|
HC CARDIAC ANGIO CONG HEART DZ
|
Facility
|
IP
|
$4,090.00
|
|
|
Service Code
|
CPT 75573
|
| Hospital Charge Code |
909201406
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$818.00 |
| Max. Negotiated Rate |
$3,681.00 |
| Rate for Payer: Adventist Health Commercial |
$818.00
|
| Rate for Payer: Cash Price |
$1,840.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,272.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,863.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,636.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,636.00
|
| Rate for Payer: Galaxy Health WC |
$3,476.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,454.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,681.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,597.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,413.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$818.00
|
| Rate for Payer: Multiplan Commercial |
$3,067.50
|
| Rate for Payer: Networks By Design Commercial |
$2,658.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,476.50
|
|
|
HC CARDIAC ANGIO, STRUCTURE/MORPH
|
Facility
|
OP
|
$3,363.00
|
|
|
Service Code
|
CPT 75572
|
| Hospital Charge Code |
909201405
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$255.00 |
| Max. Negotiated Rate |
$3,026.70 |
| Rate for Payer: Adventist Health Commercial |
$672.60
|
| Rate for Payer: Adventist Health Commercial |
$472.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$995.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$995.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,956.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,372.81
|
| Rate for Payer: Blue Shield of California Commercial |
$1,486.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,118.69
|
| Rate for Payer: Blue Shield of California EPN |
$1,335.11
|
| Rate for Payer: Blue Shield of California EPN |
$936.92
|
| Rate for Payer: Cash Price |
$1,062.00
|
| Rate for Payer: Cash Price |
$1,513.35
|
| Rate for Payer: Cash Price |
$1,513.35
|
| Rate for Payer: Cash Price |
$1,062.00
|
| Rate for Payer: Cash Price |
$1,062.00
|
| Rate for Payer: Cash Price |
$1,513.35
|
| Rate for Payer: Center for Health Promotion Commercial |
$255.00
|
| Rate for Payer: Center for Health Promotion Commercial |
$255.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,888.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,690.40
|
| Rate for Payer: Cigna of CA HMO |
$2,152.32
|
| Rate for Payer: Cigna of CA HMO |
$1,510.40
|
| Rate for Payer: Cigna of CA PPO |
$2,488.62
|
| Rate for Payer: Cigna of CA PPO |
$1,746.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,354.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,652.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$2,006.00
|
| Rate for Payer: Galaxy Health WC |
$2,858.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,416.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,017.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,124.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,026.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$375.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$375.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,498.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,135.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$414.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$414.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$472.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$672.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$2,522.25
|
| Rate for Payer: Multiplan Commercial |
$1,770.00
|
| Rate for Payer: Networks By Design Commercial |
$1,534.00
|
| Rate for Payer: Networks By Design Commercial |
$2,185.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: Prime Health Services Commercial |
$2,006.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,858.55
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,416.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,017.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,416.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,017.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$669.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$669.92
|
| Rate for Payer: United Healthcare All Other HMO |
$669.92
|
| Rate for Payer: United Healthcare All Other HMO |
$669.92
|
| Rate for Payer: United Healthcare HMO Rider |
$669.92
|
| Rate for Payer: United Healthcare HMO Rider |
$669.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$669.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$669.92
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC CARDIAC ANGIO, STRUCTURE/MORPH
|
Facility
|
IP
|
$3,363.00
|
|
|
Service Code
|
CPT 75572
|
| Hospital Charge Code |
909201405
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$672.60 |
| Max. Negotiated Rate |
$3,026.70 |
| Rate for Payer: Adventist Health Commercial |
$672.60
|
| Rate for Payer: Cash Price |
$1,513.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,690.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,354.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,345.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,345.20
|
| Rate for Payer: Galaxy Health WC |
$2,858.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,017.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,026.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,135.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,984.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$672.60
|
| Rate for Payer: Multiplan Commercial |
$2,522.25
|
| Rate for Payer: Networks By Design Commercial |
$2,185.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,858.55
|
|
|
HC CARDIAC MRI VELOCITY FLOW MAPPING
|
Facility
|
OP
|
$2,413.00
|
|
|
Service Code
|
CPT 75565
|
| Hospital Charge Code |
908875565
|
|
Hospital Revenue Code
|
614
|
| Min. Negotiated Rate |
