|
HC CARDIAC STRESS TEST
|
Facility
|
IP
|
$3,288.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
906811397
|
|
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 |
906811397
|
|
Hospital Revenue Code
|
460
|
| 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 |
$725.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$696.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$636.00
|
| 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
|
OP
|
$3,288.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
906811397
|
|
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 |
906811397
|
|
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
|
|
|
HC CARDIAC STRESS TEST
|
Facility
|
OP
|
$3,288.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
900802004
|
|
Hospital Revenue Code
|
460
|
| 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 |
$725.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$696.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$636.00
|
| 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 CARDIOLIPIN AB EAC IG CLASS
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
900913559
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$186.71 |
| Rate for Payer: Adventist Health Medi-Cal |
$25.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$186.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$38.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$105.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$128.14
|
| 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 |
$25.45
|
| 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 |
$38.18
|
| Rate for Payer: Dignity Health Media |
$25.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25.45
|
| Rate for Payer: EPIC Health Plan Transplant |
$25.45
|
| 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 |
$41.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$41.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25.45
|
| Rate for Payer: InnovAge PACE Commercial |
$38.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.10
|
| 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 |
$26.98
|
| Rate for Payer: Riverside University Health System MISP |
$28.00
|
| 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 |
$20.62
|
| Rate for Payer: United Healthcare All Other HMO |
$20.62
|
| Rate for Payer: United Healthcare HMO Rider |
$20.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$38.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.00
|
| Rate for Payer: Vantage Medical Group Senior |
$25.45
|
|
|
HC CARDIOLIPIN AB EAC IG CLASS
|
Facility
|
IP
|
$192.00
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
900913559
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$38.40 |
| Max. Negotiated Rate |
$172.80 |
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Central Health Plan Commercial |
$153.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$76.80
|
| Rate for Payer: Galaxy Health WC |
$163.20
|
| Rate for Payer: Global Benefits Group Commercial |
$115.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$172.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$128.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$73.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.40
|
| Rate for Payer: Multiplan Commercial |
$144.00
|
| Rate for Payer: Networks By Design Commercial |
$124.80
|
| Rate for Payer: Prime Health Services Commercial |
$163.20
|
|
|
HC CARDIOLITE PERFUSION SCAN
|
Facility
|
IP
|
$3,393.00
|
|
|
Service Code
|
CPT 78451
|
| Hospital Charge Code |
909301560
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$678.60 |
| Max. Negotiated Rate |
$3,053.70 |
| Rate for Payer: Cash Price |
$1,526.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,714.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,357.20
|
| Rate for Payer: Galaxy Health WC |
$2,884.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,035.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,053.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,263.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,292.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$678.60
|
| Rate for Payer: Multiplan Commercial |
$2,544.75
|
| Rate for Payer: Networks By Design Commercial |
$2,205.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,884.05
|
|
|
HC CARDIOLITE PERFUSION SCAN
|
Facility
|
OP
|
$3,393.00
|
|
|
Service Code
|
CPT 78451
|
| Hospital Charge Code |
909301560
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$383.67 |
| Max. Negotiated Rate |
$3,053.70 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,774.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,544.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,661.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,951.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,774.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$870.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,004.58
|
| Rate for Payer: Blue Distinction Transplant |
$2,035.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,096.87
|
| Rate for Payer: Blue Shield of California EPN |
$1,649.00
|
| Rate for Payer: Caremore Medicare Advantage |
$1,774.15
|
| Rate for Payer: Cash Price |
$1,526.85
|
| Rate for Payer: Cash Price |
$1,526.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,714.40
|
| Rate for Payer: Cigna of CA HMO |
$2,171.52
|
| Rate for Payer: Cigna of CA PPO |
$2,510.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,661.22
|
| Rate for Payer: Dignity Health Media |
$1,774.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,951.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,395.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,774.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,774.15
|
| Rate for Payer: Galaxy Health WC |
$2,884.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,035.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,053.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,544.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,909.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,927.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,774.15
|
| Rate for Payer: InnovAge PACE Commercial |
$2,661.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,263.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$383.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,774.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$678.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,377.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,377.36
|
| Rate for Payer: Multiplan Commercial |
$2,544.75
|
| Rate for Payer: Networks By Design Commercial |
$2,205.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,884.05
|
| Rate for Payer: Prime Health Services Medicare |
$1,880.60
|
| Rate for Payer: Riverside University Health System MISP |
