|
HC TROPONIN-T
|
Facility
|
OP
|
$78.00
|
|
|
Service Code
|
CPT 84484
|
| Hospital Charge Code |
900912119
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.10 |
| Max. Negotiated Rate |
$138.80 |
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$12.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.72
|
| Rate for Payer: Alpha Care 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 |
$28.17
|
| Rate for Payer: Blue Shield of California Commercial |
$47.35
|
| Rate for Payer: Blue Shield of California EPN |
$30.97
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Central Health Plan Commercial |
$62.40
|
| Rate for Payer: Cigna of CA HMO |
$49.92
|
| Rate for Payer: Cigna of CA PPO |
$57.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.83
|
| Rate for Payer: EPIC Health Plan Senior |
$12.47
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$20.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.47
|
| Rate for Payer: InnovAge PACE Commercial |
$18.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.60
|
| 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 |
$58.50
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12.47
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
| Rate for Payer: Prime Health Services Medicare |
$13.22
|
| Rate for Payer: Riverside University Health System MISP |
$13.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.80
|
| 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: Upland Medical Group Pediatric |
$12.47
|
| 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
|
$53,844.00
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
906820022
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,768.80 |
| Max. Negotiated Rate |
$48,459.60 |
| Rate for Payer: Adventist Health Commercial |
$10,768.80
|
| Rate for Payer: Cash Price |
$24,229.80
|
| Rate for Payer: Central Health Plan Commercial |
$43,075.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,537.60
|
| Rate for Payer: EPIC Health Plan Senior |
$21,537.60
|
| Rate for Payer: Galaxy Health WC |
$45,767.40
|
| Rate for Payer: Global Benefits Group Commercial |
$32,306.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$48,459.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35,913.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20,514.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,329.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,768.80
|
| Rate for Payer: Multiplan Commercial |
$40,383.00
|
| Rate for Payer: Networks By Design Commercial |
$34,998.60
|
| Rate for Payer: Prime Health Services Commercial |
$45,767.40
|
|
|
HC TRSNCATH INS/REPL LEADLESS PCR
|
Facility
|
IP
|
$45,767.00
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
906811498
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,153.40 |
| Max. Negotiated Rate |
$41,190.30 |
| Rate for Payer: Adventist Health Commercial |
$9,153.40
|
| Rate for Payer: Cash Price |
$20,595.15
|
| Rate for Payer: Central Health Plan Commercial |
$36,613.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,306.80
|
| Rate for Payer: EPIC Health Plan Senior |
$18,306.80
|
| Rate for Payer: Galaxy Health WC |
$38,901.95
|
| Rate for Payer: Global Benefits Group Commercial |
$27,460.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$41,190.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30,526.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,437.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,329.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,153.40
|
| Rate for Payer: Multiplan Commercial |
$34,325.25
|
| Rate for Payer: Networks By Design Commercial |
$29,748.55
|
| Rate for Payer: Prime Health Services Commercial |
$38,901.95
|
|
|
HC TRSNCATH INS/REPL LEADLESS PCR
|
Facility
|
OP
|
$53,844.00
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
906820022
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$718.48 |
| Max. Negotiated Rate |
$71,375.00 |
| Rate for Payer: Adventist Health Commercial |
$10,768.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$24,231.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36,347.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26,655.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24,231.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,070.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$38,609.08
|
| Rate for Payer: Blue Shield of California Commercial |
$5,999.40
|
| Rate for Payer: Blue Shield of California EPN |
$3,914.40
|
| Rate for Payer: Cash Price |
$24,229.80
|
| Rate for Payer: Cash Price |
$24,229.80
|
| Rate for Payer: Cash Price |
$24,229.80
|
| Rate for Payer: Central Health Plan Commercial |
$43,075.20
|
| Rate for Payer: Cigna of CA HMO |
$34,460.16
|
| Rate for Payer: Cigna of CA PPO |
$39,844.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,347.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,655.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24,231.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,712.96
|
| Rate for Payer: EPIC Health Plan Senior |
$24,231.82
|
| Rate for Payer: Galaxy Health WC |
$45,767.40
|
| Rate for Payer: Global Benefits Group Commercial |
$32,306.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$48,459.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$39,740.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$718.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,231.82
|
| Rate for Payer: InnovAge PACE Commercial |