$78.71 |
| Max. Negotiated Rate |
$2,171.70 |
| Rate for Payer: Adventist Health Commercial |
$482.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,055.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,051.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,327.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,809.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$441.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,403.64
|
| Rate for Payer: Blue Shield of California Commercial |
$1,520.19
|
| Rate for Payer: Blue Shield of California EPN |
$957.96
|
| Rate for Payer: Cash Price |
$1,085.85
|
| Rate for Payer: Cash Price |
$1,085.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,930.40
|
| Rate for Payer: Cigna of CA HMO |
$1,544.32
|
| Rate for Payer: Cigna of CA PPO |
$1,785.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,051.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,051.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,051.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,689.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$965.20
|
| Rate for Payer: EPIC Health Plan Senior |
$965.20
|
| Rate for Payer: Galaxy Health WC |
$2,051.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,447.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,171.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$78.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,532.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$86.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,423.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$482.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,689.10
|
| Rate for Payer: Multiplan Commercial |
$1,809.75
|
| Rate for Payer: Networks By Design Commercial |
$1,568.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,051.05
|
| Rate for Payer: Riverside University Health System MISP |
$965.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,447.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,447.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,206.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,206.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,206.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,206.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,051.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,051.05
|
| Rate for Payer: Vantage Medical Group Senior |
$2,051.05
|
|
|
HC CARDIAC MRI VELOCITY FLOW MAPPING
|
Facility
|
IP
|
$2,413.00
|
|
|
Service Code
|
CPT 75565
|
| Hospital Charge Code |
908875565
|
|
Hospital Revenue Code
|
614
|
| Min. Negotiated Rate |
$482.60 |
| Max. Negotiated Rate |
$2,171.70 |
| Rate for Payer: Adventist Health Commercial |
$482.60
|
| Rate for Payer: Cash Price |
$1,085.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,930.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,689.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$965.20
|
| Rate for Payer: EPIC Health Plan Senior |
$965.20
|
| Rate for Payer: Galaxy Health WC |
$2,051.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,447.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,171.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,532.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,423.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$482.60
|
| Rate for Payer: Multiplan Commercial |
$1,809.75
|
| Rate for Payer: Networks By Design Commercial |
$1,568.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,051.05
|
|
|
HC CARDIAC REHAB W/MONITORING
|
Facility
|
OP
|
$721.00
|
|
|
Service Code
|
CPT 93798
|
| Hospital Charge Code |
900201853
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$38.27 |
| Max. Negotiated Rate |
$648.90 |
| Rate for Payer: Adventist Health Commercial |
$295.61
|
| Rate for Payer: Adventist Health Medi-Cal |
$165.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$85.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$248.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$182.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$195.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$419.41
|
| Rate for Payer: Blue Shield of California Commercial |
$457.11
|
| Rate for Payer: Blue Shield of California EPN |
$287.68
|
| Rate for Payer: Cash Price |
$324.45
|
| Rate for Payer: Cash Price |
$324.45
|
| Rate for Payer: Cash Price |
$324.45
|
| Rate for Payer: Central Health Plan Commercial |
$576.80
|
| Rate for Payer: Cigna of CA HMO |
$461.44
|
| Rate for Payer: Cigna of CA PPO |
$533.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$248.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$165.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$504.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.57
|
| Rate for Payer: EPIC Health Plan Senior |
$182.38
|
| Rate for Payer: Galaxy Health WC |
$612.85
|
| Rate for Payer: Global Benefits Group Commercial |
$432.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$648.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$271.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$38.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$165.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$457.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$42.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$232.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$144.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$222.17
|
| Rate for Payer: Multiplan Commercial |
$540.75
|
| Rate for Payer: Networks By Design Commercial |
$468.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$165.80
|
| Rate for Payer: Prime Health Services Commercial |
$612.85
|
| Rate for Payer: Prime Health Services Medicare |
$175.75
|
| Rate for Payer: Riverside University Health System MISP |
$182.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$432.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$198.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$492.00
