|
HC VNUS ABLATION CATHETER
|
Facility
|
IP
|
$1,740.00
|
|
|
Service Code
|
CPT C1888
|
| Hospital Charge Code |
909080043
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$348.00 |
| Max. Negotiated Rate |
$1,566.00 |
| Rate for Payer: Adventist Health Commercial |
$348.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,345.02
|
| Rate for Payer: Blue Shield of California EPN |
$876.96
|
| Rate for Payer: Cash Price |
$957.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,392.00
|
| Rate for Payer: Cigna of CA HMO |
$1,218.00
|
| Rate for Payer: Cigna of CA PPO |
$1,218.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$696.00
|
| Rate for Payer: EPIC Health Plan Senior |
$696.00
|
| Rate for Payer: Galaxy Health WC |
$1,479.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,044.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,566.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,160.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$662.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,077.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$348.00
|
| Rate for Payer: Multiplan Commercial |
$1,305.00
|
| Rate for Payer: Networks By Design Commercial |
$870.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,479.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$653.02
|
| Rate for Payer: United Healthcare All Other HMO |
$635.62
|
| Rate for Payer: United Healthcare HMO Rider |
$621.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$569.85
|
|
|
HC VNUS ABLATION CATHETER
|
Facility
|
OP
|
$1,740.00
|
|
|
Service Code
|
CPT C1888
|
| Hospital Charge Code |
909080043
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$348.00 |
| Max. Negotiated Rate |
$1,566.00 |
| Rate for Payer: Adventist Health Commercial |
$348.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,479.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$957.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,305.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$794.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$963.44
|
| Rate for Payer: Blue Shield of California Commercial |
$1,345.02
|
| Rate for Payer: Blue Shield of California EPN |
$876.96
|
| Rate for Payer: Cash Price |
$957.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,392.00
|
| Rate for Payer: Cigna of CA HMO |
$1,218.00
|
| Rate for Payer: Cigna of CA PPO |
$1,218.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,479.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,479.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,479.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$696.00
|
| Rate for Payer: EPIC Health Plan Senior |
$696.00
|
| Rate for Payer: Galaxy Health WC |
$1,479.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,044.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,566.00
|
| Rate for Payer: InnovAge PACE Commercial |
$870.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,160.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$662.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,077.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$348.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,218.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,218.00
|
| Rate for Payer: Multiplan Commercial |
$1,305.00
|
| Rate for Payer: Networks By Design Commercial |
$870.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,479.00
|
| Rate for Payer: Riverside University Health System MISP |
$696.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,044.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,044.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$653.02
|
| Rate for Payer: United Healthcare All Other HMO |
$635.62
|
| Rate for Payer: United Healthcare HMO Rider |
$621.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$569.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,479.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,479.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,479.00
|
|
|
HC VOCATIONAL EVAL 10 DAY
|
Facility
|
IP
|
$283.00
|
|
| Hospital Charge Code |
903200103
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$56.60 |
| Max. Negotiated Rate |
$254.70 |
| Rate for Payer: Adventist Health Commercial |
$56.60
|
| Rate for Payer: Cash Price |
$155.65
|
| Rate for Payer: Central Health Plan Commercial |
$226.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$113.20
|
| Rate for Payer: EPIC Health Plan Senior |
$113.20
|
| Rate for Payer: Galaxy Health WC |
$240.55
|
| Rate for Payer: Global Benefits Group Commercial |
$169.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$254.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$188.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$107.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$175.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.60
|
| Rate for Payer: Multiplan Commercial |
$212.25
|
| Rate for Payer: Networks By Design Commercial |
$183.95
|
| Rate for Payer: Prime Health Services Commercial |
$240.55
|
|
|
HC VOCATIONAL EVAL 10 DAY
|
Facility
|
OP
|
$283.00
|
|
| Hospital Charge Code |
903200103
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$107.82 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$116.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$171.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$240.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$155.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$212.25
|
| 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 |
$155.65
|
| Rate for Payer: Cash Price |
$155.65
|
| Rate for Payer: Cash Price |
$155.65
|
| Rate for Payer: Central Health Plan Commercial |
$226.40
|
| Rate for Payer: Cigna of CA HMO |
$181.12
|
| Rate for Payer: Cigna of CA PPO |
