|
HC DVC NASAL SUCTION PREEMIE
|
Facility
|
IP
|
$19.02
|
|
| Hospital Charge Code |
901605138
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.80 |
| Max. Negotiated Rate |
$17.12 |
| Rate for Payer: Adventist Health Commercial |
$3.80
|
| Rate for Payer: Cash Price |
$8.56
|
| Rate for Payer: Central Health Plan Commercial |
$15.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.61
|
| Rate for Payer: EPIC Health Plan Senior |
$7.61
|
| Rate for Payer: Galaxy Health WC |
$16.17
|
| Rate for Payer: Global Benefits Group Commercial |
$11.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.80
|
| Rate for Payer: Multiplan Commercial |
$14.27
|
| Rate for Payer: Networks By Design Commercial |
$12.36
|
| Rate for Payer: Prime Health Services Commercial |
$16.17
|
|
|
HC DVC NASAL SUCTION STD W/COVER
|
Facility
|
IP
|
$25.34
|
|
| Hospital Charge Code |
901698481
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.07 |
| Max. Negotiated Rate |
$22.81 |
| Rate for Payer: Adventist Health Commercial |
$5.07
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Central Health Plan Commercial |
$20.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.14
|
| Rate for Payer: EPIC Health Plan Senior |
$10.14
|
| Rate for Payer: Galaxy Health WC |
$21.54
|
| Rate for Payer: Global Benefits Group Commercial |
$15.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.07
|
| Rate for Payer: Multiplan Commercial |
$19.00
|
| Rate for Payer: Networks By Design Commercial |
$16.47
|
| Rate for Payer: Prime Health Services Commercial |
$21.54
|
|
|
HC DVC NASAL SUCTION STD W/COVER
|
Facility
|
OP
|
$25.34
|
|
| Hospital Charge Code |
901698481
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.07 |
| Max. Negotiated Rate |
$22.81 |
| Rate for Payer: Adventist Health Commercial |
$5.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.88
|
| Rate for Payer: Blue Shield of California Commercial |
$15.48
|
| Rate for Payer: Blue Shield of California EPN |
$10.11
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Central Health Plan Commercial |
$20.27
|
| Rate for Payer: Cigna of CA HMO |
$16.22
|
| Rate for Payer: Cigna of CA PPO |
$18.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.14
|
| Rate for Payer: EPIC Health Plan Senior |
$10.14
|
| Rate for Payer: Galaxy Health WC |
$21.54
|
| Rate for Payer: Global Benefits Group Commercial |
$15.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.81
|
| Rate for Payer: InnovAge PACE Commercial |
$12.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.74
|
| Rate for Payer: Multiplan Commercial |
$19.00
|
| Rate for Payer: Networks By Design Commercial |
$16.47
|
| Rate for Payer: Prime Health Services Commercial |
$21.54
|
| Rate for Payer: Riverside University Health System MISP |
$10.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.67
|
| Rate for Payer: United Healthcare All Other HMO |
$12.67
|
| Rate for Payer: United Healthcare HMO Rider |
$12.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.54
|
| Rate for Payer: Vantage Medical Group Senior |
$21.54
|
|
|
HC DVC NASAL SUCTION STNDR
|
Facility
|
OP
|
$19.84
|
|
| Hospital Charge Code |
901605137
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.97 |
| Max. Negotiated Rate |
$17.86 |
| Rate for Payer: Adventist Health Commercial |
$3.97
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.65
|
| Rate for Payer: Blue Shield of California Commercial |
$12.12
|
| Rate for Payer: Blue Shield of California EPN |
$7.92
|
| Rate for Payer: Cash Price |
$8.93
|
| Rate for Payer: Central Health Plan Commercial |
$15.87
|
| Rate for Payer: Cigna of CA HMO |
$12.70
|
| Rate for Payer: Cigna of CA PPO |
$14.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.94
|
| Rate for Payer: EPIC Health Plan Senior |
$7.94
|
| Rate for Payer: Galaxy Health WC |
$16.86
|
| Rate for Payer: Global Benefits Group Commercial |
$11.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.86
|
| Rate for Payer: InnovAge PACE Commercial |
$9.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.89
|
| Rate for Payer: Multiplan Commercial |
$14.88
|
| Rate for Payer: Networks By Design Commercial |
$12.90
|
| Rate for Payer: Prime Health Services Commercial |
$16.86
|
| Rate for Payer: Riverside University Health System MISP |
$7.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.92
|
| Rate for Payer: United Healthcare All Other HMO |
$9.92
|
| Rate for Payer: United Healthcare HMO Rider |
$9.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.86
|
| Rate for Payer: Vantage Medical Group Senior |
$16.86
|
|
|
HC DVC NASAL SUCTION STNDR
|
Facility
|
IP
|
$19.84
|
|
| Hospital Charge Code |
901605137
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.97 |
| Max. Negotiated Rate |
$17.86 |
| Rate for Payer: Adventist Health Commercial |
$3.97
|
| Rate for Payer: Cash Price |
$8.93
|
| Rate for Payer: Central Health Plan Commercial |
$15.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.94
|
| Rate for Payer: EPIC Health Plan Senior |
$7.94
|
| Rate for Payer: Galaxy Health WC |
$16.86
|
| Rate for Payer: Global Benefits Group Commercial |
$11.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.97
|
| Rate for Payer: Multiplan Commercial |
$14.88
|
| Rate for Payer: Networks By Design Commercial |
$12.90
|
| Rate for Payer: Prime Health Services Commercial |
