|
HC CAP NEWBORN MED 15IN PINK
|
Facility
|
IP
|
$481.40
|
|
| Hospital Charge Code |
901608013
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$96.28 |
| Max. Negotiated Rate |
$433.26 |
| Rate for Payer: Cash Price |
$216.63
|
| Rate for Payer: Central Health Plan Commercial |
$385.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.56
|
| Rate for Payer: Galaxy Health WC |
$409.19
|
| Rate for Payer: Global Benefits Group Commercial |
$288.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$433.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$321.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.28
|
| Rate for Payer: Multiplan Commercial |
$361.05
|
| Rate for Payer: Networks By Design Commercial |
$312.91
|
| Rate for Payer: Prime Health Services Commercial |
$409.19
|
|
|
HC CAP NEWBORN MED 15IN PINK
|
Facility
|
OP
|
$481.40
|
|
| Hospital Charge Code |
901608013
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$96.28 |
| Max. Negotiated Rate |
$433.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$292.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$409.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$264.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$264.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$233.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$284.41
|
| Rate for Payer: Blue Distinction Transplant |
$288.84
|
| Rate for Payer: Blue Shield of California Commercial |
$302.80
|
| Rate for Payer: Blue Shield of California EPN |
$235.40
|
| Rate for Payer: Cash Price |
$216.63
|
| Rate for Payer: Central Health Plan Commercial |
$385.12
|
| Rate for Payer: Cigna of CA HMO |
$308.10
|
| Rate for Payer: Cigna of CA PPO |
$356.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$409.19
|
| Rate for Payer: Dignity Health Media |
$409.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$409.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$192.56
|
| Rate for Payer: Galaxy Health WC |
$409.19
|
| Rate for Payer: Global Benefits Group Commercial |
$288.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$433.26
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$361.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$168.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$321.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.28
|
| Rate for Payer: Multiplan Commercial |
$361.05
|
| Rate for Payer: Networks By Design Commercial |
$312.91
|
| Rate for Payer: Prime Health Services Commercial |
$409.19
|
| Rate for Payer: Riverside University Health System MISP |
$192.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$288.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$288.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.70
|
| Rate for Payer: United Healthcare All Other HMO |
$240.70
|
| Rate for Payer: United Healthcare HMO Rider |
$240.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$409.19
|
| Rate for Payer: Vantage Medical Group Senior |
$409.19
|
|
|
HC CAPTOPRIL RENOGRAM
|
Facility
|
OP
|
$3,946.00
|
|
|
Service Code
|
CPT 78708
|
| Hospital Charge Code |
909301431
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$295.62 |
| Max. Negotiated Rate |
$3,551.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$675.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$679.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,013.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$742.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$675.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$930.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,331.30
|
| Rate for Payer: Blue Distinction Transplant |
$2,367.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,438.63
|
| Rate for Payer: Blue Shield of California EPN |
$1,917.76
|
| Rate for Payer: Caremore Medicare Advantage |
$675.33
|
| Rate for Payer: Cash Price |
$1,775.70
|
| Rate for Payer: Cash Price |
$1,775.70
|
| Rate for Payer: Central Health Plan Commercial |
$3,156.80
|
| Rate for Payer: Cigna of CA HMO |
$2,525.44
|
| Rate for Payer: Cigna of CA PPO |
$2,920.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,013.00
|
| Rate for Payer: Dignity Health Media |
$675.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$742.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$911.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$675.33
|
| Rate for Payer: EPIC Health Plan Transplant |
$675.33
|
| Rate for Payer: Galaxy Health WC |
$3,354.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,367.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,551.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,959.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,107.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,114.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$675.33
|
| Rate for Payer: InnovAge PACE Commercial |
$1,013.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,631.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$295.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$675.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$789.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$904.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$904.94
|
| Rate for Payer: Multiplan Commercial |
$2,959.50
|
| Rate for Payer: Networks By Design Commercial |
$2,564.90
|
| Rate for Payer: Prime Health Services Commercial |
$3,354.10
|
| Rate for Payer: Prime Health Services Medicare |
$715.85
|
| Rate for Payer: Riverside University Health System MISP |
$742.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,367.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,367.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$815.78
|
| Rate for Payer: United Healthcare All Other HMO |
$815.78
|
| Rate for Payer: United Healthcare HMO Rider |