$36,347.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35,913.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$793.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,231.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,768.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,470.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,470.64
|
| Rate for Payer: Multiplan Commercial |
$40,383.00
|
| Rate for Payer: Multiplan WC |
$38,609.08
|
| Rate for Payer: Networks By Design Commercial |
$34,998.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$24,231.82
|
| Rate for Payer: Preferred Health Network WC |
$39,397.02
|
| Rate for Payer: Prime Health Services Commercial |
$45,767.40
|
| Rate for Payer: Prime Health Services Medicare |
$25,685.73
|
| Rate for Payer: Prime Health Services WC |
$38,215.11
|
| Rate for Payer: Riverside University Health System MISP |
$26,655.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32,306.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$60,866.00
|
| Rate for Payer: United Healthcare All Other HMO |
$71,375.00
|
| Rate for Payer: United Healthcare HMO Rider |
$57,385.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52,575.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$24,231.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,347.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,655.00
|
| Rate for Payer: Vantage Medical Group Senior |
$24,231.82
|
|
|
HC TRSNCATH INS/REPL LEADLESS PCR
|
Facility
|
OP
|
$45,767.00
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
906811498
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$718.48 |
| Max. Negotiated Rate |
$71,375.00 |
| Rate for Payer: Adventist Health Commercial |
$9,153.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$24,231.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36,347.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26,655.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24,231.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,070.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$38,609.08
|
| Rate for Payer: Blue Shield of California Commercial |
$5,999.40
|
| Rate for Payer: Blue Shield of California EPN |
$3,914.40
|
| Rate for Payer: Cash Price |
$20,595.15
|
| Rate for Payer: Cash Price |
$20,595.15
|
| Rate for Payer: Cash Price |
$20,595.15
|
| Rate for Payer: Central Health Plan Commercial |
$36,613.60
|
| Rate for Payer: Cigna of CA HMO |
$29,290.88
|
| Rate for Payer: Cigna of CA PPO |
$33,867.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,347.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,655.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24,231.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,712.96
|
| Rate for Payer: EPIC Health Plan Senior |
$24,231.82
|
| Rate for Payer: Galaxy Health WC |
$38,901.95
|
| Rate for Payer: Global Benefits Group Commercial |
$27,460.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$41,190.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$39,740.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$718.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,231.82
|
| Rate for Payer: InnovAge PACE Commercial |
$36,347.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30,526.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$793.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,231.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,153.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,470.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,470.64
|
| Rate for Payer: Multiplan Commercial |
$34,325.25
|
| Rate for Payer: Multiplan WC |
$38,609.08
|
| Rate for Payer: Networks By Design Commercial |
$29,748.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$24,231.82
|
| Rate for Payer: Preferred Health Network WC |
$39,397.02
|
| Rate for Payer: Prime Health Services Commercial |
$38,901.95
|
| Rate for Payer: Prime Health Services Medicare |
$25,685.73
|
| Rate for Payer: Prime Health Services WC |
$38,215.11
|
| Rate for Payer: Riverside University Health System MISP |
$26,655.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27,460.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$60,866.00
|
| Rate for Payer: United Healthcare All Other HMO |
$71,375.00
|
| Rate for Payer: United Healthcare HMO Rider |
$57,385.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52,575.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$24,231.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,347.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,655.00
|
| Rate for Payer: Vantage Medical Group Senior |
$24,231.82
|
|
|
HC TRT DEVICES COMPLEX
|
Facility
|
IP
|
$5,628.00
|
|
|
Service Code
|
CPT 77334
|
| Hospital Charge Code |
904810506
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,125.60 |
| Max. Negotiated Rate |
$5,065.20 |
| Rate for Payer: Adventist Health Commercial |
$1,125.60
|
| Rate for Payer: Cash Price |
$2,532.60
|
| Rate for Payer: Central Health Plan Commercial |
$4,502.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,251.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,251.20
|
| Rate for Payer: Galaxy Health WC |
$4,783.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,376.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,065.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,753.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,144.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,483.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,125.60
|
| Rate for Payer: Multiplan Commercial |
$4,221.00
|
| Rate for Payer: Networks By Design Commercial |
