|
HC VASOPNEUMATIC DEVICE PT
|
Facility
OP
|
$253.00
|
|
|
Service Code
|
CPT 97016
|
| Hospital Charge Code |
900419065
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$72.28 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$72.28
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$215.05
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$139.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$139.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$151.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$113.85
|
| Rate for Payer: Cash Price |
$113.85
|
| Rate for Payer: Cash Price |
$113.85
|
| Rate for Payer: Cash Price |
$113.85
|
| Rate for Payer: Central Health Plan Commercial |
$202.40
|
| Rate for Payer: Cigna of CA HMO |
$161.92
|
| Rate for Payer: Cigna of CA PPO |
$187.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$215.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$101.20
|
| Rate for Payer: Galaxy Health WC |
$215.05
|
| Rate for Payer: Global Benefits Group Commercial |
$151.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$227.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$189.75
|
| Rate for Payer: IEHP medi-cal |
$88.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$168.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$103.73
|
| Rate for Payer: Multiplan Commercial |
$189.75
|
| Rate for Payer: Networks By Design Commercial |
$164.45
|
| Rate for Payer: Prime Health Services Commercial |
$215.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$151.80
|
| Rate for Payer: Riverside University Health MISP |
$101.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$151.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$151.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$215.05
|
| Rate for Payer: Vantage Medical Group Senior |
$215.05
|
|
|
HC VASOPNEUMATIC DEVICE PT
|
Facility
IP
|
$253.00
|
|
|
Service Code
|
CPT 97016
|
| Hospital Charge Code |
900419065
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$50.60 |
| Max. Negotiated Rate |
$227.70 |
| Rate for Payer: Cash Price |
$113.85
|
| Rate for Payer: Central Health Plan Commercial |
$202.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.20
|
| Rate for Payer: Galaxy Health WC |
$215.05
|
| Rate for Payer: Global Benefits Group Commercial |
$151.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$227.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$168.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.60
|
| Rate for Payer: Multiplan Commercial |
$189.75
|
| Rate for Payer: Networks By Design Commercial |
$164.45
|
| Rate for Payer: Prime Health Services Commercial |
$215.05
|
|
|
HC VASOPNEUMATIC DEVICE PT
|
Facility
OP
|
$253.00
|
|
|
Service Code
|
CPT 97016
|
| Hospital Charge Code |
905103107
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$72.28 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$72.28
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$215.05
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$139.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$139.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$151.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$113.85
|
| Rate for Payer: Cash Price |
$113.85
|
| Rate for Payer: Cash Price |
$113.85
|
| Rate for Payer: Cash Price |
$113.85
|
| Rate for Payer: Central Health Plan Commercial |
$202.40
|
| Rate for Payer: Cigna of CA HMO |
$161.92
|
| Rate for Payer: Cigna of CA PPO |
$187.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$215.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$101.20
|
| Rate for Payer: Galaxy Health WC |
$215.05
|
| Rate for Payer: Global Benefits Group Commercial |
$151.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$227.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$189.75
|
| Rate for Payer: IEHP medi-cal |
$88.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$168.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$103.73
|
| Rate for Payer: Multiplan Commercial |
$189.75
|
| Rate for Payer: Networks By Design Commercial |
$164.45
|
| Rate for Payer: Prime Health Services Commercial |
$215.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$151.80
|
| Rate for Payer: Riverside University Health MISP |
$101.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$151.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$151.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$215.05
|
| Rate for Payer: Vantage Medical Group Senior |
$215.05
|
|
|
HC VASOPNEUMATIC DEVICE PT
|
Facility
IP
|
$253.00
|
|
|
Service Code
|
CPT 97016
|
| Hospital Charge Code |
905103107
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$50.60 |
| Max. Negotiated Rate |
$227.70 |
| Rate for Payer: Cash Price |
$113.85
|
| Rate for Payer: Central Health Plan Commercial |
$202.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.20
|
| Rate for Payer: Galaxy Health WC |
$215.05
|
| Rate for Payer: Global Benefits Group Commercial |
$151.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$227.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$168.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.60
|
| Rate for Payer: Multiplan Commercial |
$189.75
|
| Rate for Payer: Networks By Design Commercial |
$164.45
|
| Rate for Payer: Prime Health Services Commercial |
$215.05
|
|
|
HC VAT PIV KIT
|
Facility
IP
|
$188.37
|
|
| Hospital Charge Code |
901698272
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.67 |
| Max. Negotiated Rate |
$169.53 |
| Rate for Payer: Cash Price |
$84.77
|
| Rate for Payer: Central Health Plan Commercial |
$150.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$75.35
|
| Rate for Payer: Galaxy Health WC |
$160.11
|
| Rate for Payer: Global Benefits Group Commercial |