$815.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$815.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,013.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$742.86
|
| Rate for Payer: Vantage Medical Group Senior |
$675.33
|
|
|
HC CAPTOPRIL RENOGRAM
|
Facility
|
IP
|
$3,946.00
|
|
|
Service Code
|
CPT 78708
|
| Hospital Charge Code |
909301431
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$789.20 |
| Max. Negotiated Rate |
$3,551.40 |
| Rate for Payer: Cash Price |
$1,775.70
|
| Rate for Payer: Central Health Plan Commercial |
$3,156.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,578.40
|
| Rate for Payer: Galaxy Health WC |
$3,354.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,367.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,551.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,631.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,503.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$789.20
|
| Rate for Payer: Multiplan Commercial |
$2,959.50
|
| Rate for Payer: Networks By Design Commercial |
$2,564.90
|
| Rate for Payer: Prime Health Services Commercial |
$3,354.10
|
|
|
HC CARBAMATES CONF & ID
|
Facility
|
OP
|
$225.00
|
|
|
Service Code
|
CPT 82482
|
| Hospital Charge Code |
900910513
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$202.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$9.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$56.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$55.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68.16
|
| Rate for Payer: Blue Distinction Transplant |
$135.00
|
| Rate for Payer: Blue Shield of California Commercial |
$139.05
|
| Rate for Payer: Blue Shield of California EPN |
$109.35
|
| Rate for Payer: Caremore Medicare Advantage |
$9.81
|
| Rate for Payer: Cash Price |
$101.25
|
| Rate for Payer: Cash Price |
$101.25
|
| Rate for Payer: Central Health Plan Commercial |
$180.00
|
| Rate for Payer: Cigna of CA HMO |
$144.00
|
| Rate for Payer: Cigna of CA PPO |
$166.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.72
|
| Rate for Payer: Dignity Health Media |
$9.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.24
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9.81
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.81
|
| Rate for Payer: Galaxy Health WC |
$191.25
|
| Rate for Payer: Global Benefits Group Commercial |
$135.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$202.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$168.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$16.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$16.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.81
|
| Rate for Payer: InnovAge PACE Commercial |
$14.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$150.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.15
|
| Rate for Payer: Multiplan Commercial |
$168.75
|
| Rate for Payer: Networks By Design Commercial |
$146.25
|
| Rate for Payer: Prime Health Services Commercial |
$191.25
|
| Rate for Payer: Prime Health Services Medicare |
$10.40
|
| Rate for Payer: Riverside University Health System MISP |
$10.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$135.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$135.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.95
|
| Rate for Payer: United Healthcare All Other HMO |
$7.95
|
| Rate for Payer: United Healthcare HMO Rider |
$7.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.79
|
| Rate for Payer: Vantage Medical Group Senior |
$9.81
|
|
|
HC CARBAMATES CONF & ID
|
Facility
|
IP
|
$271.00
|
|
|
Service Code
|
CPT 82482
|
| Hospital Charge Code |
900910513
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.20 |
| Max. Negotiated Rate |
$243.90 |
| Rate for Payer: Cash Price |
$121.95
|
| Rate for Payer: Central Health Plan Commercial |
$216.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$108.40
|
| Rate for Payer: Galaxy Health WC |
$230.35
|
| Rate for Payer: Global Benefits Group Commercial |
$162.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$243.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$180.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$103.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.20
|
| Rate for Payer: Multiplan Commercial |
$203.25
|
| Rate for Payer: Networks By Design Commercial |
$176.15
|
| Rate for Payer: Prime Health Services Commercial |
$230.35
|
|
|
HC CARBAMAZEPINE
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
CPT 80156
|
| Hospital Charge Code |
900910396
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$129.22 |
| Rate for Payer: Adventist Health Medi-Cal |
$14.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$106.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$105.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$129.22
|
| Rate for Payer: Blue Distinction Transplant |
$30.00
|
| Rate for Payer: Blue Shield of California Commercial |
$30.90
|
| Rate for Payer: Blue Shield of California EPN |
$24.30
|
| Rate for Payer: Caremore Medicare Advantage |
$14.57
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Central Health Plan Commercial |
$40.00
|
| Rate for Payer: Cigna of CA HMO |
$32.00
|
| Rate for Payer: Cigna of CA PPO |
$37.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.86
|
| Rate for Payer: Dignity Health Media |
$14.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.67
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14.57
|
| Rate for Payer: EPIC Health Plan Transplant |
$14.57
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$37.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$24.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.57
|
| Rate for Payer: InnovAge PACE Commercial |
$21.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.52
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
| Rate for Payer: Prime Health Services Medicare |
