|
HC TRNSFR OF TNDN TO RSTR INTR FNCT 4 FNGRS
|
Facility
OP
|
$8,678.00
|
|
|
Service Code
|
CPT 26498
|
| Hospital Charge Code |
900506498
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$10,567.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: BCBS Transplant Transplant |
$5,206.80
|
| Rate for Payer: Caremore Medicare Advantage |
$4,044.21
|
| Rate for Payer: Cash Price |
$3,905.10
|
| Rate for Payer: Cash Price |
$3,905.10
|
| Rate for Payer: Cash Price |
$3,905.10
|
| Rate for Payer: Cash Price |
$3,905.10
|
| Rate for Payer: Central Health Plan Commercial |
$6,942.40
|
| Rate for Payer: Cigna of CA PPO |
$6,421.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,459.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,044.21
|
| Rate for Payer: Galaxy Health WC |
$7,376.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,206.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,810.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6,508.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,632.50
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$4,044.21
|
| Rate for Payer: Innovage PACE Commercial |
$6,066.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,788.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,044.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,735.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,419.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,419.24
|
| Rate for Payer: Multiplan Commercial |
$6,508.50
|
| Rate for Payer: Networks By Design Commercial |
$5,640.70
|
| Rate for Payer: Prime Health Services Commercial |
$7,376.30
|
| Rate for Payer: Prime Health Services Medicare |
$4,286.86
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,206.80
|
| Rate for Payer: Riverside University Health MISP |
$4,448.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,206.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,339.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,339.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,339.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,339.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
|
HC TRNSFR OF TNDN TO RSTR INTR FNCT 4 FNGRS
|
Facility
IP
|
$8,678.00
|
|
|
Service Code
|
CPT 26498
|
| Hospital Charge Code |
900506498
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,735.60 |
| Max. Negotiated Rate |
$7,810.20 |
| Rate for Payer: Cash Price |
$3,905.10
|
| Rate for Payer: Central Health Plan Commercial |
$6,942.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,471.20
|
| Rate for Payer: Galaxy Health WC |
$7,376.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,206.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,810.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,788.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,735.60
|
| Rate for Payer: Multiplan Commercial |
$6,508.50
|
| Rate for Payer: Networks By Design Commercial |
$5,640.70
|
| Rate for Payer: Prime Health Services Commercial |
$7,376.30
|
|
|
HC TROPONIN - I
|
Facility
OP
|
$18.00
|
|
|
Service Code
|
CPT 84484
|
| Hospital Charge Code |
900910994
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$169.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$12.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$72.22
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.72
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$138.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$169.30
|
| Rate for Payer: BCBS Transplant Transplant |
$10.80
|
| Rate for Payer: Blue Shield of California Commercial |
$11.12
|
| Rate for Payer: Blue Shield of California EPN |
$8.75
|
| Rate for Payer: Caremore Medicare Advantage |
$12.47
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Central Health Plan Commercial |
$14.40
|
| Rate for Payer: Cigna of CA HMO |
$11.52
|
| Rate for Payer: Cigna of CA PPO |
$13.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12.47
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.47
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$20.45
|
| Rate for Payer: IEHP medi-cal |
$20.58
|
| Rate for Payer: IEHP Medicare Advantage |
$12.47
|
| Rate for Payer: Innovage PACE Commercial |
$18.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.71
|
| Rate for Payer: Multiplan Commercial |
$13.50
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
| Rate for Payer: Prime Health Services Medicare |
$13.22
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: Riverside University Health MISP |
$13.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.10
|
| Rate for Payer: United Healthcare All Other HMO |
$10.10
|
| Rate for Payer: United Healthcare HMO Rider |
$10.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.72
|
| Rate for Payer: Vantage Medical Group Senior |
$12.47
|
|
|
HC TROPONIN - I
|
Facility
IP
|
$917.00
|
|
|
Service Code
|
CPT 84484
|
| Hospital Charge Code |
900910994
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$183.40 |
| Max. Negotiated Rate |
$825.30 |
| Rate for Payer: Cash Price |
$412.65
|
| Rate for Payer: Central Health Plan Commercial |
$733.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$366.80
|
| Rate for Payer: Galaxy Health WC |
$779.45
|
| Rate for Payer: Global Benefits Group Commercial |
$550.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$825.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$611.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$183.40
|
| Rate for Payer: Multiplan Commercial |
$687.75
|
| Rate for Payer: Networks By Design Commercial |
$596.05
|
| Rate for Payer: Prime Health Services Commercial |
