|
HC CT ANGIO HEAD W/WO CONTRAST
|
Facility
|
OP
|
$4,285.00
|
|
|
Service Code
|
CPT 70496
|
| Hospital Charge Code |
909201800
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$225.59 |
| Max. Negotiated Rate |
$3,856.50 |
| Rate for Payer: Adventist Health Commercial |
$857.00
|
| Rate for Payer: Adventist Health Commercial |
$1,221.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$225.59
|
| Rate for Payer: Adventist Health Medi-Cal |
$225.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,519.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,519.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,551.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,492.58
|
| Rate for Payer: Blue Shield of California Commercial |
$3,846.78
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.55
|
| Rate for Payer: Blue Shield of California EPN |
$1,701.14
|
| Rate for Payer: Blue Shield of California EPN |
$2,424.08
|
| Rate for Payer: Cash Price |
$1,928.25
|
| Rate for Payer: Cash Price |
$1,928.25
|
| Rate for Payer: Cash Price |
$1,928.25
|
| Rate for Payer: Cash Price |
$2,747.70
|
| Rate for Payer: Cash Price |
$2,747.70
|
| Rate for Payer: Cash Price |
$2,747.70
|
| Rate for Payer: Central Health Plan Commercial |
$3,428.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,884.80
|
| Rate for Payer: Cigna of CA HMO |
$3,907.84
|
| Rate for Payer: Cigna of CA HMO |
$2,742.40
|
| Rate for Payer: Cigna of CA PPO |
$4,518.44
|
| Rate for Payer: Cigna of CA PPO |
$3,170.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,999.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,274.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: Galaxy Health WC |
$5,190.10
|
| Rate for Payer: Galaxy Health WC |
$3,642.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,571.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,663.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,856.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,495.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$457.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$457.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,720.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,877.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$505.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$505.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,221.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$857.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$302.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$302.29
|
| Rate for Payer: Multiplan Commercial |
$4,579.50
|
| Rate for Payer: Multiplan Commercial |
$3,213.75
|
| Rate for Payer: Networks By Design Commercial |
$2,785.25
|
| Rate for Payer: Networks By Design Commercial |
$3,968.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$225.59
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$225.59
|
| Rate for Payer: Prime Health Services Commercial |
$5,190.10
|
| Rate for Payer: Prime Health Services Commercial |
$3,642.25
|
| Rate for Payer: Prime Health Services Medicare |
$239.13
|
| Rate for Payer: Prime Health Services Medicare |
$239.13
|
| Rate for Payer: Riverside University Health System MISP |
$248.15
|
| Rate for Payer: Riverside University Health System MISP |
$248.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,663.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,571.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,663.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,571.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,053.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,142.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,053.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,142.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,142.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,053.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,053.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,142.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
|
|
HC CT ANGIO LOW EXT W/WO CONT
|
Facility
|
IP
|
$4,873.00
|
|
|
Service Code
|
CPT 73706
|
| Hospital Charge Code |
909201807
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$974.60 |
| Max. Negotiated Rate |
$4,385.70 |
| Rate for Payer: Adventist Health Commercial |
$974.60
|
| Rate for Payer: Cash Price |
$2,192.85
|
| Rate for Payer: Central Health Plan Commercial |
$3,898.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,411.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,949.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,949.20
|
| Rate for Payer: Galaxy Health WC |
$4,142.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,923.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,385.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,094.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,875.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$974.60
|
| Rate for Payer: Multiplan Commercial |
$3,654.75
|
| Rate for Payer: Networks By Design Commercial |
$3,167.45
|
| Rate for Payer: Prime Health Services Commercial |
$4,142.05
|
|
|
HC CT ANGIO LOW EXT W/WO CONT
|
Facility
|
OP
|
$2,736.00
|
|
|
Service Code
|
CPT 73706
|
| Hospital Charge Code |
909201807
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$225.59 |
| Max. Negotiated Rate |
$2,462.40 |
| Rate for Payer: Adventist Health Commercial |
$547.20
|
| Rate for Payer: Adventist Health Commercial |
$974.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$225.59
|
| Rate for Payer: Adventist Health Medi-Cal |
$225.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,568.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,568.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,591.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,834.62
|
| Rate for Payer: Blue Shield of California Commercial |
$3,069.99
|
| Rate for Payer: Blue Shield of California Commercial |
$1,723.68
|
| Rate for Payer: Blue Shield of California EPN |
$1,086.19
|
| Rate for Payer: Blue Shield of California EPN |
$1,934.58
|
| Rate for Payer: Cash Price |
$1,231.20
|
| Rate for Payer: Cash Price |
$1,231.20
|
| Rate for Payer: Cash Price |
$1,231.20
|
| Rate for Payer: Cash Price |
$2,192.85
|
| Rate for Payer: Cash Price |
$2,192.85
|
| Rate for Payer: Cash Price |
$2,192.85
|
| Rate for Payer: Central Health Plan Commercial |
$3,898.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,188.80
|
| Rate for Payer: Cigna of CA HMO |
$3,118.72
|
| Rate for Payer: Cigna of CA HMO |
$1,751.04
|
| Rate for Payer: Cigna of CA PPO |
$3,606.02
|
| Rate for Payer: Cigna of CA PPO |
$2,024.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,411.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,915.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: Galaxy Health WC |
$2,325.60
|
| Rate for Payer: Galaxy Health WC |
$4,142.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,923.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,641.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,385.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,462.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$543.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$543.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,094.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,737.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$600.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$600.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$547.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$974.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$302.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$302.29
|
| Rate for Payer: Multiplan Commercial |
$3,654.75
|
| Rate for Payer: Multiplan Commercial |
$2,052.00
|
| Rate for Payer: Networks By Design Commercial |
$1,778.40
|
| Rate for Payer: Networks By Design Commercial |
$3,167.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$225.59
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$225.59
|
| Rate for Payer: Prime Health Services Commercial |