$15.44
|
| Rate for Payer: Riverside University Health System MISP |
$16.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.80
|
| Rate for Payer: United Healthcare All Other HMO |
$11.80
|
| Rate for Payer: United Healthcare HMO Rider |
$11.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.03
|
| Rate for Payer: Vantage Medical Group Senior |
$14.57
|
|
|
HC CARBAMAZEPINE
|
Facility
|
IP
|
$247.00
|
|
|
Service Code
|
CPT 80156
|
| Hospital Charge Code |
900910396
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.40 |
| Max. Negotiated Rate |
$222.30 |
| Rate for Payer: Cash Price |
$111.15
|
| Rate for Payer: Central Health Plan Commercial |
$197.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$98.80
|
| Rate for Payer: Galaxy Health WC |
$209.95
|
| Rate for Payer: Global Benefits Group Commercial |
$148.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$222.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$164.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.40
|
| Rate for Payer: Multiplan Commercial |
$185.25
|
| Rate for Payer: Networks By Design Commercial |
$160.55
|
| Rate for Payer: Prime Health Services Commercial |
$209.95
|
|
|
HC CARBA NP
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
900913010
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.30 |
| Max. Negotiated Rate |
$25.57 |
| Rate for Payer: Adventist Health Medi-Cal |
$4.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.57
|
| Rate for Payer: Blue Distinction Transplant |
$9.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9.27
|
| Rate for Payer: Blue Shield of California EPN |
$7.29
|
| Rate for Payer: Caremore Medicare Advantage |
$4.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Central Health Plan Commercial |
$12.00
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.12
|
| Rate for Payer: Dignity Health Media |
$4.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4.75
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.75
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.75
|
| Rate for Payer: InnovAge PACE Commercial |
$7.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.36
|
| Rate for Payer: Multiplan Commercial |
$11.25
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Prime Health Services Medicare |
$5.04
|
| Rate for Payer: Riverside University Health System MISP |
$5.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.85
|
| Rate for Payer: United Healthcare All Other HMO |
$3.85
|
| Rate for Payer: United Healthcare HMO Rider |
$3.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Vantage Medical Group Senior |
$4.75
|
|
|
HC CARBA NP
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
900913010
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$20.70 |
| Rate for Payer: Cash Price |
$10.35
|
| Rate for Payer: Central Health Plan Commercial |
$18.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.20
|
| Rate for Payer: Galaxy Health WC |
$19.55
|
| Rate for Payer: Global Benefits Group Commercial |
$13.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.60
|
| Rate for Payer: Multiplan Commercial |
$17.25
|
| Rate for Payer: Networks By Design Commercial |
$14.95
|
| Rate for Payer: Prime Health Services Commercial |
$19.55
|
|
|
HC CARCINOEMBRYONIC ANTIGEN (CEA)
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
900910865
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$168.05 |
| Rate for Payer: Adventist Health Medi-Cal |
$18.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$139.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$137.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$168.05
|
| Rate for Payer: Blue Distinction Transplant |
$32.40
|
| Rate for Payer: Blue Shield of California Commercial |
$33.37
|
| Rate for Payer: Blue Shield of California EPN |
$26.24
|
| Rate for Payer: Caremore Medicare Advantage |
$18.96
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Central Health Plan Commercial |
$43.20
|
| Rate for Payer: Cigna of CA HMO |
$34.56
|
| Rate for Payer: Cigna of CA PPO |
$39.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.44
|
| Rate for Payer: Dignity Health Media |
$18.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.96
|
| Rate for Payer: Galaxy Health WC |
$45.90
|
| Rate for Payer: Global Benefits Group Commercial |
$32.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$48.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$40.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$31.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$31.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.96
|
| Rate for Payer: InnovAge PACE Commercial |
$28.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.41
|
| Rate for Payer: Multiplan Commercial |
$40.50
|
| Rate for Payer: Networks By Design Commercial |
$35.10
|
| Rate for Payer: Prime Health Services Commercial |
$45.90
|
| Rate for Payer: Prime Health Services Medicare |
$20.10
|
| Rate for Payer: Riverside University Health System MISP |
$20.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$32.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.35
|
| Rate for Payer: United Healthcare All Other HMO |
$15.35
|
| Rate for Payer: United Healthcare HMO Rider |
$15.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.86
|
| Rate for Payer: Vantage Medical Group Senior |
$18.96
|
|
|
HC CARCINOEMBRYONIC ANTIGEN (CEA)
|
Facility
|
IP
|
$406.00
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
900910865
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$81.20 |
| Max. Negotiated Rate |
$365.40 |
| Rate for Payer: Cash Price |
$182.70
|
| Rate for Payer: Central Health Plan Commercial |
$324.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$162.40
|
| Rate for Payer: Galaxy Health WC |
$345.10
|
| Rate for Payer: Global Benefits Group Commercial |
