|
HC EBV PCR
|
Facility
|
IP
|
$277.00
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
900912315
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$55.40 |
| Max. Negotiated Rate |
$249.30 |
| Rate for Payer: Adventist Health Commercial |
$55.40
|
| Rate for Payer: Cash Price |
$152.35
|
| Rate for Payer: Central Health Plan Commercial |
$221.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$110.80
|
| Rate for Payer: EPIC Health Plan Senior |
$110.80
|
| Rate for Payer: Galaxy Health WC |
$235.45
|
| Rate for Payer: Global Benefits Group Commercial |
$166.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$249.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$184.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$105.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$171.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.40
|
| Rate for Payer: Multiplan Commercial |
$207.75
|
| Rate for Payer: Networks By Design Commercial |
$180.05
|
| Rate for Payer: Prime Health Services Commercial |
$235.45
|
|
|
HC EBV PCR
|
Facility
|
OP
|
$277.00
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
900912315
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$34.70 |
| Max. Negotiated Rate |
$249.30 |
| Rate for Payer: Adventist Health Commercial |
$55.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$42.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$168.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$64.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$47.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$188.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38.20
|
| Rate for Payer: Blue Shield of California Commercial |
$168.14
|
| Rate for Payer: Blue Shield of California EPN |
$109.97
|
| Rate for Payer: Cash Price |
$152.35
|
| Rate for Payer: Cash Price |
$152.35
|
| Rate for Payer: Central Health Plan Commercial |
$221.60
|
| Rate for Payer: Cigna of CA HMO |
$177.28
|
| Rate for Payer: Cigna of CA PPO |
$204.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$42.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.83
|
| Rate for Payer: EPIC Health Plan Senior |
$42.84
|
| Rate for Payer: Galaxy Health WC |
$235.45
|
| Rate for Payer: Global Benefits Group Commercial |
$166.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$249.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$70.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$65.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$42.84
|
| Rate for Payer: InnovAge PACE Commercial |
$64.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$184.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$72.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57.41
|
| Rate for Payer: Multiplan Commercial |
$207.75
|
| Rate for Payer: Networks By Design Commercial |
$180.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$42.84
|
| Rate for Payer: Prime Health Services Commercial |
$235.45
|
| Rate for Payer: Prime Health Services Medicare |
$45.41
|
| Rate for Payer: Riverside University Health System MISP |
$47.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$166.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$166.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$34.70
|
| Rate for Payer: United Healthcare All Other HMO |
$34.70
|
| Rate for Payer: United Healthcare HMO Rider |
$34.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34.70
|
| Rate for Payer: Upland Medical Group Pediatric |
$42.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$64.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.12
|
| Rate for Payer: Vantage Medical Group Senior |
$42.84
|
|
|
HC EBV-VCA IGG/IGM
|
Facility
|
IP
|
$76.00
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
900913535
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$68.40 |
| Rate for Payer: Adventist Health Commercial |
$15.20
|
| Rate for Payer: Cash Price |
$41.80
|
| Rate for Payer: Central Health Plan Commercial |
$60.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.40
|
| Rate for Payer: EPIC Health Plan Senior |
$30.40
|
| Rate for Payer: Galaxy Health WC |
$64.60
|
| Rate for Payer: Global Benefits Group Commercial |
$45.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$68.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.20
|
| Rate for Payer: Multiplan Commercial |
$57.00
|
| Rate for Payer: Networks By Design Commercial |
$49.40
|
| Rate for Payer: Prime Health Services Commercial |
$64.60
|
|
|
HC EBV-VCA IGG/IGM
|
Facility
|
OP
|
$76.00
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
900913535
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.70 |
| Max. Negotiated Rate |
$117.30 |
| Rate for Payer: Adventist Health Commercial |
$15.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$18.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$46.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$117.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.81
|
| Rate for Payer: Blue Shield of California Commercial |
$46.13
|
| Rate for Payer: Blue Shield of California EPN |
$30.17
|
| Rate for Payer: Cash Price |
$41.80
|
| Rate for Payer: Cash Price |
$41.80
|
| Rate for Payer: Central Health Plan Commercial |
$60.80
|
| Rate for Payer: Cigna of CA HMO |
$48.64
|
| Rate for Payer: Cigna of CA PPO |
$56.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.49
|
| Rate for Payer: EPIC Health Plan Senior |
$18.14
|
| Rate for Payer: Galaxy Health WC |
$64.60
|
| Rate for Payer: Global Benefits Group Commercial |
$45.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$68.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.14
|
| Rate for Payer: InnovAge PACE Commercial |
$27.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.31