$2,325.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,142.05
|
| Rate for Payer: Prime Health Services Medicare |
$239.13
|
| Rate for Payer: Prime Health Services Medicare |
$239.13
|
| Rate for Payer: Riverside University Health System MISP |
$248.15
|
| Rate for Payer: Riverside University Health System MISP |
$248.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,641.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,923.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,641.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,923.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.48
|
| Rate for Payer: United Healthcare All Other HMO |
$866.48
|
| Rate for Payer: United Healthcare All Other HMO |
$866.48
|
| Rate for Payer: United Healthcare HMO Rider |
$866.48
|
| Rate for Payer: United Healthcare HMO Rider |
$866.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.48
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
|
|
HC CT ANGIO NECK W/WO CONTRAST
|
Facility
|
OP
|
$4,285.00
|
|
|
Service Code
|
CPT 70498
|
| Hospital Charge Code |
909201801
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$225.59 |
| Max. Negotiated Rate |
$3,856.50 |
| Rate for Payer: Adventist Health Commercial |
$857.00
|
| Rate for Payer: Adventist Health Commercial |
$1,221.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$225.59
|
| Rate for Payer: Adventist Health Medi-Cal |
$225.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,519.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,519.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,551.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,492.58
|
| Rate for Payer: Blue Shield of California Commercial |
$3,846.78
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.55
|
| Rate for Payer: Blue Shield of California EPN |
$1,701.14
|
| Rate for Payer: Blue Shield of California EPN |
$2,424.08
|
| Rate for Payer: Cash Price |
$1,928.25
|
| Rate for Payer: Cash Price |
$1,928.25
|
| Rate for Payer: Cash Price |
$1,928.25
|
| Rate for Payer: Cash Price |
$2,747.70
|
| Rate for Payer: Cash Price |
$2,747.70
|
| Rate for Payer: Cash Price |
$2,747.70
|
| Rate for Payer: Central Health Plan Commercial |
$3,428.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,884.80
|
| Rate for Payer: Cigna of CA HMO |
$3,907.84
|
| Rate for Payer: Cigna of CA HMO |
$2,742.40
|
| Rate for Payer: Cigna of CA PPO |
$4,518.44
|
| Rate for Payer: Cigna of CA PPO |
$3,170.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,999.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,274.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: Galaxy Health WC |
$5,190.10
|
| Rate for Payer: Galaxy Health WC |
$3,642.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,571.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,663.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,856.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,495.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$456.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$456.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,720.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,877.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$503.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$503.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,221.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$857.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$302.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$302.29
|
| Rate for Payer: Multiplan Commercial |
$4,579.50
|
| Rate for Payer: Multiplan Commercial |
$3,213.75
|
| Rate for Payer: Networks By Design Commercial |
$2,785.25
|
| Rate for Payer: Networks By Design Commercial |
$3,968.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$225.59
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$225.59
|
| Rate for Payer: Prime Health Services Commercial |
$5,190.10
|
| Rate for Payer: Prime Health Services Commercial |
$3,642.25
|
| Rate for Payer: Prime Health Services Medicare |
$239.13
|
| Rate for Payer: Prime Health Services Medicare |
$239.13
|
| Rate for Payer: Riverside University Health System MISP |
$248.15
|
| Rate for Payer: Riverside University Health System MISP |
$248.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,663.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,571.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,663.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,571.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,053.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,142.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,053.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,142.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,142.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,053.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,053.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,142.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
|
|
HC CT ANGIO NECK W/WO CONTRAST
|
Facility
|
IP
|
$6,106.00
|
|
|
Service Code
|
CPT 70498
|
| Hospital Charge Code |
909201801
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,221.20 |
| Max. Negotiated Rate |
$5,495.40 |
| Rate for Payer: Adventist Health Commercial |
$1,221.20
|
| Rate for Payer: Cash Price |
$2,747.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,884.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,274.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,442.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,442.40
|
| Rate for Payer: Galaxy Health WC |
$5,190.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,663.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,495.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,877.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,602.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,221.20
|
| Rate for Payer: Multiplan Commercial |
$4,579.50
|
| Rate for Payer: Networks By Design Commercial |
$3,968.90
|
| Rate for Payer: Prime Health Services Commercial |
$5,190.10
|
|
|
HC CT ANGIO PELVIS W/WO CONTRAST
|
Facility
|
IP
|
$5,516.00
|
|
|
Service Code
|
CPT 72191
|
| Hospital Charge Code |
909201803
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,103.20 |
| Max. Negotiated Rate |
$4,964.40 |
| Rate for Payer: Adventist Health Commercial |
$1,103.20
|
| Rate for Payer: Cash Price |
$2,482.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,412.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,861.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,206.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,206.40
|
| Rate for Payer: Galaxy Health WC |
$4,688.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,309.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,964.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,502.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,254.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,103.20
|
| Rate for Payer: Multiplan Commercial |
$4,137.00
|
| Rate for Payer: Networks By Design Commercial |
$3,585.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,688.60
|
|
|
HC CT ANGIO PELVIS W/WO CONTRAST
|
Facility
|
OP
|
$3,097.00
|
|
|
Service Code
|
CPT 72191
|
| Hospital Charge Code |
909201803
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$225.59 |
| Max. Negotiated Rate |
$2,787.30 |
| Rate for Payer: Adventist Health Commercial |
$619.40
|
| Rate for Payer: Adventist Health Commercial |
$1,103.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$225.59
|
| Rate for Payer: Adventist Health Medi-Cal |
$225.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,786.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,786.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,801.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,208.66
|
| Rate for Payer: Blue Shield of California Commercial |
$3,475.08
|
| Rate for Payer: Blue Shield of California Commercial |
$1,951.11
|
| Rate for Payer: Blue Shield of California EPN |
$1,229.51
|