$243.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$365.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$270.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$154.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.20
|
| Rate for Payer: Multiplan Commercial |
$304.50
|
| Rate for Payer: Networks By Design Commercial |
$263.90
|
| Rate for Payer: Prime Health Services Commercial |
$345.10
|
|
|
HC CARDIAC ANGIO CONG HEART DZ
|
Facility
|
IP
|
$4,812.00
|
|
|
Service Code
|
CPT 75573
|
| Hospital Charge Code |
909201406
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$962.40 |
| Max. Negotiated Rate |
$4,330.80 |
| Rate for Payer: Cash Price |
$2,165.40
|
| Rate for Payer: Central Health Plan Commercial |
$3,849.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.80
|
| Rate for Payer: Galaxy Health WC |
$4,090.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,887.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,330.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,209.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,833.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$962.40
|
| Rate for Payer: Multiplan Commercial |
$3,609.00
|
| Rate for Payer: Networks By Design Commercial |
$3,127.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,090.20
|
|
|
HC CARDIAC ANGIO CONG HEART DZ
|
Facility
|
OP
|
$2,776.00
|
|
|
Service Code
|
CPT 75573
|
| Hospital Charge Code |
909201406
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$229.56 |
| Max. Negotiated Rate |
$2,498.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$229.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$344.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$252.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$229.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,411.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,640.06
|
| Rate for Payer: Blue Distinction Transplant |
$1,665.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1,715.57
|
| Rate for Payer: Blue Shield of California EPN |
$1,349.14
|
| Rate for Payer: Caremore Medicare Advantage |
$229.56
|
| Rate for Payer: Cash Price |
$1,249.20
|
| Rate for Payer: Cash Price |
$1,249.20
|
| Rate for Payer: Center for Health Promotion Commercial |
$255.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,220.80
|
| Rate for Payer: Cigna of CA HMO |
$1,776.64
|
| Rate for Payer: Cigna of CA PPO |
$2,054.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$344.34
|
| Rate for Payer: Dignity Health Media |
$229.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$252.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$229.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$229.56
|
| Rate for Payer: Galaxy Health WC |
$2,359.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,665.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,498.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,082.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$376.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$378.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$229.56
|
| Rate for Payer: InnovAge PACE Commercial |
$344.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,851.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$555.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$229.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$555.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$307.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$307.61
|
| Rate for Payer: Multiplan Commercial |
$2,082.00
|
| Rate for Payer: Networks By Design Commercial |
$1,804.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,359.60
|
| Rate for Payer: Prime Health Services Medicare |
$243.33
|
| Rate for Payer: Riverside University Health System MISP |
$252.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,665.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,665.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$669.92
|
| Rate for Payer: United Healthcare All Other HMO |
$669.92
|
| Rate for Payer: United Healthcare HMO Rider |
$669.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$669.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$344.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$252.52
|
| Rate for Payer: Vantage Medical Group Senior |
$229.56
|
|
|
HC CARDIAC ANGIO, STRUCTURE/MORPH
|
Facility
|
IP
|
$3,957.00
|
|
|
Service Code
|
CPT 75572
|
| Hospital Charge Code |
909201405
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$791.40 |
| Max. Negotiated Rate |
$3,561.30 |
| Rate for Payer: Cash Price |
$1,780.65
|
| Rate for Payer: Central Health Plan Commercial |
$3,165.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,582.80
|
| Rate for Payer: Galaxy Health WC |
$3,363.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,374.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,561.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,639.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,507.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$791.40
|
| Rate for Payer: Multiplan Commercial |
$2,967.75
|
| Rate for Payer: Networks By Design Commercial |
$2,572.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,363.45
|
|
|
HC CARDIAC ANGIO, STRUCTURE/MORPH
|
Facility
|
OP
|
$2,776.00
|
|
|
Service Code
|
CPT 75572
|
| Hospital Charge Code |
909201405
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$229.56 |
| Max. Negotiated Rate |
$2,498.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$229.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$344.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$252.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$229.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$995.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,640.06
|
| Rate for Payer: Blue Distinction Transplant |