|
| Rate for Payer: Multiplan Commercial |
$57.00
|
| Rate for Payer: Networks By Design Commercial |
$49.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$18.14
|
| Rate for Payer: Prime Health Services Commercial |
$64.60
|
| Rate for Payer: Prime Health Services Medicare |
$19.23
|
| Rate for Payer: Riverside University Health System MISP |
$19.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$45.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.70
|
| Rate for Payer: United Healthcare All Other HMO |
$14.70
|
| Rate for Payer: United Healthcare HMO Rider |
$14.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.70
|
| Rate for Payer: Upland Medical Group Pediatric |
$18.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.95
|
| Rate for Payer: Vantage Medical Group Senior |
$18.14
|
|
|
HC ECG 48 HR MONITOR-RECORDING
|
Facility
|
OP
|
$1,745.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
900200113
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$51.29 |
| Max. Negotiated Rate |
$1,570.50 |
| Rate for Payer: Adventist Health Commercial |
$349.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$163.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,059.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$316.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,024.84
|
| Rate for Payer: Blue Shield of California Commercial |
$1,059.21
|
| Rate for Payer: Blue Shield of California EPN |
$692.76
|
| Rate for Payer: Cash Price |
$959.75
|
| Rate for Payer: Cash Price |
$959.75
|
| Rate for Payer: Cash Price |
$959.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,396.00
|
| Rate for Payer: Cigna of CA HMO |
$1,116.80
|
| Rate for Payer: Cigna of CA PPO |
$1,291.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$1,483.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,047.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,570.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$51.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,163.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$349.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$1,308.75
|
| Rate for Payer: Networks By Design Commercial |
$1,134.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Prime Health Services Commercial |
$1,483.25
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,047.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,047.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,477.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,006.00
|
| Rate for Payer: United Healthcare HMO Rider |
$765.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$701.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC ECG 48 HR MONITOR-RECORDING
|
Facility
|
IP
|
$1,745.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
900200113
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$349.00 |
| Max. Negotiated Rate |
$1,570.50 |
| Rate for Payer: Adventist Health Commercial |
$349.00
|
| Rate for Payer: Cash Price |
$959.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,396.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$698.00
|
| Rate for Payer: EPIC Health Plan Senior |
$698.00
|
| Rate for Payer: Galaxy Health WC |
$1,483.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,047.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,570.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,163.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$664.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,080.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$349.00
|
| Rate for Payer: Multiplan Commercial |
$1,308.75
|
| Rate for Payer: Networks By Design Commercial |
$1,134.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,483.25
|
|
|
HC ECG 48 HR MONITOR-RECORDING EC
|
Facility
|
OP
|
$1,745.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
900100041
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$51.29 |
| Max. Negotiated Rate |
$1,570.50 |
| Rate for Payer: Adventist Health Commercial |
$349.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$163.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,059.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$316.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,024.84
|
| Rate for Payer: Blue Shield of California Commercial |
$1,059.21
|
| Rate for Payer: Blue Shield of California EPN |
$692.76
|
| Rate for Payer: Cash Price |
$959.75
|
| Rate for Payer: Cash Price |
$959.75
|
| Rate for Payer: Cash Price |
$959.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,396.00
|
| Rate for Payer: Cigna of CA HMO |
$1,116.80
|
| Rate for Payer: Cigna of CA PPO |
$1,291.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$1,483.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,047.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,570.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$51.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,163.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$349.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$1,308.75
|
| Rate for Payer: Networks By Design Commercial |
$1,134.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Prime Health Services Commercial |
$1,483.25
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,047.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,047.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,477.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,006.00
|
| Rate for Payer: United Healthcare HMO Rider |
$765.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$701.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC ECG 48 HR MONITOR-RECORDING EC
|
Facility
|
IP
|
$1,745.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
