|
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 |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$673.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$395.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,045.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,630.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,978.03
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$1,852.40
|
| Rate for Payer: Cash Price |
$1,852.40
|
| Rate for Payer: Cash Price |
$1,852.40
|
| 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 |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.14
|
| Rate for Payer: EPIC Health Plan Senior |
$395.66
|
| Rate for Payer: Galaxy Health WC |
$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 |
$648.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$197.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: InnovAge PACE Commercial |
$593.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,246.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$673.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$530.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$530.18
|
| Rate for Payer: Multiplan Commercial |
$2,526.00
|
| Rate for Payer: Networks By Design Commercial |
$2,189.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$395.66
|
| Rate for Payer: Prime Health Services Commercial |
$2,862.80
|
| Rate for Payer: Prime Health Services Medicare |
$419.40
|
| Rate for Payer: Riverside University Health System MISP |
$435.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$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 |
$395.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
IP
|
$3,962.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906820082
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$792.40 |
| Max. Negotiated Rate |
$3,565.80 |
| Rate for Payer: Adventist Health Commercial |
$792.40
|
| Rate for Payer: Cash Price |
$2,179.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,169.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,584.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,584.80
|
| Rate for Payer: Galaxy Health WC |
$3,367.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,377.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,565.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,642.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,509.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,452.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$792.40
|
| Rate for Payer: Multiplan Commercial |
$2,971.50
|
| Rate for Payer: Networks By Design Commercial |
$2,575.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,367.70
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
OP
|
$3,962.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906820082
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$197.80 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$792.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$395.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,918.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,326.88
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$2,179.10
|
| Rate for Payer: Cash Price |
$2,179.10
|
| Rate for Payer: Cash Price |
$2,179.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,169.60
|
| Rate for Payer: Cigna of CA HMO |
$2,575.30
|
| Rate for Payer: Cigna of CA PPO |
$2,931.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.14
|
| Rate for Payer: EPIC Health Plan Senior |
$395.66
|
| Rate for Payer: Galaxy Health WC |
$3,367.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,377.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,565.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$648.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$197.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: InnovAge PACE Commercial |
$593.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,642.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$792.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$530.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$530.18
|
| Rate for Payer: Multiplan Commercial |
$2,971.50
|
| Rate for Payer: Networks By Design Commercial |
$2,575.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$395.66
|
| Rate for Payer: Prime Health Services Commercial |
$3,367.70
|
| Rate for Payer: Prime Health Services Medicare |
$419.40
|
| Rate for Payer: Riverside University Health System MISP |
$435.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,377.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,377.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| 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 |
$395.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
OP
|
$3,368.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
900802005
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$197.80 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$673.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$395.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,045.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,630.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,978.03
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$1,852.40
|
| Rate for Payer: Cash Price |
$1,852.40
|
| Rate for Payer: Cash Price |
$1,852.40
|
| 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 |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.14
|
| Rate for Payer: EPIC Health Plan Senior |
$395.66
|
| Rate for Payer: Galaxy Health WC |
$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 |
$648.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$197.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: InnovAge PACE Commercial |
$593.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,246.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$673.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$530.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$530.18
|
| Rate for Payer: Multiplan Commercial |
$2,526.00
|
| Rate for Payer: Networks By Design Commercial |
$2,189.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$395.66
|
| Rate for Payer: Prime Health Services Commercial |
$2,862.80
|
| Rate for Payer: Prime Health Services Medicare |
$419.40
|
| Rate for Payer: Riverside University Health System MISP |
$435.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$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 |
$395.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC 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 |
$1,852.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,694.40
|
| 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 Permanente of CA Commercial/Self Funded |
$2,246.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,283.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,084.79
|
| 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 |
$1,852.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,694.40
|
| 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 Permanente of CA Commercial/Self Funded |
$2,246.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,283.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,084.79
|
| 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
|
IP
|
$6,044.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
906820027
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,208.80 |
| Max. Negotiated Rate |
$5,439.60 |
| Rate for Payer: Adventist Health Commercial |
$1,208.80
|
| Rate for Payer: Cash Price |
$3,324.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,835.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,417.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,417.60
|
| Rate for Payer: Galaxy Health WC |
$5,137.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,626.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,439.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,031.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,302.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,741.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,208.80
|
| Rate for Payer: Multiplan Commercial |
$4,533.00
|
| Rate for Payer: Networks By Design Commercial |
$3,928.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,137.40
|
|
|
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 |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$1,390.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$831.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4,221.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$914.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$831.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,365.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,082.32
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,823.05
|
| Rate for Payer: Cash Price |
$3,823.05
|
| Rate for Payer: Cash Price |
$3,823.05
|
| 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 |
$1,247.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$914.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$831.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,122.47
|
| Rate for Payer: EPIC Health Plan Senior |
$831.46
|
| 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 |
$1,363.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$210.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$831.46
|
| Rate for Payer: InnovAge PACE Commercial |
$1,247.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,636.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$232.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$831.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,390.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,114.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,114.16
|
| 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 |
$831.46
|
| Rate for Payer: Prime Health Services Commercial |
$5,908.35
|
| Rate for Payer: Prime Health Services Medicare |
$881.35
|
| Rate for Payer: Riverside University Health System MISP |
$914.61
|
| 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 |
$831.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$914.61
|
| Rate for Payer: Vantage Medical Group Senior |
$831.46
|
|
|
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 |
$3,823.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,560.80
|
| 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 Permanente of CA Commercial/Self Funded |
$4,636.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,648.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,302.67