$113.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$169.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$125.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.67
|
| Rate for Payer: Multiplan Commercial |
$141.28
|
| Rate for Payer: Networks By Design Commercial |
$122.44
|
| Rate for Payer: Prime Health Services Commercial |
$160.11
|
|
|
HC VAT PIV KIT
|
Facility
OP
|
$188.37
|
|
| Hospital Charge Code |
901698272
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.67 |
| Max. Negotiated Rate |
$169.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$114.40
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$160.11
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$103.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$103.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$91.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$111.29
|
| Rate for Payer: BCBS Transplant Transplant |
$113.02
|
| Rate for Payer: Blue Shield of California Commercial |
$118.48
|
| Rate for Payer: Blue Shield of California EPN |
$92.11
|
| Rate for Payer: Cash Price |
$84.77
|
| Rate for Payer: Central Health Plan Commercial |
$150.70
|
| Rate for Payer: Cigna of CA HMO |
$120.56
|
| Rate for Payer: Cigna of CA PPO |
$139.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$160.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$75.35
|
| Rate for Payer: EPIC Health Plan Transplant |
$75.35
|
| Rate for Payer: Galaxy Health WC |
$160.11
|
| Rate for Payer: Global Benefits Group Commercial |
$113.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$169.53
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$141.28
|
| Rate for Payer: IEHP medi-cal |
$65.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$125.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.67
|
| Rate for Payer: Multiplan Commercial |
$141.28
|
| Rate for Payer: Networks By Design Commercial |
$122.44
|
| Rate for Payer: Prime Health Services Commercial |
$160.11
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$113.02
|
| Rate for Payer: Riverside University Health MISP |
$75.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$113.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$113.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$94.18
|
| Rate for Payer: United Healthcare All Other HMO |
$94.18
|
| Rate for Payer: United Healthcare HMO Rider |
$94.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$94.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$160.11
|
| Rate for Payer: Vantage Medical Group Senior |
$160.11
|
|
|
HC VEEG 21-12HR INTMT MNTRD
|
Facility
OP
|
$944.00
|
|
|
Service Code
|
CPT 95712
|
| Hospital Charge Code |
900605712
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$188.80 |
| Max. Negotiated Rate |
$3,209.17 |
| Rate for Payer: Adventist Health Medi-Cal |
$392.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,806.16
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$392.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,209.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$557.72
|
| Rate for Payer: BCBS Transplant Transplant |
$566.40
|
| Rate for Payer: Blue Shield of California Commercial |
$583.39
|
| Rate for Payer: Blue Shield of California EPN |
$458.78
|
| Rate for Payer: Caremore Medicare Advantage |
$392.17
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Central Health Plan Commercial |
$755.20
|
| Rate for Payer: Cigna of CA HMO |
$604.16
|
| Rate for Payer: Cigna of CA PPO |
$698.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$529.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$392.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$392.17
|
| Rate for Payer: Galaxy Health WC |
$802.40
|
| Rate for Payer: Global Benefits Group Commercial |
$566.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$849.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$708.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$643.16
|
| Rate for Payer: IEHP medi-cal |
$647.08
|
| Rate for Payer: IEHP Medicare Advantage |
$392.17
|
| Rate for Payer: Innovage PACE Commercial |
$588.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$629.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$188.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$525.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$525.51
|
| Rate for Payer: Multiplan Commercial |
$708.00
|
| Rate for Payer: Networks By Design Commercial |
$613.60
|
| Rate for Payer: Prime Health Services Commercial |
$802.40
|
| Rate for Payer: Prime Health Services Medicare |
$415.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$566.40
|
| Rate for Payer: Riverside University Health MISP |
$431.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$566.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$566.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,935.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,806.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,323.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Vantage Medical Group Senior |
$392.17
|
|
|
HC VEEG 21-12HR INTMT MNTRD
|
Facility
IP
|
$944.00
|
|
|
Service Code
|
CPT 95712
|
| Hospital Charge Code |
900605712
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$188.80 |
| Max. Negotiated Rate |
$849.60 |
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Central Health Plan Commercial |
$755.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$377.60
|
| Rate for Payer: Galaxy Health WC |
$802.40
|
| Rate for Payer: Global Benefits Group Commercial |
$566.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$849.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$629.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$188.80
|
| Rate for Payer: Multiplan Commercial |
$708.00
|
| Rate for Payer: Networks By Design Commercial |
$613.60
|
| Rate for Payer: Prime Health Services Commercial |
$802.40
|
|
|
HC VEEG 21-12HR UNMNTRD
