| Rate for Payer: IEHP medi-cal |
$850.28
|
| Rate for Payer: IEHP Medicare Advantage |
$515.32
|
| Rate for Payer: Innovage PACE Commercial |
$772.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$950.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$515.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$285.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$690.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$690.53
|
| Rate for Payer: Multiplan Commercial |
$1,068.75
|
| Rate for Payer: Networks By Design Commercial |
$926.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,211.25
|
| Rate for Payer: Prime Health Services Medicare |
$546.24
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$855.00
|
| Rate for Payer: Riverside University Health MISP |
$566.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$855.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$855.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$384.10
|
| Rate for Payer: United Healthcare All Other HMO |
$384.10
|
| Rate for Payer: United Healthcare HMO Rider |
$384.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$384.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$772.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$566.85
|
| Rate for Payer: Vantage Medical Group Senior |
$515.32
|
|
|
HC THYROID UPTAKE MULT
|
Facility
OP
|
$953.00
|
|
|
Service Code
|
CPT 78012
|
| Hospital Charge Code |
909301311
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$190.60 |
| Max. Negotiated Rate |
$857.70 |
| Rate for Payer: Adventist Health Medi-Cal |
$515.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$416.80
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$772.98
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$566.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$515.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$444.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$563.03
|
| Rate for Payer: BCBS Transplant Transplant |
$571.80
|
| Rate for Payer: Blue Shield of California Commercial |
$588.95
|
| Rate for Payer: Blue Shield of California EPN |
$463.16
|
| Rate for Payer: Caremore Medicare Advantage |
$515.32
|
| Rate for Payer: Cash Price |
$428.85
|
| Rate for Payer: Cash Price |
$428.85
|
| Rate for Payer: Central Health Plan Commercial |
$762.40
|
| Rate for Payer: Cigna of CA HMO |
$609.92
|
| Rate for Payer: Cigna of CA PPO |
$705.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$772.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$695.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$515.32
|
| Rate for Payer: EPIC Health Plan Transplant |
$515.32
|
| Rate for Payer: Galaxy Health WC |
$810.05
|
| Rate for Payer: Global Benefits Group Commercial |
$571.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$857.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$714.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$845.12
|
| Rate for Payer: IEHP medi-cal |
$850.28
|
| Rate for Payer: IEHP Medicare Advantage |
$515.32
|
| Rate for Payer: Innovage PACE Commercial |
$772.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$635.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$515.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$190.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$690.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$690.53
|
| Rate for Payer: Multiplan Commercial |
$714.75
|
| Rate for Payer: Networks By Design Commercial |
$619.45
|
| Rate for Payer: Prime Health Services Commercial |
$810.05
|
| Rate for Payer: Prime Health Services Medicare |
$546.24
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$571.80
|
| Rate for Payer: Riverside University Health MISP |
$566.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$571.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$571.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$291.92
|
| Rate for Payer: United Healthcare All Other HMO |
$291.92
|
| Rate for Payer: United Healthcare HMO Rider |
$291.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$291.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$772.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$566.85
|
| Rate for Payer: Vantage Medical Group Senior |
$515.32
|
|
|
HC THYROID UPTAKE MULT
|
Facility
IP
|
$953.00
|
|
|
Service Code
|
CPT 78012
|
| Hospital Charge Code |
909301311
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$190.60 |
| Max. Negotiated Rate |
$857.70 |
| Rate for Payer: Cash Price |
$428.85
|
| Rate for Payer: Central Health Plan Commercial |
$762.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$381.20
|
| Rate for Payer: Galaxy Health WC |
$810.05
|
| Rate for Payer: Global Benefits Group Commercial |
$571.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$857.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$635.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$190.60
|
| Rate for Payer: Multiplan Commercial |
$714.75
|
| Rate for Payer: Networks By Design Commercial |
$619.45
|
| Rate for Payer: Prime Health Services Commercial |
$810.05
|
|
|
HC THYROID UPTAKE/SCAN
|
Facility
OP
|
$2,698.00
|
|
|
Service Code
|
CPT 78014
|
| Hospital Charge Code |
909301315
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$515.32 |
| Max. Negotiated Rate |
$2,428.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$515.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,235.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$772.98
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$566.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$515.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,316.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,593.98
|
| Rate for Payer: BCBS Transplant Transplant |
$1,618.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,667.36
|
| Rate for Payer: Blue Shield of California EPN |
$1,311.23
|
| Rate for Payer: Caremore Medicare Advantage |
$515.32
|
| Rate for Payer: Cash Price |
$1,214.10
|
| Rate for Payer: Cash Price |
$1,214.10
|
| Rate for Payer: Central Health Plan Commercial |
$2,158.40
|
| Rate for Payer: Cigna of CA HMO |
$1,726.72
|
| Rate for Payer: Cigna of CA PPO |
$1,996.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$772.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$695.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$515.32
|
| Rate for Payer: EPIC Health Plan Transplant |
$515.32
|
| Rate for Payer: Galaxy Health WC |
$2,293.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,618.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,428.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,023.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$845.12
|
| Rate for Payer: IEHP medi-cal |
$850.28
|
| Rate for Payer: IEHP Medicare Advantage |
$515.32
|
| Rate for Payer: Innovage PACE Commercial |
$772.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,799.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$515.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$539.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$690.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$690.53
|
| Rate for Payer: Multiplan Commercial |
$2,023.50
|
| Rate for Payer: Networks By Design Commercial |
$1,753.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,293.30
|
| Rate for Payer: Prime Health Services Medicare |
$546.24
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,618.80
|
| Rate for Payer: Riverside University Health MISP |
$566.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,618.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,618.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$596.32
|
| Rate for Payer: United Healthcare All Other HMO |
$596.32
|
| Rate for Payer: United Healthcare HMO Rider |
$596.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$596.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$772.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$566.85
|
| Rate for Payer: Vantage Medical Group Senior |
$515.32
|
|
