|
HC ATTEN CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9165
|
| Hospital Charge Code |
900018130
|
|
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 ATTEN D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9167
|
| Hospital Charge Code |
900018432
|
|
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 ATTEN D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9167
|
| Hospital Charge Code |
900018232
|
|
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 ATTEN D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9167
|
| Hospital Charge Code |
900018132
|
|
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 ATTEN D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9167
|
| Hospital Charge Code |
900018432
|
|
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 ATTEN D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9167
|
| Hospital Charge Code |
900018232
|
|
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 ATTEN D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9167
|
| Hospital Charge Code |
900018132
|
|
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 ATTEN GOAL STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9166
|
| Hospital Charge Code |
900018231
|
|
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 ATTEN GOAL STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9166
|
| Hospital Charge Code |
900018431
|
|
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 ATTEN GOAL STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9166
|
| Hospital Charge Code |
900018231
|
|
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 ATTEN GOAL STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9166
|
| Hospital Charge Code |
900018131
|
|
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 ATTEN GOAL STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9166
|
| Hospital Charge Code |
900018431
|
|
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 ATTEN GOAL STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9166
|
| Hospital Charge Code |
900018131
|
|
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 AUD EP NRO DGNTC W INT AND RPT
|
Facility
|
OP
|
$888.00
|
|
|
Service Code
|
CPT 92653
|
| Hospital Charge Code |
900600653
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$132.30 |
| Max. Negotiated Rate |
$799.20 |
| Rate for Payer: Adventist Health Commercial |
$177.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$395.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$539.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$429.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$521.52
|
| Rate for Payer: Blue Shield of California Commercial |
$539.02
|
| Rate for Payer: Blue Shield of California EPN |
$352.54
|
| Rate for Payer: Cash Price |
$488.40
|
| Rate for Payer: Cash Price |
$488.40
|
| Rate for Payer: Cash Price |
$488.40
|
| Rate for Payer: Central Health Plan Commercial |
$710.40
|
| Rate for Payer: Cigna of CA HMO |
$568.32
|
| Rate for Payer: Cigna of CA PPO |
$657.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.14
|
| Rate for Payer: EPIC Health Plan Senior |
$395.66
|
| Rate for Payer: Galaxy Health WC |
$754.80
|
| Rate for Payer: Global Benefits Group Commercial |
$532.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$799.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$648.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$132.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: InnovAge PACE Commercial |
$593.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$592.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$146.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$177.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$530.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$530.18
|
| Rate for Payer: Multiplan Commercial |
$666.00
|
| Rate for Payer: Networks By Design Commercial |
$577.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$395.66
|
| Rate for Payer: Prime Health Services Commercial |
$754.80
|
| Rate for Payer: Prime Health Services Medicare |
$419.40
|
| Rate for Payer: Riverside University Health System MISP |
$435.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$532.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$532.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$233.00
|
| Rate for Payer: United Healthcare All Other HMO |
$226.00
|
| Rate for Payer: United Healthcare HMO Rider |
$184.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$160.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$395.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC AUD EP NRO DGNTC W INT AND RPT
|
Facility
|
IP
|
$888.00
|
|
|
Service Code
|
CPT 92653
|
| Hospital Charge Code |
900600653
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$177.60 |
| Max. Negotiated Rate |
$799.20 |
| Rate for Payer: Adventist Health Commercial |
$177.60
|
| Rate for Payer: Cash Price |
$488.40
|
| Rate for Payer: Central Health Plan Commercial |
$710.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$355.20
|
| Rate for Payer: EPIC Health Plan Senior |
$355.20
|
| Rate for Payer: Galaxy Health WC |
$754.80
|
| Rate for Payer: Global Benefits Group Commercial |
$532.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$799.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$592.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$338.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$549.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$177.60
|
| Rate for Payer: Multiplan Commercial |
$666.00
|
| Rate for Payer: Networks By Design Commercial |
$577.20
|
| Rate for Payer: Prime Health Services Commercial |
$754.80
|
|
|
HC AUD EP SCRN AP W/BB STIMULI AA
|
Facility
|
IP
|
$888.00
|
|
|
Service Code
|
CPT 92650
|
| Hospital Charge Code |
900600650
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$177.60 |
| Max. Negotiated Rate |
$799.20 |
| Rate for Payer: Adventist Health Commercial |
$177.60
|