|
Facility
OP
|
$944.00
|
|
|
Service Code
|
CPT 95711
|
| Hospital Charge Code |
900605711
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$188.80 |
| Max. Negotiated Rate |
$3,209.17 |
| Rate for Payer: Adventist Health Medi-Cal |
$392.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$700.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$392.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,209.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$557.72
|
| Rate for Payer: BCBS Transplant Transplant |
$566.40
|
| Rate for Payer: Blue Shield of California Commercial |
$583.39
|
| Rate for Payer: Blue Shield of California EPN |
$458.78
|
| Rate for Payer: Caremore Medicare Advantage |
$392.17
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Central Health Plan Commercial |
$755.20
|
| Rate for Payer: Cigna of CA HMO |
$604.16
|
| Rate for Payer: Cigna of CA PPO |
$698.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$529.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$392.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$392.17
|
| Rate for Payer: Galaxy Health WC |
$802.40
|
| Rate for Payer: Global Benefits Group Commercial |
$566.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$849.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$708.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$643.16
|
| Rate for Payer: IEHP medi-cal |
$647.08
|
| Rate for Payer: IEHP Medicare Advantage |
$392.17
|
| Rate for Payer: Innovage PACE Commercial |
$588.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$629.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$188.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$525.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$525.51
|
| Rate for Payer: Multiplan Commercial |
$708.00
|
| Rate for Payer: Networks By Design Commercial |
$613.60
|
| Rate for Payer: Prime Health Services Commercial |
$802.40
|
| Rate for Payer: Prime Health Services Medicare |
$415.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$566.40
|
| Rate for Payer: Riverside University Health MISP |
$431.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$566.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$566.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,935.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,806.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,323.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Vantage Medical Group Senior |
$392.17
|
|
|
HC VEEG 21-12HR UNMNTRD
|
Facility
IP
|
$944.00
|
|
|
Service Code
|
CPT 95711
|
| Hospital Charge Code |
900605711
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$188.80 |
| Max. Negotiated Rate |
$849.60 |
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Central Health Plan Commercial |
$755.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$377.60
|
| Rate for Payer: Galaxy Health WC |
$802.40
|
| Rate for Payer: Global Benefits Group Commercial |
$566.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$849.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$629.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$188.80
|
| Rate for Payer: Multiplan Commercial |
$708.00
|
| Rate for Payer: Networks By Design Commercial |
$613.60
|
| Rate for Payer: Prime Health Services Commercial |
$802.40
|
|
|
HC VEEG 2-12HR CONT MNTRD
|
Facility
IP
|
$1,812.00
|
|
|
Service Code
|
CPT 95713
|
| Hospital Charge Code |
900605713
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$362.40 |
| Max. Negotiated Rate |
$1,630.80 |
| Rate for Payer: Cash Price |
$815.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,449.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$724.80
|
| Rate for Payer: Galaxy Health WC |
$1,540.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,087.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,630.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,208.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$362.40
|
| Rate for Payer: Multiplan Commercial |
$1,359.00
|
| Rate for Payer: Networks By Design Commercial |
$1,177.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,540.20
|
|
|
HC VEEG 2-12HR CONT MNTRD
|
Facility
OP
|
$1,812.00
|
|
|
Service Code
|
CPT 95713
|
| Hospital Charge Code |
900605713
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$362.40 |
| Max. Negotiated Rate |
$3,509.07 |
| Rate for Payer: Adventist Health Medi-Cal |
$669.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,509.07
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,004.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$736.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$669.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,209.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,070.53
|
| Rate for Payer: BCBS Transplant Transplant |
$1,087.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,119.82
|
| Rate for Payer: Blue Shield of California EPN |
$880.63
|
| Rate for Payer: Caremore Medicare Advantage |
$669.68
|
| Rate for Payer: Cash Price |
$815.40
|
| Rate for Payer: Cash Price |
$815.40
|
| Rate for Payer: Cash Price |
$815.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,449.60
|
| Rate for Payer: Cigna of CA HMO |
$1,159.68
|
| Rate for Payer: Cigna of CA PPO |
$1,340.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,004.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$904.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$669.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$669.68
|
| Rate for Payer: Galaxy Health WC |
$1,540.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,087.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,630.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,359.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,098.28
|
| Rate for Payer: IEHP medi-cal |
$1,104.97
|