$16.86
|
|
|
HC DVC NASAL SUCTN PREEMIE W/CVR
|
Facility
|
OP
|
$25.34
|
|
| Hospital Charge Code |
901698482
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.07 |
| Max. Negotiated Rate |
$22.81 |
| Rate for Payer: Adventist Health Commercial |
$5.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.88
|
| Rate for Payer: Blue Shield of California Commercial |
$15.48
|
| Rate for Payer: Blue Shield of California EPN |
$10.11
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Central Health Plan Commercial |
$20.27
|
| Rate for Payer: Cigna of CA HMO |
$16.22
|
| Rate for Payer: Cigna of CA PPO |
$18.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.14
|
| Rate for Payer: EPIC Health Plan Senior |
$10.14
|
| Rate for Payer: Galaxy Health WC |
$21.54
|
| Rate for Payer: Global Benefits Group Commercial |
$15.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.81
|
| Rate for Payer: InnovAge PACE Commercial |
$12.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.74
|
| Rate for Payer: Multiplan Commercial |
$19.00
|
| Rate for Payer: Networks By Design Commercial |
$16.47
|
| Rate for Payer: Prime Health Services Commercial |
$21.54
|
| Rate for Payer: Riverside University Health System MISP |
$10.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.67
|
| Rate for Payer: United Healthcare All Other HMO |
$12.67
|
| Rate for Payer: United Healthcare HMO Rider |
$12.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.54
|
| Rate for Payer: Vantage Medical Group Senior |
$21.54
|
|
|
HC DVC NASAL SUCTN PREEMIE W/CVR
|
Facility
|
IP
|
$25.34
|
|
| Hospital Charge Code |
901698482
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.07 |
| Max. Negotiated Rate |
$22.81 |
| Rate for Payer: Adventist Health Commercial |
$5.07
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Central Health Plan Commercial |
$20.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.14
|
| Rate for Payer: EPIC Health Plan Senior |
$10.14
|
| Rate for Payer: Galaxy Health WC |
$21.54
|
| Rate for Payer: Global Benefits Group Commercial |
$15.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.07
|
| Rate for Payer: Multiplan Commercial |
$19.00
|
| Rate for Payer: Networks By Design Commercial |
$16.47
|
| Rate for Payer: Prime Health Services Commercial |
$21.54
|
|
|
HC DVC PELVIC ORTHOTIC TPOD
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT E0944 NU
|
| Hospital Charge Code |
901605152
|
|
Hospital Revenue Code
|
290
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC DVC PELVIC ORTHOTIC TPOD
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT E0944 NU
|
| Hospital Charge Code |
901605152
|
|
Hospital Revenue Code
|
290
|
| Min. Negotiated Rate |
$53.66 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$352.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$280.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$340.63
|
| Rate for Payer: Blue Shield of California Commercial |
$354.38
|
| Rate for Payer: Blue Shield of California EPN |
$231.42
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$53.66
|
| Rate for Payer: InnovAge PACE Commercial |
$290.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$59.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC DVC RESQPOD RESUSCITATOR
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
901605270
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC DVC RESQPOD RESUSCITATOR
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
901605270
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$352.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$280.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$340.63
|
| Rate for Payer: Blue Shield of California Commercial |
$354.38
|
| Rate for Payer: Blue Shield of California EPN |
$231.42
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: InnovAge PACE Commercial |
$290.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC DVC THORACENTESIS 8FR
|
Facility
|
OP
|
$295.40
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901600672
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$59.08 |
| Max. Negotiated Rate |
$265.86 |
| Rate for Payer: Adventist Health Commercial |
$59.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$251.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$162.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$221.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$134.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$163.56
|
| Rate for Payer: Blue Shield of California Commercial |
$228.34
|
| Rate for Payer: Blue Shield of California EPN |
$148.88
|
| Rate for Payer: Cash Price |
$132.93
|
| Rate for Payer: Central Health Plan Commercial |
$236.32
|
| Rate for Payer: Cigna of CA HMO |
$206.78
|
| Rate for Payer: Cigna of CA PPO |
$206.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$251.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$251.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$251.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$118.16
|
| Rate for Payer: EPIC Health Plan Senior |
$118.16
|
| Rate for Payer: Galaxy Health WC |
$251.09
|
| Rate for Payer: Global Benefits Group Commercial |
$177.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$265.86
|
| Rate for Payer: InnovAge PACE Commercial |