$3,658.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,783.80
|
|
|
HC TRT DEVICES COMPLEX
|
Facility
|
OP
|
$5,628.00
|
|
|
Service Code
|
CPT 77334
|
| Hospital Charge Code |
904810506
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$137.19 |
| Max. Negotiated Rate |
$5,065.20 |
| Rate for Payer: Adventist Health Commercial |
$1,125.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$465.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,417.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$697.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$511.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$465.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$675.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$137.19
|
| Rate for Payer: Blue Shield of California Commercial |
$3,416.20
|
| Rate for Payer: Blue Shield of California EPN |
$2,234.32
|
| Rate for Payer: Cash Price |
$2,532.60
|
| Rate for Payer: Cash Price |
$2,532.60
|
| Rate for Payer: Cash Price |
$2,532.60
|
| Rate for Payer: Central Health Plan Commercial |
$4,502.40
|
| Rate for Payer: Cigna of CA HMO |
$3,601.92
|
| Rate for Payer: Cigna of CA PPO |
$4,164.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$697.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$511.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$465.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$627.93
|
| Rate for Payer: EPIC Health Plan Senior |
$465.13
|
| Rate for Payer: Galaxy Health WC |
$4,783.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,376.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,065.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$762.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$192.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$465.13
|
| Rate for Payer: InnovAge PACE Commercial |
$697.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,753.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$213.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$465.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,125.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$623.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$623.27
|
| Rate for Payer: Multiplan Commercial |
$4,221.00
|
| Rate for Payer: Networks By Design Commercial |
$3,658.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$465.13
|
| Rate for Payer: Prime Health Services Commercial |
$4,783.80
|
| Rate for Payer: Prime Health Services Medicare |
$493.04
|
| Rate for Payer: Riverside University Health System MISP |
$511.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,376.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,748.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,759.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,332.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,221.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$465.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$697.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$511.64
|
| Rate for Payer: Vantage Medical Group Senior |
$465.13
|
|
|
HC TRT DEVICES INTER
|
Facility
|
OP
|
$2,078.00
|
|
|
Service Code
|
CPT 77333
|
| Hospital Charge Code |
909100210
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$78.66 |
| Max. Negotiated Rate |
$1,870.20 |
| Rate for Payer: Adventist Health Commercial |
$415.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$168.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,261.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$253.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$185.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$168.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$80.70
|
| Rate for Payer: Blue Shield of California Commercial |
$1,261.35
|
| Rate for Payer: Blue Shield of California EPN |
$824.97
|
| Rate for Payer: Cash Price |
$935.10
|
| Rate for Payer: Cash Price |
$935.10
|
| Rate for Payer: Cash Price |
$935.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,662.40
|
| Rate for Payer: Cigna of CA HMO |
$1,329.92
|
| Rate for Payer: Cigna of CA PPO |
$1,537.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$253.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$185.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$168.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$227.75
|
| Rate for Payer: EPIC Health Plan Senior |
$168.70
|
| Rate for Payer: Galaxy Health WC |
$1,766.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,246.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,870.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$276.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$78.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$168.70
|
| Rate for Payer: InnovAge PACE Commercial |
$253.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,386.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$86.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$168.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$415.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$226.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$226.06
|
| Rate for Payer: Multiplan Commercial |
$1,558.50
|
| Rate for Payer: Networks By Design Commercial |
$1,350.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$168.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,766.30
|
| Rate for Payer: Prime Health Services Medicare |
$178.82
|
| Rate for Payer: Riverside University Health System MISP |
$185.57