$779.45
|
|
|
HC TROPONIN-T
|
Facility
IP
|
$285.00
|
|
|
Service Code
|
CPT 84484
|
| Hospital Charge Code |
900912119
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$57.00 |
| Max. Negotiated Rate |
$256.50 |
| Rate for Payer: Cash Price |
$128.25
|
| Rate for Payer: Central Health Plan Commercial |
$228.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$114.00
|
| Rate for Payer: Galaxy Health WC |
$242.25
|
| Rate for Payer: Global Benefits Group Commercial |
$171.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$256.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$190.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.00
|
| Rate for Payer: Multiplan Commercial |
$213.75
|
| Rate for Payer: Networks By Design Commercial |
$185.25
|
| Rate for Payer: Prime Health Services Commercial |
$242.25
|
|
|
HC TROPONIN-T
|
Facility
OP
|
$29.00
|
|
|
Service Code
|
CPT 84484
|
| Hospital Charge Code |
900912119
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.80 |
| Max. Negotiated Rate |
$169.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$12.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$72.22
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.72
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$138.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$169.30
|
| Rate for Payer: BCBS Transplant Transplant |
$17.40
|
| Rate for Payer: Blue Shield of California Commercial |
$17.92
|
| Rate for Payer: Blue Shield of California EPN |
$14.09
|
| Rate for Payer: Caremore Medicare Advantage |
$12.47
|
| Rate for Payer: Cash Price |
$13.05
|
| Rate for Payer: Cash Price |
$13.05
|
| Rate for Payer: Central Health Plan Commercial |
$23.20
|
| Rate for Payer: Cigna of CA HMO |
$18.56
|
| Rate for Payer: Cigna of CA PPO |
$21.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12.47
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.47
|
| Rate for Payer: Galaxy Health WC |
$24.65
|
| Rate for Payer: Global Benefits Group Commercial |
$17.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$21.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$20.45
|
| Rate for Payer: IEHP medi-cal |
$20.58
|
| Rate for Payer: IEHP Medicare Advantage |
$12.47
|
| Rate for Payer: Innovage PACE Commercial |
$18.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.71
|
| Rate for Payer: Multiplan Commercial |
$21.75
|
| Rate for Payer: Networks By Design Commercial |
$18.85
|
| Rate for Payer: Prime Health Services Commercial |
$24.65
|
| Rate for Payer: Prime Health Services Medicare |
$13.22
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$17.40
|
| Rate for Payer: Riverside University Health MISP |
$13.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.10
|
| Rate for Payer: United Healthcare All Other HMO |
$10.10
|
| Rate for Payer: United Healthcare HMO Rider |
$10.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.72
|
| Rate for Payer: Vantage Medical Group Senior |
$12.47
|
|
|
HC TRSNCATH INS/REPL LEADLESS PCR
|
Facility
IP
|
$56,678.00
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
906811498
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,335.60 |
| Max. Negotiated Rate |
$51,010.20 |
| Rate for Payer: Cash Price |
$25,505.10
|
| Rate for Payer: Central Health Plan Commercial |
$45,342.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,671.20
|
| Rate for Payer: Galaxy Health WC |
$48,176.30
|
| Rate for Payer: Global Benefits Group Commercial |
$34,006.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$51,010.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37,804.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,335.60
|
| Rate for Payer: Multiplan Commercial |
$42,508.50
|
| Rate for Payer: Networks By Design Commercial |
$36,840.70
|
| Rate for Payer: Prime Health Services Commercial |
$48,176.30
|
|
|
HC TRSNCATH INS/REPL LEADLESS PCR
|
Facility
OP
|
$56,678.00
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
906820022
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,183.44 |
| Max. Negotiated Rate |
$67,976.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$24,345.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$24,345.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,838.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,283.75
|
| Rate for Payer: BCBS Transplant Transplant |
$34,006.80
|
| Rate for Payer: Blue Shield of California Commercial |
$5,824.53
|
| Rate for Payer: Blue Shield of California EPN |
$4,183.44
|
| Rate for Payer: Caremore Medicare Advantage |
$24,345.49
|
| Rate for Payer: Cash Price |
$25,505.10
|
| Rate for Payer: Cash Price |
$25,505.10
|
| Rate for Payer: Cash Price |
$25,505.10
|
| Rate for Payer: Central Health Plan Commercial |
$45,342.40
|
| Rate for Payer: Cigna of CA PPO |
$41,941.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,518.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,866.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,345.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$24,345.49
|
| Rate for Payer: Galaxy Health WC |
$48,176.30
|
| Rate for Payer: Global Benefits Group Commercial |
$34,006.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$51,010.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$42,508.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$39,926.60
|
| Rate for Payer: IEHP medi-cal |
$40,170.06
|
| Rate for Payer: IEHP Medicare Advantage |
$24,345.49
|
| Rate for Payer: Innovage PACE Commercial |