|
| 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: Upland Medical Group Pediatric |
$165.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$248.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.38
|
| Rate for Payer: Vantage Medical Group Senior |
$165.80
|
|
|
HC CARDIAC REHAB W/MONITORING
|
Facility
|
IP
|
$721.00
|
|
|
Service Code
|
CPT 93798
|
| Hospital Charge Code |
900201853
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$144.20 |
| Max. Negotiated Rate |
$648.90 |
| Rate for Payer: Adventist Health Commercial |
$144.20
|
| Rate for Payer: Cash Price |
$324.45
|
| Rate for Payer: Central Health Plan Commercial |
$576.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$504.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$288.40
|
| Rate for Payer: EPIC Health Plan Senior |
$288.40
|
| Rate for Payer: Galaxy Health WC |
$612.85
|
| Rate for Payer: Global Benefits Group Commercial |
$432.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$648.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$457.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$425.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$144.20
|
| Rate for Payer: Multiplan Commercial |
$540.75
|
| Rate for Payer: Networks By Design Commercial |
$468.65
|
| Rate for Payer: Prime Health Services Commercial |
$612.85
|
|
|
HC CARDIAC REHAB W/O MONITORING
|
Facility
|
OP
|
$641.00
|
|
|
Service Code
|
CPT 93797
|
| Hospital Charge Code |
900201854
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$24.87 |
| Max. Negotiated Rate |
$576.90 |
| Rate for Payer: Adventist Health Commercial |
$262.81
|
| Rate for Payer: Adventist Health Medi-Cal |
$165.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$55.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$248.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$182.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$123.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$372.87
|
| Rate for Payer: Blue Shield of California Commercial |
$406.39
|
| Rate for Payer: Blue Shield of California EPN |
$255.76
|
| Rate for Payer: Cash Price |
$288.45
|
| Rate for Payer: Cash Price |
$288.45
|
| Rate for Payer: Cash Price |
$288.45
|
| Rate for Payer: Central Health Plan Commercial |
$512.80
|
| Rate for Payer: Cigna of CA HMO |
$410.24
|
| Rate for Payer: Cigna of CA PPO |
$474.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$248.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$165.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$448.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.57
|
| Rate for Payer: EPIC Health Plan Senior |
$182.38
|
| Rate for Payer: Galaxy Health WC |
$544.85
|
| Rate for Payer: Global Benefits Group Commercial |
$384.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$576.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$271.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$24.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$165.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$407.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$232.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$128.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$222.17
|
| Rate for Payer: Multiplan Commercial |
$480.75
|
| Rate for Payer: Networks By Design Commercial |
$416.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$165.80
|
| Rate for Payer: Prime Health Services Commercial |
$544.85
|
| Rate for Payer: Prime Health Services Medicare |
$175.75
|
| Rate for Payer: Riverside University Health System MISP |
$182.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$384.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$198.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$492.00
|
| 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: Upland Medical Group Pediatric |
$165.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$248.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.38
|
| Rate for Payer: Vantage Medical Group Senior |
$165.80
|
|
|
HC CARDIAC REHAB W/O MONITORING
|
Facility
|
IP
|
$641.00
|
|
|
Service Code
|
CPT 93797
|
| Hospital Charge Code |
900201854
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$128.20 |
| Max. Negotiated Rate |
$576.90 |
| Rate for Payer: Adventist Health Commercial |
$128.20
|
| Rate for Payer: Cash Price |
$288.45
|
| Rate for Payer: Central Health Plan Commercial |
$512.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$448.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$256.40
|
| Rate for Payer: EPIC Health Plan Senior |
$256.40
|
| Rate for Payer: Galaxy Health WC |
$544.85
|
| Rate for Payer: Global Benefits Group Commercial |
$384.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$576.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$407.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$378.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$128.20
|
| Rate for Payer: Multiplan Commercial |
$480.75
|
| Rate for Payer: Networks By Design Commercial |
$416.65
|
| Rate for Payer: Prime Health Services Commercial |
$544.85
|
|
|
HC CARDIAC STRESS TEST
|
Facility
|
IP
|
$4,348.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
906811397
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$869.60 |
| Max. Negotiated Rate |
$3,913.20 |
| Rate for Payer: Adventist Health Commercial |
$869.60
|
| Rate for Payer: Cash Price |
$1,956.60
|
| Rate for Payer: Central Health Plan Commercial |
$3,478.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,043.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,739.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,739.20
|
| Rate for Payer: Galaxy Health WC |
$3,695.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,608.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,913.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,760.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,565.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$869.60