$1,951.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,035.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,035.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,721.55
|
| Rate for Payer: United Healthcare All Other HMO |
$1,721.55
|
| Rate for Payer: United Healthcare HMO Rider |
$1,721.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,721.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,661.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,951.56
|
| Rate for Payer: Vantage Medical Group Senior |
$1,774.15
|
|
|
HC CARDIOLITE PERFUSION SCAN 1 DY
|
Facility
|
OP
|
$6,668.00
|
|
|
Service Code
|
CPT 78452
|
| Hospital Charge Code |
909301562
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$661.43 |
| Max. Negotiated Rate |
$6,001.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,774.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,244.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,661.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,951.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,774.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,514.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,939.45
|
| Rate for Payer: Blue Distinction Transplant |
$4,000.80
|
| Rate for Payer: Blue Shield of California Commercial |
$4,120.82
|
| Rate for Payer: Blue Shield of California EPN |
$3,240.65
|
| Rate for Payer: Caremore Medicare Advantage |
$1,774.15
|
| Rate for Payer: Cash Price |
$3,000.60
|
| Rate for Payer: Cash Price |
$3,000.60
|
| Rate for Payer: Central Health Plan Commercial |
$5,334.40
|
| Rate for Payer: Cigna of CA HMO |
$4,267.52
|
| Rate for Payer: Cigna of CA PPO |
$4,934.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,661.22
|
| Rate for Payer: Dignity Health Media |
$1,774.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,951.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,395.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,774.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,774.15
|
| Rate for Payer: Galaxy Health WC |
$5,667.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,000.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,001.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,001.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,909.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,927.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,774.15
|
| Rate for Payer: InnovAge PACE Commercial |
$2,661.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,447.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$661.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,774.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,333.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,377.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,377.36
|
| Rate for Payer: Multiplan Commercial |
$5,001.00
|
| Rate for Payer: Networks By Design Commercial |
$4,334.20
|
| Rate for Payer: Prime Health Services Commercial |
$5,667.80
|
| Rate for Payer: Prime Health Services Medicare |
$1,880.60
|
| Rate for Payer: Riverside University Health System MISP |
$1,951.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,000.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,000.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,721.55
|
| Rate for Payer: United Healthcare All Other HMO |
$1,721.55
|
| Rate for Payer: United Healthcare HMO Rider |
$1,721.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,721.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,661.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,951.56
|
| Rate for Payer: Vantage Medical Group Senior |
$1,774.15
|
|
|
HC CARDIOLITE PERFUSION SCAN 1 DY
|
Facility
|
IP
|
$6,668.00
|
|
|
Service Code
|
CPT 78452
|
| Hospital Charge Code |
909301562
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,333.60 |
| Max. Negotiated Rate |
$6,001.20 |
| Rate for Payer: Cash Price |
$3,000.60
|
| Rate for Payer: Central Health Plan Commercial |
$5,334.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,667.20
|
| Rate for Payer: Galaxy Health WC |
$5,667.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,000.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,001.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,447.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,540.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,333.60
|
| Rate for Payer: Multiplan Commercial |
$5,001.00
|
| Rate for Payer: Networks By Design Commercial |
$4,334.20
|
| Rate for Payer: Prime Health Services Commercial |
$5,667.80
|
|
|
HC CARDIOPULMONARY MAINTENANCE CL
|
Facility
|
OP
|
$17.00
|
|
| Hospital Charge Code |
900201842
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$467.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$10.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.04
|
| Rate for Payer: Blue Distinction Transplant |
$10.20
|
| Rate for Payer: Blue Shield of California Commercial |
$10.69
|
| Rate for Payer: Blue Shield of California EPN |
$8.31
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Central Health Plan Commercial |
$13.60
|
| Rate for Payer: Cigna of CA HMO |
$10.88
|
| Rate for Payer: Cigna of CA PPO |
$12.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.45
|
| Rate for Payer: Dignity Health Media |
$14.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.80
|
| Rate for Payer: Galaxy Health WC |
$14.45
|
| Rate for Payer: Global Benefits Group Commercial |
$10.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$12.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.40
|
| Rate for Payer: Multiplan Commercial |
$12.75
|
| Rate for Payer: Networks By Design Commercial |
$11.05
|
| Rate for Payer: Prime Health Services Commercial |
$14.45
|
| Rate for Payer: Riverside University Health System MISP |
$6.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.20
|
| 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 Medi-Cal |
$14.45
|
| Rate for Payer: Vantage Medical Group Senior |
$14.45
|
|
|
HC CARDIOPULMONARY MAINTENANCE CL
|
Facility
|
IP
|
$17.00
|
|
| Hospital Charge Code |
900201842
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$15.30 |
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Central Health Plan Commercial |
$13.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.80
|
| Rate for Payer: Galaxy Health WC |
$14.45
|
| Rate for Payer: Global Benefits Group Commercial |
$10.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.40
|
| Rate for Payer: Multiplan Commercial |
$12.75
|
| Rate for Payer: Networks By Design Commercial |
$11.05
|
| Rate for Payer: Prime Health Services Commercial |
$14.45
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
OP
|
$4,170.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
900802005
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$218.50 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Adventist Health Medi-Cal |