| Rate for Payer: IEHP Medicare Advantage |
$669.68
|
| Rate for Payer: Innovage PACE Commercial |
$1,004.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,208.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$669.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$362.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$897.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$897.37
|
| Rate for Payer: Multiplan Commercial |
$1,359.00
|
| Rate for Payer: Networks By Design Commercial |
$1,177.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,540.20
|
| Rate for Payer: Prime Health Services Medicare |
$709.86
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,087.20
|
| Rate for Payer: Riverside University Health MISP |
$736.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,087.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,087.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,935.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,806.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,323.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,004.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$736.65
|
| Rate for Payer: Vantage Medical Group Senior |
$669.68
|
|
|
HC VEEG EA 12-26HR CONT MNTRD
|
Facility
OP
|
$3,391.00
|
|
|
Service Code
|
CPT 95716
|
| Hospital Charge Code |
900605716
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$678.20 |
| Max. Negotiated Rate |
$7,371.92 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,306.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,018.69
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,959.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,436.96
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,306.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7,371.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,003.40
|
| Rate for Payer: BCBS Transplant Transplant |
$2,034.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,095.64
|
| Rate for Payer: Blue Shield of California EPN |
$1,648.03
|
| Rate for Payer: Caremore Medicare Advantage |
$1,306.33
|
| Rate for Payer: Cash Price |
$1,525.95
|
| Rate for Payer: Cash Price |
$1,525.95
|
| Rate for Payer: Cash Price |
$1,525.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,712.80
|
| Rate for Payer: Cigna of CA HMO |
$2,170.24
|
| Rate for Payer: Cigna of CA PPO |
$2,509.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,959.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,763.55
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,306.33
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,306.33
|
| Rate for Payer: Galaxy Health WC |
$2,882.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,034.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,051.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,543.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,142.38
|
| Rate for Payer: IEHP medi-cal |
$2,155.44
|
| Rate for Payer: IEHP Medicare Advantage |
$1,306.33
|
| Rate for Payer: Innovage PACE Commercial |
$1,959.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,261.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,306.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$678.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,750.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,750.48
|
| Rate for Payer: Multiplan Commercial |
$2,543.25
|
| Rate for Payer: Networks By Design Commercial |
$2,204.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,882.35
|
| Rate for Payer: Prime Health Services Medicare |
$1,384.71
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,034.60
|
| Rate for Payer: Riverside University Health MISP |
$1,436.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,034.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,034.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,935.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,806.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,323.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,959.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,436.96
|
| Rate for Payer: Vantage Medical Group Senior |
$1,306.33
|
|
|
HC VEEG EA 12-26HR CONT MNTRD
|
Facility
IP
|
$3,391.00
|
|
|
Service Code
|
CPT 95716
|
| Hospital Charge Code |
900605716
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$678.20 |
| Max. Negotiated Rate |
$3,051.90 |
| Rate for Payer: Cash Price |
$1,525.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,712.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,356.40
|
| Rate for Payer: Galaxy Health WC |
$2,882.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,034.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,051.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,261.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$678.20
|
| Rate for Payer: Multiplan Commercial |
$2,543.25
|
| Rate for Payer: Networks By Design Commercial |
$2,204.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,882.35
|
|
|
HC VEEG EA 12-26HR INTMT MNTRD
|
Facility
OP
|
$1,812.00
|
|
|
Service Code
|
CPT 95715
|
| Hospital Charge Code |
900605715
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$362.40 |
| Max. Negotiated Rate |
$7,371.92 |
| Rate for Payer: Adventist Health Medi-Cal |
$669.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5,614.35
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,004.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$736.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$669.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7,371.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,070.53
|
| Rate for Payer: BCBS Transplant Transplant |
$1,087.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,119.82
|
| Rate for Payer: Blue Shield of California EPN |
$880.63
|
| Rate for Payer: Caremore Medicare Advantage |