$147.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$197.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$112.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$182.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$206.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$206.78
|
| Rate for Payer: Multiplan Commercial |
$221.55
|
| Rate for Payer: Networks By Design Commercial |
$147.70
|
| Rate for Payer: Prime Health Services Commercial |
$251.09
|
| Rate for Payer: Riverside University Health System MISP |
$118.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$177.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$177.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$110.86
|
| Rate for Payer: United Healthcare All Other HMO |
$107.91
|
| Rate for Payer: United Healthcare HMO Rider |
$105.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$96.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$251.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$251.09
|
| Rate for Payer: Vantage Medical Group Senior |
$251.09
|
|
|
HC DVC THORACENTESIS 8FR
|
Facility
|
IP
|
$295.40
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901600672
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$59.08 |
| Max. Negotiated Rate |
$265.86 |
| Rate for Payer: Adventist Health Commercial |
$59.08
|
| Rate for Payer: Blue Shield of California Commercial |
$228.34
|
| Rate for Payer: Blue Shield of California EPN |
$148.88
|
| Rate for Payer: Cash Price |
$132.93
|
| Rate for Payer: Central Health Plan Commercial |
$236.32
|
| Rate for Payer: Cigna of CA HMO |
$206.78
|
| Rate for Payer: Cigna of CA PPO |
$206.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$118.16
|
| Rate for Payer: EPIC Health Plan Senior |
$118.16
|
| Rate for Payer: Galaxy Health WC |
$251.09
|
| Rate for Payer: Global Benefits Group Commercial |
$177.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$265.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$197.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$112.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$182.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.08
|
| Rate for Payer: Multiplan Commercial |
$221.55
|
| Rate for Payer: Networks By Design Commercial |
$147.70
|
| Rate for Payer: Prime Health Services Commercial |
$251.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$110.86
|
| Rate for Payer: United Healthcare All Other HMO |
$107.91
|
| Rate for Payer: United Healthcare HMO Rider |
$105.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$96.74
|
|
|
HC DVC TURN POSITION BARIATRIC TORTOISE
|
Facility
|
OP
|
$1,030.40
|
|
| Hospital Charge Code |
901606315
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$206.08 |
| Max. Negotiated Rate |
$927.36 |
| Rate for Payer: Adventist Health Commercial |
$206.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$625.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$875.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$566.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$772.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$498.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$605.15
|
| Rate for Payer: Blue Shield of California Commercial |
$629.57
|
| Rate for Payer: Blue Shield of California EPN |
$411.13
|
| Rate for Payer: Cash Price |
$463.68
|
| Rate for Payer: Central Health Plan Commercial |
$824.32
|
| Rate for Payer: Cigna of CA HMO |
$659.46
|
| Rate for Payer: Cigna of CA PPO |
$762.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$875.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$875.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$875.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.16
|
| Rate for Payer: EPIC Health Plan Senior |
$412.16
|
| Rate for Payer: Galaxy Health WC |
$875.84
|
| Rate for Payer: Global Benefits Group Commercial |
$618.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$927.36
|
| Rate for Payer: InnovAge PACE Commercial |
$515.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$687.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$392.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$637.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$206.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$721.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$721.28
|
| Rate for Payer: Multiplan Commercial |
$772.80
|
| Rate for Payer: Networks By Design Commercial |
$669.76
|
| Rate for Payer: Prime Health Services Commercial |
$875.84
|
| Rate for Payer: Riverside University Health System MISP |
$412.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$618.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$618.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$515.20
|
| Rate for Payer: United Healthcare All Other HMO |
$515.20
|
| Rate for Payer: United Healthcare HMO Rider |
$515.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$515.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$875.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$875.84
|
| Rate for Payer: Vantage Medical Group Senior |
$875.84
|
|
|
HC DVC TURN POSITION BARIATRIC TORTOISE
|
Facility
|
IP
|
$1,030.40
|
|
| Hospital Charge Code |
901606315
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$206.08 |
| Max. Negotiated Rate |
$927.36 |
| Rate for Payer: Adventist Health Commercial |
$206.08
|