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,246.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,748.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,759.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,332.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,221.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$168.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$253.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$185.57
|
| Rate for Payer: Vantage Medical Group Senior |
$168.70
|
|
|
HC TRT DEVICES INTER
|
Facility
|
IP
|
$2,078.00
|
|
|
Service Code
|
CPT 77333
|
| Hospital Charge Code |
909100210
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$415.60 |
| Max. Negotiated Rate |
$1,870.20 |
| Rate for Payer: Adventist Health Commercial |
$415.60
|
| Rate for Payer: Cash Price |
$935.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,662.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$831.20
|
| Rate for Payer: EPIC Health Plan Senior |
$831.20
|
| Rate for Payer: Galaxy Health WC |
$1,766.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,246.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,870.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,386.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$791.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,286.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$415.60
|
| Rate for Payer: Multiplan Commercial |
$1,558.50
|
| Rate for Payer: Networks By Design Commercial |
$1,350.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,766.30
|
|
|
HC TRT DEVICES SIMPLE
|
Facility
|
IP
|
$1,854.00
|
|
|
Service Code
|
CPT 77332
|
| Hospital Charge Code |
909100209
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$370.80 |
| Max. Negotiated Rate |
$1,668.60 |
| Rate for Payer: Adventist Health Commercial |
$370.80
|
| Rate for Payer: Cash Price |
$834.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,483.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$741.60
|
| Rate for Payer: EPIC Health Plan Senior |
$741.60
|
| Rate for Payer: Galaxy Health WC |
$1,575.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,112.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,668.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,236.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$706.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,147.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$370.80
|
| Rate for Payer: Multiplan Commercial |
$1,390.50
|
| Rate for Payer: Networks By Design Commercial |
$1,205.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,575.90
|
|
|
HC TRT DEVICES SIMPLE
|
Facility
|
OP
|
$1,854.00
|
|
|
Service Code
|
CPT 77332
|
| Hospital Charge Code |
909100209
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$56.74 |
| Max. Negotiated Rate |
$1,759.00 |
| Rate for Payer: Adventist Health Commercial |
$370.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$168.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,125.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$253.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$185.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$168.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$279.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$56.74
|
| Rate for Payer: Blue Shield of California Commercial |
$1,125.38
|
| Rate for Payer: Blue Shield of California EPN |
$736.04
|
| Rate for Payer: Cash Price |
$834.30
|
| Rate for Payer: Cash Price |
$834.30
|
| Rate for Payer: Cash Price |
$834.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,483.20
|
| Rate for Payer: Cigna of CA HMO |
$1,186.56
|
| Rate for Payer: Cigna of CA PPO |
$1,371.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$253.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$185.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$168.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$227.75
|
| Rate for Payer: EPIC Health Plan Senior |
$168.70
|
| Rate for Payer: Galaxy Health WC |
$1,575.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,112.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,668.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$276.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$59.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$168.70
|
| Rate for Payer: InnovAge PACE Commercial |
$253.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,236.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$168.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$370.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$226.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$226.06
|
| Rate for Payer: Multiplan Commercial |
$1,390.50
|
| Rate for Payer: Networks By Design Commercial |
$1,205.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$168.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,575.90
|
| Rate for Payer: Prime Health Services Medicare |
$178.82
|
| Rate for Payer: Riverside University Health System MISP |
$185.57
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,112.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,748.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,759.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,332.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,221.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$168.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$253.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$185.57
|
| Rate for Payer: Vantage Medical Group Senior |
$168.70
|
|
|
HC TRT SPEECH/LANG/VOICE INDIV
|
Facility
|
IP
|
$774.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
905601401
