|
HC TRT SWALLOW/ORAL FUNC FEEDING MCAL
|
Facility
|
IP
|
$742.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
901300021
|
|
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: Kaiser Permanente of CA Medi-Cal |
$282.70
|
| 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 MCAL
|
Facility
|
OP
|
$742.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
907000039
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$64.26 |
| Max. Negotiated Rate |
$667.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$549.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$630.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$408.10
|
| Rate for Payer: Alpha Care 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: Blue Distinction 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: Dignity Health Media |
$630.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$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) Other |
$556.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$259.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$494.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$64.26
|
| 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: Riverside University Health System 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: Kaiser Permanente of CA Medi-Cal |
$282.70
|
| 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 MCARE COMM
|
Facility
|
OP
|
$742.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
901300802
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$64.26 |
| Max. Negotiated Rate |
$667.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$549.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$630.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$408.10
|
| Rate for Payer: Alpha Care 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: Blue Distinction 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: Dignity Health Media |
$630.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$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) Other |
$556.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$259.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$494.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$64.26
|
| 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: Riverside University Health System 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 MCARE COMM
|
Facility
|
IP
|
$742.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
901300802
|
|
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: Kaiser Permanente of CA Medi-Cal |
$282.70
|
| 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 TARS BONE FX;W/MANIPUL, EA
|
Facility
|
OP
|
$3,039.00
|
|
|
Service Code
|
CPT 28455
|
| Hospital Charge Code |
900501247
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$276.58 |
| Max. Negotiated Rate |
$3,293.27 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,823.40
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,431.20
|
| Rate for Payer: Cigna of CA PPO |
$2,248.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Dignity Health Media |
$2,008.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,208.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,710.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,008.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,008.09
|
| Rate for Payer: Galaxy Health WC |
$2,583.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,823.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,735.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,279.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,293.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,008.09
|
| Rate for Payer: InnovAge PACE Commercial |
$3,012.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,027.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$276.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$607.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,690.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,690.84
|
| Rate for Payer: Multiplan Commercial |
$2,279.25
|
| Rate for Payer: Networks By Design Commercial |
$1,975.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,583.15
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Riverside University Health System MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,823.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,519.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,519.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,519.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,519.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Vantage Medical Group Senior |
$2,008.09
|
|
|
HC TRT TARS BONE FX;W/MANIPUL, EA
|
Facility
|
IP
|
$3,039.00
|
|
|
Service Code
|
CPT 28455
|
| Hospital Charge Code |
900501247
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$607.80 |
| Max. Negotiated Rate |
$2,735.10 |
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,431.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,215.60
|
| Rate for Payer: Galaxy Health WC |
$2,583.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,823.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,735.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,027.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,157.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$607.80
|
| Rate for Payer: Multiplan Commercial |
$2,279.25
|
| Rate for Payer: Networks By Design Commercial |
$1,975.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,583.15
|
|
|
HC TRUE CUT SOFT TISSUE
|