$392.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$987.05
|
| 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,502.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$392.17
|
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,336.00
|
| Rate for Payer: Cigna of CA HMO |
$2,668.80
|
| Rate for Payer: Cigna of CA PPO |
$3,085.80
|
| 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 |
$3,544.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,502.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,753.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,127.50
|
| 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 |
$2,781.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$834.00
|
| 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 |
$3,127.50
|
| Rate for Payer: Networks By Design Commercial |
$2,710.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,544.50
|
| 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 |
$2,502.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,502.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| 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 CARDIOPULMONARY RESUSCITATION
|
Facility
|
IP
|
$4,170.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
900802005
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$834.00 |
| Max. Negotiated Rate |
$3,753.00 |
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,336.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,668.00
|
| Rate for Payer: Galaxy Health WC |
$3,544.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,502.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,753.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,781.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,588.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$834.00
|
| Rate for Payer: Multiplan Commercial |
$3,127.50
|
| Rate for Payer: Networks By Design Commercial |
$2,710.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,544.50
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
OP
|
$4,170.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906812198
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$218.50 |
| Max. Negotiated Rate |
$3,753.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$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 |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,502.00
|
| Rate for Payer: Caremore Medicare Advantage |
$392.17
|
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,336.00
|
| Rate for Payer: Cigna of CA PPO |
$3,085.80
|
| 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 |
$3,544.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,502.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,753.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,127.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$643.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| 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 |
$2,781.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$834.00
|
| 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 |
$3,127.50
|
| Rate for Payer: Networks By Design Commercial |
$2,710.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,544.50
|
| 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 |
$2,502.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,085.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,085.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,085.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,085.00
|
| 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 CARDIOPULMONARY RESUSCITATION
|
Facility
|
IP
|
$4,170.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906812198
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$834.00 |
| Max. Negotiated Rate |
$3,753.00 |
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,336.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,668.00
|
| Rate for Payer: Galaxy Health WC |
$3,544.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,502.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,753.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,781.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,588.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$834.00
|
| Rate for Payer: Multiplan Commercial |
$3,127.50
|
| Rate for Payer: Networks By Design Commercial |
$2,710.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,544.50
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
IP
|
$4,170.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906812198
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$834.00 |
| Max. Negotiated Rate |
$3,753.00 |
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,336.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,668.00
|
| Rate for Payer: Galaxy Health WC |
$3,544.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,502.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,753.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,781.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,588.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$834.00
|
| Rate for Payer: Multiplan Commercial |
$3,127.50
|
| Rate for Payer: Networks By Design Commercial |
$2,710.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,544.50
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
OP
|
$4,170.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906812198
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$218.50 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Adventist Health Medi-Cal |
$392.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$987.05
|
| 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,502.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$392.17
|
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,336.00
|
| Rate for Payer: Cigna of CA HMO |
$2,668.80
|
| Rate for Payer: Cigna of CA PPO |
$3,085.80
|
| 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 |
$3,544.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,502.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,753.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,127.50
|
| 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 |
$2,781.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$834.00
|
| 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 |
$3,127.50
|
| Rate for Payer: Networks By Design Commercial |
$2,710.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,544.50
|
| 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 |
$2,502.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,502.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| 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 CARDIOPULMONARY RESUSCITATION
|
Facility
|
OP
|
$4,170.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906820082