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$154.80 |
| Max. Negotiated Rate |
$696.60 |
| Rate for Payer: Adventist Health Commercial |
$154.80
|
| Rate for Payer: Cash Price |
$348.30
|
| Rate for Payer: Central Health Plan Commercial |
$619.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.60
|
| Rate for Payer: EPIC Health Plan Senior |
$309.60
|
| Rate for Payer: Galaxy Health WC |
$657.90
|
| Rate for Payer: Global Benefits Group Commercial |
$464.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$696.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$516.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$294.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$479.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.80
|
| Rate for Payer: Multiplan Commercial |
$580.50
|
| Rate for Payer: Networks By Design Commercial |
$503.10
|
| Rate for Payer: Prime Health Services Commercial |
$657.90
|
|
|
HC TRT SPEECH/LANG/VOICE INDIV
|
Facility
|
OP
|
$774.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
907001401
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$51.12 |
| Max. Negotiated Rate |
$696.60 |
| Rate for Payer: Adventist Health Commercial |
$317.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$470.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$657.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$580.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$348.30
|
| Rate for Payer: Cash Price |
$348.30
|
| Rate for Payer: Cash Price |
$348.30
|
| Rate for Payer: Cash Price |
$348.30
|
| Rate for Payer: Central Health Plan Commercial |
$619.20
|
| Rate for Payer: Cigna of CA HMO |
$495.36
|
| Rate for Payer: Cigna of CA PPO |
$572.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$657.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$657.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$657.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.60
|
| Rate for Payer: EPIC Health Plan Senior |
$309.60
|
| Rate for Payer: Galaxy Health WC |
$657.90
|
| Rate for Payer: Global Benefits Group Commercial |
$464.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$696.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$51.12
|
| Rate for Payer: InnovAge PACE Commercial |
$387.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$516.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$479.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$317.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$541.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$541.80
|
| Rate for Payer: Multiplan Commercial |
$580.50
|
| Rate for Payer: Networks By Design Commercial |
$503.10
|
| Rate for Payer: Prime Health Services Commercial |
$657.90
|
| Rate for Payer: Riverside University Health System MISP |
$309.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$464.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$464.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$657.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$657.90
|
| Rate for Payer: Vantage Medical Group Senior |
$657.90
|
|
|
HC TRT SPEECH/LANG/VOICE INDIV
|
Facility
|
IP
|
$774.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
907001401
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$154.80 |
| Max. Negotiated Rate |
$696.60 |
| Rate for Payer: Adventist Health Commercial |
$154.80
|
| Rate for Payer: Cash Price |
$348.30
|
| Rate for Payer: Central Health Plan Commercial |
$619.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.60
|
| Rate for Payer: EPIC Health Plan Senior |
$309.60
|
| Rate for Payer: Galaxy Health WC |
$657.90
|
| Rate for Payer: Global Benefits Group Commercial |
$464.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$696.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$516.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$294.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$479.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.80
|
| Rate for Payer: Multiplan Commercial |
$580.50
|
| Rate for Payer: Networks By Design Commercial |
$503.10
|
| Rate for Payer: Prime Health Services Commercial |
$657.90
|
|
|
HC TRT SPEECH/LANG/VOICE INDIV
|
Facility
|
OP
|
$774.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
905601401
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$51.12 |
| Max. Negotiated Rate |
$696.60 |
| Rate for Payer: Adventist Health Commercial |
$317.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$470.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$657.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$580.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$348.30
|
| Rate for Payer: Cash Price |
$348.30
|
| Rate for Payer: Cash Price |
$348.30
|
| Rate for Payer: Cash Price |
$348.30
|
| Rate for Payer: Central Health Plan Commercial |
$619.20
|
| Rate for Payer: Cigna of CA HMO |
$495.36
|
| Rate for Payer: Cigna of CA PPO |
$572.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$657.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$657.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$657.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.60
|
| Rate for Payer: EPIC Health Plan Senior |
$309.60
|
| Rate for Payer: Galaxy Health WC |
$657.90
|
| Rate for Payer: Global Benefits Group Commercial |
$464.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$696.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$51.12
|
| Rate for Payer: InnovAge PACE Commercial |