|
| Rate for Payer: Multiplan Commercial |
$3,261.00
|
| Rate for Payer: Networks By Design Commercial |
$2,826.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,695.80
|
|
|
HC CARDIAC STRESS TEST
|
Facility
|
OP
|
$4,348.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
906811397
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$90.30 |
| Max. Negotiated Rate |
$3,913.20 |
| Rate for Payer: Adventist Health Commercial |
$869.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$277.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$350.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$277.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$376.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,529.23
|
| Rate for Payer: Blue Shield of California Commercial |
$2,739.24
|
| Rate for Payer: Blue Shield of California EPN |
$1,726.16
|
| Rate for Payer: Cash Price |
$1,956.60
|
| Rate for Payer: Cash Price |
$1,956.60
|
| Rate for Payer: Cash Price |
$1,956.60
|
| Rate for Payer: Central Health Plan Commercial |
$3,478.40
|
| Rate for Payer: Cigna of CA HMO |
$2,782.72
|
| Rate for Payer: Cigna of CA PPO |
$3,217.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$416.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$305.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$277.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,043.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$458.22
|
| Rate for Payer: EPIC Health Plan Senior |
$305.48
|
| Rate for Payer: Galaxy Health WC |
$3,695.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,608.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,913.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$455.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$90.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$277.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,760.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$99.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$388.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$869.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$372.13
|
| Rate for Payer: Multiplan Commercial |
$3,261.00
|
| Rate for Payer: Networks By Design Commercial |
$2,826.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$277.71
|
| Rate for Payer: Prime Health Services Commercial |
$3,695.80
|
| Rate for Payer: Prime Health Services Medicare |
$294.37
|
| Rate for Payer: Riverside University Health System MISP |
$305.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,608.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,608.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$764.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$731.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$669.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$277.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Vantage Medical Group Senior |
$277.71
|
|
|
HC CARDIAC STRESS TEST
|
Facility
|
OP
|
$4,348.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
900802004
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$90.30 |
| Max. Negotiated Rate |
$3,913.20 |
| Rate for Payer: Adventist Health Commercial |
$869.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$277.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$350.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$277.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$376.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,529.23
|
| Rate for Payer: Blue Shield of California Commercial |
$2,739.24
|
| Rate for Payer: Blue Shield of California EPN |
$1,726.16
|
| Rate for Payer: Cash Price |
$1,956.60
|
| Rate for Payer: Cash Price |
$1,956.60
|
| Rate for Payer: Cash Price |
$1,956.60
|
| Rate for Payer: Central Health Plan Commercial |
$3,478.40
|
| Rate for Payer: Cigna of CA HMO |
$2,782.72
|
| Rate for Payer: Cigna of CA PPO |
$3,217.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$416.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$305.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$277.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,043.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$458.22
|
| Rate for Payer: EPIC Health Plan Senior |
$305.48
|
| Rate for Payer: Galaxy Health WC |
$3,695.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,608.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,913.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$455.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$90.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$277.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,760.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$99.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$388.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$869.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$372.13
|
| Rate for Payer: Multiplan Commercial |
$3,261.00
|
| Rate for Payer: Networks By Design Commercial |
$2,826.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$277.71
|
| Rate for Payer: Prime Health Services Commercial |
$3,695.80
|
| Rate for Payer: Prime Health Services Medicare |
$294.37
|
| Rate for Payer: Riverside University Health System MISP |
$305.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,608.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,608.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$764.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$731.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$669.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$277.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Vantage Medical Group Senior |
$277.71
|
|
|
HC CARDIAC STRESS TEST
|
Facility
|
IP
|
$4,348.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
900802004
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$869.60 |