$209.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$240.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$240.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$240.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$113.20
|
| Rate for Payer: EPIC Health Plan Senior |
$113.20
|
| Rate for Payer: Galaxy Health WC |
$240.55
|
| Rate for Payer: Global Benefits Group Commercial |
$169.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$254.70
|
| Rate for Payer: InnovAge PACE Commercial |
$141.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$188.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$107.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$175.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$198.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$198.10
|
| Rate for Payer: Multiplan Commercial |
$212.25
|
| Rate for Payer: Networks By Design Commercial |
$183.95
|
| Rate for Payer: Prime Health Services Commercial |
$240.55
|
| Rate for Payer: Riverside University Health System MISP |
$113.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$169.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$169.80
|
| 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 |
$240.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$240.55
|
| Rate for Payer: Vantage Medical Group Senior |
$240.55
|
|
|
HC VOCATIONAL EVAL 1 DAY
|
Facility
|
OP
|
$461.00
|
|
| Hospital Charge Code |
903200100
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$175.64 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$189.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$279.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$391.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$253.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$345.75
|
| 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 |
$253.55
|
| Rate for Payer: Cash Price |
$253.55
|
| Rate for Payer: Cash Price |
$253.55
|
| Rate for Payer: Central Health Plan Commercial |
$368.80
|
| Rate for Payer: Cigna of CA HMO |
$295.04
|
| Rate for Payer: Cigna of CA PPO |
$341.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$391.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$391.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.40
|
| Rate for Payer: EPIC Health Plan Senior |
$184.40
|
| Rate for Payer: Galaxy Health WC |
$391.85
|
| Rate for Payer: Global Benefits Group Commercial |
$276.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$414.90
|
| Rate for Payer: InnovAge PACE Commercial |
$230.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$307.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$175.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$285.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$189.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$322.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$322.70
|
| Rate for Payer: Multiplan Commercial |
$345.75
|
| Rate for Payer: Networks By Design Commercial |
$299.65
|
| Rate for Payer: Prime Health Services Commercial |
$391.85
|
| Rate for Payer: Riverside University Health System MISP |
$184.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$276.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$276.60
|
| 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 |
$391.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$391.85
|
| Rate for Payer: Vantage Medical Group Senior |
$391.85
|
|
|
HC VOCATIONAL EVAL 1 DAY
|
Facility
|
IP
|
$461.00
|
|
| Hospital Charge Code |
903200100
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$92.20 |
| Max. Negotiated Rate |
$414.90 |
| Rate for Payer: Adventist Health Commercial |
$92.20
|
| Rate for Payer: Cash Price |
$253.55
|
| Rate for Payer: Central Health Plan Commercial |
$368.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.40
|
| Rate for Payer: EPIC Health Plan Senior |
$184.40
|
| Rate for Payer: Galaxy Health WC |
$391.85
|
| Rate for Payer: Global Benefits Group Commercial |
$276.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$414.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$307.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$175.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$285.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.20
|
| Rate for Payer: Multiplan Commercial |
$345.75
|
| Rate for Payer: Networks By Design Commercial |
$299.65
|
| Rate for Payer: Prime Health Services Commercial |
$391.85
|
|
|
HC VOCATIONAL EVAL 3 DAY
|
Facility
|
IP
|
$419.00
|
|
| Hospital Charge Code |
903200101
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$83.80 |
| Max. Negotiated Rate |
$377.10 |
| Rate for Payer: Adventist Health Commercial |
$83.80
|
| Rate for Payer: Cash Price |
$230.45
|
| Rate for Payer: Central Health Plan Commercial |
$335.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$167.60
|
| Rate for Payer: EPIC Health Plan Senior |
$167.60
|
| Rate for Payer: Galaxy Health WC |
$356.15
|
| Rate for Payer: Global Benefits Group Commercial |
$251.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$377.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$279.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$159.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$259.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$83.80
|
| Rate for Payer: Multiplan Commercial |
$314.25
|
| Rate for Payer: Networks By Design Commercial |
$272.35
|
| Rate for Payer: Prime Health Services Commercial |
$356.15
|
|
|
HC VOCATIONAL EVAL 3 DAY
|
Facility
|
OP
|
$419.00
|
|
| Hospital Charge Code |
903200101
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$159.64 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$171.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$254.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$356.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$230.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$314.25