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$218.50 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Adventist Health Medi-Cal |
$392.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$987.05
|
| 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,502.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$392.17
|
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,336.00
|
| Rate for Payer: Cigna of CA PPO |
$3,085.80
|
| 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 |
$3,544.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,502.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,753.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,127.50
|
| 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 |
$2,781.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$834.00
|
| 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 |
$3,127.50
|
| Rate for Payer: Networks By Design Commercial |
$2,710.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,544.50
|
| 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 |
$2,502.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,502.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| 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 CARDIOPULMONARY RESUSCITATION
|
Facility
|
IP
|
$4,170.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906812198
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$834.00 |
| Max. Negotiated Rate |
$3,753.00 |
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,336.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,668.00
|
| Rate for Payer: Galaxy Health WC |
$3,544.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,502.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,753.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,781.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,588.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$834.00
|
| Rate for Payer: Multiplan Commercial |
$3,127.50
|
| Rate for Payer: Networks By Design Commercial |
$2,710.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,544.50
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
IP
|
$4,170.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906820082
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$834.00 |
| Max. Negotiated Rate |
$3,753.00 |
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,336.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,668.00
|
| Rate for Payer: Galaxy Health WC |
$3,544.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,502.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,753.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,781.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,588.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$834.00
|
| Rate for Payer: Multiplan Commercial |
$3,127.50
|
| Rate for Payer: Networks By Design Commercial |
$2,710.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,544.50
|
|
|
HC CARDIOPULMONARY RESUSCITATION
|
Facility
|
OP
|
$4,170.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906812198
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$218.50 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Adventist Health Medi-Cal |
$392.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$987.05
|
| 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,502.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$392.17
|
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,336.00
|
| Rate for Payer: Cigna of CA PPO |
$3,085.80
|
| 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 |
$3,544.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,502.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,753.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,127.50
|
| 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 |
$2,781.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$834.00
|
| 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 |
$3,127.50
|
| Rate for Payer: Networks By Design Commercial |
$2,710.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,544.50
|
| 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 |
$2,502.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,502.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| 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 CARDIOPULMONARY RESUSCITATION
|
Facility
|
OP
|
$4,170.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906812198
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$218.50 |
| Max. Negotiated Rate |
$3,753.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$392.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$987.05
|
| 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 |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,502.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,622.93
|
| Rate for Payer: Blue Shield of California EPN |
$2,039.13
|
| Rate for Payer: Caremore Medicare Advantage |
$392.17
|
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,336.00
|
| Rate for Payer: Cigna of CA HMO |
$2,668.80
|
| Rate for Payer: Cigna of CA PPO |
$3,085.80
|
| 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 |
$3,544.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,502.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,753.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,127.50
|
| 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 |
$2,781.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$834.00
|
| 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 |
$3,127.50
|
| Rate for Payer: Networks By Design Commercial |
$2,710.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,544.50
|
| 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 |
$2,502.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,502.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,085.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,085.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,085.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,085.00
|
| 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 CARDIOPULMONARY RESUSCITATION
|
Facility
|
IP
|
$4,170.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
906812198
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$834.00 |
| Max. Negotiated Rate |
$3,753.00 |
| Rate for Payer: Cash Price |
$1,876.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,336.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,668.00
|
| Rate for Payer: Galaxy Health WC |
$3,544.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,502.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,753.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,781.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,588.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$834.00
|
| Rate for Payer: Multiplan Commercial |
$3,127.50
|
| Rate for Payer: Networks By Design Commercial |
$2,710.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,544.50
|
|