Facility
|
IP
|
$79.00
|
|
| Hospital Charge Code |
909001070
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.80 |
| Max. Negotiated Rate |
$71.10 |
| Rate for Payer: Cash Price |
$35.55
|
| Rate for Payer: Central Health Plan Commercial |
$63.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.60
|
| Rate for Payer: Galaxy Health WC |
$67.15
|
| Rate for Payer: Global Benefits Group Commercial |
$47.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$71.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.80
|
| Rate for Payer: Multiplan Commercial |
$59.25
|
| Rate for Payer: Networks By Design Commercial |
$51.35
|
| Rate for Payer: Prime Health Services Commercial |
$67.15
|
|
|
HC TRUE CUT SOFT TISSUE
|
Facility
|
OP
|
$79.00
|
|
| Hospital Charge Code |
909001070
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.80 |
| Max. Negotiated Rate |
$71.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$67.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$43.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$43.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.67
|
| Rate for Payer: Blue Distinction Transplant |
$47.40
|
| Rate for Payer: Blue Shield of California Commercial |
$49.69
|
| Rate for Payer: Blue Shield of California EPN |
$38.63
|
| Rate for Payer: Cash Price |
$35.55
|
| Rate for Payer: Central Health Plan Commercial |
$63.20
|
| Rate for Payer: Cigna of CA HMO |
$50.56
|
| Rate for Payer: Cigna of CA PPO |
$58.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$67.15
|
| Rate for Payer: Dignity Health Media |
$67.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$67.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$31.60
|
| Rate for Payer: Galaxy Health WC |
$67.15
|
| Rate for Payer: Global Benefits Group Commercial |
$47.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$71.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$59.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.80
|
| Rate for Payer: Multiplan Commercial |
$59.25
|
| Rate for Payer: Networks By Design Commercial |
$51.35
|
| Rate for Payer: Prime Health Services Commercial |
$67.15
|
| Rate for Payer: Riverside University Health System MISP |
$31.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$47.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$47.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$39.50
|
| Rate for Payer: United Healthcare All Other HMO |
$39.50
|
| Rate for Payer: United Healthcare HMO Rider |
$39.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$39.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$67.15
|
| Rate for Payer: Vantage Medical Group Senior |
$67.15
|
|
|
HC TRUFILL N-BCA
|
Facility
|
IP
|
$6,235.00
|
|
| Hospital Charge Code |
909081833
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,247.00 |
| Max. Negotiated Rate |
$5,611.50 |
| Rate for Payer: Cash Price |
$2,805.75
|
| Rate for Payer: Central Health Plan Commercial |
$4,988.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,494.00
|
| Rate for Payer: Galaxy Health WC |
$5,299.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,741.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,611.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,158.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,375.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,247.00
|
| Rate for Payer: Multiplan Commercial |
$4,676.25
|
| Rate for Payer: Networks By Design Commercial |
$4,052.75
|
| Rate for Payer: Prime Health Services Commercial |
$5,299.75
|
|
|
HC TRUFILL N-BCA
|
Facility
|
OP
|
$6,235.00
|
|
| Hospital Charge Code |
909081833
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,247.00 |
| Max. Negotiated Rate |
$5,611.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,786.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,299.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,429.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,429.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,018.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,683.64
|
| Rate for Payer: Blue Distinction Transplant |
$3,741.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,921.82
|
| Rate for Payer: Blue Shield of California EPN |
$3,048.92
|
| Rate for Payer: Cash Price |
$2,805.75
|
| Rate for Payer: Central Health Plan Commercial |
$4,988.00
|
| Rate for Payer: Cigna of CA HMO |
$3,990.40
|
| Rate for Payer: Cigna of CA PPO |
$4,613.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,299.75
|
| Rate for Payer: Dignity Health Media |
$5,299.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,299.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,494.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,494.00
|
| Rate for Payer: Galaxy Health WC |
$5,299.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,741.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,611.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,676.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,182.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,158.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,375.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,247.00
|
| Rate for Payer: Multiplan Commercial |
$4,676.25
|
| Rate for Payer: Networks By Design Commercial |
$4,052.75
|
| Rate for Payer: Prime Health Services Commercial |
$5,299.75
|
| Rate for Payer: Riverside University Health System MISP |