$36,518.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37,804.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,345.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,335.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,622.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,622.96
|
| Rate for Payer: Multiplan Commercial |
$42,508.50
|
| Rate for Payer: Multiplan WC |
$33,283.75
|
| Rate for Payer: Networks By Design Commercial |
$36,840.70
|
| Rate for Payer: Preferred Health Network WC |
$33,963.01
|
| Rate for Payer: Prime Health Services Commercial |
$48,176.30
|
| Rate for Payer: Prime Health Services Medicare |
$25,806.22
|
| Rate for Payer: Prime Health Services WC |
$32,944.12
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$34,006.80
|
| Rate for Payer: Riverside University Health MISP |
$26,780.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34,006.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$57,775.00
|
| Rate for Payer: United Healthcare All Other HMO |
$67,976.00
|
| Rate for Payer: United Healthcare HMO Rider |
$54,652.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49,976.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Vantage Medical Group Senior |
$24,345.49
|
|
|
HC TRSNCATH INS/REPL LEADLESS PCR
|
Facility
IP
|
$56,678.00
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
906820022
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,335.60 |
| Max. Negotiated Rate |
$51,010.20 |
| Rate for Payer: Cash Price |
$25,505.10
|
| Rate for Payer: Central Health Plan Commercial |
$45,342.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,671.20
|
| Rate for Payer: Galaxy Health WC |
$48,176.30
|
| Rate for Payer: Global Benefits Group Commercial |
$34,006.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$51,010.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37,804.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,335.60
|
| Rate for Payer: Multiplan Commercial |
$42,508.50
|
| Rate for Payer: Networks By Design Commercial |
$36,840.70
|
| Rate for Payer: Prime Health Services Commercial |
$48,176.30
|
|
|
HC TRSNCATH INS/REPL LEADLESS PCR
|
Facility
OP
|
$56,678.00
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
906811498
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,183.44 |
| Max. Negotiated Rate |
$67,976.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$24,345.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$24,345.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,838.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,283.75
|
| Rate for Payer: BCBS Transplant Transplant |
$34,006.80
|
| Rate for Payer: Blue Shield of California Commercial |
$5,824.53
|
| Rate for Payer: Blue Shield of California EPN |
$4,183.44
|
| Rate for Payer: Caremore Medicare Advantage |
$24,345.49
|
| Rate for Payer: Cash Price |
$25,505.10
|
| Rate for Payer: Cash Price |
$25,505.10
|
| Rate for Payer: Cash Price |
$25,505.10
|
| Rate for Payer: Central Health Plan Commercial |
$45,342.40
|
| Rate for Payer: Cigna of CA PPO |
$41,941.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,518.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,866.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,345.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$24,345.49
|
| Rate for Payer: Galaxy Health WC |
$48,176.30
|
| Rate for Payer: Global Benefits Group Commercial |
$34,006.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$51,010.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$42,508.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$39,926.60
|
| Rate for Payer: IEHP medi-cal |
$40,170.06
|
| Rate for Payer: IEHP Medicare Advantage |
$24,345.49
|
| Rate for Payer: Innovage PACE Commercial |
$36,518.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37,804.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,345.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,335.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,622.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,622.96
|
| Rate for Payer: Multiplan Commercial |
$42,508.50
|
| Rate for Payer: Multiplan WC |
$33,283.75
|
| Rate for Payer: Networks By Design Commercial |
$36,840.70
|
| Rate for Payer: Preferred Health Network WC |
$33,963.01
|
| Rate for Payer: Prime Health Services Commercial |
$48,176.30
|
| Rate for Payer: Prime Health Services Medicare |
$25,806.22
|
| Rate for Payer: Prime Health Services WC |
$32,944.12
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$34,006.80
|
| Rate for Payer: Riverside University Health MISP |
$26,780.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34,006.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$57,775.00
|
| Rate for Payer: United Healthcare All Other HMO |
$67,976.00
|
| Rate for Payer: United Healthcare HMO Rider |
$54,652.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49,976.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Vantage Medical Group Senior |
$24,345.49
|
|
|
HC TRT DEVICES COMPLEX
|
Facility
OP
|
$4,894.00
|
|
|
Service Code
|
CPT 77334
|
| Hospital Charge Code |
904810506
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$461.66 |
| Max. Negotiated Rate |
$4,404.60 |
| Rate for Payer: Adventist Health Medi-Cal |
$461.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$514.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$692.49
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$507.83
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$461.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$675.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$824.53
|
| Rate for Payer: BCBS Transplant Transplant |
$2,936.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,024.49
|
| Rate for Payer: Blue Shield of California EPN |