| Rate for Payer: Cash Price |
$488.40
|
| Rate for Payer: Central Health Plan Commercial |
$710.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$355.20
|
| Rate for Payer: EPIC Health Plan Senior |
$355.20
|
| Rate for Payer: Galaxy Health WC |
$754.80
|
| Rate for Payer: Global Benefits Group Commercial |
$532.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$799.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$592.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$338.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$549.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$177.60
|
| Rate for Payer: Multiplan Commercial |
$666.00
|
| Rate for Payer: Networks By Design Commercial |
$577.20
|
| Rate for Payer: Prime Health Services Commercial |
$754.80
|
|
|
HC AUD EP SCRN AP W/BB STIMULI AA
|
Facility
|
OP
|
$888.00
|
|
|
Service Code
|
CPT 92650
|
| Hospital Charge Code |
900600650
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$44.17 |
| Max. Negotiated Rate |
$799.20 |
| Rate for Payer: Adventist Health Commercial |
$177.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$539.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$754.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$488.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$666.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$429.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$521.52
|
| Rate for Payer: Blue Shield of California Commercial |
$539.02
|
| Rate for Payer: Blue Shield of California EPN |
$352.54
|
| Rate for Payer: Cash Price |
$488.40
|
| Rate for Payer: Cash Price |
$488.40
|
| Rate for Payer: Cash Price |
$488.40
|
| Rate for Payer: Central Health Plan Commercial |
$710.40
|
| Rate for Payer: Cigna of CA HMO |
$568.32
|
| Rate for Payer: Cigna of CA PPO |
$657.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$754.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$754.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$754.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$355.20
|
| Rate for Payer: EPIC Health Plan Senior |
$355.20
|
| Rate for Payer: Galaxy Health WC |
$754.80
|
| Rate for Payer: Global Benefits Group Commercial |
$532.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$799.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$44.17
|
| Rate for Payer: InnovAge PACE Commercial |
$444.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$592.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$549.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$177.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$621.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$621.60
|
| Rate for Payer: Multiplan Commercial |
$666.00
|
| Rate for Payer: Networks By Design Commercial |
$577.20
|
| Rate for Payer: Prime Health Services Commercial |
$754.80
|
| Rate for Payer: Riverside University Health System MISP |
$355.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$532.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$532.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$233.00
|
| Rate for Payer: United Healthcare All Other HMO |
$226.00
|
| Rate for Payer: United Healthcare HMO Rider |
$184.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$160.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$754.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$754.80
|
| Rate for Payer: Vantage Medical Group Senior |
$754.80
|
|
|
HC AUDIOLOGIC EVAL PURE TONE
|
Facility
|
OP
|
$389.00
|
|
|
Service Code
|
CPT 92551
|
| Hospital Charge Code |
905601816
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$17.54 |
| Max. Negotiated Rate |
$350.10 |
| Rate for Payer: Adventist Health Commercial |
$77.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$236.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$330.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$213.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$291.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$188.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$228.46
|
| Rate for Payer: Blue Shield of California Commercial |
$236.12
|
| Rate for Payer: Blue Shield of California EPN |
$154.43
|
| Rate for Payer: Cash Price |
$213.95
|
| Rate for Payer: Cash Price |
$213.95
|
| Rate for Payer: Cash Price |
$213.95
|
| Rate for Payer: Central Health Plan Commercial |
$311.20
|
| Rate for Payer: Cigna of CA HMO |
$248.96
|
| Rate for Payer: Cigna of CA PPO |
$287.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$330.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$330.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$330.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$155.60
|
| Rate for Payer: EPIC Health Plan Senior |
$155.60
|
| Rate for Payer: Galaxy Health WC |
$330.65
|
| Rate for Payer: Global Benefits Group Commercial |
$233.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$350.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17.54
|
| Rate for Payer: InnovAge PACE Commercial |
$194.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$259.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$240.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$272.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$272.30
|
| Rate for Payer: Multiplan Commercial |
$291.75
|
| Rate for Payer: Networks By Design Commercial |
$252.85
|
| Rate for Payer: Prime Health Services Commercial |
$330.65
|
| Rate for Payer: Riverside University Health System MISP |
$155.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$233.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$233.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$233.00
|
| Rate for Payer: United Healthcare All Other HMO |
$226.00
|
| Rate for Payer: United Healthcare HMO Rider |
$184.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$160.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$330.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$330.65
|