900100041
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$349.00 |
| Max. Negotiated Rate |
$1,570.50 |
| Rate for Payer: Adventist Health Commercial |
$349.00
|
| Rate for Payer: Cash Price |
$959.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,396.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$698.00
|
| Rate for Payer: EPIC Health Plan Senior |
$698.00
|
| Rate for Payer: Galaxy Health WC |
$1,483.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,047.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,570.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,163.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$664.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,080.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$349.00
|
| Rate for Payer: Multiplan Commercial |
$1,308.75
|
| Rate for Payer: Networks By Design Commercial |
$1,134.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,483.25
|
|
|
HC ECG 48 HR MONITOR-RECORDING HSH
|
Facility
|
OP
|
$1,745.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
900100042
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$51.29 |
| Max. Negotiated Rate |
$1,570.50 |
| Rate for Payer: Adventist Health Commercial |
$349.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$163.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,059.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$316.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,024.84
|
| Rate for Payer: Blue Shield of California Commercial |
$1,059.21
|
| Rate for Payer: Blue Shield of California EPN |
$692.76
|
| Rate for Payer: Cash Price |
$959.75
|
| Rate for Payer: Cash Price |
$959.75
|
| Rate for Payer: Cash Price |
$959.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,396.00
|
| Rate for Payer: Cigna of CA HMO |
$1,116.80
|
| Rate for Payer: Cigna of CA PPO |
$1,291.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$1,483.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,047.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,570.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$51.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,163.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$349.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$1,308.75
|
| Rate for Payer: Networks By Design Commercial |
$1,134.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Prime Health Services Commercial |
$1,483.25
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,047.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,047.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,477.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,006.00
|
| Rate for Payer: United Healthcare HMO Rider |
$765.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$701.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC ECG 48 HR MONITOR-RECORDING HSH
|
Facility
|
IP
|
$1,745.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
900100042
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$349.00 |
| Max. Negotiated Rate |
$1,570.50 |
| Rate for Payer: Adventist Health Commercial |
$349.00
|
| Rate for Payer: Cash Price |
$959.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,396.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$698.00
|
| Rate for Payer: EPIC Health Plan Senior |
$698.00
|
| Rate for Payer: Galaxy Health WC |
$1,483.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,047.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,570.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,163.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$664.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,080.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$349.00
|
| Rate for Payer: Multiplan Commercial |
$1,308.75
|
| Rate for Payer: Networks By Design Commercial |
$1,134.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,483.25
|
|
|
HC ECG 48 HR MONITOR-SCANNING
|
Facility
|
IP
|
$2,589.00
|
|
|
Service Code
|
CPT 93226
|
| Hospital Charge Code |
900200114
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$517.80 |
| Max. Negotiated Rate |
$2,330.10 |
| Rate for Payer: Adventist Health Commercial |
$517.80
|
| Rate for Payer: Cash Price |
$1,423.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,071.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,035.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,035.60
|
| Rate for Payer: Galaxy Health WC |
$2,200.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,553.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,330.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,726.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$986.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,602.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$517.80
|
| Rate for Payer: Multiplan Commercial |
$1,941.75
|
| Rate for Payer: Networks By Design Commercial |
$1,682.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,200.65
|
|
|
HC ECG 48 HR MONITOR-SCANNING
|
Facility
|
OP
|
$2,589.00
|
|
|
Service Code
|
CPT 93226
|
| Hospital Charge Code |
900200114
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$75.47 |
| Max. Negotiated Rate |
$2,330.10 |
| Rate for Payer: Adventist Health Commercial |
$517.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$75.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,572.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$558.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,520.52
|
| Rate for Payer: Blue Shield of California Commercial |
$1,571.52
|
| Rate for Payer: Blue Shield of California EPN |
$1,027.83
|
| Rate for Payer: Cash Price |
$1,423.95
|
| Rate for Payer: Cash Price |
$1,423.95
|
| Rate for Payer: Cash Price |