$2,378.48
|
| Rate for Payer: Caremore Medicare Advantage |
$461.66
|
| Rate for Payer: Cash Price |
$2,202.30
|
| Rate for Payer: Cash Price |
$2,202.30
|
| Rate for Payer: Cash Price |
$2,202.30
|
| Rate for Payer: Central Health Plan Commercial |
$3,915.20
|
| Rate for Payer: Cigna of CA HMO |
$3,132.16
|
| Rate for Payer: Cigna of CA PPO |
$3,621.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$692.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$623.24
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$461.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$461.66
|
| Rate for Payer: Galaxy Health WC |
$4,159.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,936.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,404.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,670.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$757.12
|
| Rate for Payer: IEHP medi-cal |
$761.74
|
| Rate for Payer: IEHP Medicare Advantage |
$461.66
|
| Rate for Payer: Innovage PACE Commercial |
$692.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,264.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$461.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$978.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$618.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$618.62
|
| Rate for Payer: Multiplan Commercial |
$3,670.50
|
| Rate for Payer: Networks By Design Commercial |
$3,181.10
|
| Rate for Payer: Prime Health Services Commercial |
$4,159.90
|
| Rate for Payer: Prime Health Services Medicare |
$489.36
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,180.00
|
| Rate for Payer: Riverside University Health MISP |
$507.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,936.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,659.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,675.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,269.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,161.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$692.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$507.83
|
| Rate for Payer: Vantage Medical Group Senior |
$461.66
|
|
|
HC TRT DEVICES COMPLEX
|
Facility
IP
|
$4,894.00
|
|
|
Service Code
|
CPT 77334
|
| Hospital Charge Code |
904810506
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$978.80 |
| Max. Negotiated Rate |
$4,404.60 |
| Rate for Payer: Cash Price |
$2,202.30
|
| Rate for Payer: Central Health Plan Commercial |
$3,915.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,957.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,957.60
|
| Rate for Payer: Galaxy Health WC |
$4,159.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,936.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,404.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,264.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$978.80
|
| Rate for Payer: Multiplan Commercial |
$3,670.50
|
| Rate for Payer: Networks By Design Commercial |
$3,181.10
|
| Rate for Payer: Prime Health Services Commercial |
$4,159.90
|
|
|
HC TRT DEVICES INTER
|
Facility
OP
|
$1,571.00
|
|
|
Service Code
|
CPT 77333
|
| Hospital Charge Code |
909100210
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$98.42 |
| Max. Negotiated Rate |
$4,180.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$169.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$98.42
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$254.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$186.48
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$169.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$485.03
|
| Rate for Payer: BCBS Transplant Transplant |
$942.60
|
| Rate for Payer: Blue Shield of California Commercial |
$970.88
|
| Rate for Payer: Blue Shield of California EPN |
$763.51
|
| Rate for Payer: Caremore Medicare Advantage |
$169.53
|
| Rate for Payer: Cash Price |
$706.95
|
| Rate for Payer: Cash Price |
$706.95
|
| Rate for Payer: Cash Price |
$706.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,256.80
|
| Rate for Payer: Cigna of CA HMO |
$1,005.44
|
| Rate for Payer: Cigna of CA PPO |
$1,162.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$254.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$228.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$169.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$169.53
|
| Rate for Payer: Galaxy Health WC |
$1,335.35
|
| Rate for Payer: Global Benefits Group Commercial |
$942.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,413.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,178.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$278.03
|
| Rate for Payer: IEHP medi-cal |
$279.72
|
| Rate for Payer: IEHP Medicare Advantage |
$169.53
|
| Rate for Payer: Innovage PACE Commercial |
$254.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,047.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$169.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$314.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$227.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$227.17
|
| Rate for Payer: Multiplan Commercial |
$1,178.25
|
| Rate for Payer: Networks By Design Commercial |
$1,021.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,335.35
|
| Rate for Payer: Prime Health Services Medicare |
$179.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,180.00
|
| Rate for Payer: Riverside University Health MISP |