$2,494.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,741.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,741.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,117.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,117.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,117.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,117.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,299.75
|
| Rate for Payer: Vantage Medical Group Senior |
$5,299.75
|
|
|
HC TRUWAVE DBL A-LINE CVP
|
Facility
|
OP
|
$269.29
|
|
| Hospital Charge Code |
901698617
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.86 |
| Max. Negotiated Rate |
$242.36 |
| Rate for Payer: Aetna of CA HMO/PPO |
$163.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$228.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$148.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$130.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.10
|
| Rate for Payer: Blue Distinction Transplant |
$161.57
|
| Rate for Payer: Blue Shield of California Commercial |
$169.38
|
| Rate for Payer: Blue Shield of California EPN |
$131.68
|
| Rate for Payer: Cash Price |
$121.18
|
| Rate for Payer: Central Health Plan Commercial |
$215.43
|
| Rate for Payer: Cigna of CA HMO |
$172.35
|
| Rate for Payer: Cigna of CA PPO |
$199.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$228.90
|
| Rate for Payer: Dignity Health Media |
$228.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$228.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$107.72
|
| Rate for Payer: EPIC Health Plan Transplant |
$107.72
|
| Rate for Payer: Galaxy Health WC |
$228.90
|
| Rate for Payer: Global Benefits Group Commercial |
$161.57
|
| Rate for Payer: Health Management Network EPO/PPO |
$242.36
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$201.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$94.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$179.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.86
|
| Rate for Payer: Multiplan Commercial |
$201.97
|
| Rate for Payer: Networks By Design Commercial |
$175.04
|
| Rate for Payer: Prime Health Services Commercial |
$228.90
|
| Rate for Payer: Riverside University Health System MISP |
$107.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$161.57
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$161.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$134.64
|
| Rate for Payer: United Healthcare All Other HMO |
$134.64
|
| Rate for Payer: United Healthcare HMO Rider |
$134.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$134.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$228.90
|
| Rate for Payer: Vantage Medical Group Senior |
$228.90
|
|
|
HC TRUWAVE DBL A-LINE CVP
|
Facility
|
IP
|
$269.29
|
|
| Hospital Charge Code |
901698617
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.86 |
| Max. Negotiated Rate |
$242.36 |
| Rate for Payer: Cash Price |
$121.18
|
| Rate for Payer: Central Health Plan Commercial |
$215.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$107.72
|
| Rate for Payer: Galaxy Health WC |
$228.90
|
| Rate for Payer: Global Benefits Group Commercial |
$161.57
|
| Rate for Payer: Health Management Network EPO/PPO |
$242.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$179.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.86
|
| Rate for Payer: Multiplan Commercial |
$201.97
|
| Rate for Payer: Networks By Design Commercial |
$175.04
|
| Rate for Payer: Prime Health Services Commercial |
$228.90
|
|
|
HC TRYPSIN STOOL
|
Facility
|
OP
|
$28.00
|
|
|
Service Code
|
CPT 84488
|
| Hospital Charge Code |
900910231
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.60 |
| Max. Negotiated Rate |
$64.76 |
| Rate for Payer: Adventist Health Medi-Cal |
$7.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$53.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$53.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$64.76
|
| Rate for Payer: Blue Distinction Transplant |
$16.80
|
| Rate for Payer: Blue Shield of California Commercial |
$17.30
|
| Rate for Payer: Blue Shield of California EPN |
$13.61
|
| Rate for Payer: Caremore Medicare Advantage |
$7.30
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Central Health Plan Commercial |
$22.40
|
| Rate for Payer: Cigna of CA HMO |
$17.92
|
| Rate for Payer: Cigna of CA PPO |
$20.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.95
|
| Rate for Payer: Dignity Health Media |
$7.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.86
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7.30
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.30
|
| Rate for Payer: Galaxy Health WC |
$23.80
|
| Rate for Payer: Global Benefits Group Commercial |
$16.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$25.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$21.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.30
|
| Rate for Payer: InnovAge PACE Commercial |
$10.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.78
|
| Rate for Payer: Multiplan Commercial |
$21.00
|
| Rate for Payer: Networks By Design Commercial |
$18.20
|
| Rate for Payer: Prime Health Services Commercial |
$23.80
|
| Rate for Payer: Prime Health Services Medicare |
$7.74
|
| Rate for Payer: Riverside University Health System MISP |
$8.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.91
|
| Rate for Payer: United Healthcare All Other HMO |
$5.91
|
| Rate for Payer: United Healthcare HMO Rider |
$5.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.03
|
| Rate for Payer: Vantage Medical Group Senior |
$7.30
|
|
|
HC TRYPSIN STOOL
|
Facility
|
IP
|
$406.00
|
|
|
Service Code
|
CPT 84488
|
