|
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 |
$1,165.05
|
| 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 |
$1,165.05
|
| Rate for Payer: Cash Price |
$1,165.05
|
| Rate for Payer: Cash Price |
$1,165.05
|
| 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
|
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 |
$657.90
|
| Rate for Payer: Cash Price |
$657.90
|
| Rate for Payer: Cash Price |
$657.90
|
| 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 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 |
$657.90
|
| 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 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 |
$524.25
|
| 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 |
$524.25
|
| 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 |
$524.25
|
| Rate for Payer: Cash Price |
$524.25
|
| Rate for Payer: Cash Price |
$524.25
|
| 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 |
$524.25
|
| 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 |
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 |
$524.25
|
| 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 |
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 |
$524.25
|
| 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 |
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 |
$524.25
|
| Rate for Payer: Cash Price |
$524.25
|
| Rate for Payer: Cash Price |
$524.25
|
| 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 |
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 |
$524.25
|
| Rate for Payer: Cash Price |
$524.25
|
| Rate for Payer: Cash Price |
$524.25
|
| 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 |
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 |
$524.25
|
| Rate for Payer: Cash Price |
$524.25
|
| Rate for Payer: Cash Price |
$524.25
|
| 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 |
$524.25
|
| Rate for Payer: Cash Price |
$524.25
|
| Rate for Payer: Cash Price |
$524.25
|
| 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 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 |
$524.25
|
| 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
|
OP
|
$1,165.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
900100039
|
|
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 |
$524.25
|
| Rate for Payer: Cash Price |
$524.25
|
| Rate for Payer: Cash Price |
$524.25
|
| 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 RSPC EC
|
Facility
|
OP
|
$1,165.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
900100037
|
|
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 |
$524.25
|
| Rate for Payer: Cash Price |
$524.25
|
| Rate for Payer: Cash Price |
$524.25
|
| 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 RSPC EC
|
Facility
|
IP
|
$1,165.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
900100037
|
|
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 |
$524.25
|
| 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 HSH
|
Facility
|
OP
|
$1,165.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
900100040
|
|
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 |
$524.25
|
| Rate for Payer: Cash Price |
$524.25
|
| Rate for Payer: Cash Price |
$524.25
|
| 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 RSPC HSH
|
Facility
|
IP
|
$1,165.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
900100040
|
|
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 |
$524.25
|
| 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 MC
|
Facility
|
IP
|
$1,165.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
900100038
|
|
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 |
$524.25
|
| 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 MC
|
Facility
|
OP
|
$1,165.00
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
900100038
|
|
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 |
$524.25
|
| Rate for Payer: Cash Price |
$524.25
|
| Rate for Payer: Cash Price |
$524.25
|
| 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 ECHO-C 2D/M-MODE COMPLETE
|
Facility
|
IP
|
$1,954.00
|
|
|
Service Code
|
CPT 93307
|
| Hospital Charge Code |
900200204
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$390.80 |
| Max. Negotiated Rate |
$1,758.60 |
| Rate for Payer: Adventist Health Commercial |
$390.80
|
| Rate for Payer: Cash Price |
$879.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,563.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$781.60
|
| Rate for Payer: EPIC Health Plan Senior |
$781.60
|
| Rate for Payer: Galaxy Health WC |
$1,660.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,172.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,758.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,303.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$744.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,209.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$390.80
|
| Rate for Payer: Multiplan Commercial |
$1,465.50
|
| Rate for Payer: Networks By Design Commercial |
$1,270.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,660.90
|
|
|
HC ECHO-C 2D/M-MODE COMPLETE
|
Facility
|
OP
|
$1,954.00
|
|
|
Service Code
|
CPT 93307
|
| Hospital Charge Code |
900200204
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$258.17 |
| Max. Negotiated Rate |
$1,758.60 |
| Rate for Payer: Adventist Health Commercial |
$390.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$307.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,186.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$307.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$998.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,147.58
|
| Rate for Payer: Blue Shield of California Commercial |
$1,186.08
|
| Rate for Payer: Blue Shield of California EPN |
$775.74
|
| Rate for Payer: Cash Price |
$879.30
|
| Rate for Payer: Cash Price |
$879.30
|
| Rate for Payer: Cash Price |
$879.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,563.20
|
| Rate for Payer: Cigna of CA HMO |
$1,250.56
|
| Rate for Payer: Cigna of CA PPO |
$1,445.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$307.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$414.63
|
| Rate for Payer: EPIC Health Plan Senior |
$307.13
|
| Rate for Payer: Galaxy Health WC |
$1,660.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,172.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,758.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$258.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$307.13
|
| Rate for Payer: InnovAge PACE Commercial |
$460.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,303.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$285.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$307.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$390.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$411.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$411.55
|
| Rate for Payer: Multiplan Commercial |
$1,465.50
|
| Rate for Payer: Networks By Design Commercial |
$1,270.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$307.13
|
| Rate for Payer: Prime Health Services Commercial |
$1,660.90
|
| Rate for Payer: Prime Health Services Medicare |
$325.56
|
| Rate for Payer: Riverside University Health System MISP |
$337.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,172.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,172.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$968.00
|
| Rate for Payer: United Healthcare All Other HMO |
$982.00
|
| Rate for Payer: United Healthcare HMO Rider |
$832.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$762.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$307.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.84
|
| Rate for Payer: Vantage Medical Group Senior |
$307.13
|
|
|
HC ECHO-C CONG 2D COMPLETE CONGEN
|
Facility
|
IP
|
$2,527.00
|
|
|
Service Code
|
CPT 93303
|
| Hospital Charge Code |
900200225
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$505.40 |
| Max. Negotiated Rate |
$2,274.30 |
| Rate for Payer: Adventist Health Commercial |
$505.40
|
| Rate for Payer: Cash Price |
$1,137.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,021.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,010.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,010.80
|
| Rate for Payer: Galaxy Health WC |
$2,147.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,516.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,274.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,685.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$962.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,564.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$505.40
|
| Rate for Payer: Multiplan Commercial |
$1,895.25
|
| Rate for Payer: Networks By Design Commercial |
$1,642.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,147.95
|
|