| Rate for Payer: Vantage Medical Group Senior |
$330.65
|
|
|
HC AUDIOLOGIC EVAL PURE TONE
|
Facility
|
IP
|
$389.00
|
|
|
Service Code
|
CPT 92551
|
| Hospital Charge Code |
905601816
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$77.80 |
| Max. Negotiated Rate |
$350.10 |
| Rate for Payer: Adventist Health Commercial |
$77.80
|
| Rate for Payer: Cash Price |
$213.95
|
| Rate for Payer: Central Health Plan Commercial |
$311.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$155.60
|
| Rate for Payer: EPIC Health Plan Senior |
$155.60
|
| Rate for Payer: Galaxy Health WC |
$330.65
|
| Rate for Payer: Global Benefits Group Commercial |
$233.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$350.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$259.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$148.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$240.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.80
|
| Rate for Payer: Multiplan Commercial |
$291.75
|
| Rate for Payer: Networks By Design Commercial |
$252.85
|
| Rate for Payer: Prime Health Services Commercial |
$330.65
|
|
|
HC AUDIOLOGIC EVAL PURE TONE 30M
|
Facility
|
IP
|
$389.00
|
|
|
Service Code
|
CPT 92551
|
| Hospital Charge Code |
905601900
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$77.80 |
| Max. Negotiated Rate |
$350.10 |
| Rate for Payer: Adventist Health Commercial |
$77.80
|
| Rate for Payer: Cash Price |
$213.95
|
| Rate for Payer: Central Health Plan Commercial |
$311.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$155.60
|
| Rate for Payer: EPIC Health Plan Senior |
$155.60
|
| Rate for Payer: Galaxy Health WC |
$330.65
|
| Rate for Payer: Global Benefits Group Commercial |
$233.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$350.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$259.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$148.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$240.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.80
|
| Rate for Payer: Multiplan Commercial |
$291.75
|
| Rate for Payer: Networks By Design Commercial |
$252.85
|
| Rate for Payer: Prime Health Services Commercial |
$330.65
|
|
|
HC AUDIOLOGIC EVAL PURE TONE 30M
|
Facility
|
OP
|
$389.00
|
|
|
Service Code
|
CPT 92551
|
| Hospital Charge Code |
905601900
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$17.54 |
| Max. Negotiated Rate |
$350.10 |
| Rate for Payer: Adventist Health Commercial |
$77.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$236.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$330.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$213.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$291.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$188.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$228.46
|
| Rate for Payer: Blue Shield of California Commercial |
$236.12
|
| Rate for Payer: Blue Shield of California EPN |
$154.43
|
| Rate for Payer: Cash Price |
$213.95
|
| Rate for Payer: Cash Price |
$213.95
|
| Rate for Payer: Cash Price |
$213.95
|
| Rate for Payer: Central Health Plan Commercial |
$311.20
|
| Rate for Payer: Cigna of CA HMO |
$248.96
|
| Rate for Payer: Cigna of CA PPO |
$287.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$330.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$330.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$330.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$155.60
|
| Rate for Payer: EPIC Health Plan Senior |
$155.60
|
| Rate for Payer: Galaxy Health WC |
$330.65
|
| Rate for Payer: Global Benefits Group Commercial |
$233.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$350.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17.54
|
| Rate for Payer: InnovAge PACE Commercial |
$194.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$259.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$240.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$272.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$272.30
|
| Rate for Payer: Multiplan Commercial |
$291.75
|
| Rate for Payer: Networks By Design Commercial |
$252.85
|
| Rate for Payer: Prime Health Services Commercial |
$330.65
|
| Rate for Payer: Riverside University Health System MISP |
$155.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$233.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$233.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$233.00
|
| Rate for Payer: United Healthcare All Other HMO |
$226.00
|
| Rate for Payer: United Healthcare HMO Rider |
$184.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$160.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$330.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$330.65
|
| Rate for Payer: Vantage Medical Group Senior |
$330.65
|
|
|
HC AUDITORY EP, COMPREHENSIVE
|
Facility
|
OP
|
$1,209.00
|
|
|
Service Code
|
CPT 92585
|
| Hospital Charge Code |
900600215
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$160.00 |
| Max. Negotiated Rate |
$1,088.10 |
| Rate for Payer: Adventist Health Commercial |
$241.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$734.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,027.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$664.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$906.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$585.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$710.05
|
| Rate for Payer: Blue Shield of California Commercial |
$733.86
|
| Rate for Payer: Blue Shield of California EPN |
$479.97
|
| Rate for Payer: Cash Price |
$664.95
|
| Rate for Payer: Cash Price |
$664.95
|
| Rate for Payer: Central Health Plan Commercial |
$967.20
|
| Rate for Payer: Cigna of CA HMO |
$773.76
|
| Rate for Payer: Cigna of CA PPO |
$894.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,027.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,027.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,027.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$483.60