| Hospital Charge Code |
900910231
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$81.20 |
| Max. Negotiated Rate |
$365.40 |
| Rate for Payer: Cash Price |
$182.70
|
| Rate for Payer: Central Health Plan Commercial |
$324.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$162.40
|
| Rate for Payer: Galaxy Health WC |
$345.10
|
| Rate for Payer: Global Benefits Group Commercial |
$243.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$365.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$270.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$154.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.20
|
| Rate for Payer: Multiplan Commercial |
$304.50
|
| Rate for Payer: Networks By Design Commercial |
$263.90
|
| Rate for Payer: Prime Health Services Commercial |
$345.10
|
|
|
HC TSH (THYROTROPIN)
|
Facility
|
IP
|
$276.00
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
900910829
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.20 |
| Max. Negotiated Rate |
$248.40 |
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Central Health Plan Commercial |
$220.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$110.40
|
| Rate for Payer: Galaxy Health WC |
$234.60
|
| Rate for Payer: Global Benefits Group Commercial |
$165.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$248.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$184.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$105.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.20
|
| Rate for Payer: Multiplan Commercial |
$207.00
|
| Rate for Payer: Networks By Design Commercial |
$179.40
|
| Rate for Payer: Prime Health Services Commercial |
$234.60
|
|
|
HC TSH (THYROTROPIN)
|
Facility
|
OP
|
$28.00
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
900910829
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.60 |
| Max. Negotiated Rate |
$149.11 |
| Rate for Payer: Adventist Health Medi-Cal |
$16.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$123.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$122.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$149.11
|
| Rate for Payer: Blue Distinction Transplant |
$16.80
|
| Rate for Payer: Blue Shield of California Commercial |
$17.30
|
| Rate for Payer: Blue Shield of California EPN |
$13.61
|
| Rate for Payer: Caremore Medicare Advantage |
$16.80
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Central Health Plan Commercial |
$22.40
|
| Rate for Payer: Cigna of CA HMO |
$17.92
|
| Rate for Payer: Cigna of CA PPO |
$20.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.20
|
| Rate for Payer: Dignity Health Media |
$16.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$16.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.80
|
| Rate for Payer: Galaxy Health WC |
$23.80
|
| Rate for Payer: Global Benefits Group Commercial |
$16.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$25.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$21.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$27.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.80
|
| Rate for Payer: InnovAge PACE Commercial |
$25.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.51
|
| Rate for Payer: Multiplan Commercial |
$21.00
|
| Rate for Payer: Networks By Design Commercial |
$18.20
|
| Rate for Payer: Prime Health Services Commercial |
$23.80
|
| Rate for Payer: Prime Health Services Medicare |
$17.81
|
| Rate for Payer: Riverside University Health System MISP |
$18.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.61
|
| Rate for Payer: United Healthcare All Other HMO |
$13.61
|
| Rate for Payer: United Healthcare HMO Rider |
$13.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.48
|
| Rate for Payer: Vantage Medical Group Senior |
$16.80
|
|
|
HC T-STRAP PADDED ADDITION LE
|
Facility
|
IP
|
$170.00
|
|
|
Service Code
|
CPT L2270
|
| Hospital Charge Code |
905352270
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Blue Shield of California EPN |
$90.78
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Central Health Plan Commercial |
$136.00
|
| Rate for Payer: Cigna of CA HMO |
$119.00
|
| Rate for Payer: Cigna of CA PPO |
$119.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$68.00
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$153.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$113.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$64.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.00
|
| Rate for Payer: Multiplan Commercial |
$127.50
|
| Rate for Payer: Networks By Design Commercial |
$85.00
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$64.19
|
| Rate for Payer: United Healthcare All Other HMO |
$62.70
|
| Rate for Payer: United Healthcare HMO Rider |
$61.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$56.10
|
|
|
HC T-STRAP PADDED ADDITION LE
|
Facility
|
OP
|
$170.00
|
|
|
Service Code
|
CPT L2270
|
| Hospital Charge Code |
905352270
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$59.50 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$144.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$93.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$93.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$82.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$100.44
|
| Rate for Payer: Blue Distinction Transplant |
$102.00
|
| Rate for Payer: Blue Shield of California Commercial |
$127.50
|
| Rate for Payer: Blue Shield of California EPN |
$92.48
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Central Health Plan Commercial |
$136.00
|