| Rate for Payer: Blue Shield of California EPN |
$2,189.85
|
| Rate for Payer: Cash Price |
$1,393.65
|
| Rate for Payer: Cash Price |
$1,393.65
|
| Rate for Payer: Cash Price |
$1,393.65
|
| Rate for Payer: Cash Price |
$2,482.20
|
| Rate for Payer: Cash Price |
$2,482.20
|
| Rate for Payer: Cash Price |
$2,482.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,412.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,477.60
|
| Rate for Payer: Cigna of CA HMO |
$3,530.24
|
| Rate for Payer: Cigna of CA HMO |
$1,982.08
|
| Rate for Payer: Cigna of CA PPO |
$4,081.84
|
| Rate for Payer: Cigna of CA PPO |
$2,291.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,861.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,167.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: Galaxy Health WC |
$2,632.45
|
| Rate for Payer: Galaxy Health WC |
$4,688.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,309.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,858.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,964.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,787.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$472.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$472.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,502.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,966.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$522.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$522.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$619.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,103.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$302.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$302.29
|
| Rate for Payer: Multiplan Commercial |
$4,137.00
|
| Rate for Payer: Multiplan Commercial |
$2,322.75
|
| Rate for Payer: Networks By Design Commercial |
$2,013.05
|
| Rate for Payer: Networks By Design Commercial |
$3,585.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$225.59
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$225.59
|
| Rate for Payer: Prime Health Services Commercial |
$2,632.45
|
| Rate for Payer: Prime Health Services Commercial |
$4,688.60
|
| Rate for Payer: Prime Health Services Medicare |
$239.13
|
| Rate for Payer: Prime Health Services Medicare |
$239.13
|
| Rate for Payer: Riverside University Health System MISP |
$248.15
|
| Rate for Payer: Riverside University Health System MISP |
$248.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,858.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,309.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,858.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,309.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.48
|
| Rate for Payer: United Healthcare All Other HMO |
$866.48
|
| Rate for Payer: United Healthcare All Other HMO |
$866.48
|
| Rate for Payer: United Healthcare HMO Rider |
$866.48
|
| Rate for Payer: United Healthcare HMO Rider |
$866.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.48
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
|
|
HC CT ANGIO UPP EXT W/WO CON
|
Facility
|
OP
|
$3,004.00
|
|
|
Service Code
|
CPT 73206
|
| Hospital Charge Code |
909201804
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$225.59 |
| Max. Negotiated Rate |
$2,703.60 |
| Rate for Payer: Adventist Health Commercial |
$600.80
|
| Rate for Payer: Adventist Health Commercial |
$1,070.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$225.59
|
| Rate for Payer: Adventist Health Medi-Cal |
$225.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,568.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,568.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,747.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,112.09
|
| Rate for Payer: Blue Shield of California Commercial |
$3,370.50
|
| Rate for Payer: Blue Shield of California Commercial |
$1,892.52
|
| Rate for Payer: Blue Shield of California EPN |
$1,192.59
|
| Rate for Payer: Blue Shield of California EPN |
$2,123.95
|
| Rate for Payer: Cash Price |
$1,351.80
|
| Rate for Payer: Cash Price |
$1,351.80
|
| Rate for Payer: Cash Price |
$1,351.80
|
| Rate for Payer: Cash Price |
$2,407.50
|
| Rate for Payer: Cash Price |
$2,407.50
|
| Rate for Payer: Cash Price |
$2,407.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,280.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,403.20
|
| Rate for Payer: Cigna of CA HMO |
$3,424.00
|
| Rate for Payer: Cigna of CA HMO |
$1,922.56
|
| Rate for Payer: Cigna of CA PPO |
$3,959.00
|
| Rate for Payer: Cigna of CA PPO |
$2,222.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,745.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,102.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: Galaxy Health WC |
$2,553.40
|
| Rate for Payer: Galaxy Health WC |
$4,547.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,210.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,802.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,815.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,703.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$500.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$500.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,397.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,907.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$553.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$553.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$600.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,070.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$302.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$302.29
|
| Rate for Payer: Multiplan Commercial |
$4,012.50
|
| Rate for Payer: Multiplan Commercial |
$2,253.00
|
| Rate for Payer: Networks By Design Commercial |
$1,952.60
|
| Rate for Payer: Networks By Design Commercial |
$3,477.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$225.59
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$225.59
|
| Rate for Payer: Prime Health Services Commercial |
$2,553.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,547.50
|
| Rate for Payer: Prime Health Services Medicare |
$239.13
|
| Rate for Payer: Prime Health Services Medicare |
$239.13
|
| Rate for Payer: Riverside University Health System MISP |
$248.15
|
| Rate for Payer: Riverside University Health System MISP |
$248.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,802.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,802.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.48
|
| Rate for Payer: United Healthcare All Other HMO |
$866.48
|
| Rate for Payer: United Healthcare All Other HMO |
$866.48
|
| Rate for Payer: United Healthcare HMO Rider |
$866.48
|
| Rate for Payer: United Healthcare HMO Rider |
$866.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.48
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
|
|
HC CT ANGIO UPP EXT W/WO CON
|
Facility
|
IP
|
$5,350.00
|
|
|
Service Code
|
CPT 73206
|
| Hospital Charge Code |
909201804
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,070.00 |
| Max. Negotiated Rate |
$4,815.00 |
| Rate for Payer: Adventist Health Commercial |
$1,070.00
|
| Rate for Payer: Cash Price |
$2,407.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,280.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,745.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,140.00
|
| Rate for Payer: Galaxy Health WC |
$4,547.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,815.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,397.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,156.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,070.00
|
| Rate for Payer: Multiplan Commercial |
$4,012.50
|
| Rate for Payer: Networks By Design Commercial |
$3,477.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,547.50
|
|
|
HC CT BONE L-SPINE W CONTRAST
|
Facility
|
OP
|
$2,736.00
|
|
|
Service Code
|
CPT 72132
|
| Hospital Charge Code |
909201008
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$280.50 |
| Max. Negotiated Rate |
$2,462.40 |
| Rate for Payer: Adventist Health Commercial |
