|
HC ECHO-C CONG 2D COMPLETE CONGEN
|
Facility
|
OP
|
$2,527.00
|
|
|
Service Code
|
CPT 93303
|
| Hospital Charge Code |
900200225
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$262.56 |
| Max. Negotiated Rate |
$2,274.30 |
| Rate for Payer: Adventist Health Commercial |
$505.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$696.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,534.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,045.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$766.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$696.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$891.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,484.11
|
| Rate for Payer: Blue Shield of California Commercial |
$1,533.89
|
| Rate for Payer: Blue Shield of California EPN |
$1,003.22
|
| Rate for Payer: Cash Price |
$1,137.15
|
| Rate for Payer: Cash Price |
$1,137.15
|
| Rate for Payer: Cash Price |
$1,137.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,021.60
|
| Rate for Payer: Cigna of CA HMO |
$1,617.28
|
| Rate for Payer: Cigna of CA PPO |
$1,869.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,045.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$766.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$696.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$940.50
|
| Rate for Payer: EPIC Health Plan Senior |
$696.67
|
| 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: Heritage Provider Network Commercial/Senior |
$1,142.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$262.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$696.67
|
| Rate for Payer: InnovAge PACE Commercial |
$1,045.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,685.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$290.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$696.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$505.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$933.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$933.54
|
| Rate for Payer: Multiplan Commercial |
$1,895.25
|
| Rate for Payer: Networks By Design Commercial |
$1,642.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$696.67
|
| Rate for Payer: Prime Health Services Commercial |
$2,147.95
|
| Rate for Payer: Prime Health Services Medicare |
$738.47
|
| Rate for Payer: Riverside University Health System MISP |
$766.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,516.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,516.20
|
| 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 |
$696.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,045.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$766.34
|
| Rate for Payer: Vantage Medical Group Senior |
$696.67
|
|
|
HC ECHO-C DOPPLER COMPLETE
|
Facility
|
IP
|
$1,310.00
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
900200205
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$1,179.00 |
| Rate for Payer: Adventist Health Commercial |
$262.00
|
| Rate for Payer: Cash Price |
$589.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,048.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$524.00
|
| Rate for Payer: EPIC Health Plan Senior |
$524.00
|
| Rate for Payer: Galaxy Health WC |
$1,113.50
|
| Rate for Payer: Global Benefits Group Commercial |
$786.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,179.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$873.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$499.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$810.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$262.00
|
| Rate for Payer: Multiplan Commercial |
$982.50
|
| Rate for Payer: Networks By Design Commercial |
$851.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,113.50
|
|
|
HC ECHO-C DOPPLER COMPLETE
|
Facility
|
OP
|
$1,310.00
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
900200205
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$131.70 |
| Max. Negotiated Rate |
$1,179.00 |
| Rate for Payer: Adventist Health Commercial |
$262.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$795.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,113.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$720.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$982.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$444.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$769.36
|
| Rate for Payer: Blue Shield of California Commercial |
$795.17
|
| Rate for Payer: Blue Shield of California EPN |
$520.07
|
| Rate for Payer: Cash Price |
$589.50
|
| Rate for Payer: Cash Price |
$589.50
|
| Rate for Payer: Cash Price |
$589.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,048.00
|
| Rate for Payer: Cigna of CA HMO |
$838.40
|
| Rate for Payer: Cigna of CA PPO |
$969.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,113.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,113.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,113.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$524.00
|
| Rate for Payer: EPIC Health Plan Senior |
$524.00
|
| Rate for Payer: Galaxy Health WC |
$1,113.50
|
| Rate for Payer: Global Benefits Group Commercial |
$786.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,179.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$131.70
|
| Rate for Payer: InnovAge PACE Commercial |
$655.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$873.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$145.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$810.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$262.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$917.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$917.00