$1,423.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,071.20
|
| Rate for Payer: Cigna of CA HMO |
$1,656.96
|
| Rate for Payer: Cigna of CA PPO |
$1,915.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.88
|
| Rate for Payer: EPIC Health Plan Senior |
$75.47
|
| Rate for Payer: Galaxy Health WC |
$2,200.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,553.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,330.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$123.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$96.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: InnovAge PACE Commercial |
$113.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,726.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$106.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$517.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$101.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.13
|
| Rate for Payer: Multiplan Commercial |
$1,941.75
|
| Rate for Payer: Networks By Design Commercial |
$1,682.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.47
|
| Rate for Payer: Prime Health Services Commercial |
$2,200.65
|
| Rate for Payer: Prime Health Services Medicare |
$80.00
|
| Rate for Payer: Riverside University Health System MISP |
$83.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,553.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,553.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,477.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,006.00
|
| Rate for Payer: United Healthcare HMO Rider |
$765.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$701.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC ECG SIGNAL AVERAGE
|
Facility
|
IP
|
$1,462.00
|
|
|
Service Code
|
CPT 93278
|
| Hospital Charge Code |
900200141
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$292.40 |
| Max. Negotiated Rate |
$1,315.80 |
| Rate for Payer: Adventist Health Commercial |
$292.40
|
| Rate for Payer: Cash Price |
$804.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,169.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$584.80
|
| Rate for Payer: EPIC Health Plan Senior |
$584.80
|
| Rate for Payer: Galaxy Health WC |
$1,242.70
|
| Rate for Payer: Global Benefits Group Commercial |
$877.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,315.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$975.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$557.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$904.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$292.40
|
| Rate for Payer: Multiplan Commercial |
$1,096.50
|
| Rate for Payer: Networks By Design Commercial |
$950.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,242.70
|
|
|
HC ECG SIGNAL AVERAGE
|
Facility
|
OP
|
$1,462.00
|
|
|
Service Code
|
CPT 93278
|
| Hospital Charge Code |
900200141
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$46.29 |
| Max. Negotiated Rate |
$1,315.80 |
| Rate for Payer: Adventist Health Commercial |
$292.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$75.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$887.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$480.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$858.63
|
| Rate for Payer: Blue Shield of California Commercial |
$887.43
|
| Rate for Payer: Blue Shield of California EPN |
$580.41
|
| Rate for Payer: Cash Price |
$804.10
|
| Rate for Payer: Cash Price |
$804.10
|
| Rate for Payer: Cash Price |
$804.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,169.60
|
| Rate for Payer: Cigna of CA HMO |
$935.68
|
| Rate for Payer: Cigna of CA PPO |
$1,081.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.88
|
| Rate for Payer: EPIC Health Plan Senior |
$75.47
|
| Rate for Payer: Galaxy Health WC |
$1,242.70
|
| Rate for Payer: Global Benefits Group Commercial |
$877.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,315.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$123.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$46.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: InnovAge PACE Commercial |
$113.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$975.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$51.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$292.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$101.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.13
|
| Rate for Payer: Multiplan Commercial |
$1,096.50
|
| Rate for Payer: Networks By Design Commercial |
$950.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.47
|
| Rate for Payer: Prime Health Services Commercial |
$1,242.70
|
| Rate for Payer: Prime Health Services Medicare |
$80.00
|
| Rate for Payer: Riverside University Health System MISP |
$83.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$877.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$877.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$691.00
|
| Rate for Payer: United Healthcare All Other HMO |
$419.00
|
| Rate for Payer: United Healthcare HMO Rider |
$317.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC ECG TRACING ONLY
|
Facility
|
OP
|
$1,165.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
905493005
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$28.21 |
| Max. Negotiated Rate |
$1,048.50 |
| Rate for Payer: Adventist Health Commercial |
$233.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$75.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$707.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$114.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$684.20
|
| Rate for Payer: Blue Shield of California Commercial |
$707.15
|
| Rate for Payer: Blue Shield of California EPN |
$462.50