$547.20
|
| Rate for Payer: Adventist Health Commercial |
$974.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,458.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,458.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,591.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,834.62
|
| Rate for Payer: Blue Shield of California Commercial |
$3,069.99
|
| Rate for Payer: Blue Shield of California Commercial |
$1,723.68
|
| Rate for Payer: Blue Shield of California EPN |
$1,086.19
|
| Rate for Payer: Blue Shield of California EPN |
$1,934.58
|
| Rate for Payer: Cash Price |
$1,231.20
|
| Rate for Payer: Cash Price |
$1,231.20
|
| Rate for Payer: Cash Price |
$1,231.20
|
| Rate for Payer: Cash Price |
$2,192.85
|
| Rate for Payer: Cash Price |
$2,192.85
|
| Rate for Payer: Cash Price |
$2,192.85
|
| Rate for Payer: Central Health Plan Commercial |
$3,898.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,188.80
|
| Rate for Payer: Cigna of CA HMO |
$3,118.72
|
| Rate for Payer: Cigna of CA HMO |
$1,751.04
|
| Rate for Payer: Cigna of CA PPO |
$3,606.02
|
| Rate for Payer: Cigna of CA PPO |
$2,024.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,411.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,915.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$2,325.60
|
| Rate for Payer: Galaxy Health WC |
$4,142.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,923.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,641.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,385.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,462.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$280.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$280.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,094.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,737.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$309.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$309.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$547.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$974.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$3,654.75
|
| Rate for Payer: Multiplan Commercial |
$2,052.00
|
| Rate for Payer: Networks By Design Commercial |
$1,778.40
|
| Rate for Payer: Networks By Design Commercial |
$3,167.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: Prime Health Services Commercial |
$2,325.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,142.05
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,641.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,923.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,641.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,923.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$769.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$769.25
|
| Rate for Payer: United Healthcare All Other HMO |
$769.25
|
| Rate for Payer: United Healthcare All Other HMO |
$769.25
|
| Rate for Payer: United Healthcare HMO Rider |
$769.25
|
| Rate for Payer: United Healthcare HMO Rider |
$769.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$769.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$769.25
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC CT BONE L-SPINE W CONTRAST
|
Facility
|
IP
|
$4,873.00
|
|
|
Service Code
|
CPT 72132
|
| Hospital Charge Code |
909201008
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$974.60 |
| Max. Negotiated Rate |
$4,385.70 |
| Rate for Payer: Adventist Health Commercial |
$974.60
|
| Rate for Payer: Cash Price |
$2,192.85
|
| Rate for Payer: Central Health Plan Commercial |
$3,898.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,411.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,949.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,949.20
|
| Rate for Payer: Galaxy Health WC |
$4,142.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,923.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,385.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,094.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,875.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$974.60
|
| Rate for Payer: Multiplan Commercial |
$3,654.75
|
| Rate for Payer: Networks By Design Commercial |
$3,167.45
|
| Rate for Payer: Prime Health Services Commercial |
$4,142.05
|
|
|
HC CT BONE L-SPINE W/O CONTRAST
|
Facility
|
IP
|
$4,543.00
|
|
|
Service Code
|
CPT 72131
|
| Hospital Charge Code |
909201007
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$908.60 |
| Max. Negotiated Rate |
$4,088.70 |
| Rate for Payer: Adventist Health Commercial |
$908.60
|
| Rate for Payer: Cash Price |
$2,044.35
|
| Rate for Payer: Central Health Plan Commercial |
$3,634.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,180.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,817.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,817.20
|
| Rate for Payer: Galaxy Health WC |
$3,861.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,725.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,088.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,884.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,680.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$908.60
|
| Rate for Payer: Multiplan Commercial |
$3,407.25
|
| Rate for Payer: Networks By Design Commercial |
$2,952.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,861.55
|
|
|
HC CT BONE L-SPINE W/O CONTRAST
|
Facility
|
OP
|
$2,550.00
|
|
|
Service Code
|
CPT 72131
|
| Hospital Charge Code |
909201007
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$134.46 |
| Max. Negotiated Rate |
$2,364.00 |
| Rate for Payer: Adventist Health Commercial |
$510.00
|
| Rate for Payer: Adventist Health Commercial |
$908.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$134.46
|
| Rate for Payer: Adventist Health Medi-Cal |
$134.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,220.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,220.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,483.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,642.66
|
| Rate for Payer: Blue Shield of California Commercial |
$2,862.09
|
| Rate for Payer: Blue Shield of California Commercial |
$1,606.50
|
| Rate for Payer: Blue Shield of California EPN |
$1,012.35
|
| Rate for Payer: Blue Shield of California EPN |
$1,803.57
|
| Rate for Payer: Cash Price |
$1,147.50
|
| Rate for Payer: Cash Price |
$1,147.50
|
| Rate for Payer: Cash Price |
$1,147.50
|
| Rate for Payer: Cash Price |
$2,044.35
|
| Rate for Payer: Cash Price |
$2,044.35
|
| Rate for Payer: Cash Price |
$2,044.35
|
| Rate for Payer: Central Health Plan Commercial |
$3,634.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,040.00
|
| Rate for Payer: Cigna of CA HMO |
$2,907.52
|
| Rate for Payer: Cigna of CA HMO |
$1,632.00
|
| Rate for Payer: Cigna of CA PPO |
$3,361.82
|
| Rate for Payer: Cigna of CA PPO |
$1,887.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,180.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,785.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: Galaxy Health WC |
$2,167.50
|
| Rate for Payer: Galaxy Health WC |
$3,861.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,725.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,530.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,088.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,295.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$213.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$213.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,884.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,619.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$236.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$236.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$510.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$908.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$180.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$3,407.25
|
| Rate for Payer: Multiplan Commercial |
$1,912.50
|
| Rate for Payer: Networks By Design Commercial |
$1,657.50
|
| Rate for Payer: Networks By Design Commercial |