$1,665.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1,715.57
|
| Rate for Payer: Blue Shield of California EPN |
$1,349.14
|
| Rate for Payer: Caremore Medicare Advantage |
$229.56
|
| Rate for Payer: Cash Price |
$1,249.20
|
| Rate for Payer: Cash Price |
$1,249.20
|
| Rate for Payer: Center for Health Promotion Commercial |
$255.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,220.80
|
| Rate for Payer: Cigna of CA HMO |
$1,776.64
|
| Rate for Payer: Cigna of CA PPO |
$2,054.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$344.34
|
| Rate for Payer: Dignity Health Media |
$229.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$252.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$229.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$229.56
|
| Rate for Payer: Galaxy Health WC |
$2,359.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,665.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,498.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,082.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$376.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$378.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$229.56
|
| Rate for Payer: InnovAge PACE Commercial |
$344.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,851.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$414.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$229.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$555.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$307.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$307.61
|
| Rate for Payer: Multiplan Commercial |
$2,082.00
|
| Rate for Payer: Networks By Design Commercial |
$1,804.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,359.60
|
| Rate for Payer: Prime Health Services Medicare |
$243.33
|
| Rate for Payer: Riverside University Health System MISP |
$252.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,665.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,665.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$669.92
|
| Rate for Payer: United Healthcare All Other HMO |
$669.92
|
| Rate for Payer: United Healthcare HMO Rider |
$669.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$669.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$344.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$252.52
|
| Rate for Payer: Vantage Medical Group Senior |
$229.56
|
|
|
HC CARDIAC MRI VELOCITY FLOW MAPPING
|
Facility
|
IP
|
$1,995.00
|
|
|
Service Code
|
CPT 75565
|
| Hospital Charge Code |
908875565
|
|
Hospital Revenue Code
|
614
|
| Min. Negotiated Rate |
$399.00 |
| Max. Negotiated Rate |
$1,795.50 |
| Rate for Payer: Cash Price |
$897.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,596.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$798.00
|
| Rate for Payer: Galaxy Health WC |
$1,695.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,197.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,795.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,330.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$760.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$399.00
|
| Rate for Payer: Multiplan Commercial |
$1,496.25
|
| Rate for Payer: Networks By Design Commercial |
$1,296.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,695.75
|
|
|
HC CARDIAC MRI VELOCITY FLOW MAPPING
|
Facility
|
OP
|
$1,995.00
|
|
|
Service Code
|
CPT 75565
|
| Hospital Charge Code |
908875565
|
|
Hospital Revenue Code
|
614
|
| Min. Negotiated Rate |
$86.94 |
| Max. Negotiated Rate |
$2,055.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,055.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,695.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,097.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,097.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$441.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,178.65
|
| Rate for Payer: Blue Distinction Transplant |
$1,197.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,232.91
|
| Rate for Payer: Blue Shield of California EPN |
$969.57
|
| Rate for Payer: Cash Price |
$897.75
|
| Rate for Payer: Cash Price |
$897.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,596.00
|
| Rate for Payer: Cigna of CA HMO |
$1,276.80
|
| Rate for Payer: Cigna of CA PPO |
$1,476.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,695.75
|
| Rate for Payer: Dignity Health Media |
$1,695.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,695.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$798.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$798.00
|
| Rate for Payer: Galaxy Health WC |
$1,695.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,197.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,795.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,496.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$698.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,330.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$86.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$399.00
|
| Rate for Payer: Multiplan Commercial |
$1,496.25
|
| Rate for Payer: Networks By Design Commercial |
$1,296.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,695.75
|
| Rate for Payer: Riverside University Health System MISP |
$798.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,197.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,197.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$997.50
|
| Rate for Payer: United Healthcare All Other HMO |
$997.50
|
| Rate for Payer: United Healthcare HMO Rider |
$997.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$997.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,695.75
|
| Rate for Payer: Vantage Medical Group Senior |
$1,695.75
|
|
|
HC CARDIAC REHAB W/MONITORING
|
Facility
|
IP
|
$599.00
|
|
|
Service Code
|
CPT 93798
|
| Hospital Charge Code |
900201853