|
| Rate for Payer: EPIC Health Plan Senior |
$483.60
|
| Rate for Payer: Galaxy Health WC |
$1,027.65
|
| Rate for Payer: Global Benefits Group Commercial |
$725.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,088.10
|
| Rate for Payer: InnovAge PACE Commercial |
$604.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$806.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$460.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$748.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$846.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$846.30
|
| Rate for Payer: Multiplan Commercial |
$906.75
|
| Rate for Payer: Networks By Design Commercial |
$785.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,027.65
|
| Rate for Payer: Riverside University Health System MISP |
$483.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$725.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$725.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$233.00
|
| Rate for Payer: United Healthcare All Other HMO |
$226.00
|
| Rate for Payer: United Healthcare HMO Rider |
$184.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$160.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,027.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,027.65
|
| Rate for Payer: Vantage Medical Group Senior |
$1,027.65
|
|
|
HC AUDITORY EP, COMPREHENSIVE
|
Facility
|
IP
|
$1,209.00
|
|
|
Service Code
|
CPT 92585
|
| Hospital Charge Code |
900600215
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$241.80 |
| Max. Negotiated Rate |
$1,088.10 |
| Rate for Payer: Adventist Health Commercial |
$241.80
|
| Rate for Payer: Cash Price |
$664.95
|
| Rate for Payer: Central Health Plan Commercial |
$967.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$483.60
|
| Rate for Payer: EPIC Health Plan Senior |
$483.60
|
| Rate for Payer: Galaxy Health WC |
$1,027.65
|
| Rate for Payer: Global Benefits Group Commercial |
$725.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,088.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$806.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$460.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$748.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.80
|
| Rate for Payer: Multiplan Commercial |
$906.75
|
| Rate for Payer: Networks By Design Commercial |
$785.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,027.65
|
|
|
HC AUDITORY EP, LIMITED
|
Facility
|
OP
|
$393.00
|
|
|
Service Code
|
CPT 92586
|
| Hospital Charge Code |
900600216
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$78.60 |
| Max. Negotiated Rate |
$353.70 |
| Rate for Payer: Adventist Health Commercial |
$78.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$238.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$334.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$216.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$190.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$230.81
|
| Rate for Payer: Blue Shield of California Commercial |
$238.55
|
| Rate for Payer: Blue Shield of California EPN |
$156.02
|
| Rate for Payer: Cash Price |
$216.15
|
| Rate for Payer: Cash Price |
$216.15
|
| Rate for Payer: Central Health Plan Commercial |
$314.40
|
| Rate for Payer: Cigna of CA HMO |
$251.52
|
| Rate for Payer: Cigna of CA PPO |
$290.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$334.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$334.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$334.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.20
|
| Rate for Payer: EPIC Health Plan Senior |
$157.20
|
| Rate for Payer: Galaxy Health WC |
$334.05
|
| Rate for Payer: Global Benefits Group Commercial |
$235.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$353.70
|
| Rate for Payer: InnovAge PACE Commercial |
$196.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$262.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$149.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$243.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$275.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$275.10
|
| Rate for Payer: Multiplan Commercial |
$294.75
|
| Rate for Payer: Networks By Design Commercial |
$255.45
|
| Rate for Payer: Prime Health Services Commercial |
$334.05
|
| Rate for Payer: Riverside University Health System MISP |
$157.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$235.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$235.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$233.00
|
| Rate for Payer: United Healthcare All Other HMO |
$226.00
|
| Rate for Payer: United Healthcare HMO Rider |
$184.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$160.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$334.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$334.05
|
| Rate for Payer: Vantage Medical Group Senior |
$334.05
|
|
|
HC AUDITORY EP, LIMITED
|
Facility
|
IP
|
$393.00
|
|
|
Service Code
|
CPT 92586
|
| Hospital Charge Code |
900600216
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$78.60 |
| Max. Negotiated Rate |
$353.70 |
| Rate for Payer: Adventist Health Commercial |
$78.60
|
| Rate for Payer: Cash Price |
$216.15
|
| Rate for Payer: Central Health Plan Commercial |
$314.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.20
|
| Rate for Payer: EPIC Health Plan Senior |
$157.20
|
| Rate for Payer: Galaxy Health WC |
$334.05
|
| Rate for Payer: Global Benefits Group Commercial |
$235.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$353.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$262.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$149.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$243.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.60
|
| Rate for Payer: Multiplan Commercial |
$294.75
|
| Rate for Payer: Networks By Design Commercial |
$255.45
|
| Rate for Payer: Prime Health Services Commercial |
$334.05
|
|