$2,952.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$134.46
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$134.46
|
| Rate for Payer: Prime Health Services Commercial |
$2,167.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,861.55
|
| Rate for Payer: Prime Health Services Medicare |
$142.53
|
| Rate for Payer: Prime Health Services Medicare |
$142.53
|
| Rate for Payer: Riverside University Health System MISP |
$147.91
|
| Rate for Payer: Riverside University Health System MISP |
$147.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,530.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,725.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,530.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,725.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$491.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$491.23
|
| Rate for Payer: United Healthcare All Other HMO |
$491.23
|
| Rate for Payer: United Healthcare All Other HMO |
$491.23
|
| Rate for Payer: United Healthcare HMO Rider |
$491.23
|
| Rate for Payer: United Healthcare HMO Rider |
$491.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$491.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$491.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC CT BONE L-SPINE W/WO CONTRAST
|
Facility
|
OP
|
$3,004.00
|
|
|
Service Code
|
CPT 72133
|
| Hospital Charge Code |
909201009
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$225.59 |
| Max. Negotiated Rate |
$2,703.60 |
| Rate for Payer: Adventist Health Commercial |
$600.80
|
| Rate for Payer: Adventist Health Commercial |
$1,023.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$225.59
|
| Rate for Payer: Adventist Health Medi-Cal |
$225.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,817.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,817.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,747.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,975.98
|
| Rate for Payer: Blue Shield of California Commercial |
$3,223.08
|
| Rate for Payer: Blue Shield of California Commercial |
$1,892.52
|
| Rate for Payer: Blue Shield of California EPN |
$1,192.59
|
| Rate for Payer: Blue Shield of California EPN |
$2,031.05
|
| Rate for Payer: Cash Price |
$1,351.80
|
| Rate for Payer: Cash Price |
$1,351.80
|
| Rate for Payer: Cash Price |
$1,351.80
|
| Rate for Payer: Cash Price |
$2,302.20
|
| Rate for Payer: Cash Price |
$2,302.20
|
| Rate for Payer: Cash Price |
$2,302.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,092.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,403.20
|
| Rate for Payer: Cigna of CA HMO |
$3,274.24
|
| Rate for Payer: Cigna of CA HMO |
$1,922.56
|
| Rate for Payer: Cigna of CA PPO |
$3,785.84
|
| Rate for Payer: Cigna of CA PPO |
$2,222.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,581.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,102.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: Galaxy Health WC |
$2,553.40
|
| Rate for Payer: Galaxy Health WC |
$4,348.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,069.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,802.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,604.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,703.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$330.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$330.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,248.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,907.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$364.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$364.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$600.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,023.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$302.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$302.29
|
| Rate for Payer: Multiplan Commercial |
$3,837.00
|
| Rate for Payer: Multiplan Commercial |
$2,253.00
|
| Rate for Payer: Networks By Design Commercial |
$1,952.60
|
| Rate for Payer: Networks By Design Commercial |
$3,325.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$225.59
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$225.59
|
| Rate for Payer: Prime Health Services Commercial |
$2,553.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,348.60
|
| Rate for Payer: Prime Health Services Medicare |
$239.13
|
| Rate for Payer: Prime Health Services Medicare |
$239.13
|
| Rate for Payer: Riverside University Health System MISP |
$248.15
|
| Rate for Payer: Riverside University Health System MISP |
$248.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,802.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,069.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,802.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,069.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$855.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$855.26
|
| Rate for Payer: United Healthcare All Other HMO |
$855.26
|
| Rate for Payer: United Healthcare All Other HMO |
$855.26
|
| Rate for Payer: United Healthcare HMO Rider |
$855.26
|
| Rate for Payer: United Healthcare HMO Rider |
$855.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$855.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$855.26
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
|
|
HC CT BONE L-SPINE W/WO CONTRAST
|
Facility
|
IP
|
$5,116.00
|
|
|
Service Code
|
CPT 72133
|
| Hospital Charge Code |
909201009
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,023.20 |
| Max. Negotiated Rate |
$4,604.40 |
| Rate for Payer: Adventist Health Commercial |
$1,023.20
|
| Rate for Payer: Cash Price |
$2,302.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,092.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,581.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,046.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,046.40
|
| Rate for Payer: Galaxy Health WC |
$4,348.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,069.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,604.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,248.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,018.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,023.20
|
| Rate for Payer: Multiplan Commercial |
$3,837.00
|
| Rate for Payer: Networks By Design Commercial |
$3,325.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,348.60
|
|
|
HC CT BONE PELVIS W CONTRAST
|
Facility
|
IP
|
$4,918.00
|
|
|
Service Code
|
CPT 72193
|
| Hospital Charge Code |
909201931
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$983.60 |
| Max. Negotiated Rate |
$4,426.20 |
| Rate for Payer: Adventist Health Commercial |
$983.60
|
| Rate for Payer: Cash Price |
$2,213.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,934.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,442.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,967.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,967.20
|
| Rate for Payer: Galaxy Health WC |
$4,180.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,950.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,426.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,122.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,901.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$983.60
|
| Rate for Payer: Multiplan Commercial |
$3,688.50
|
| Rate for Payer: Networks By Design Commercial |
$3,196.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,180.30
|
|
|
HC CT BONE PELVIS W CONTRAST
|
Facility
|
OP
|
$2,761.00
|
|
|
Service Code
|
CPT 72193
|
| Hospital Charge Code |
909201931
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$225.59 |
| Max. Negotiated Rate |
$2,484.90 |
| Rate for Payer: Adventist Health Commercial |
$552.20
|
| Rate for Payer: Adventist Health Commercial |
$983.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$225.59
|
| Rate for Payer: Adventist Health Medi-Cal |
$225.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,409.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,409.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,606.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,860.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,098.34
