|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
OP
|
$3,368.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906812198
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$197.80 |
| Max. Negotiated Rate |
$8,136.21 |
| Rate for Payer: Adventist Health Commercial |
$673.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$277.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$985.82
|
| 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| 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 |
$197.80
|
| 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 |
$388.79
|
| 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: Networks By Design Commercial |
$2,189.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$277.71
|
| Rate for Payer: Prime Health Services Commercial |
$2,862.80
|
| 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 |
$2,020.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,020.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| 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
|
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
|
OP
|
$3,368.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906812198
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$197.80 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$673.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$277.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| 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 |
$2,189.20
|
| 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 |
$197.80
|
| 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 |
$388.79
|
| 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: Networks By Design Commercial |
$2,189.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$277.71
|
| Rate for Payer: Prime Health Services Commercial |
$2,862.80
|
| 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 |
$2,020.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,020.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,684.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| 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
|
450
|
| 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
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
IP
|
$3,368.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
900802005
|
|
Hospital Revenue Code
|
480
|
| 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
|
|
|
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
|
|
|
HC CARDIOVERSION EXTERNAL ELECTIVE
|
Facility
|
OP
|
$6,951.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
900200140
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$210.63 |
| Max. Negotiated Rate |
$8,136.21 |
| Rate for Payer: Adventist Health Commercial |
$1,390.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$850.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$752.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,275.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$935.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$850.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,127.95
|
| Rate for Payer: Cash Price |
$3,127.95
|
| Rate for Payer: Cash Price |
$3,127.95
|
| Rate for Payer: Cash Price |
$3,127.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,560.80
|
| Rate for Payer: Cigna of CA HMO |
$4,448.64
|
| Rate for Payer: Cigna of CA PPO |
$5,143.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,275.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$935.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$850.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,865.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,402.63
|
| Rate for Payer: EPIC Health Plan Senior |
$935.09
|
| Rate for Payer: Galaxy Health WC |
$5,908.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,170.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,255.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,394.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$210.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$850.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,413.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$232.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,190.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,390.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,139.11
|
| Rate for Payer: Multiplan Commercial |
$5,213.25
|
| Rate for Payer: Networks By Design Commercial |
$4,518.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$850.08
|
| Rate for Payer: Prime Health Services Commercial |
$5,908.35
|
| Rate for Payer: Prime Health Services Medicare |
$901.08
|
| Rate for Payer: Riverside University Health System MISP |
$935.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,170.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,170.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$850.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,275.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$935.09
|
| Rate for Payer: Vantage Medical Group Senior |
$850.08
|
|
|
HC CARDIOVERSION EXTERNAL ELECTIVE
|
Facility
|
OP
|
$6,951.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
900200140
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$232.67 |
| Max. Negotiated Rate |
$6,255.90 |
| Rate for Payer: Adventist Health Commercial |
$1,390.20
|
| 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 |
$1,275.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$935.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$850.08
|
| 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 |
$1,324.78
|
| Rate for Payer: Cash Price |
$3,127.95
|
| Rate for Payer: Cash Price |
$3,127.95
|
| Rate for Payer: Cash Price |
$3,127.95
|
| Rate for Payer: Cash Price |
$3,127.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,560.80
|
| Rate for Payer: Cigna of CA HMO |
$4,448.64
|
| Rate for Payer: Cigna of CA PPO |
$5,143.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,275.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$935.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$850.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,865.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,402.63
|
| Rate for Payer: EPIC Health Plan Senior |
$935.09
|
| Rate for Payer: Galaxy Health WC |
$5,908.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,170.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,255.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,394.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$850.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,413.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$232.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$913.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,390.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,139.11
|
| Rate for Payer: Multiplan Commercial |
$5,213.25
|
| Rate for Payer: Multiplan WC |
$1,324.78
|
| Rate for Payer: Networks By Design Commercial |
$4,518.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$850.08
|
| Rate for Payer: Preferred Health Network WC |
$1,351.82
|
| Rate for Payer: Prime Health Services Commercial |
$5,908.35
|
| Rate for Payer: Prime Health Services Medicare |
$901.08
|
| Rate for Payer: Prime Health Services WC |
$1,311.27
|
| Rate for Payer: Riverside University Health System MISP |
$935.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,170.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,475.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,475.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,475.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,475.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$850.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,275.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$935.09
|
| Rate for Payer: Vantage Medical Group Senior |
$850.08
|
|
|
HC CARDIOVERSION EXTERNAL ELECTIVE
|
Facility
|
IP
|
$6,951.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
900200140
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,390.20 |
| Max. Negotiated Rate |
$6,255.90 |
| Rate for Payer: Adventist Health Commercial |
$1,390.20
|
| Rate for Payer: Cash Price |
$3,127.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,560.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,865.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,780.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,780.40
|
| Rate for Payer: Galaxy Health WC |
$5,908.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,170.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,255.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,413.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,101.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,390.20
|
| Rate for Payer: Multiplan Commercial |
$5,213.25
|
| Rate for Payer: Networks By Design Commercial |
$4,518.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,908.35
|
|
|
HC CARDIOVERSION EXTERNAL ELECTIVE
|
Facility
|
IP
|
$6,951.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
900200140
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,390.20 |
| Max. Negotiated Rate |
$6,255.90 |
| Rate for Payer: Adventist Health Commercial |
$1,390.20
|
| Rate for Payer: Cash Price |
$3,127.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,560.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,865.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,780.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,780.40
|
| Rate for Payer: Galaxy Health WC |
$5,908.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,170.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,255.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,413.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,101.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,390.20
|
| Rate for Payer: Multiplan Commercial |
$5,213.25
|
| Rate for Payer: Networks By Design Commercial |
$4,518.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,908.35
|
|
|
HC CARDIOVERSION EXTERNAL ELECTIVE
|
Facility
|
OP
|
$6,951.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
900802000