|
| 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 |
$230.45
|
| Rate for Payer: Cash Price |
$230.45
|
| Rate for Payer: Cash Price |
$230.45
|
| Rate for Payer: Central Health Plan Commercial |
$335.20
|
| Rate for Payer: Cigna of CA HMO |
$268.16
|
| Rate for Payer: Cigna of CA PPO |
$310.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$356.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$356.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$356.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$167.60
|
| Rate for Payer: EPIC Health Plan Senior |
$167.60
|
| Rate for Payer: Galaxy Health WC |
$356.15
|
| Rate for Payer: Global Benefits Group Commercial |
$251.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$377.10
|
| Rate for Payer: InnovAge PACE Commercial |
$209.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$279.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$159.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$259.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$171.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$293.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$293.30
|
| Rate for Payer: Multiplan Commercial |
$314.25
|
| Rate for Payer: Networks By Design Commercial |
$272.35
|
| Rate for Payer: Prime Health Services Commercial |
$356.15
|
| Rate for Payer: Riverside University Health System MISP |
$167.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$251.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$251.40
|
| 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 |
$356.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$356.15
|
| Rate for Payer: Vantage Medical Group Senior |
$356.15
|
|
|
HC VOCATIONAL EVAL 5 DAY
|
Facility
|
OP
|
$394.00
|
|
| Hospital Charge Code |
903200102
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$150.11 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$161.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$239.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$334.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$216.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$295.50
|
| 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 |
$216.70
|
| Rate for Payer: Cash Price |
$216.70
|
| Rate for Payer: Cash Price |
$216.70
|
| Rate for Payer: Central Health Plan Commercial |
$315.20
|
| Rate for Payer: Cigna of CA HMO |
$252.16
|
| Rate for Payer: Cigna of CA PPO |
$291.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$334.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$334.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$334.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.60
|
| Rate for Payer: EPIC Health Plan Senior |
$157.60
|
| Rate for Payer: Galaxy Health WC |
$334.90
|
| Rate for Payer: Global Benefits Group Commercial |
$236.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$354.60
|
| Rate for Payer: InnovAge PACE Commercial |
$197.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$262.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$150.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$243.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$275.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$275.80
|
| Rate for Payer: Multiplan Commercial |
$295.50
|
| Rate for Payer: Networks By Design Commercial |
$256.10
|
| Rate for Payer: Prime Health Services Commercial |
$334.90
|
| Rate for Payer: Riverside University Health System MISP |
$157.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$236.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$236.40
|
| 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 |
$334.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$334.90
|
| Rate for Payer: Vantage Medical Group Senior |
$334.90
|
|
|
HC VOCATIONAL EVAL 5 DAY
|
Facility
|
IP
|
$394.00
|
|
| Hospital Charge Code |
903200102
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$78.80 |
| Max. Negotiated Rate |
$354.60 |
| Rate for Payer: Adventist Health Commercial |
$78.80
|
| Rate for Payer: Cash Price |
$216.70
|
| Rate for Payer: Central Health Plan Commercial |
$315.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.60
|
| Rate for Payer: EPIC Health Plan Senior |
$157.60
|
| Rate for Payer: Galaxy Health WC |
$334.90
|
| Rate for Payer: Global Benefits Group Commercial |
$236.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$354.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$262.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$150.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$243.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.80
|
| Rate for Payer: Multiplan Commercial |
$295.50
|
| Rate for Payer: Networks By Design Commercial |
$256.10
|
| Rate for Payer: Prime Health Services Commercial |
$334.90
|
|
|
HC VOCATIONAL EVAL 8 DAY
|
Facility
|
OP
|
$283.00
|
|
| Hospital Charge Code |
903200104
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$107.82 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$116.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$171.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$240.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$155.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$212.25
|
| 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 |
$155.65
|
| Rate for Payer: Cash Price |
$155.65
|
| Rate for Payer: Cash Price |
$155.65
|
| Rate for Payer: Central Health Plan Commercial |
$226.40
|
| Rate for Payer: Cigna of CA HMO |
$181.12
|
| Rate for Payer: Cigna of CA PPO |
$209.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$240.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$240.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$240.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$113.20