| Rate for Payer: Cash Price |
$463.68
|
| Rate for Payer: Central Health Plan Commercial |
$824.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.16
|
| Rate for Payer: EPIC Health Plan Senior |
$412.16
|
| Rate for Payer: Galaxy Health WC |
$875.84
|
| Rate for Payer: Global Benefits Group Commercial |
$618.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$927.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$687.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$392.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$637.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$206.08
|
| Rate for Payer: Multiplan Commercial |
$772.80
|
| Rate for Payer: Networks By Design Commercial |
$669.76
|
| Rate for Payer: Prime Health Services Commercial |
$875.84
|
|
|
HC DVLP COG SKILL 15 MIN OT MCARE
|
Facility
|
OP
|
$124.00
|
|
|
Service Code
|
CPT G0515
|
| Hospital Charge Code |
905104369
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$47.24 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$50.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$75.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$105.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$93.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Central Health Plan Commercial |
$99.20
|
| Rate for Payer: Cigna of CA HMO |
$79.36
|
| Rate for Payer: Cigna of CA PPO |
$91.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$105.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$105.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$105.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.60
|
| Rate for Payer: EPIC Health Plan Senior |
$49.60
|
| Rate for Payer: Galaxy Health WC |
$105.40
|
| Rate for Payer: Global Benefits Group Commercial |
$74.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$111.60
|
| Rate for Payer: InnovAge PACE Commercial |
$62.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$82.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$86.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$86.80
|
| Rate for Payer: Multiplan Commercial |
$93.00
|
| Rate for Payer: Networks By Design Commercial |
$80.60
|
| Rate for Payer: Prime Health Services Commercial |
$105.40
|
| Rate for Payer: Riverside University Health System MISP |
$49.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$74.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$74.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$105.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$105.40
|
| Rate for Payer: Vantage Medical Group Senior |
$105.40
|
|
|
HC DVLP COG SKILL 15 MIN OT MCARE
|
Facility
|
IP
|
$124.00
|
|
|
Service Code
|
CPT G0515
|
| Hospital Charge Code |
905104369
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$24.80 |
| Max. Negotiated Rate |
$111.60 |
| Rate for Payer: Adventist Health Commercial |
$24.80
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Central Health Plan Commercial |
$99.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.60
|
| Rate for Payer: EPIC Health Plan Senior |
$49.60
|
| Rate for Payer: Galaxy Health WC |
$105.40
|
| Rate for Payer: Global Benefits Group Commercial |
$74.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$111.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$82.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.80
|
| Rate for Payer: Multiplan Commercial |
$93.00
|
| Rate for Payer: Networks By Design Commercial |
$80.60
|
| Rate for Payer: Prime Health Services Commercial |
$105.40
|
|
|
HC DVLP COG SKILL 15 MIN PT MCARE
|
Facility
|
IP
|
$124.00
|
|
|
Service Code
|
CPT G0515
|
| Hospital Charge Code |
905103369
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$24.80 |
| Max. Negotiated Rate |
$111.60 |
| Rate for Payer: Adventist Health Commercial |
$24.80
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Central Health Plan Commercial |
$99.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.60
|
| Rate for Payer: EPIC Health Plan Senior |
$49.60
|
| Rate for Payer: Galaxy Health WC |
$105.40
|
| Rate for Payer: Global Benefits Group Commercial |
$74.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$111.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$82.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.80
|
| Rate for Payer: Multiplan Commercial |
$93.00
|
| Rate for Payer: Networks By Design Commercial |
$80.60
|
| Rate for Payer: Prime Health Services Commercial |
$105.40
|
|
|
HC DVLP COG SKILL 15 MIN PT MCARE
|
Facility
|
OP
|
$124.00
|
|
|
Service Code
|
CPT G0515
|
| Hospital Charge Code |
905103369
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$47.24 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$50.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$75.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$105.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$93.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Central Health Plan Commercial |
$99.20
|
| Rate for Payer: Cigna of CA HMO |
$79.36
|
| Rate for Payer: Cigna of CA PPO |
$91.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$105.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$105.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$105.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.60
|
| Rate for Payer: EPIC Health Plan Senior |
$49.60
|