$669.68
|
| Rate for Payer: Cash Price |
$815.40
|
| Rate for Payer: Cash Price |
$815.40
|
| Rate for Payer: Cash Price |
$815.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,449.60
|
| Rate for Payer: Cigna of CA HMO |
$1,159.68
|
| Rate for Payer: Cigna of CA PPO |
$1,340.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,004.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$904.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$669.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$669.68
|
| Rate for Payer: Galaxy Health WC |
$1,540.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,087.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,630.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,359.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,098.28
|
| Rate for Payer: IEHP medi-cal |
$1,104.97
|
| Rate for Payer: IEHP Medicare Advantage |
$669.68
|
| Rate for Payer: Innovage PACE Commercial |
$1,004.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,208.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$669.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$362.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$897.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$897.37
|
| Rate for Payer: Multiplan Commercial |
$1,359.00
|
| Rate for Payer: Networks By Design Commercial |
$1,177.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,540.20
|
| Rate for Payer: Prime Health Services Medicare |
$709.86
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,087.20
|
| Rate for Payer: Riverside University Health MISP |
$736.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,087.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,087.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,935.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,806.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,323.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,004.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$736.65
|
| Rate for Payer: Vantage Medical Group Senior |
$669.68
|
|
|
HC VEEG EA 12-26HR INTMT MNTRD
|
Facility
IP
|
$1,812.00
|
|
|
Service Code
|
CPT 95715
|
| Hospital Charge Code |
900605715
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$362.40 |
| Max. Negotiated Rate |
$1,630.80 |
| Rate for Payer: Cash Price |
$815.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,449.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$724.80
|
| Rate for Payer: Galaxy Health WC |
$1,540.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,087.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,630.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,208.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$362.40
|
| Rate for Payer: Multiplan Commercial |
$1,359.00
|
| Rate for Payer: Networks By Design Commercial |
$1,177.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,540.20
|
|
|
HC VEEG EA 12-26HR UNMNTRD
|
Facility
OP
|
$1,812.00
|
|
|
Service Code
|
CPT 95714
|
| Hospital Charge Code |
900605714
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$362.40 |
| Max. Negotiated Rate |
$1,935.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$669.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,123.08
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,004.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$736.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$669.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,624.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,070.53
|
| Rate for Payer: BCBS Transplant Transplant |
$1,087.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,119.82
|
| Rate for Payer: Blue Shield of California EPN |
$880.63
|
| Rate for Payer: Caremore Medicare Advantage |
$669.68
|
| Rate for Payer: Cash Price |
$815.40
|
| Rate for Payer: Cash Price |
$815.40
|
| Rate for Payer: Cash Price |
$815.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,449.60
|
| Rate for Payer: Cigna of CA HMO |
$1,159.68
|
| Rate for Payer: Cigna of CA PPO |
$1,340.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,004.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$904.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$669.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$669.68
|
| Rate for Payer: Galaxy Health WC |
$1,540.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,087.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,630.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,359.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,098.28
|
| Rate for Payer: IEHP medi-cal |
$1,104.97
|
| Rate for Payer: IEHP Medicare Advantage |
$669.68
|
| Rate for Payer: Innovage PACE Commercial |
$1,004.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,208.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$669.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$362.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$897.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$897.37
|
| Rate for Payer: Multiplan Commercial |
$1,359.00
|
| Rate for Payer: Networks By Design Commercial |
$1,177.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,540.20
|
| Rate for Payer: Prime Health Services Medicare |
$709.86
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,087.20
|
| Rate for Payer: Riverside University Health MISP |
$736.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,087.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,087.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,935.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,806.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,323.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,004.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$736.65
|
| Rate for Payer: Vantage Medical Group Senior |
$669.68
|
|
|