| Rate for Payer: Cigna of CA HMO |
$119.00
|
| Rate for Payer: Cigna of CA PPO |
$119.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$144.50
|
| Rate for Payer: Dignity Health Media |
$144.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$144.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$68.00
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$153.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$127.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$59.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$113.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.70
|
| Rate for Payer: Multiplan Commercial |
$127.50
|
| Rate for Payer: Networks By Design Commercial |
$85.00
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
| Rate for Payer: Riverside University Health System MISP |
$68.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$102.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$102.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$85.00
|
| Rate for Payer: United Healthcare All Other HMO |
$85.00
|
| Rate for Payer: United Healthcare HMO Rider |
$85.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$85.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$144.50
|
| Rate for Payer: Vantage Medical Group Senior |
$144.50
|
|
|
HC TTE W OR W/O FOL W/CON,DOPPLER
|
Facility
|
OP
|
$2,109.00
|
|
|
Service Code
|
CPT C8929
|
| Hospital Charge Code |
900200256
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$421.80 |
| Max. Negotiated Rate |
$9,690.17 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,000.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,690.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,500.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,100.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,000.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,154.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,246.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,265.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,303.36
|
| Rate for Payer: Blue Shield of California EPN |
$1,024.97
|
| Rate for Payer: Caremore Medicare Advantage |
$1,000.40
|
| Rate for Payer: Cash Price |
$949.05
|
| Rate for Payer: Cash Price |
$949.05
|
| Rate for Payer: Cash Price |
$949.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,687.20
|
| Rate for Payer: Cigna of CA HMO |
$1,349.76
|
| Rate for Payer: Cigna of CA PPO |
$1,560.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,500.60
|
| Rate for Payer: Dignity Health Media |
$1,000.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,100.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,350.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,000.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,000.40
|
| Rate for Payer: Galaxy Health WC |
$1,792.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,265.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,898.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,581.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,640.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,650.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,000.40
|
| Rate for Payer: InnovAge PACE Commercial |
$1,500.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,406.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$803.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,000.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$421.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,340.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,340.54
|
| Rate for Payer: Multiplan Commercial |
$1,581.75
|
| Rate for Payer: Networks By Design Commercial |
$1,370.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,792.65
|
| Rate for Payer: Prime Health Services Medicare |
$1,060.42
|
| Rate for Payer: Riverside University Health System MISP |
$1,100.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,265.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,265.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$919.00
|
| Rate for Payer: United Healthcare All Other HMO |
$935.00
|
| Rate for Payer: United Healthcare HMO Rider |
$792.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$724.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,500.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,100.44
|
| Rate for Payer: Vantage Medical Group Senior |
$1,000.40
|
|
|
HC TTE W OR W/O FOL W/CON,DOPPLER
|
Facility
|
IP
|
$2,109.00
|
|
|
Service Code
|
CPT C8929
|
| Hospital Charge Code |
900200256
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$421.80 |
| Max. Negotiated Rate |
$1,898.10 |
| Rate for Payer: Cash Price |
$949.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,687.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$843.60
|
| Rate for Payer: Galaxy Health WC |
$1,792.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,265.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,898.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,406.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$803.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$421.80
|
| Rate for Payer: Multiplan Commercial |
$1,581.75
|
| Rate for Payer: Networks By Design Commercial |
$1,370.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,792.65
|
|
|
HC TTE W WO CONTR ECG
|
Facility
|
OP
|
$2,414.00
|
|
|
Service Code
|
CPT C8930
|
| Hospital Charge Code |
900200257
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$482.80 |
| Max. Negotiated Rate |