| Rate for Payer: Galaxy Health WC |
$105.40
|
| Rate for Payer: Global Benefits Group Commercial |
$74.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$111.60
|
| Rate for Payer: InnovAge PACE Commercial |
$62.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$82.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$86.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$86.80
|
| Rate for Payer: Multiplan Commercial |
$93.00
|
| Rate for Payer: Networks By Design Commercial |
$80.60
|
| Rate for Payer: Prime Health Services Commercial |
$105.40
|
| Rate for Payer: Riverside University Health System MISP |
$49.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$74.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$74.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$105.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$105.40
|
| Rate for Payer: Vantage Medical Group Senior |
$105.40
|
|
|
HC DVLP COG SKILL 15 MIN ST MCARE
|
Facility
|
OP
|
$124.00
|
|
|
Service Code
|
CPT G0515
|
| Hospital Charge Code |
905601809
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$47.24 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$50.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$75.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$105.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$93.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Central Health Plan Commercial |
$99.20
|
| Rate for Payer: Cigna of CA HMO |
$79.36
|
| Rate for Payer: Cigna of CA PPO |
$91.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$105.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$105.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$105.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.60
|
| Rate for Payer: EPIC Health Plan Senior |
$49.60
|
| Rate for Payer: Galaxy Health WC |
$105.40
|
| Rate for Payer: Global Benefits Group Commercial |
$74.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$111.60
|
| Rate for Payer: InnovAge PACE Commercial |
$62.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$82.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$86.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$86.80
|
| Rate for Payer: Multiplan Commercial |
$93.00
|
| Rate for Payer: Networks By Design Commercial |
$80.60
|
| Rate for Payer: Prime Health Services Commercial |
$105.40
|
| Rate for Payer: Riverside University Health System MISP |
$49.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$74.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$74.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$105.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$105.40
|
| Rate for Payer: Vantage Medical Group Senior |
$105.40
|
|
|
HC DVLP COG SKILL 15 MIN ST MCARE
|
Facility
|
IP
|
$124.00
|
|
|
Service Code
|
CPT G0515
|
| Hospital Charge Code |
905601809
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$24.80 |
| Max. Negotiated Rate |
$111.60 |
| Rate for Payer: Adventist Health Commercial |
$24.80
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Central Health Plan Commercial |
$99.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.60
|
| Rate for Payer: EPIC Health Plan Senior |
$49.60
|
| Rate for Payer: Galaxy Health WC |
$105.40
|
| Rate for Payer: Global Benefits Group Commercial |
$74.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$111.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$82.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.80
|
| Rate for Payer: Multiplan Commercial |
$93.00
|
| Rate for Payer: Networks By Design Commercial |
$80.60
|
| Rate for Payer: Prime Health Services Commercial |
$105.40
|
|
|
HC DVLP TEST PHYS/QHP PT 1ST HR
|
Facility
|
OP
|
$1,370.00
|
|
|
Service Code
|
CPT 96112
|
| Hospital Charge Code |
900400020
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$198.80 |
| Max. Negotiated Rate |
$1,233.00 |
| Rate for Payer: Adventist Health Commercial |
$561.70
|
| Rate for Payer: Adventist Health Medi-Cal |
$198.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$832.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$198.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$616.50
|
| Rate for Payer: Cash Price |
$616.50
|
| Rate for Payer: Cash Price |
$616.50
|
| Rate for Payer: Cash Price |
$616.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,096.00
|
| Rate for Payer: Cigna of CA HMO |
$876.80
|
| Rate for Payer: Cigna of CA PPO |
$1,013.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$298.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$218.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$198.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$268.38
|
| Rate for Payer: EPIC Health Plan Senior |
$198.80
|
| Rate for Payer: Galaxy Health WC |
$1,164.50
|
| Rate for Payer: Global Benefits Group Commercial |
$822.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,233.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$326.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$200.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$198.80
|
| Rate for Payer: InnovAge PACE Commercial |
$298.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$913.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$221.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$198.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$561.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$266.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$266.39