| Max. Negotiated Rate |
$3,913.20 |
| Rate for Payer: Adventist Health Commercial |
$869.60
|
| Rate for Payer: Cash Price |
$1,956.60
|
| Rate for Payer: Central Health Plan Commercial |
$3,478.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,043.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,739.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,739.20
|
| Rate for Payer: Galaxy Health WC |
$3,695.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,608.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,913.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,760.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,565.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$869.60
|
| Rate for Payer: Multiplan Commercial |
$3,261.00
|
| Rate for Payer: Networks By Design Commercial |
$2,826.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,695.80
|
|
|
HC CARDIAC STRESS TEST
|
Facility
|
IP
|
$4,348.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
906811397
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$869.60 |
| Max. Negotiated Rate |
$3,913.20 |
| Rate for Payer: Adventist Health Commercial |
$869.60
|
| Rate for Payer: Cash Price |
$1,956.60
|
| Rate for Payer: Central Health Plan Commercial |
$3,478.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,043.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,739.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,739.20
|
| Rate for Payer: Galaxy Health WC |
$3,695.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,608.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,913.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,760.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,565.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$869.60
|
| Rate for Payer: Multiplan Commercial |
$3,261.00
|
| Rate for Payer: Networks By Design Commercial |
$2,826.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,695.80
|
|
|
HC CARDIAC STRESS TEST
|
Facility
|
OP
|
$4,348.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
906811397
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$90.30 |
| Max. Negotiated Rate |
$3,913.20 |
| Rate for Payer: Adventist Health Commercial |
$869.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$277.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$350.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$277.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$376.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,529.23
|
| Rate for Payer: Blue Shield of California Commercial |
$2,739.24
|
| Rate for Payer: Blue Shield of California EPN |
$1,726.16
|
| Rate for Payer: Cash Price |
$1,956.60
|
| Rate for Payer: Cash Price |
$1,956.60
|
| Rate for Payer: Cash Price |
$1,956.60
|
| Rate for Payer: Central Health Plan Commercial |
$3,478.40
|
| Rate for Payer: Cigna of CA HMO |
$2,782.72
|
| Rate for Payer: Cigna of CA PPO |
$3,217.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$416.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$305.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$277.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,043.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$458.22
|
| Rate for Payer: EPIC Health Plan Senior |
$305.48
|
| Rate for Payer: Galaxy Health WC |
$3,695.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,608.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,913.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$455.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$90.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$277.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,760.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$99.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$388.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$869.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$372.13
|
| Rate for Payer: Multiplan Commercial |
$3,261.00
|
| Rate for Payer: Networks By Design Commercial |
$2,826.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$277.71
|
| Rate for Payer: Prime Health Services Commercial |
$3,695.80
|
| Rate for Payer: Prime Health Services Medicare |
$294.37
|
| Rate for Payer: Riverside University Health System MISP |
$305.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,608.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,608.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,391.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,369.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,119.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,026.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$277.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Vantage Medical Group Senior |
$277.71
|
|
|
HC CARDIOLIPIN AB EAC IG CLASS
|
Facility
|
OP
|
$221.00
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
900913559
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.62 |
| Max. Negotiated Rate |
$198.90 |
| Rate for Payer: Adventist Health Commercial |
$44.20
|
| Rate for Payer: Adventist Health Commercial |
$19.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$25.45
|
| Rate for Payer: Adventist Health Medi-Cal |
$25.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$186.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$186.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$38.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$38.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$105.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$105.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$146.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$146.05
|
| Rate for Payer: Blue Shield of California Commercial |
$62.37
|
| Rate for Payer: Blue Shield of California Commercial |
$139.23
|
| Rate for Payer: Blue Shield of California EPN |
$39.30
|
| Rate for Payer: Blue Shield of California EPN |
$87.74
|