HC VEEG EA 12-26HR UNMNTRD
|
Facility
IP
|
$1,812.00
|
|
|
Service Code
|
CPT 95714
|
| Hospital Charge Code |
900605714
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$362.40 |
| Max. Negotiated Rate |
$1,630.80 |
| Rate for Payer: Cash Price |
$815.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,449.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$724.80
|
| Rate for Payer: Galaxy Health WC |
$1,540.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,087.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,630.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,208.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$362.40
|
| Rate for Payer: Multiplan Commercial |
$1,359.00
|
| Rate for Payer: Networks By Design Commercial |
$1,177.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,540.20
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
OP
|
$405.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$81.00 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$344.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$222.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$222.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$243.00
|
| Rate for Payer: Cash Price |
$182.25
|
| Rate for Payer: Cash Price |
$182.25
|
| Rate for Payer: Cash Price |
$182.25
|
| Rate for Payer: Central Health Plan Commercial |
$324.00
|
| Rate for Payer: Cigna of CA PPO |
$299.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$344.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$162.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$162.00
|
| Rate for Payer: Galaxy Health WC |
$344.25
|
| Rate for Payer: Global Benefits Group Commercial |
$243.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$364.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$303.75
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$270.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.00
|
| Rate for Payer: Multiplan Commercial |
$303.75
|
| Rate for Payer: Networks By Design Commercial |
$263.25
|
| Rate for Payer: Prime Health Services Commercial |
$344.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$243.00
|
| Rate for Payer: Riverside University Health MISP |
$162.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$243.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$202.50
|
| Rate for Payer: United Healthcare All Other HMO |
$202.50
|
| Rate for Payer: United Healthcare HMO Rider |
$202.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$202.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$344.25
|
| Rate for Payer: Vantage Medical Group Senior |
$344.25
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
OP
|
$405.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$51.17 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51.17
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$344.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$222.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$222.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$243.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$182.25
|
| Rate for Payer: Cash Price |
$182.25
|
| Rate for Payer: Cash Price |
$182.25
|
| Rate for Payer: Central Health Plan Commercial |
$324.00
|
| Rate for Payer: Cigna of CA PPO |
$299.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$344.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$162.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$162.00
|
| Rate for Payer: Galaxy Health WC |
$344.25
|
| Rate for Payer: Global Benefits Group Commercial |
$243.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$364.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$303.75
|
| Rate for Payer: IEHP medi-cal |
$141.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$270.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.00
|
| Rate for Payer: Multiplan Commercial |
$303.75
|
| Rate for Payer: Networks By Design Commercial |
$263.25
|
| Rate for Payer: Prime Health Services Commercial |
$344.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$243.00
|
| Rate for Payer: Riverside University Health MISP |
$162.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$243.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$344.25
|
| Rate for Payer: Vantage Medical Group Senior |
$344.25
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
IP
|
$405.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$81.00 |
| Max. Negotiated Rate |
$364.50 |
| Rate for Payer: Cash Price |
$182.25
|
| Rate for Payer: Central Health Plan Commercial |
$324.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$162.00
|
| Rate for Payer: Galaxy Health WC |
$344.25
|
| Rate for Payer: Global Benefits Group Commercial |
$243.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$364.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$270.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.00
|
| Rate for Payer: Multiplan Commercial |
$303.75
|
| Rate for Payer: Networks By Design Commercial |
$263.25
|
| Rate for Payer: Prime Health Services Commercial |
$344.25
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
IP
|
$405.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$81.00 |
| Max. Negotiated Rate |
$364.50 |
| Rate for Payer: Cash Price |
$182.25
|
| Rate for Payer: Central Health Plan Commercial |
$324.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$162.00
|
| Rate for Payer: Galaxy Health WC |
$344.25
|
| Rate for Payer: Global Benefits Group Commercial |
$243.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$364.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$270.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.00
|
| Rate for Payer: Multiplan Commercial |
$303.75
|
| Rate for Payer: Networks By Design Commercial |
$263.25
|
| Rate for Payer: Prime Health Services Commercial |
$344.25