|
| Rate for Payer: Multiplan Commercial |
$982.50
|
| Rate for Payer: Networks By Design Commercial |
$851.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,113.50
|
| Rate for Payer: Riverside University Health System MISP |
$524.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$786.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$786.00
|
| 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: Vantage Medical Group Commercial/Exchange |
$1,113.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,113.50
|
| Rate for Payer: Vantage Medical Group Senior |
$1,113.50
|
|
|
HC ECHO-C FETAL 2D COMPLETE
|
Facility
|
IP
|
$3,453.00
|
|
|
Service Code
|
CPT 76825
|
| Hospital Charge Code |
900200231
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$690.60 |
| Max. Negotiated Rate |
$3,107.70 |
| Rate for Payer: Adventist Health Commercial |
$690.60
|
| Rate for Payer: Cash Price |
$1,553.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,762.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,381.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,381.20
|
| Rate for Payer: Galaxy Health WC |
$2,935.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,071.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,107.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,303.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,315.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,137.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$690.60
|
| Rate for Payer: Multiplan Commercial |
$2,589.75
|
| Rate for Payer: Networks By Design Commercial |
$2,244.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,935.05
|
|
|
HC ECHO-C FETAL 2D COMPLETE
|
Facility
|
OP
|
$3,453.00
|
|
|
Service Code
|
CPT 76825
|
| Hospital Charge Code |
900200231
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$140.15 |
| Max. Negotiated Rate |
$3,107.70 |
| Rate for Payer: Adventist Health Commercial |
$690.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$696.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,097.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,045.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$766.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$696.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,027.95
|
| Rate for Payer: Blue Shield of California Commercial |
$2,095.97
|
| Rate for Payer: Blue Shield of California EPN |
$1,370.84
|
| Rate for Payer: Cash Price |
$1,553.85
|
| Rate for Payer: Cash Price |
$1,553.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,762.40
|
| Rate for Payer: Cigna of CA HMO |
$2,209.92
|
| Rate for Payer: Cigna of CA PPO |
$2,555.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,045.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$766.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$696.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$940.50
|
| Rate for Payer: EPIC Health Plan Senior |
$696.67
|
| Rate for Payer: Galaxy Health WC |
$2,935.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,071.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,107.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,142.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$140.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$696.67
|
| Rate for Payer: InnovAge PACE Commercial |
$1,045.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,303.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$154.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$696.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$690.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$933.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$933.54
|
| Rate for Payer: Multiplan Commercial |
$2,589.75
|
| Rate for Payer: Networks By Design Commercial |
$2,244.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$696.67
|
| Rate for Payer: Prime Health Services Commercial |
$2,935.05
|
| Rate for Payer: Prime Health Services Medicare |
$738.47
|
| Rate for Payer: Riverside University Health System MISP |
$766.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,071.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,071.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$566.19
|
| Rate for Payer: United Healthcare All Other HMO |
$566.19
|
| Rate for Payer: United Healthcare HMO Rider |
$566.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$566.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$696.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,045.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$766.34
|
| Rate for Payer: Vantage Medical Group Senior |
$696.67
|
|
|
HC ECHO-C FETAL DOPPLER COMPLETE
|
Facility
|
IP
|
$2,258.00
|
|
|
Service Code
|
CPT 76827
|
| Hospital Charge Code |
900200233
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$451.60 |
| Max. Negotiated Rate |
$2,032.20 |
| Rate for Payer: Adventist Health Commercial |
$451.60
|
| Rate for Payer: Cash Price |
$1,016.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,806.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$903.20
|
| Rate for Payer: EPIC Health Plan Senior |
$903.20
|
| Rate for Payer: Galaxy Health WC |
$1,919.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,354.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,032.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,506.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$860.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,397.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$451.60