|
| Rate for Payer: Multiplan Commercial |
$1,027.50
|
| Rate for Payer: Networks By Design Commercial |
$890.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$198.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,164.50
|
| Rate for Payer: Prime Health Services Medicare |
$210.73
|
| Rate for Payer: Riverside University Health System MISP |
$218.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$822.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$238.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$198.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Vantage Medical Group Senior |
$198.80
|
|
|
HC DVLP TEST PHYS/QHP PT 1ST HR
|
Facility
|
IP
|
$1,370.00
|
|
|
Service Code
|
CPT 96112
|
| Hospital Charge Code |
900400020
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$274.00 |
| Max. Negotiated Rate |
$1,233.00 |
| Rate for Payer: Adventist Health Commercial |
$274.00
|
| Rate for Payer: Cash Price |
$616.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,096.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$548.00
|
| Rate for Payer: EPIC Health Plan Senior |
$548.00
|
| Rate for Payer: Galaxy Health WC |
$1,164.50
|
| Rate for Payer: Global Benefits Group Commercial |
$822.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,233.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$913.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$521.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$848.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$274.00
|
| Rate for Payer: Multiplan Commercial |
$1,027.50
|
| Rate for Payer: Networks By Design Commercial |
$890.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,164.50
|
|
|
HC DVLP TEST PHYS/QHP ST 1ST HR
|
Facility
|
OP
|
$1,370.00
|
|
|
Service Code
|
CPT 96112
|
| Hospital Charge Code |
905601811
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$198.80 |
| Max. Negotiated Rate |
$1,233.00 |
| Rate for Payer: Adventist Health Commercial |
$561.70
|
| Rate for Payer: Adventist Health Medi-Cal |
$198.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$832.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$198.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$616.50
|
| Rate for Payer: Cash Price |
$616.50
|
| Rate for Payer: Cash Price |
$616.50
|
| Rate for Payer: Cash Price |
$616.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,096.00
|
| Rate for Payer: Cigna of CA HMO |
$876.80
|
| Rate for Payer: Cigna of CA PPO |
$1,013.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$298.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$218.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$198.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$268.38
|
| Rate for Payer: EPIC Health Plan Senior |
$198.80
|
| Rate for Payer: Galaxy Health WC |
$1,164.50
|
| Rate for Payer: Global Benefits Group Commercial |
$822.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,233.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$326.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$200.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$198.80
|
| Rate for Payer: InnovAge PACE Commercial |
$298.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$913.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$221.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$198.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$561.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$266.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$266.39
|
| Rate for Payer: Multiplan Commercial |
$1,027.50
|
| Rate for Payer: Networks By Design Commercial |
$890.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$198.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,164.50
|
| Rate for Payer: Prime Health Services Medicare |
$210.73
|
| Rate for Payer: Riverside University Health System MISP |
$218.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$822.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$238.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$198.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Vantage Medical Group Senior |
$198.80
|
|
|
HC DVLP TEST PHYS/QHP ST 1ST HR
|
Facility
|
IP
|
$1,370.00
|
|
|
Service Code
|
CPT 96112
|
| Hospital Charge Code |
905601811
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$274.00 |
| Max. Negotiated Rate |
$1,233.00 |
| Rate for Payer: Adventist Health Commercial |
$274.00
|
| Rate for Payer: Cash Price |
$616.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,096.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$548.00
|
| Rate for Payer: EPIC Health Plan Senior |
$548.00
|
| Rate for Payer: Galaxy Health WC |
$1,164.50
|
| Rate for Payer: Global Benefits Group Commercial |
$822.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,233.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$913.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$521.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$848.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$274.00
|
| Rate for Payer: Multiplan Commercial |
$1,027.50
|
| Rate for Payer: Networks By Design Commercial |
$890.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,164.50
|
|