$387.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$516.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$479.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$317.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$541.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$541.80
|
| Rate for Payer: Multiplan Commercial |
$580.50
|
| Rate for Payer: Networks By Design Commercial |
$503.10
|
| Rate for Payer: Prime Health Services Commercial |
$657.90
|
| Rate for Payer: Riverside University Health System MISP |
$309.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$464.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$464.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$657.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$657.90
|
| Rate for Payer: Vantage Medical Group Senior |
$657.90
|
|
|
HC TRT SWALLOW/ORAL FUNC FEEDING
|
Facility
|
OP
|
$668.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
905601801
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$58.17 |
| Max. Negotiated Rate |
$601.20 |
| Rate for Payer: Adventist Health Commercial |
$273.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$405.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$567.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$367.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$501.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Central Health Plan Commercial |
$534.40
|
| Rate for Payer: Cigna of CA HMO |
$427.52
|
| Rate for Payer: Cigna of CA PPO |
$494.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$567.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$567.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$567.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$267.20
|
| Rate for Payer: EPIC Health Plan Senior |
$267.20
|
| Rate for Payer: Galaxy Health WC |
$567.80
|
| Rate for Payer: Global Benefits Group Commercial |
$400.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$601.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$58.17
|
| Rate for Payer: InnovAge PACE Commercial |
$334.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$445.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$64.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$413.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$273.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$467.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$467.60
|
| Rate for Payer: Multiplan Commercial |
$501.00
|
| Rate for Payer: Networks By Design Commercial |
$434.20
|
| Rate for Payer: Prime Health Services Commercial |
$567.80
|
| Rate for Payer: Riverside University Health System MISP |
$267.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$400.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$400.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$567.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$567.80
|
| Rate for Payer: Vantage Medical Group Senior |
$567.80
|
|
|
HC TRT SWALLOW/ORAL FUNC FEEDING
|
Facility
|
IP
|
$668.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
905601801
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$133.60 |
| Max. Negotiated Rate |
$601.20 |
| Rate for Payer: Adventist Health Commercial |
$133.60
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Central Health Plan Commercial |
$534.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$267.20
|
| Rate for Payer: EPIC Health Plan Senior |
$267.20
|
| Rate for Payer: Galaxy Health WC |
$567.80
|
| Rate for Payer: Global Benefits Group Commercial |
$400.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$601.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$445.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$254.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$413.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.60
|
| Rate for Payer: Multiplan Commercial |
$501.00
|
| Rate for Payer: Networks By Design Commercial |
$434.20
|
| Rate for Payer: Prime Health Services Commercial |
$567.80
|
|
|
HC TRT SWALLOW/ORAL FUNC FEEDING
|
Facility
|
OP
|
$668.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
905601801
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$58.17 |
| Max. Negotiated Rate |
$601.20 |
| Rate for Payer: Adventist Health Commercial |
$273.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$405.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$567.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$367.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$501.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Central Health Plan Commercial |
$534.40
|
| Rate for Payer: Cigna of CA HMO |
$427.52
|
| Rate for Payer: Cigna of CA PPO |
$494.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$567.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$567.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$567.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$267.20
|
| Rate for Payer: EPIC Health Plan Senior |
$267.20
|
| Rate for Payer: Galaxy Health WC |
$567.80
|
| Rate for Payer: Global Benefits Group Commercial |
$400.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$601.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$58.17
|
| Rate for Payer: InnovAge PACE Commercial |
$334.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$445.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$64.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$413.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$273.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$467.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$467.60
|
| Rate for Payer: Multiplan Commercial |
$501.00
|