|
| Rate for Payer: Blue Shield of California Commercial |
$1,739.43
|
| Rate for Payer: Blue Shield of California EPN |
$1,096.12
|
| Rate for Payer: Blue Shield of California EPN |
$1,952.45
|
| Rate for Payer: Cash Price |
$1,242.45
|
| Rate for Payer: Cash Price |
$1,242.45
|
| Rate for Payer: Cash Price |
$1,242.45
|
| Rate for Payer: Cash Price |
$2,213.10
|
| Rate for Payer: Cash Price |
$2,213.10
|
| Rate for Payer: Cash Price |
$2,213.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,934.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,208.80
|
| Rate for Payer: Cigna of CA HMO |
$3,147.52
|
| Rate for Payer: Cigna of CA HMO |
$1,767.04
|
| Rate for Payer: Cigna of CA PPO |
$3,639.32
|
| Rate for Payer: Cigna of CA PPO |
$2,043.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,442.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,932.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: Galaxy Health WC |
$2,346.85
|
| Rate for Payer: Galaxy Health WC |
$4,180.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,950.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,656.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,426.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,484.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$351.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$351.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,122.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,753.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$388.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$388.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$983.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$302.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$302.29
|
| Rate for Payer: Multiplan Commercial |
$3,688.50
|
| Rate for Payer: Multiplan Commercial |
$2,070.75
|
| Rate for Payer: Networks By Design Commercial |
$1,794.65
|
| Rate for Payer: Networks By Design Commercial |
$3,196.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$225.59
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$225.59
|
| Rate for Payer: Prime Health Services Commercial |
$2,346.85
|
| Rate for Payer: Prime Health Services Commercial |
$4,180.30
|
| Rate for Payer: Prime Health Services Medicare |
$239.13
|
| Rate for Payer: Prime Health Services Medicare |
$239.13
|
| Rate for Payer: Riverside University Health System MISP |
$248.15
|
| Rate for Payer: Riverside University Health System MISP |
$248.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,656.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,950.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,656.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,950.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$769.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$769.25
|
| Rate for Payer: United Healthcare All Other HMO |
$769.25
|
| Rate for Payer: United Healthcare All Other HMO |
$769.25
|
| Rate for Payer: United Healthcare HMO Rider |
$769.25
|
| Rate for Payer: United Healthcare HMO Rider |
$769.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$769.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$769.25
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
|
|
HC CT BONE PELVIS W/O CONTRAST
|
Facility
|
OP
|
$2,541.00
|
|
|
Service Code
|
CPT 72192
|
| Hospital Charge Code |
909201930
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$134.46 |
| Max. Negotiated Rate |
$2,364.00 |
| Rate for Payer: Adventist Health Commercial |
$508.20
|
| Rate for Payer: Adventist Health Commercial |
$905.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$134.46
|
| Rate for Payer: Adventist Health Medi-Cal |
$134.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,219.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,219.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,478.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,632.19
|
| Rate for Payer: Blue Shield of California Commercial |
$2,850.75
|
| Rate for Payer: Blue Shield of California Commercial |
$1,600.83
|
| Rate for Payer: Blue Shield of California EPN |
$1,008.78
|
| Rate for Payer: Blue Shield of California EPN |
$1,796.42
|
| Rate for Payer: Cash Price |
$1,143.45
|
| Rate for Payer: Cash Price |
$1,143.45
|
| Rate for Payer: Cash Price |
$1,143.45
|
| Rate for Payer: Cash Price |
$2,036.25
|
| Rate for Payer: Cash Price |
$2,036.25
|
| Rate for Payer: Cash Price |
$2,036.25
|
| Rate for Payer: Central Health Plan Commercial |
$3,620.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,032.80
|
| Rate for Payer: Cigna of CA HMO |
$2,896.00
|
| Rate for Payer: Cigna of CA HMO |
$1,626.24
|
| Rate for Payer: Cigna of CA PPO |
$3,348.50
|
| Rate for Payer: Cigna of CA PPO |
$1,880.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,167.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,778.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: Galaxy Health WC |
$2,159.85
|
| Rate for Payer: Galaxy Health WC |
$3,846.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,715.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,524.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,072.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,286.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$219.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$219.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,873.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,613.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$242.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$242.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$508.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$905.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$180.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$3,393.75
|
| Rate for Payer: Multiplan Commercial |
$1,905.75
|
| Rate for Payer: Networks By Design Commercial |
$1,651.65
|
| Rate for Payer: Networks By Design Commercial |
$2,941.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$134.46
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$134.46
|
| Rate for Payer: Prime Health Services Commercial |
$2,159.85
|
| Rate for Payer: Prime Health Services Commercial |
$3,846.25
|
| Rate for Payer: Prime Health Services Medicare |
$142.53
|
| Rate for Payer: Prime Health Services Medicare |
$142.53
|
| Rate for Payer: Riverside University Health System MISP |
$147.91
|
| Rate for Payer: Riverside University Health System MISP |
$147.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,524.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,715.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,524.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,715.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$491.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$491.23
|
| Rate for Payer: United Healthcare All Other HMO |
$491.23
|
| Rate for Payer: United Healthcare All Other HMO |
$491.23
|
| Rate for Payer: United Healthcare HMO Rider |
$491.23
|
| Rate for Payer: United Healthcare HMO Rider |
$491.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$491.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$491.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC CT BONE PELVIS W/O CONTRAST
|
Facility
|
IP
|
$4,525.00
|
|
|
Service Code
|
CPT 72192
|
| Hospital Charge Code |
909201930
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$905.00 |
| Max. Negotiated Rate |
$4,072.50 |
| Rate for Payer: Adventist Health Commercial |
$905.00
|
| Rate for Payer: Cash Price |
$2,036.25
|
| Rate for Payer: Central Health Plan Commercial |
$3,620.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,167.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,810.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,810.00
|
| Rate for Payer: Galaxy Health WC |