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$119.80 |
| Max. Negotiated Rate |
$539.10 |
| Rate for Payer: Cash Price |
$269.55
|
| Rate for Payer: Central Health Plan Commercial |
$479.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$239.60
|
| Rate for Payer: Galaxy Health WC |
$509.15
|
| Rate for Payer: Global Benefits Group Commercial |
$359.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$539.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$399.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$228.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.80
|
| Rate for Payer: Multiplan Commercial |
$449.25
|
| Rate for Payer: Networks By Design Commercial |
$389.35
|
| Rate for Payer: Prime Health Services Commercial |
$509.15
|
|
|
HC CARDIAC REHAB W/MONITORING
|
Facility
|
OP
|
$599.00
|
|
|
Service Code
|
CPT 93798
|
| Hospital Charge Code |
900201853
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$42.28 |
| Max. Negotiated Rate |
$539.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$165.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$84.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$247.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$181.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$195.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$353.89
|
| Rate for Payer: Blue Distinction Transplant |
$359.40
|
| Rate for Payer: Blue Shield of California Commercial |
$376.77
|
| Rate for Payer: Blue Shield of California EPN |
$292.91
|
| Rate for Payer: Caremore Medicare Advantage |
$165.10
|
| Rate for Payer: Cash Price |
$269.55
|
| Rate for Payer: Cash Price |
$269.55
|
| Rate for Payer: Cash Price |
$269.55
|
| Rate for Payer: Central Health Plan Commercial |
$479.20
|
| Rate for Payer: Cigna of CA HMO |
$383.36
|
| Rate for Payer: Cigna of CA PPO |
$443.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$247.65
|
| Rate for Payer: Dignity Health Media |
$165.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$181.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$222.88
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$165.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$165.10
|
| Rate for Payer: Galaxy Health WC |
$509.15
|
| Rate for Payer: Global Benefits Group Commercial |
$359.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$539.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$449.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$270.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$272.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$165.10
|
| Rate for Payer: InnovAge PACE Commercial |
$247.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$399.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$165.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$221.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$221.23
|
| Rate for Payer: Multiplan Commercial |
$449.25
|
| Rate for Payer: Networks By Design Commercial |
$389.35
|
| Rate for Payer: Prime Health Services Commercial |
$509.15
|
| Rate for Payer: Prime Health Services Medicare |
$175.01
|
| Rate for Payer: Riverside University Health System MISP |
$181.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$359.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$198.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$467.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$247.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$181.61
|
| Rate for Payer: Vantage Medical Group Senior |
$165.10
|
|
|
HC CARDIAC REHAB W/O MONITORING
|
Facility
|
OP
|
$532.00
|
|
|
Service Code
|
CPT 93797
|
| Hospital Charge Code |
900201854
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$27.47 |
| Max. Negotiated Rate |
$478.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$165.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$54.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$247.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$181.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$123.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$314.31
|
| Rate for Payer: Blue Distinction Transplant |
$319.20
|
| Rate for Payer: Blue Shield of California Commercial |
$334.63
|
| Rate for Payer: Blue Shield of California EPN |
$260.15
|
| Rate for Payer: Caremore Medicare Advantage |
$165.10
|
| Rate for Payer: Cash Price |
$239.40
|
| Rate for Payer: Cash Price |
$239.40
|
| Rate for Payer: Cash Price |
$239.40
|
| Rate for Payer: Central Health Plan Commercial |
$425.60
|
| Rate for Payer: Cigna of CA HMO |
$340.48
|
| Rate for Payer: Cigna of CA PPO |
$393.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$247.65
|
| Rate for Payer: Dignity Health Media |
$165.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$181.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$222.88
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$165.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$165.10
|
| Rate for Payer: Galaxy Health WC |
$452.20
|
| Rate for Payer: Global Benefits Group Commercial |
$319.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$478.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$399.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$270.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$272.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$165.10
|
| Rate for Payer: InnovAge PACE Commercial |
$247.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$354.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$165.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$106.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$221.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$221.23
|
| Rate for Payer: Multiplan Commercial |
$399.00
|
| Rate for Payer: Networks By Design Commercial |
$345.80
|
| Rate for Payer: Prime Health Services Commercial |
$452.20