| Rate for Payer: Cash Price |
$44.55
|
| Rate for Payer: Cash Price |
$44.55
|
| Rate for Payer: Cash Price |
$99.45
|
| Rate for Payer: Cash Price |
$99.45
|
| Rate for Payer: Central Health Plan Commercial |
$176.80
|
| Rate for Payer: Central Health Plan Commercial |
$79.20
|
| Rate for Payer: Cigna of CA HMO |
$63.36
|
| Rate for Payer: Cigna of CA HMO |
$141.44
|
| Rate for Payer: Cigna of CA PPO |
$73.26
|
| Rate for Payer: Cigna of CA PPO |
$163.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$154.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$69.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.99
|
| Rate for Payer: EPIC Health Plan Senior |
$28.00
|
| Rate for Payer: EPIC Health Plan Senior |
$28.00
|
| Rate for Payer: Galaxy Health WC |
$84.15
|
| Rate for Payer: Galaxy Health WC |
$187.85
|
| Rate for Payer: Global Benefits Group Commercial |
$59.40
|
| Rate for Payer: Global Benefits Group Commercial |
$132.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$89.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$198.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$41.74
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$41.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$30.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$30.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$140.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$33.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$33.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$34.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$34.10
|
| Rate for Payer: Multiplan Commercial |
$74.25
|
| Rate for Payer: Multiplan Commercial |
$165.75
|
| Rate for Payer: Networks By Design Commercial |
$143.65
|
| Rate for Payer: Networks By Design Commercial |
$64.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$25.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$25.45
|
| Rate for Payer: Prime Health Services Commercial |
$84.15
|
| Rate for Payer: Prime Health Services Commercial |
$187.85
|
| Rate for Payer: Prime Health Services Medicare |
$26.98
|
| Rate for Payer: Prime Health Services Medicare |
$26.98
|
| Rate for Payer: Riverside University Health System MISP |
$28.00
|
| Rate for Payer: Riverside University Health System MISP |
$28.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$132.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$59.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$59.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$132.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.62
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.62
|
| Rate for Payer: United Healthcare All Other HMO |
$20.62
|
| Rate for Payer: United Healthcare All Other HMO |
$20.62
|
| Rate for Payer: United Healthcare HMO Rider |
$20.62
|
| Rate for Payer: United Healthcare HMO Rider |
$20.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.62
|
| Rate for Payer: Upland Medical Group Pediatric |
$25.45
|
| Rate for Payer: Upland Medical Group Pediatric |
$25.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$38.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$38.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.00
|
| Rate for Payer: Vantage Medical Group Senior |
$25.45
|
| Rate for Payer: Vantage Medical Group Senior |
$25.45
|
|
|
HC CARDIOLIPIN AB EAC IG CLASS
|
Facility
|
IP
|
$221.00
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
900913559
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.20 |
| Max. Negotiated Rate |
$198.90 |
| Rate for Payer: Adventist Health Commercial |
$44.20
|
| Rate for Payer: Cash Price |
$99.45
|
| Rate for Payer: Central Health Plan Commercial |
$176.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$154.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$88.40
|
| Rate for Payer: EPIC Health Plan Senior |
$88.40
|
| Rate for Payer: Galaxy Health WC |
$187.85
|
| Rate for Payer: Global Benefits Group Commercial |
$132.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$198.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$140.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$130.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.20
|
| Rate for Payer: Multiplan Commercial |
$165.75
|
| Rate for Payer: Networks By Design Commercial |
$143.65
|
| Rate for Payer: Prime Health Services Commercial |
$187.85
|
|
|
HC CARDIOLITE PERFUSION SCAN
|
Facility
|
IP
|
$2,740.00
|
|
|
Service Code
|
CPT 78451
|
| Hospital Charge Code |
909301560
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$548.00 |
| Max. Negotiated Rate |
$2,466.00 |
| Rate for Payer: Adventist Health Commercial |
$548.00
|
| Rate for Payer: Cash Price |
$1,233.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,192.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,918.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,096.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,096.00
|
| Rate for Payer: Galaxy Health WC |
$2,329.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,644.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,466.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,739.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,616.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$548.00
|
| Rate for Payer: Multiplan Commercial |
$2,055.00
|
| Rate for Payer: Networks By Design Commercial |
$1,781.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,329.00
|
|
|
HC CARDIOLITE PERFUSION SCAN
|
Facility
|
OP
|
$2,740.00
|
|
|
Service Code
|
CPT 78451
|
| Hospital Charge Code |
909301560
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$347.32 |
| Max. Negotiated Rate |
$2,747.46 |
| Rate for Payer: Adventist Health Commercial |
$548.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,665.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,748.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,497.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,831.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,665.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$870.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,593.86