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
OP
|
$405.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$51.17 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51.17
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$344.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$222.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$222.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$243.00
|
| Rate for Payer: Blue Shield of California Commercial |
$254.74
|
| Rate for Payer: Blue Shield of California EPN |
$198.04
|
| Rate for Payer: Cash Price |
$182.25
|
| Rate for Payer: Cash Price |
$182.25
|
| Rate for Payer: Cash Price |
$182.25
|
| Rate for Payer: Central Health Plan Commercial |
$324.00
|
| Rate for Payer: Cigna of CA HMO |
$259.20
|
| Rate for Payer: Cigna of CA PPO |
$299.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$344.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$162.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$162.00
|
| Rate for Payer: Galaxy Health WC |
$344.25
|
| Rate for Payer: Global Benefits Group Commercial |
$243.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$364.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$303.75
|
| Rate for Payer: IEHP medi-cal |
$141.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$270.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.00
|
| Rate for Payer: Multiplan Commercial |
$303.75
|
| Rate for Payer: Networks By Design Commercial |
$263.25
|
| Rate for Payer: Prime Health Services Commercial |
$344.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$243.00
|
| Rate for Payer: Riverside University Health MISP |
$162.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$243.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$243.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$202.50
|
| Rate for Payer: United Healthcare All Other HMO |
$202.50
|
| Rate for Payer: United Healthcare HMO Rider |
$202.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$202.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$344.25
|
| Rate for Payer: Vantage Medical Group Senior |
$344.25
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
IP
|
$405.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$81.00 |
| Max. Negotiated Rate |
$364.50 |
| Rate for Payer: Cash Price |
$182.25
|
| Rate for Payer: Central Health Plan Commercial |
$324.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$162.00
|
| Rate for Payer: Galaxy Health WC |
$344.25
|
| Rate for Payer: Global Benefits Group Commercial |
$243.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$364.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$270.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.00
|
| Rate for Payer: Multiplan Commercial |
$303.75
|
| Rate for Payer: Networks By Design Commercial |
$263.25
|
| Rate for Payer: Prime Health Services Commercial |
$344.25
|
|
|
HC VELOPHARYNGEAL STUDY
|
Facility
OP
|
$797.00
|
|
|
Service Code
|
CPT 70371
|
| Hospital Charge Code |
909001252
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$159.40 |
| Max. Negotiated Rate |
$717.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$306.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$300.89
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$459.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$336.78
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$306.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$431.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$526.25
|
| Rate for Payer: BCBS Transplant Transplant |
$478.20
|
| Rate for Payer: Blue Shield of California Commercial |
$492.55
|
| Rate for Payer: Blue Shield of California EPN |
$387.34
|
| Rate for Payer: Caremore Medicare Advantage |
$306.16
|
| Rate for Payer: Cash Price |
$358.65
|
| Rate for Payer: Cash Price |
$358.65
|
| Rate for Payer: Central Health Plan Commercial |
$637.60
|
| Rate for Payer: Cigna of CA HMO |
$510.08
|
| Rate for Payer: Cigna of CA PPO |
$589.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$459.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$413.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$306.16
|
| Rate for Payer: EPIC Health Plan Transplant |
$306.16
|
| Rate for Payer: Galaxy Health WC |
$677.45
|
| Rate for Payer: Global Benefits Group Commercial |
$478.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$717.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$597.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$502.10
|
| Rate for Payer: IEHP medi-cal |
$505.16
|
| Rate for Payer: IEHP Medicare Advantage |
$306.16
|
| Rate for Payer: Innovage PACE Commercial |
$459.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$531.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$306.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$159.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$410.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$410.25
|
| Rate for Payer: Multiplan Commercial |
$597.75
|
| Rate for Payer: Networks By Design Commercial |
$518.05
|
| Rate for Payer: Prime Health Services Commercial |
$677.45
|
| Rate for Payer: Prime Health Services Medicare |
$324.53
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$478.20
|
| Rate for Payer: Riverside University Health MISP |
$336.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$478.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$478.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$225.63
|
| Rate for Payer: United Healthcare All Other HMO |
$225.63
|
| Rate for Payer: United Healthcare HMO Rider |
$225.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$225.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$459.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$336.78
|
| Rate for Payer: Vantage Medical Group Senior |
$306.16
|
|