|
| Rate for Payer: EPIC Health Plan Senior |
$113.20
|
| Rate for Payer: Galaxy Health WC |
$240.55
|
| Rate for Payer: Global Benefits Group Commercial |
$169.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$254.70
|
| Rate for Payer: InnovAge PACE Commercial |
$141.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$188.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$107.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$175.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$198.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$198.10
|
| Rate for Payer: Multiplan Commercial |
$212.25
|
| Rate for Payer: Networks By Design Commercial |
$183.95
|
| Rate for Payer: Prime Health Services Commercial |
$240.55
|
| Rate for Payer: Riverside University Health System MISP |
$113.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$169.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$169.80
|
| 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 |
$240.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$240.55
|
| Rate for Payer: Vantage Medical Group Senior |
$240.55
|
|
|
HC VOCATIONAL EVAL 8 DAY
|
Facility
|
IP
|
$283.00
|
|
| Hospital Charge Code |
903200104
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$56.60 |
| Max. Negotiated Rate |
$254.70 |
| Rate for Payer: Adventist Health Commercial |
$56.60
|
| Rate for Payer: Cash Price |
$155.65
|
| Rate for Payer: Central Health Plan Commercial |
$226.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$113.20
|
| Rate for Payer: EPIC Health Plan Senior |
$113.20
|
| Rate for Payer: Galaxy Health WC |
$240.55
|
| Rate for Payer: Global Benefits Group Commercial |
$169.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$254.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$188.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$107.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$175.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.60
|
| Rate for Payer: Multiplan Commercial |
$212.25
|
| Rate for Payer: Networks By Design Commercial |
$183.95
|
| Rate for Payer: Prime Health Services Commercial |
$240.55
|
|
|
HC VOICE CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9171
|
| Hospital Charge Code |
900018436
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC VOICE CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9171
|
| Hospital Charge Code |
900018136
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| 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 |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| 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 |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC VOICE CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9171
|
| Hospital Charge Code |
900018236
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC VOICE CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9171
|
| Hospital Charge Code |
900018436
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| 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 |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| 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 |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC VOICE CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9171
|
| Hospital Charge Code |
900018136
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC VOICE CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9171
|
| Hospital Charge Code |
900018236
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| 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 |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| 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 |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC VOICE D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9173
|
| Hospital Charge Code |
900018138
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC VOICE D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9173
|
| Hospital Charge Code |
900018438
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC VOICE D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9173
|
| Hospital Charge Code |
900018138
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| 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 |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| 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 |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC VOICE D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9173
|
| Hospital Charge Code |
900018238
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| 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 |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| 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 |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC VOICE D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9173
|
| Hospital Charge Code |
900018438
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| 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 |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| 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 |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC VOICE D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9173
|
| Hospital Charge Code |
900018238
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC VOICE GOAL STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9172
|
| Hospital Charge Code |
900018237
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| 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 |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| 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 |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