|
| Rate for Payer: Blue Shield of California Commercial |
$1,726.20
|
| Rate for Payer: Blue Shield of California EPN |
$1,087.78
|
| Rate for Payer: Cash Price |
$1,233.00
|
| Rate for Payer: Cash Price |
$1,233.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,192.00
|
| Rate for Payer: Cigna of CA HMO |
$1,753.60
|
| Rate for Payer: Cigna of CA PPO |
$2,027.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,497.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,831.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,665.13
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,918.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,747.46
|
| Rate for Payer: EPIC Health Plan Senior |
$1,831.64
|
| Rate for Payer: Galaxy Health WC |
$2,329.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,644.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,466.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,730.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$347.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,665.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,739.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$383.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,331.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$548.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,231.27
|
| Rate for Payer: Multiplan Commercial |
$2,055.00
|
| Rate for Payer: Networks By Design Commercial |
$1,781.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,665.13
|
| Rate for Payer: Prime Health Services Commercial |
$2,329.00
|
| Rate for Payer: Prime Health Services Medicare |
$1,765.04
|
| Rate for Payer: Riverside University Health System MISP |
$1,831.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,644.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,644.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,721.55
|
| Rate for Payer: United Healthcare All Other HMO |
$1,721.55
|
| Rate for Payer: United Healthcare HMO Rider |
$1,721.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,721.55
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,665.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,497.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,831.64
|
| Rate for Payer: Vantage Medical Group Senior |
$1,665.13
|
|
|
HC CARDIOLITE PERFUSION SCAN 1 DY
|
Facility
|
IP
|
$5,385.00
|
|
|
Service Code
|
CPT 78452
|
| Hospital Charge Code |
909301562
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,077.00 |
| Max. Negotiated Rate |
$4,846.50 |
| Rate for Payer: Adventist Health Commercial |
$1,077.00
|
| Rate for Payer: Cash Price |
$2,423.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,308.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,769.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,154.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,154.00
|
| Rate for Payer: Galaxy Health WC |
$4,577.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,231.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,846.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,419.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,177.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,077.00
|
| Rate for Payer: Multiplan Commercial |
$4,038.75
|
| Rate for Payer: Networks By Design Commercial |
$3,500.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,577.25
|
|
|
HC CARDIOLITE PERFUSION SCAN 1 DY
|
Facility
|
OP
|
$5,385.00
|
|
|
Service Code
|
CPT 78452
|
| Hospital Charge Code |
909301562
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$598.77 |
| Max. Negotiated Rate |
$4,846.50 |
| Rate for Payer: Adventist Health Commercial |
$1,077.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,665.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,540.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,497.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,831.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,665.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,514.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,132.45
|
| Rate for Payer: Blue Shield of California Commercial |
$3,392.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,137.84
|
| Rate for Payer: Cash Price |
$2,423.25
|
| Rate for Payer: Cash Price |
$2,423.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,308.00
|
| Rate for Payer: Cigna of CA HMO |
$3,446.40
|
| Rate for Payer: Cigna of CA PPO |
$3,984.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,497.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,831.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,665.13
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,769.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,747.46
|
| Rate for Payer: EPIC Health Plan Senior |
$1,831.64
|
| Rate for Payer: Galaxy Health WC |
$4,577.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,231.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,846.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,730.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$598.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,665.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,419.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$661.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,331.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,077.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,231.27
|
| Rate for Payer: Multiplan Commercial |
$4,038.75
|
| Rate for Payer: Networks By Design Commercial |
$3,500.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,665.13
|
| Rate for Payer: Prime Health Services Commercial |
$4,577.25
|
| Rate for Payer: Prime Health Services Medicare |
$1,765.04
|