$186.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$942.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,659.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,675.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,269.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,161.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$254.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$186.48
|
| Rate for Payer: Vantage Medical Group Senior |
$169.53
|
|
|
HC TRT DEVICES INTER
|
Facility
IP
|
$1,571.00
|
|
|
Service Code
|
CPT 77333
|
| Hospital Charge Code |
909100210
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$314.20 |
| Max. Negotiated Rate |
$1,413.90 |
| Rate for Payer: Cash Price |
$706.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,256.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$628.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$628.40
|
| Rate for Payer: Galaxy Health WC |
$1,335.35
|
| Rate for Payer: Global Benefits Group Commercial |
$942.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,413.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,047.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$314.20
|
| Rate for Payer: Multiplan Commercial |
$1,178.25
|
| Rate for Payer: Networks By Design Commercial |
$1,021.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,335.35
|
|
|
HC TRT DEVICES SIMPLE
|
Facility
OP
|
$1,402.00
|
|
|
Service Code
|
CPT 77332
|
| Hospital Charge Code |
909100209
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$169.53 |
| Max. Negotiated Rate |
$4,180.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$169.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$289.42
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$254.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$186.48
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$169.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$279.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$341.00
|
| Rate for Payer: BCBS Transplant Transplant |
$841.20
|
| Rate for Payer: Blue Shield of California Commercial |
$866.44
|
| Rate for Payer: Blue Shield of California EPN |
$681.37
|
| Rate for Payer: Caremore Medicare Advantage |
$169.53
|
| Rate for Payer: Cash Price |
$630.90
|
| Rate for Payer: Cash Price |
$630.90
|
| Rate for Payer: Cash Price |
$630.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,121.60
|
| Rate for Payer: Cigna of CA HMO |
$897.28
|
| Rate for Payer: Cigna of CA PPO |
$1,037.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$254.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$228.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$169.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$169.53
|
| Rate for Payer: Galaxy Health WC |
$1,191.70
|
| Rate for Payer: Global Benefits Group Commercial |
$841.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,261.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,051.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$278.03
|
| Rate for Payer: IEHP medi-cal |
$279.72
|
| Rate for Payer: IEHP Medicare Advantage |
$169.53
|
| Rate for Payer: Innovage PACE Commercial |
$254.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$935.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$169.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$280.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$227.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$227.17
|
| Rate for Payer: Multiplan Commercial |
$1,051.50
|
| Rate for Payer: Networks By Design Commercial |
$911.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,191.70
|
| Rate for Payer: Prime Health Services Medicare |
$179.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,180.00
|
| Rate for Payer: Riverside University Health MISP |
$186.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$841.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,659.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,675.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,269.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,161.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$254.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$186.48
|
| Rate for Payer: Vantage Medical Group Senior |
$169.53
|
|
|
HC TRT DEVICES SIMPLE
|
Facility
IP
|
$1,402.00
|
|
|
Service Code
|
CPT 77332
|
| Hospital Charge Code |
909100209
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$280.40 |
| Max. Negotiated Rate |
$1,261.80 |
| Rate for Payer: Cash Price |
$630.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,121.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$560.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$560.80
|
| Rate for Payer: Galaxy Health WC |
$1,191.70
|
| Rate for Payer: Global Benefits Group Commercial |
$841.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,261.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$935.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$280.40
|
| Rate for Payer: Multiplan Commercial |
$1,051.50
|
| Rate for Payer: Networks By Design Commercial |
$911.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,191.70
|
|
|
HC TRT SPEECH/LANG/VOICE INDIV
|
Facility
OP
|
$860.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
907001401
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$196.00 |
| Max. Negotiated Rate |
$774.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$405.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$731.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$473.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$473.00
|
| 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 |
$516.00
|
| 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 |
$387.00
|
| Rate for Payer: Cash Price |
$387.00
|