|
| Rate for Payer: Cash Price |
$640.75
|
| Rate for Payer: Cash Price |
$640.75
|
| Rate for Payer: Cash Price |
$640.75
|
| Rate for Payer: Central Health Plan Commercial |
$932.00
|
| Rate for Payer: Cigna of CA HMO |
$745.60
|
| Rate for Payer: Cigna of CA PPO |
$862.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.88
|
| Rate for Payer: EPIC Health Plan Senior |
$75.47
|
| Rate for Payer: Galaxy Health WC |
$990.25
|
| Rate for Payer: Global Benefits Group Commercial |
$699.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,048.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$123.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$28.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: InnovAge PACE Commercial |
$113.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$777.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$233.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$101.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.13
|
| Rate for Payer: Multiplan Commercial |
$873.75
|
| Rate for Payer: Networks By Design Commercial |
$757.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.47
|
| Rate for Payer: Prime Health Services Commercial |
$990.25
|
| Rate for Payer: Prime Health Services Medicare |
$80.00
|
| Rate for Payer: Riverside University Health System MISP |
$83.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$699.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$699.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$691.00
|
| Rate for Payer: United Healthcare All Other HMO |
$419.00
|
| Rate for Payer: United Healthcare HMO Rider |
$317.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC ECG TRACING ONLY
|
Facility
|
OP
|
$1,165.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
906593005
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$28.21 |
| Max. Negotiated Rate |
$1,048.50 |
| Rate for Payer: Adventist Health Commercial |
$233.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$75.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$707.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$114.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$684.20
|
| Rate for Payer: Blue Shield of California Commercial |
$707.15
|
| Rate for Payer: Blue Shield of California EPN |
$462.50
|
| Rate for Payer: Cash Price |
$640.75
|
| Rate for Payer: Cash Price |
$640.75
|
| Rate for Payer: Cash Price |
$640.75
|
| Rate for Payer: Central Health Plan Commercial |
$932.00
|
| Rate for Payer: Cigna of CA HMO |
$745.60
|
| Rate for Payer: Cigna of CA PPO |
$862.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.88
|
| Rate for Payer: EPIC Health Plan Senior |
$75.47
|
| Rate for Payer: Galaxy Health WC |
$990.25
|
| Rate for Payer: Global Benefits Group Commercial |
$699.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,048.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$123.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$28.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: InnovAge PACE Commercial |
$113.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$777.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$233.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$101.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.13
|
| Rate for Payer: Multiplan Commercial |
$873.75
|
| Rate for Payer: Networks By Design Commercial |
$757.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.47
|
| Rate for Payer: Prime Health Services Commercial |
$990.25
|
| Rate for Payer: Prime Health Services Medicare |
$80.00
|
| Rate for Payer: Riverside University Health System MISP |
$83.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$699.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$699.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$691.00
|
| Rate for Payer: United Healthcare All Other HMO |
$419.00
|
| Rate for Payer: United Healthcare HMO Rider |
$317.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC ECG TRACING ONLY
|
Facility
|
IP
|
$1,165.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
941093005
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$233.00 |
| Max. Negotiated Rate |
$1,048.50 |
| Rate for Payer: Adventist Health Commercial |
$233.00
|
| Rate for Payer: Cash Price |
$640.75
|
| Rate for Payer: Central Health Plan Commercial |
$932.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$466.00
|
| Rate for Payer: EPIC Health Plan Senior |
$466.00
|
| Rate for Payer: Galaxy Health WC |
$990.25
|
| Rate for Payer: Global Benefits Group Commercial |
$699.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,048.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$777.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$443.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$721.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$233.00
|
| Rate for Payer: Multiplan Commercial |
$873.75
|
| Rate for Payer: Networks By Design Commercial |
$757.25
|
| Rate for Payer: Prime Health Services Commercial |
$990.25
|
|
|
HC ECG TRACING ONLY
|
Facility
|
OP
|
$1,165.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
900200101
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$28.21 |
| Max. Negotiated Rate |
$1,048.50 |
| Rate for Payer: Adventist Health Commercial |
$233.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$75.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$707.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$114.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$684.20
|
| Rate for Payer: Blue Shield of California Commercial |
$707.15
|
| Rate for Payer: Blue Shield of California EPN |
$462.50
|
| Rate for Payer: Cash Price |
$640.75
|
| Rate for Payer: Cash Price |
$640.75
|