| Rate for Payer: Networks By Design Commercial |
$434.20
|
| Rate for Payer: Prime Health Services Commercial |
$567.80
|
| Rate for Payer: Riverside University Health System MISP |
$267.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$400.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$400.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$567.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$567.80
|
| Rate for Payer: Vantage Medical Group Senior |
$567.80
|
|
|
HC TRT SWALLOW/ORAL FUNC FEEDING
|
Facility
|
IP
|
$668.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
905601801
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$133.60 |
| Max. Negotiated Rate |
$601.20 |
| Rate for Payer: Adventist Health Commercial |
$133.60
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Central Health Plan Commercial |
$534.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$267.20
|
| Rate for Payer: EPIC Health Plan Senior |
$267.20
|
| Rate for Payer: Galaxy Health WC |
$567.80
|
| Rate for Payer: Global Benefits Group Commercial |
$400.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$601.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$445.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$254.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$413.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.60
|
| Rate for Payer: Multiplan Commercial |
$501.00
|
| Rate for Payer: Networks By Design Commercial |
$434.20
|
| Rate for Payer: Prime Health Services Commercial |
$567.80
|
|
|
HC TRT SWALLOW/ORAL FUNC FEEDING MCAL
|
Facility
|
IP
|
$668.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
901300021
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$133.60 |
| Max. Negotiated Rate |
$601.20 |
| Rate for Payer: Adventist Health Commercial |
$133.60
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Central Health Plan Commercial |
$534.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$267.20
|
| Rate for Payer: EPIC Health Plan Senior |
$267.20
|
| Rate for Payer: Galaxy Health WC |
$567.80
|
| Rate for Payer: Global Benefits Group Commercial |
$400.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$601.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$445.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$254.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$413.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.60
|
| Rate for Payer: Multiplan Commercial |
$501.00
|
| Rate for Payer: Networks By Design Commercial |
$434.20
|
| Rate for Payer: Prime Health Services Commercial |
$567.80
|
|
|
HC TRT SWALLOW/ORAL FUNC FEEDING MCAL
|
Facility
|
OP
|
$668.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
901300021
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$58.17 |
| Max. Negotiated Rate |
$601.20 |
| Rate for Payer: Adventist Health Commercial |
$273.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$405.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$567.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$367.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$501.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Central Health Plan Commercial |
$534.40
|
| Rate for Payer: Cigna of CA HMO |
$427.52
|
| Rate for Payer: Cigna of CA PPO |
$494.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$567.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$567.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$567.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$267.20
|
| Rate for Payer: EPIC Health Plan Senior |
$267.20
|
| Rate for Payer: Galaxy Health WC |
$567.80
|
| Rate for Payer: Global Benefits Group Commercial |
$400.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$601.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$58.17
|
| Rate for Payer: InnovAge PACE Commercial |
$334.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$445.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$64.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$413.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$273.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$467.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$467.60
|
| Rate for Payer: Multiplan Commercial |
$501.00
|
| Rate for Payer: Networks By Design Commercial |
$434.20
|
| Rate for Payer: Prime Health Services Commercial |
$567.80
|
| Rate for Payer: Riverside University Health System MISP |
$267.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$400.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$400.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$567.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$567.80
|
| Rate for Payer: Vantage Medical Group Senior |
$567.80
|
|
|
HC TRT SWALLOW/ORAL FUNC FEEDING MCAL
|
Facility
|
OP
|
$668.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
907000039
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$58.17 |
| Max. Negotiated Rate |
$601.20 |
| Rate for Payer: Adventist Health Commercial |
$273.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$405.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$567.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$367.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$501.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Central Health Plan Commercial |
$534.40
|
| Rate for Payer: Cigna of CA HMO |
$427.52
|
| Rate for Payer: Cigna of CA PPO |
$494.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$567.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$567.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$567.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$267.20