| Rate for Payer: Riverside University Health System MISP |
$1,831.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,231.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,231.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,721.55
|
| Rate for Payer: United Healthcare All Other HMO |
$1,721.55
|
| Rate for Payer: United Healthcare HMO Rider |
$1,721.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,721.55
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,665.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,497.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,831.64
|
| Rate for Payer: Vantage Medical Group Senior |
$1,665.13
|
|
|
HC CARDIOPULMONARY MAINTENANCE CL
|
Facility
|
OP
|
$18.00
|
|
| Hospital Charge Code |
900201842
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$492.00 |
| Rate for Payer: Adventist Health Commercial |
$7.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.47
|
| Rate for Payer: Blue Shield of California Commercial |
$11.41
|
| Rate for Payer: Blue Shield of California EPN |
$7.18
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Central Health Plan Commercial |
$14.40
|
| Rate for Payer: Cigna of CA HMO |
$11.52
|
| Rate for Payer: Cigna of CA PPO |
$13.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.20
|
| Rate for Payer: EPIC Health Plan Senior |
$7.20
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$12.60
|
| Rate for Payer: Multiplan Commercial |
$13.50
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
| Rate for Payer: Riverside University Health System MISP |
$7.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$492.00
|
| 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 |
$15.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.30
|
| Rate for Payer: Vantage Medical Group Senior |
$15.30
|
|
|
HC CARDIOPULMONARY MAINTENANCE CL
|
Facility
|
IP
|
$18.00
|
|
| Hospital Charge Code |
900201842
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$16.20 |
| Rate for Payer: Adventist Health Commercial |
$3.60
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Central Health Plan Commercial |
$14.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.20
|
| Rate for Payer: EPIC Health Plan Senior |
$7.20
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Multiplan Commercial |
$13.50
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
OP
|
$3,368.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906812198
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$218.50 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$673.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$277.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$630.41
|
| Rate for Payer: Cash Price |
$1,515.60
|
| Rate for Payer: Cash Price |
$1,515.60
|
| Rate for Payer: Cash Price |
$1,515.60
|
| Rate for Payer: Cash Price |
$1,515.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,694.40
|
| Rate for Payer: Cigna of CA HMO |
$2,155.52
|
| Rate for Payer: Cigna of CA PPO |
$2,492.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$416.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$305.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$277.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,357.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$458.22
|
| Rate for Payer: EPIC Health Plan Senior |
$305.48
|
| Rate for Payer: Galaxy Health WC |
$2,862.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,020.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,031.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$455.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$277.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,138.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$218.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$298.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$673.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$372.13
|
| Rate for Payer: Multiplan Commercial |
$2,526.00
|
| Rate for Payer: Multiplan WC |
$630.41
|
| Rate for Payer: Networks By Design Commercial |
$2,189.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$277.71
|
| Rate for Payer: Preferred Health Network WC |
$643.28
|
| Rate for Payer: Prime Health Services Commercial |
$2,862.80
|
| Rate for Payer: Prime Health Services Medicare |
$294.37
|
| Rate for Payer: Prime Health Services WC |
$623.98
|
| Rate for Payer: Riverside University Health System MISP |
$305.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,020.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,684.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,684.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,684.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,684.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$277.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Vantage Medical Group Senior |
$277.71
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
IP
|
$3,368.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906812198
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$673.60 |
| Max. Negotiated Rate |
$3,031.20 |
| Rate for Payer: Adventist Health Commercial |
$673.60
|
| Rate for Payer: Cash Price |
$1,515.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,694.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,357.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,347.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,347.20
|
| Rate for Payer: Galaxy Health WC |
$2,862.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,020.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,031.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,138.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,987.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$673.60
|
| Rate for Payer: Multiplan Commercial |
$2,526.00
|
| Rate for Payer: Networks By Design Commercial |
$2,189.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,862.80
|
|