| Rate for Payer: Cash Price |
$640.75
|
| Rate for Payer: Central Health Plan Commercial |
$932.00
|
| Rate for Payer: Cigna of CA HMO |
$745.60
|
| Rate for Payer: Cigna of CA PPO |
$862.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.88
|
| Rate for Payer: EPIC Health Plan Senior |
$75.47
|
| Rate for Payer: Galaxy Health WC |
$990.25
|
| Rate for Payer: Global Benefits Group Commercial |
$699.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,048.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$123.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$28.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: InnovAge PACE Commercial |
$113.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$777.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$233.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$101.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.13
|
| Rate for Payer: Multiplan Commercial |
$873.75
|
| Rate for Payer: Networks By Design Commercial |
$757.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.47
|
| Rate for Payer: Prime Health Services Commercial |
$990.25
|
| Rate for Payer: Prime Health Services Medicare |
$80.00
|
| Rate for Payer: Riverside University Health System MISP |
$83.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$699.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$699.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$691.00
|
| Rate for Payer: United Healthcare All Other HMO |
$419.00
|
| Rate for Payer: United Healthcare HMO Rider |
$317.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC ECG TRACING ONLY
|
Facility
|
OP
|
$1,165.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
949093005
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$28.21 |
| Max. Negotiated Rate |
$1,048.50 |
| Rate for Payer: Adventist Health Commercial |
$233.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$75.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$707.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$114.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$684.20
|
| Rate for Payer: Blue Shield of California Commercial |
$707.15
|
| Rate for Payer: Blue Shield of California EPN |
$462.50
|
| Rate for Payer: Cash Price |
$640.75
|
| Rate for Payer: Cash Price |
$640.75
|
| Rate for Payer: Cash Price |
$640.75
|
| Rate for Payer: Central Health Plan Commercial |
$932.00
|
| Rate for Payer: Cigna of CA HMO |
$745.60
|
| Rate for Payer: Cigna of CA PPO |
$862.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.88
|
| Rate for Payer: EPIC Health Plan Senior |
$75.47
|
| Rate for Payer: Galaxy Health WC |
$990.25
|
| Rate for Payer: Global Benefits Group Commercial |
$699.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,048.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$123.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$28.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: InnovAge PACE Commercial |
$113.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$777.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$233.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$101.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.13
|
| Rate for Payer: Multiplan Commercial |
$873.75
|
| Rate for Payer: Networks By Design Commercial |
$757.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.47
|
| Rate for Payer: Prime Health Services Commercial |
$990.25
|
| Rate for Payer: Prime Health Services Medicare |
$80.00
|
| Rate for Payer: Riverside University Health System MISP |
$83.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$699.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$699.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$691.00
|
| Rate for Payer: United Healthcare All Other HMO |
$419.00
|
| Rate for Payer: United Healthcare HMO Rider |
$317.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC ECG TRACING ONLY
|
Facility
|
IP
|
$1,165.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
905493005
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$233.00 |
| Max. Negotiated Rate |
$1,048.50 |
| Rate for Payer: Adventist Health Commercial |
$233.00
|
| Rate for Payer: Cash Price |
$640.75
|
| Rate for Payer: Central Health Plan Commercial |
$932.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$466.00
|
| Rate for Payer: EPIC Health Plan Senior |
$466.00
|
| Rate for Payer: Galaxy Health WC |
$990.25
|
| Rate for Payer: Global Benefits Group Commercial |
$699.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,048.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$777.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$443.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$721.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$233.00
|
| Rate for Payer: Multiplan Commercial |
$873.75
|
| Rate for Payer: Networks By Design Commercial |
$757.25
|
| Rate for Payer: Prime Health Services Commercial |
$990.25
|
|
|
HC ECG TRACING ONLY
|
Facility
|
IP
|
$1,165.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
900200101
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$233.00 |
| Max. Negotiated Rate |
$1,048.50 |
| Rate for Payer: Adventist Health Commercial |
$233.00
|
| Rate for Payer: Cash Price |
$640.75
|
| Rate for Payer: Central Health Plan Commercial |
$932.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$466.00
|
| Rate for Payer: EPIC Health Plan Senior |
$466.00
|
| Rate for Payer: Galaxy Health WC |
$990.25
|
| Rate for Payer: Global Benefits Group Commercial |
$699.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,048.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$777.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$443.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$721.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$233.00