| Rate for Payer: Cash Price |
$387.00
|
| Rate for Payer: Cash Price |
$387.00
|
| Rate for Payer: Central Health Plan Commercial |
$688.00
|
| Rate for Payer: Cigna of CA HMO |
$550.40
|
| Rate for Payer: Cigna of CA PPO |
$636.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$731.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$344.00
|
| Rate for Payer: Galaxy Health WC |
$731.00
|
| Rate for Payer: Global Benefits Group Commercial |
$516.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$774.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$645.00
|
| Rate for Payer: IEHP medi-cal |
$301.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$573.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$352.60
|
| Rate for Payer: Multiplan Commercial |
$645.00
|
| Rate for Payer: Networks By Design Commercial |
$559.00
|
| Rate for Payer: Prime Health Services Commercial |
$731.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$516.00
|
| Rate for Payer: Riverside University Health MISP |
$344.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$516.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$516.00
|
| 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 |
$731.00
|
| Rate for Payer: Vantage Medical Group Senior |
$731.00
|
|
|
HC TRT SPEECH/LANG/VOICE INDIV
|
Facility
IP
|
$860.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
907001401
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$172.00 |
| Max. Negotiated Rate |
$774.00 |
| Rate for Payer: Cash Price |
$387.00
|
| Rate for Payer: Central Health Plan Commercial |
$688.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.00
|
| Rate for Payer: Galaxy Health WC |
$731.00
|
| Rate for Payer: Global Benefits Group Commercial |
$516.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$774.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$573.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.00
|
| Rate for Payer: Multiplan Commercial |
$645.00
|
| Rate for Payer: Networks By Design Commercial |
$559.00
|
| Rate for Payer: Prime Health Services Commercial |
$731.00
|
|
|
HC TRT SPEECH/LANG/VOICE INDIV
|
Facility
IP
|
$860.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
905601401
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$172.00 |
| Max. Negotiated Rate |
$774.00 |
| Rate for Payer: Cash Price |
$387.00
|
| Rate for Payer: Central Health Plan Commercial |
$688.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.00
|
| Rate for Payer: Galaxy Health WC |
$731.00
|
| Rate for Payer: Global Benefits Group Commercial |
$516.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$774.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$573.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.00
|
| Rate for Payer: Multiplan Commercial |
$645.00
|
| Rate for Payer: Networks By Design Commercial |
$559.00
|
| Rate for Payer: Prime Health Services Commercial |
$731.00
|
|
|
HC TRT SPEECH/LANG/VOICE INDIV
|
Facility
OP
|
$860.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
905601401
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$196.00 |
| Max. Negotiated Rate |
$774.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$405.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$731.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$473.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$473.00
|
| 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 |
$516.00
|
| 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 |
$387.00
|
| Rate for Payer: Cash Price |
$387.00
|
| Rate for Payer: Cash Price |
$387.00
|
| Rate for Payer: Cash Price |
$387.00
|
| Rate for Payer: Central Health Plan Commercial |
$688.00
|
| Rate for Payer: Cigna of CA HMO |
$550.40
|
| Rate for Payer: Cigna of CA PPO |
$636.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$731.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$344.00
|
| Rate for Payer: Galaxy Health WC |
$731.00
|
| Rate for Payer: Global Benefits Group Commercial |
$516.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$774.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$645.00
|
| Rate for Payer: IEHP medi-cal |
$301.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$573.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$352.60
|
| Rate for Payer: Multiplan Commercial |
$645.00
|
| Rate for Payer: Networks By Design Commercial |
$559.00
|
| Rate for Payer: Prime Health Services Commercial |
$731.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$516.00
|
| Rate for Payer: Riverside University Health MISP |
$344.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$516.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$516.00
|
| 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 |
$731.00
|
| Rate for Payer: Vantage Medical Group Senior |
$731.00
|
|
|
HC TRT SWALLOW/ORAL FUNC FEEDING
|
Facility
IP
|
$742.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
905601801
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$148.40 |
| Max. Negotiated Rate |
$667.80 |
| Rate for Payer: Cash Price |
$333.90
|
| Rate for Payer: Central Health Plan Commercial |
$593.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$296.80
|
| Rate for Payer: Galaxy Health WC |
$630.70
|
| Rate for Payer: Global Benefits Group Commercial |
$445.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$667.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$494.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$148.40
|
| Rate for Payer: Multiplan Commercial |
$556.50
|
| Rate for Payer: Networks By Design Commercial |
$482.30
|
| Rate for Payer: Prime Health Services Commercial |