$15,235.07 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,000.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15,235.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,500.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,100.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,000.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,419.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,426.19
|
| Rate for Payer: Blue Distinction Transplant |
$1,448.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,491.85
|
| Rate for Payer: Blue Shield of California EPN |
$1,173.20
|
| Rate for Payer: Caremore Medicare Advantage |
$1,000.40
|
| Rate for Payer: Cash Price |
$1,086.30
|
| Rate for Payer: Cash Price |
$1,086.30
|
| Rate for Payer: Cash Price |
$1,086.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,931.20
|
| Rate for Payer: Cigna of CA HMO |
$1,544.96
|
| Rate for Payer: Cigna of CA PPO |
$1,786.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,500.60
|
| Rate for Payer: Dignity Health Media |
$1,000.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,100.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,350.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,000.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,000.40
|
| Rate for Payer: Galaxy Health WC |
$2,051.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,448.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,172.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,810.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,640.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,650.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,000.40
|
| Rate for Payer: InnovAge PACE Commercial |
$1,500.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,610.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$919.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,000.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$482.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,340.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,340.54
|
| Rate for Payer: Multiplan Commercial |
$1,810.50
|
| Rate for Payer: Networks By Design Commercial |
$1,569.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,051.90
|
| Rate for Payer: Prime Health Services Medicare |
$1,060.42
|
| Rate for Payer: Riverside University Health System MISP |
$1,100.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,448.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,448.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$919.00
|
| Rate for Payer: United Healthcare All Other HMO |
$935.00
|
| Rate for Payer: United Healthcare HMO Rider |
$792.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$724.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,500.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,100.44
|
| Rate for Payer: Vantage Medical Group Senior |
$1,000.40
|
|
|
HC TTE W WO CONTR ECG
|
Facility
|
IP
|
$2,414.00
|
|
|
Service Code
|
CPT C8930
|
| Hospital Charge Code |
900200257
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$482.80 |
| Max. Negotiated Rate |
$2,172.60 |
| Rate for Payer: Cash Price |
$1,086.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,931.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$965.60
|
| Rate for Payer: Galaxy Health WC |
$2,051.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,448.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,172.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,610.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$919.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$482.80
|
| Rate for Payer: Multiplan Commercial |
$1,810.50
|
| Rate for Payer: Networks By Design Commercial |
$1,569.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,051.90
|
|
|
HC TTG IGA
|
Facility
|
IP
|
$58.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913669
|
|
Hospital Revenue Code
|
302
|
| 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: Kaiser Permanente of CA Medi-Cal |
$22.10
|
| 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 TTG IGA
|
Facility
|
OP
|
$39.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913669
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$207.60 |
| Rate for Payer: Adventist Health Medi-Cal |
$11.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$170.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$207.60
|
| Rate for Payer: Blue Distinction Transplant |
$23.40
|
| Rate for Payer: Blue Shield of California Commercial |
$24.10
|
| Rate for Payer: Blue Shield of California EPN |
$18.95
|
| Rate for Payer: Caremore Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Central Health Plan Commercial |
$31.20
|
| Rate for Payer: Cigna of CA HMO |
$24.96
|
| Rate for Payer: Cigna of CA PPO |
$28.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Media |
$11.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.53
|
| Rate for Payer: Galaxy Health WC |
$33.15
|
| Rate for Payer: Global Benefits Group Commercial |
$23.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$29.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.53
|
| Rate for Payer: InnovAge PACE Commercial |
$17.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.45
|
| Rate for Payer: Multiplan Commercial |
$29.25
|
| Rate for Payer: Networks By Design Commercial |
$25.35
|
| Rate for Payer: Prime Health Services Commercial |
$33.15
|
| Rate for Payer: Prime Health Services Medicare |
$12.22
|
| Rate for Payer: Riverside University Health System MISP |
$12.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
|