|
| Rate for Payer: Multiplan Commercial |
$873.75
|
| Rate for Payer: Networks By Design Commercial |
$757.25
|
| Rate for Payer: Prime Health Services Commercial |
$990.25
|
|
|
HC ECG TRACING ONLY
|
Facility
|
OP
|
$1,165.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
941093005
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$28.21 |
| Max. Negotiated Rate |
$1,048.50 |
| Rate for Payer: Adventist Health Commercial |
$233.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$75.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$707.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$114.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$684.20
|
| Rate for Payer: Blue Shield of California Commercial |
$707.15
|
| Rate for Payer: Blue Shield of California EPN |
$462.50
|
| Rate for Payer: Cash Price |
$640.75
|
| Rate for Payer: Cash Price |
$640.75
|
| Rate for Payer: Cash Price |
$640.75
|
| Rate for Payer: Central Health Plan Commercial |
$932.00
|
| Rate for Payer: Cigna of CA HMO |
$745.60
|
| Rate for Payer: Cigna of CA PPO |
$862.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.88
|
| Rate for Payer: EPIC Health Plan Senior |
$75.47
|
| Rate for Payer: Galaxy Health WC |
$990.25
|
| Rate for Payer: Global Benefits Group Commercial |
$699.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,048.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$123.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$28.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: InnovAge PACE Commercial |
$113.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$777.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$233.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$101.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.13
|
| Rate for Payer: Multiplan Commercial |
$873.75
|
| Rate for Payer: Networks By Design Commercial |
$757.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.47
|
| Rate for Payer: Prime Health Services Commercial |
$990.25
|
| Rate for Payer: Prime Health Services Medicare |
$80.00
|
| Rate for Payer: Riverside University Health System MISP |
$83.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$699.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$699.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$691.00
|
| Rate for Payer: United Healthcare All Other HMO |
$419.00
|
| Rate for Payer: United Healthcare HMO Rider |
$317.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC ECG TRACING ONLY
|
Facility
|
IP
|
$1,165.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
949093005
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$233.00 |
| Max. Negotiated Rate |
$1,048.50 |
| Rate for Payer: Adventist Health Commercial |
$233.00
|
| Rate for Payer: Cash Price |
$640.75
|
| Rate for Payer: Central Health Plan Commercial |
$932.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$466.00
|
| Rate for Payer: EPIC Health Plan Senior |
$466.00
|
| Rate for Payer: Galaxy Health WC |
$990.25
|
| Rate for Payer: Global Benefits Group Commercial |
$699.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,048.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$777.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$443.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$721.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$233.00
|
| Rate for Payer: Multiplan Commercial |
$873.75
|
| Rate for Payer: Networks By Design Commercial |
$757.25
|
| Rate for Payer: Prime Health Services Commercial |
$990.25
|
|
|
HC ECG TRACING ONLY
|
Facility
|
IP
|
$1,165.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
906593005
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$233.00 |
| Max. Negotiated Rate |
$1,048.50 |
| Rate for Payer: Adventist Health Commercial |
$233.00
|
| Rate for Payer: Cash Price |
$640.75
|
| Rate for Payer: Central Health Plan Commercial |
$932.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$466.00
|
| Rate for Payer: EPIC Health Plan Senior |
$466.00
|
| Rate for Payer: Galaxy Health WC |
$990.25
|
| Rate for Payer: Global Benefits Group Commercial |
$699.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,048.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$777.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$443.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$721.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$233.00
|
| Rate for Payer: Multiplan Commercial |
$873.75
|
| Rate for Payer: Networks By Design Commercial |
$757.25
|
| Rate for Payer: Prime Health Services Commercial |
$990.25
|
|
|
HC ECG TRACING ONLY RSPC CH
|
Facility
|
IP
|
$1,165.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
900100039
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$233.00 |
| Max. Negotiated Rate |
$1,048.50 |
| Rate for Payer: Adventist Health Commercial |
$233.00
|
| Rate for Payer: Cash Price |
$640.75
|
| Rate for Payer: Central Health Plan Commercial |
$932.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$466.00
|
| Rate for Payer: EPIC Health Plan Senior |
$466.00
|
| Rate for Payer: Galaxy Health WC |
$990.25
|
| Rate for Payer: Global Benefits Group Commercial |
$699.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,048.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$777.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$443.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$721.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$233.00
|
| Rate for Payer: Multiplan Commercial |
$873.75
|
| Rate for Payer: Networks By Design Commercial |
$757.25
|
| Rate for Payer: Prime Health Services Commercial |
$990.25
|
|