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$210.63 |
| Max. Negotiated Rate |
$8,136.21 |
| Rate for Payer: Adventist Health Commercial |
$1,390.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$850.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$752.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,275.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$935.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$850.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,127.95
|
| Rate for Payer: Cash Price |
$3,127.95
|
| Rate for Payer: Cash Price |
$3,127.95
|
| Rate for Payer: Cash Price |
$3,127.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,560.80
|
| Rate for Payer: Cigna of CA HMO |
$4,448.64
|
| Rate for Payer: Cigna of CA PPO |
$5,143.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,275.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$935.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$850.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,865.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,402.63
|
| Rate for Payer: EPIC Health Plan Senior |
$935.09
|
| Rate for Payer: Galaxy Health WC |
$5,908.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,170.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,255.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,394.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$210.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$850.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,413.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$232.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,190.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,390.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,139.11
|
| Rate for Payer: Multiplan Commercial |
$5,213.25
|
| Rate for Payer: Networks By Design Commercial |
$4,518.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$850.08
|
| Rate for Payer: Prime Health Services Commercial |
$5,908.35
|
| Rate for Payer: Prime Health Services Medicare |
$901.08
|
| Rate for Payer: Riverside University Health System MISP |
$935.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,170.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,170.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$850.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,275.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$935.09
|
| Rate for Payer: Vantage Medical Group Senior |
$850.08
|
|
|
HC CARDIOVERSION EXTERNAL ELECTIVE
|
Facility
|
IP
|
$6,951.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
900802000
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,390.20 |
| Max. Negotiated Rate |
$6,255.90 |
| Rate for Payer: Adventist Health Commercial |
$1,390.20
|
| Rate for Payer: Cash Price |
$3,127.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,560.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,865.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,780.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,780.40
|
| Rate for Payer: Galaxy Health WC |
$5,908.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,170.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,255.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,413.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,101.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,390.20
|
| Rate for Payer: Multiplan Commercial |
$5,213.25
|
| Rate for Payer: Networks By Design Commercial |
$4,518.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,908.35
|
|
|
HC CARDIOVERSION EXTERNAL ELECTIVE
|
Facility
|
OP
|
$6,951.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
900802140
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$210.63 |
| Max. Negotiated Rate |
$8,136.21 |
| Rate for Payer: Adventist Health Commercial |
$1,390.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$850.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$752.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,275.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$935.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$850.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,127.95
|
| Rate for Payer: Cash Price |
$3,127.95
|
| Rate for Payer: Cash Price |
$3,127.95
|
| Rate for Payer: Cash Price |
$3,127.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,560.80
|
| Rate for Payer: Cigna of CA HMO |
$4,448.64
|
| Rate for Payer: Cigna of CA PPO |
$5,143.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,275.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$935.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$850.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,865.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,402.63
|
| Rate for Payer: EPIC Health Plan Senior |
$935.09
|
| Rate for Payer: Galaxy Health WC |
$5,908.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,170.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,255.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,394.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$210.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$850.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,413.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$232.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,190.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,390.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,139.11
|
| Rate for Payer: Multiplan Commercial |
$5,213.25
|
| Rate for Payer: Networks By Design Commercial |
$4,518.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$850.08
|
| Rate for Payer: Prime Health Services Commercial |
$5,908.35
|
| Rate for Payer: Prime Health Services Medicare |
$901.08
|
| Rate for Payer: Riverside University Health System MISP |
$935.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,170.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,170.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$850.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,275.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$935.09
|
| Rate for Payer: Vantage Medical Group Senior |
$850.08
|
|
|
HC CARDIOVERSION EXTERNAL ELECTIVE
|
Facility
|
IP
|
$6,951.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
900802140
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,390.20 |
| Max. Negotiated Rate |
$6,255.90 |
| Rate for Payer: Adventist Health Commercial |
$1,390.20
|
| Rate for Payer: Cash Price |
$3,127.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,560.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,865.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,780.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,780.40
|
| Rate for Payer: Galaxy Health WC |
$5,908.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,170.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,255.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,413.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,101.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,390.20
|
| Rate for Payer: Multiplan Commercial |
$5,213.25
|
| Rate for Payer: Networks By Design Commercial |
$4,518.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,908.35
|
|
|
HC CARRY CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8984
|
| Hospital Charge Code |
900018406
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$465.00 |
| 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 |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/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 CARRY CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8984
|
| Hospital Charge Code |
900018406
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals 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 CARRY CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8984
|
| Hospital Charge Code |
900018306
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals 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 CARRY CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8984
|
| Hospital Charge Code |
900018306
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$465.00 |
| 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 |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/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 CARRY D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8986
|
| Hospital Charge Code |
900018308
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals 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 CARRY D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8986
|
| Hospital Charge Code |
900018308
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$465.00 |
| 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 |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/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 CARRY D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8986
|
| Hospital Charge Code |
900018408
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals 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 CARRY D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8986
|
| Hospital Charge Code |
900018408
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$465.00 |
| 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 |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/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 CARRY GOAL STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8985
|
| Hospital Charge Code |
900018407
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals 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 CARRY GOAL STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8985
|
| Hospital Charge Code |
900018307
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals 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 CARRY GOAL STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8985
|
| Hospital Charge Code |
900018307
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$465.00 |
| 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 |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/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
|
|