$3,846.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,715.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,072.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,873.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,669.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$905.00
|
| Rate for Payer: Multiplan Commercial |
$3,393.75
|
| Rate for Payer: Networks By Design Commercial |
$2,941.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,846.25
|
|
|
HC CT BONE PELVIS W/WO CONTRAST
|
Facility
|
IP
|
$5,375.00
|
|
|
Service Code
|
CPT 72194
|
| Hospital Charge Code |
909201932
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,075.00 |
| Max. Negotiated Rate |
$4,837.50 |
| Rate for Payer: Adventist Health Commercial |
$1,075.00
|
| Rate for Payer: Cash Price |
$2,418.75
|
| Rate for Payer: Central Health Plan Commercial |
$4,300.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,762.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,150.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,150.00
|
| Rate for Payer: Galaxy Health WC |
$4,568.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,225.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,837.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,413.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,171.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,075.00
|
| Rate for Payer: Multiplan Commercial |
$4,031.25
|
| Rate for Payer: Networks By Design Commercial |
$3,493.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,568.75
|
|
|
HC CT BONE PELVIS W/WO CONTRAST
|
Facility
|
OP
|
$3,018.00
|
|
|
Service Code
|
CPT 72194
|
| Hospital Charge Code |
909201932
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$225.59 |
| Max. Negotiated Rate |
$2,716.20 |
| Rate for Payer: Adventist Health Commercial |
$603.60
|
| Rate for Payer: Adventist Health Commercial |
$1,075.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$225.59
|
| Rate for Payer: Adventist Health Medi-Cal |
$225.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,744.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,744.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,755.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,126.64
|
| Rate for Payer: Blue Shield of California Commercial |
$3,386.25
|
| Rate for Payer: Blue Shield of California Commercial |
$1,901.34
|
| Rate for Payer: Blue Shield of California EPN |
$1,198.15
|
| Rate for Payer: Blue Shield of California EPN |
$2,133.88
|
| Rate for Payer: Cash Price |
$1,358.10
|
| Rate for Payer: Cash Price |
$1,358.10
|
| Rate for Payer: Cash Price |
$1,358.10
|
| Rate for Payer: Cash Price |
$2,418.75
|
| Rate for Payer: Cash Price |
$2,418.75
|
| Rate for Payer: Cash Price |
$2,418.75
|
| Rate for Payer: Central Health Plan Commercial |
$4,300.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,414.40
|
| Rate for Payer: Cigna of CA HMO |
$3,440.00
|
| Rate for Payer: Cigna of CA HMO |
$1,931.52
|
| Rate for Payer: Cigna of CA PPO |
$3,977.50
|
| Rate for Payer: Cigna of CA PPO |
$2,233.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,762.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,112.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: Galaxy Health WC |
$2,565.30
|
| Rate for Payer: Galaxy Health WC |
$4,568.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,225.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,810.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,837.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,716.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$406.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$406.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,413.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,916.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$449.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$449.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$603.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,075.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$302.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$302.29
|
| Rate for Payer: Multiplan Commercial |
$4,031.25
|
| Rate for Payer: Multiplan Commercial |
$2,263.50
|
| Rate for Payer: Networks By Design Commercial |
$1,961.70
|
| Rate for Payer: Networks By Design Commercial |
$3,493.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$225.59
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$225.59
|
| Rate for Payer: Prime Health Services Commercial |
$2,565.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,568.75
|
| Rate for Payer: Prime Health Services Medicare |
$239.13
|
| Rate for Payer: Prime Health Services Medicare |
$239.13
|
| Rate for Payer: Riverside University Health System MISP |
$248.15
|
| Rate for Payer: Riverside University Health System MISP |
$248.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,810.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,225.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,810.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$855.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$855.26
|
| Rate for Payer: United Healthcare All Other HMO |
$855.26
|
| Rate for Payer: United Healthcare All Other HMO |
$855.26
|
| Rate for Payer: United Healthcare HMO Rider |
$855.26
|
| Rate for Payer: United Healthcare HMO Rider |
$855.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$855.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$855.26
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
|
|
HC CT CARDIAC SCORING
|
Facility
|
OP
|
$961.00
|
|
|
Service Code
|
CPT 75571
|
| Hospital Charge Code |
909201981
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$25.00 |
| Max. Negotiated Rate |
$2,364.00 |
| Rate for Payer: Adventist Health Commercial |
$192.20
|
| Rate for Payer: Adventist Health Commercial |
$108.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$111.93
|
| Rate for Payer: Adventist Health Medi-Cal |
$111.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$251.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$251.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$559.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$314.12
|
| Rate for Payer: Blue Shield of California Commercial |
$340.20
|
| Rate for Payer: Blue Shield of California Commercial |
$605.43
|
| Rate for Payer: Blue Shield of California EPN |
$381.52
|
| Rate for Payer: Blue Shield of California EPN |
$214.38
|
| Rate for Payer: Cash Price |
$243.00
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cash Price |
$243.00
|
| Rate for Payer: Cash Price |
$243.00
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Center for Health Promotion Commercial |
$25.00
|
| Rate for Payer: Center for Health Promotion Commercial |
$25.00
|
| Rate for Payer: Central Health Plan Commercial |
$432.00
|
| Rate for Payer: Central Health Plan Commercial |
$768.80
|
| Rate for Payer: Cigna of CA HMO |
$615.04
|
| Rate for Payer: Cigna of CA HMO |
$345.60
|
| Rate for Payer: Cigna of CA PPO |
$711.14
|
| Rate for Payer: Cigna of CA PPO |
$399.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$672.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$378.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.68
|
| Rate for Payer: EPIC Health Plan Senior |
$123.12
|
| Rate for Payer: EPIC Health Plan Senior |
$123.12
|
| Rate for Payer: Galaxy Health WC |
$459.00
|
| Rate for Payer: Galaxy Health WC |
$816.85
|
| Rate for Payer: Global Benefits Group Commercial |
$324.00
|
| Rate for Payer: Global Benefits Group Commercial |
$576.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$486.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$864.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$183.57
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$183.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$139.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$139.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$342.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$610.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$154.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$154.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$156.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$156.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$108.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$149.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$149.99