|
| 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 |
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 |
$3,823.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,560.80
|
| 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 Permanente of CA Commercial/Self Funded |
$4,636.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,648.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,302.67
|
| 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
|
$6,044.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
906820027
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$210.63 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$1,208.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$831.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,670.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$914.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$831.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,926.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,549.64
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,324.20
|
| Rate for Payer: Cash Price |
$3,324.20
|
| Rate for Payer: Cash Price |
$3,324.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,835.20
|
| Rate for Payer: Cigna of CA HMO |
$3,868.16
|
| Rate for Payer: Cigna of CA PPO |
$4,472.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$914.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$831.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,122.47
|
| Rate for Payer: EPIC Health Plan Senior |
$831.46
|
| Rate for Payer: Galaxy Health WC |
$5,137.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,626.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,439.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,363.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$210.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$831.46
|
| Rate for Payer: InnovAge PACE Commercial |
$1,247.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,031.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$232.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$831.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,208.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,114.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,114.16
|
| Rate for Payer: Multiplan Commercial |
$4,533.00
|
| Rate for Payer: Networks By Design Commercial |
$3,928.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$831.46
|
| Rate for Payer: Prime Health Services Commercial |
$5,137.40
|
| Rate for Payer: Prime Health Services Medicare |
$881.35
|
| Rate for Payer: Riverside University Health System MISP |
$914.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,626.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,626.40
|
| 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 |
$831.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$914.61
|
| Rate for Payer: Vantage Medical Group Senior |
$831.46
|
|
|
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 |
$3,823.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,560.80
|
| 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 Permanente of CA Commercial/Self Funded |
$4,636.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,648.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,302.67
|
| 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 |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$1,390.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$831.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4,221.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$914.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$831.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,365.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,082.32
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,823.05
|
| Rate for Payer: Cash Price |
$3,823.05
|
| Rate for Payer: Cash Price |
$3,823.05
|
| 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 |
$1,247.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$914.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$831.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,122.47
|
| Rate for Payer: EPIC Health Plan Senior |
$831.46
|
| 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 |
$1,363.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$210.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$831.46
|
| Rate for Payer: InnovAge PACE Commercial |
$1,247.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,636.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$232.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$831.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,390.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,114.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,114.16
|
| 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 |
$831.46
|
| Rate for Payer: Prime Health Services Commercial |
$5,908.35
|
| Rate for Payer: Prime Health Services Medicare |
$881.35
|
| Rate for Payer: Riverside University Health System MISP |
$914.61
|
| 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 |
$831.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$914.61
|
| Rate for Payer: Vantage Medical Group Senior |
$831.46
|
|
|
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 |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$1,390.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$831.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4,221.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$914.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$831.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,365.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,082.32
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,823.05
|
| Rate for Payer: Cash Price |
$3,823.05
|
| Rate for Payer: Cash Price |
$3,823.05
|
| 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 |
$1,247.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$914.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$831.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,122.47
|
| Rate for Payer: EPIC Health Plan Senior |
$831.46
|
| 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 |
$1,363.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$210.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$831.46
|
| Rate for Payer: InnovAge PACE Commercial |
$1,247.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,636.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$232.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$831.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,390.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,114.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,114.16
|
| 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 |
$831.46
|
| Rate for Payer: Prime Health Services Commercial |
$5,908.35
|
| Rate for Payer: Prime Health Services Medicare |
$881.35
|
| Rate for Payer: Riverside University Health System MISP |
$914.61
|
| 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 |
$831.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$914.61
|
| Rate for Payer: Vantage Medical Group Senior |
$831.46
|
|
|
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 |
$1,247.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$914.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$831.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,324.78
|
| Rate for Payer: Cash Price |
$3,823.05
|
| Rate for Payer: Cash Price |
$3,823.05
|
| Rate for Payer: Cash Price |
$3,823.05
|
| Rate for Payer: Cash Price |
$3,823.05
|
| 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 |
$1,247.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$914.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$831.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,122.47
|
| Rate for Payer: EPIC Health Plan Senior |
$831.46
|
| 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 |
$1,363.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$831.46
|
| Rate for Payer: InnovAge PACE Commercial |
$1,247.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,636.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$232.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$831.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,390.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,114.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,114.16
|
| 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 |
$831.46
|
| 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 |
$881.35
|
| Rate for Payer: Prime Health Services WC |
$1,311.27
|
| Rate for Payer: Riverside University Health System MISP |
$914.61
|
| 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 |
$831.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$914.61
|
| Rate for Payer: Vantage Medical Group Senior |
$831.46
|
|
|
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 |
$3,823.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,560.80
|
| 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 Permanente of CA Commercial/Self Funded |
$4,636.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,648.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,302.67
|
| 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
|
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: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC 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: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC CARRY CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8984
|
| Hospital Charge Code |
900018306
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC CARRY CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8984
|
| Hospital Charge Code |
900018406
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC CARRY D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8986
|
| Hospital Charge Code |
900018408
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC 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: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC CARRY D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8986
|
| Hospital Charge Code |
900018308
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC 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: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC CARRY GOAL STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8985
|
| Hospital Charge Code |
900018407
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