|
| Rate for Payer: EPIC Health Plan Senior |
$267.20
|
| Rate for Payer: Galaxy Health WC |
$567.80
|
| Rate for Payer: Global Benefits Group Commercial |
$400.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$601.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$58.17
|
| Rate for Payer: InnovAge PACE Commercial |
$334.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$445.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$64.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$413.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$273.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$467.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$467.60
|
| Rate for Payer: Multiplan Commercial |
$501.00
|
| Rate for Payer: Networks By Design Commercial |
$434.20
|
| Rate for Payer: Prime Health Services Commercial |
$567.80
|
| Rate for Payer: Riverside University Health System MISP |
$267.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$400.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$400.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$567.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$567.80
|
| Rate for Payer: Vantage Medical Group Senior |
$567.80
|
|
|
HC TRT SWALLOW/ORAL FUNC FEEDING MCAL
|
Facility
|
IP
|
$668.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
907000039
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$133.60 |
| Max. Negotiated Rate |
$601.20 |
| Rate for Payer: Adventist Health Commercial |
$133.60
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Central Health Plan Commercial |
$534.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$267.20
|
| Rate for Payer: EPIC Health Plan Senior |
$267.20
|
| Rate for Payer: Galaxy Health WC |
$567.80
|
| Rate for Payer: Global Benefits Group Commercial |
$400.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$601.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$445.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$254.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$413.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.60
|
| Rate for Payer: Multiplan Commercial |
$501.00
|
| Rate for Payer: Networks By Design Commercial |
$434.20
|
| Rate for Payer: Prime Health Services Commercial |
$567.80
|
|
|
HC TRT SWALLOW ORAL FUNC FEEDING MCARE COMM
|
Facility
|
IP
|
$668.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
901300802
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$133.60 |
| Max. Negotiated Rate |
$601.20 |
| Rate for Payer: Adventist Health Commercial |
$133.60
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Central Health Plan Commercial |
$534.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$267.20
|
| Rate for Payer: EPIC Health Plan Senior |
$267.20
|
| Rate for Payer: Galaxy Health WC |
$567.80
|
| Rate for Payer: Global Benefits Group Commercial |
$400.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$601.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$445.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$254.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$413.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.60
|
| Rate for Payer: Multiplan Commercial |
$501.00
|
| Rate for Payer: Networks By Design Commercial |
$434.20
|
| Rate for Payer: Prime Health Services Commercial |
$567.80
|
|
|
HC TRT SWALLOW ORAL FUNC FEEDING MCARE COMM
|
Facility
|
OP
|
$668.00
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
901300802
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$58.17 |
| Max. Negotiated Rate |
$601.20 |
| Rate for Payer: Adventist Health Commercial |
$273.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$405.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$567.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$367.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$501.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Cash Price |
$300.60
|
| Rate for Payer: Central Health Plan Commercial |
$534.40
|
| Rate for Payer: Cigna of CA HMO |
$427.52
|
| Rate for Payer: Cigna of CA PPO |
$494.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$567.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$567.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$567.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$267.20
|
| Rate for Payer: EPIC Health Plan Senior |
$267.20
|
| Rate for Payer: Galaxy Health WC |
$567.80
|
| Rate for Payer: Global Benefits Group Commercial |
$400.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$601.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$58.17
|
| Rate for Payer: InnovAge PACE Commercial |
$334.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$445.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$64.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$413.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$273.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$467.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$467.60
|
| Rate for Payer: Multiplan Commercial |
$501.00
|
| Rate for Payer: Networks By Design Commercial |
$434.20
|
| Rate for Payer: Prime Health Services Commercial |
$567.80
|
| Rate for Payer: Riverside University Health System MISP |
$267.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$400.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$400.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$567.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$567.80
|
| Rate for Payer: Vantage Medical Group Senior |
$567.80
|
|