$630.70
|
|
|
HC TRT SWALLOW/ORAL FUNC FEEDING
|
Facility
OP
|
$742.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
905601801
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$196.00 |
| Max. Negotiated Rate |
$667.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$549.64
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$630.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$408.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$408.10
|
| 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 |
$445.20
|
| 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 |
$333.90
|
| Rate for Payer: Cash Price |
$333.90
|
| Rate for Payer: Cash Price |
$333.90
|
| Rate for Payer: Cash Price |
$333.90
|
| Rate for Payer: Central Health Plan Commercial |
$593.60
|
| Rate for Payer: Cigna of CA HMO |
$474.88
|
| Rate for Payer: Cigna of CA PPO |
$549.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$630.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$296.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$296.80
|
| Rate for Payer: Galaxy Health WC |
$630.70
|
| Rate for Payer: Global Benefits Group Commercial |
$445.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$667.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$556.50
|
| Rate for Payer: IEHP medi-cal |
$259.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$494.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$304.22
|
| Rate for Payer: Multiplan Commercial |
$556.50
|
| Rate for Payer: Networks By Design Commercial |
$482.30
|
| Rate for Payer: Prime Health Services Commercial |
$630.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$445.20
|
| Rate for Payer: Riverside University Health MISP |
$296.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$445.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$445.20
|
| 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 |
$630.70
|
| Rate for Payer: Vantage Medical Group Senior |
$630.70
|
|
|
HC TRT SWALLOW/ORAL FUNC FEEDING
|
Facility
IP
|
$742.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
905601801
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$148.40 |
| Max. Negotiated Rate |
$667.80 |
| Rate for Payer: Cash Price |
$333.90
|
| Rate for Payer: Central Health Plan Commercial |
$593.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$296.80
|
| Rate for Payer: Galaxy Health WC |
$630.70
|
| Rate for Payer: Global Benefits Group Commercial |
$445.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$667.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$494.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$148.40
|
| Rate for Payer: Multiplan Commercial |
$556.50
|
| Rate for Payer: Networks By Design Commercial |
$482.30
|
| Rate for Payer: Prime Health Services Commercial |
$630.70
|
|
|
HC TRT SWALLOW/ORAL FUNC FEEDING
|
Facility
OP
|
$742.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
905601801
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$196.00 |
| Max. Negotiated Rate |
$667.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$549.64
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$630.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$408.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$408.10
|
| 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 |
$445.20
|
| 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 |
$333.90
|
| Rate for Payer: Cash Price |
$333.90
|
| Rate for Payer: Cash Price |
$333.90
|
| Rate for Payer: Cash Price |
$333.90
|
| Rate for Payer: Central Health Plan Commercial |
$593.60
|
| Rate for Payer: Cigna of CA HMO |
$474.88
|
| Rate for Payer: Cigna of CA PPO |
$549.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$630.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$296.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$296.80
|
| Rate for Payer: Galaxy Health WC |
$630.70
|
| Rate for Payer: Global Benefits Group Commercial |
$445.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$667.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$556.50
|
| Rate for Payer: IEHP medi-cal |
$259.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$494.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$304.22
|
| Rate for Payer: Multiplan Commercial |
$556.50
|
| Rate for Payer: Networks By Design Commercial |
$482.30
|
| Rate for Payer: Prime Health Services Commercial |
$630.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$445.20
|
| Rate for Payer: Riverside University Health MISP |
$296.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$445.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$445.20
|
| 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 |
$630.70
|
| Rate for Payer: Vantage Medical Group Senior |
$630.70
|
|
|
HC TRT SWALLOW/ORAL FUNC FEEDING MCAL
|
Facility
IP
|
$742.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
907000039
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$148.40 |
| Max. Negotiated Rate |
$667.80 |
| Rate for Payer: Cash Price |
$333.90
|
| Rate for Payer: Central Health Plan Commercial |
$593.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$296.80
|
| Rate for Payer: Galaxy Health WC |
$630.70
|
| Rate for Payer: Global Benefits Group Commercial |
$445.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$667.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$494.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$148.40
|
| Rate for Payer: Multiplan Commercial |
$556.50
|
| Rate for Payer: Networks By Design Commercial |
$482.30
|
| Rate for Payer: Prime Health Services Commercial |
$630.70
|
|