|
| Rate for Payer: Prime Health Services Medicare |
$175.01
|
| Rate for Payer: Riverside University Health System MISP |
$181.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$319.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$198.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$467.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$247.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$181.61
|
| Rate for Payer: Vantage Medical Group Senior |
$165.10
|
|
|
HC CARDIAC REHAB W/O MONITORING
|
Facility
|
IP
|
$532.00
|
|
|
Service Code
|
CPT 93797
|
| Hospital Charge Code |
900201854
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$106.40 |
| Max. Negotiated Rate |
$478.80 |
| Rate for Payer: Cash Price |
$239.40
|
| Rate for Payer: Central Health Plan Commercial |
$425.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$212.80
|
| Rate for Payer: Galaxy Health WC |
$452.20
|
| Rate for Payer: Global Benefits Group Commercial |
$319.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$478.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$354.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$202.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$106.40
|
| Rate for Payer: Multiplan Commercial |
$399.00
|
| Rate for Payer: Networks By Design Commercial |
$345.80
|
| Rate for Payer: Prime Health Services Commercial |
$452.20
|
|
|
HC CARDIAC STRESS TEST
|
Facility
|
IP
|
$3,288.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
900802004
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$657.60 |
| Max. Negotiated Rate |
$2,959.20 |
| Rate for Payer: Cash Price |
$1,479.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,630.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,315.20
|
| Rate for Payer: Galaxy Health WC |
$2,794.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,972.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,959.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,193.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,252.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$657.60
|
| Rate for Payer: Multiplan Commercial |
$2,466.00
|
| Rate for Payer: Networks By Design Commercial |
$2,137.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,794.80
|
|
|
HC CARDIAC STRESS TEST
|
Facility
|
OP
|
$3,288.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
900800405
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$99.75 |
| Max. Negotiated Rate |
$2,959.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$392.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$327.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$392.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$376.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,942.55
|
| Rate for Payer: Blue Distinction Transplant |
$1,972.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,031.98
|
| Rate for Payer: Blue Shield of California EPN |
$1,597.97
|
| Rate for Payer: Caremore Medicare Advantage |
$392.17
|
| Rate for Payer: Cash Price |
$1,479.60
|
| Rate for Payer: Cash Price |
$1,479.60
|
| Rate for Payer: Cash Price |
$1,479.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,630.40
|
| Rate for Payer: Cigna of CA HMO |
$2,104.32
|
| Rate for Payer: Cigna of CA PPO |
$2,433.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.26
|
| Rate for Payer: Dignity Health Media |
$392.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$529.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$392.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$392.17
|
| Rate for Payer: Galaxy Health WC |
$2,794.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,972.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,959.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,466.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$643.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$647.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$392.17
|
| Rate for Payer: InnovAge PACE Commercial |
$588.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,193.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$99.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$657.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$525.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$525.51
|
| Rate for Payer: Multiplan Commercial |
$2,466.00
|
| Rate for Payer: Networks By Design Commercial |
$2,137.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,794.80
|
| Rate for Payer: Prime Health Services Medicare |
$415.70
|
| Rate for Payer: Riverside University Health System MISP |
$431.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,972.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,972.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,320.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,304.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$975.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Vantage Medical Group Senior |
$392.17
|
|
|
HC CARDIAC STRESS TEST
|
Facility
|
IP
|
$3,288.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
900800405
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$657.60 |
| Max. Negotiated Rate |
$2,959.20 |
| Rate for Payer: Cash Price |
$1,479.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,630.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,315.20
|
| Rate for Payer: Galaxy Health WC |
$2,794.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,972.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,959.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,193.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,252.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$657.60
|
| Rate for Payer: Multiplan Commercial |
$2,466.00
|
| Rate for Payer: Networks By Design Commercial |
$2,137.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,794.80
|
|