|
| Rate for Payer: Multiplan Commercial |
$720.75
|
| Rate for Payer: Multiplan Commercial |
$405.00
|
| Rate for Payer: Networks By Design Commercial |
$351.00
|
| Rate for Payer: Networks By Design Commercial |
$624.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$111.93
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$111.93
|
| Rate for Payer: Prime Health Services Commercial |
$459.00
|
| Rate for Payer: Prime Health Services Commercial |
$816.85
|
| Rate for Payer: Prime Health Services Medicare |
$118.65
|
| Rate for Payer: Prime Health Services Medicare |
$118.65
|
| Rate for Payer: Riverside University Health System MISP |
$123.12
|
| Rate for Payer: Riverside University Health System MISP |
$123.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$324.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$576.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$324.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$576.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$116.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$116.83
|
| Rate for Payer: United Healthcare All Other HMO |
$116.83
|
| Rate for Payer: United Healthcare All Other HMO |
$116.83
|
| Rate for Payer: United Healthcare HMO Rider |
$116.83
|
| Rate for Payer: United Healthcare HMO Rider |
$116.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$116.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$116.83
|
| Rate for Payer: Upland Medical Group Pediatric |
$111.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$111.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Vantage Medical Group Senior |
$111.93
|
| Rate for Payer: Vantage Medical Group Senior |
$111.93
|
|
|
HC CT CARDIAC SCORING
|
Facility
|
IP
|
$961.00
|
|
|
Service Code
|
CPT 75571
|
| Hospital Charge Code |
909201981
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$192.20 |
| Max. Negotiated Rate |
$864.90 |
| Rate for Payer: Adventist Health Commercial |
$192.20
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Central Health Plan Commercial |
$768.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$672.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$384.40
|
| Rate for Payer: EPIC Health Plan Senior |
$384.40
|
| Rate for Payer: Galaxy Health WC |
$816.85
|
| Rate for Payer: Global Benefits Group Commercial |
$576.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$864.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$610.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$566.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.20
|
| Rate for Payer: Multiplan Commercial |
$720.75
|
| Rate for Payer: Networks By Design Commercial |
$624.65
|
| Rate for Payer: Prime Health Services Commercial |
$816.85
|
|
|
HC CT CHEST W CONTRAST
|
Facility
|
OP
|
$2,761.00
|
|
|
Service Code
|
CPT 71260
|
| Hospital Charge Code |
909201913
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$225.59 |
| Max. Negotiated Rate |
$2,484.90 |
| Rate for Payer: Adventist Health Commercial |
$552.20
|
| Rate for Payer: Adventist Health Commercial |
$983.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$225.59
|
| Rate for Payer: Adventist Health Medi-Cal |
$225.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,459.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,459.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,606.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,860.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,098.34
|
| Rate for Payer: Blue Shield of California Commercial |
$1,739.43
|
| Rate for Payer: Blue Shield of California EPN |
$1,096.12
|
| Rate for Payer: Blue Shield of California EPN |
$1,952.45
|
| Rate for Payer: Cash Price |
$1,242.45
|
| Rate for Payer: Cash Price |
$1,242.45
|
| Rate for Payer: Cash Price |
$1,242.45
|
| Rate for Payer: Cash Price |
$2,213.10
|
| Rate for Payer: Cash Price |
$2,213.10
|
| Rate for Payer: Cash Price |
$2,213.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,934.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,208.80
|
| Rate for Payer: Cigna of CA HMO |
$3,147.52
|
| Rate for Payer: Cigna of CA HMO |
$1,767.04
|
| Rate for Payer: Cigna of CA PPO |
$3,639.32
|
| Rate for Payer: Cigna of CA PPO |
$2,043.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,442.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,932.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: Galaxy Health WC |
$2,346.85
|
| Rate for Payer: Galaxy Health WC |
$4,180.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,950.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,656.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,426.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,484.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$276.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$276.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,122.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,753.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$305.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$305.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$983.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$302.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$302.29
|
| Rate for Payer: Multiplan Commercial |
$3,688.50
|
| Rate for Payer: Multiplan Commercial |
$2,070.75
|
| Rate for Payer: Networks By Design Commercial |
$1,794.65
|
| Rate for Payer: Networks By Design Commercial |
$3,196.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$225.59
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$225.59
|
| Rate for Payer: Prime Health Services Commercial |
$2,346.85
|
| Rate for Payer: Prime Health Services Commercial |
$4,180.30
|
| Rate for Payer: Prime Health Services Medicare |
$239.13
|
| Rate for Payer: Prime Health Services Medicare |
$239.13
|
| Rate for Payer: Riverside University Health System MISP |
$248.15
|
| Rate for Payer: Riverside University Health System MISP |
$248.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,656.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,950.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,656.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,950.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$769.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$769.25
|
| Rate for Payer: United Healthcare All Other HMO |
$769.25
|
| Rate for Payer: United Healthcare All Other HMO |
$769.25
|
| Rate for Payer: United Healthcare HMO Rider |
$769.25
|
| Rate for Payer: United Healthcare HMO Rider |
$769.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$769.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$769.25
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
|
|
HC CT CHEST W CONTRAST
|
Facility
|
IP
|
$4,918.00
|
|
|
Service Code
|
CPT 71260
|
| Hospital Charge Code |
909201913
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$983.60 |
| Max. Negotiated Rate |
$4,426.20 |
| Rate for Payer: Adventist Health Commercial |
$983.60
|
| Rate for Payer: Cash Price |
$2,213.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,934.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,442.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,967.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,967.20
|
| Rate for Payer: Galaxy Health WC |
$4,180.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,950.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,426.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,122.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,901.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$983.60
|
| Rate for Payer: Multiplan Commercial |
$3,688.50
|
| Rate for Payer: Networks By Design Commercial |
$3,196.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,180.30
|
|