|
| Rate for Payer: Multiplan Commercial |
$1,693.50
|
| Rate for Payer: Networks By Design Commercial |
$1,467.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,919.30
|
|
|
HC ECHO-C FETAL DOPPLER COMPLETE
|
Facility
|
OP
|
$2,258.00
|
|
|
Service Code
|
CPT 76827
|
| Hospital Charge Code |
900200233
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$99.02 |
| Max. Negotiated Rate |
$2,032.20 |
| Rate for Payer: Adventist Health Commercial |
$451.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$135.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,371.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$173.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,326.12
|
| Rate for Payer: Blue Shield of California Commercial |
$1,370.61
|
| Rate for Payer: Blue Shield of California EPN |
$896.43
|
| Rate for Payer: Cash Price |
$1,016.10
|
| Rate for Payer: Cash Price |
$1,016.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,806.40
|
| Rate for Payer: Cigna of CA HMO |
$1,445.12
|
| Rate for Payer: Cigna of CA PPO |
$1,670.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.41
|
| Rate for Payer: EPIC Health Plan Senior |
$135.12
|
| Rate for Payer: Galaxy Health WC |
$1,919.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,354.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,032.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$221.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$99.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: InnovAge PACE Commercial |
$202.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,506.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$135.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$451.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$181.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$181.06
|
| Rate for Payer: Multiplan Commercial |
$1,693.50
|
| Rate for Payer: Networks By Design Commercial |
$1,467.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$135.12
|
| Rate for Payer: Prime Health Services Commercial |
$1,919.30
|
| Rate for Payer: Prime Health Services Medicare |
$143.23
|
| Rate for Payer: Riverside University Health System MISP |
$148.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,354.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,354.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$161.07
|
| Rate for Payer: United Healthcare All Other HMO |
$161.07
|
| Rate for Payer: United Healthcare HMO Rider |
$161.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$161.07
|
| Rate for Payer: Upland Medical Group Pediatric |
$135.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC ECHO CHD TEE IMG ACQ, INT AND RPT ONLY
|
Facility
|
OP
|
$1,621.00
|
|
|
Service Code
|
CPT 93317
|
| Hospital Charge Code |
900200317
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$324.20 |
| Max. Negotiated Rate |
$1,458.90 |
| Rate for Payer: Adventist Health Commercial |
$324.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$984.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,377.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$891.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,215.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$704.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$952.01
|
| Rate for Payer: Blue Shield of California Commercial |
$983.95
|
| Rate for Payer: Blue Shield of California EPN |
$643.54
|
| Rate for Payer: Cash Price |
$729.45
|
| Rate for Payer: Cash Price |
$729.45
|
| Rate for Payer: Cash Price |
$729.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,296.80
|
| Rate for Payer: Cigna of CA HMO |
$1,037.44
|
| Rate for Payer: Cigna of CA PPO |
$1,199.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,377.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,377.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,377.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$648.40
|
| Rate for Payer: EPIC Health Plan Senior |
$648.40
|
| Rate for Payer: Galaxy Health WC |
$1,377.85
|
| Rate for Payer: Global Benefits Group Commercial |
$972.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,458.90
|
| Rate for Payer: InnovAge PACE Commercial |
$810.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,081.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$617.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,003.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$324.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,134.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,134.70
|
| Rate for Payer: Multiplan Commercial |
$1,215.75
|
| Rate for Payer: Networks By Design Commercial |
$1,053.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,377.85
|
| Rate for Payer: Riverside University Health System MISP |
$648.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$972.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$972.60
|
| 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: Vantage Medical Group Commercial/Exchange |
$1,377.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,377.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,377.85
|
|
|
HC ECHO CHD TEE IMG ACQ, INT AND RPT ONLY
|
Facility
|
IP
|
$1,621.00
|
|
|
Service Code
|
CPT 93317
|
| Hospital Charge Code |
900200317
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$324.20 |
| Max. Negotiated Rate |
$1,458.90 |
| Rate for Payer: Adventist Health Commercial |
$324.20
|
| Rate for Payer: Cash Price |
$729.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,296.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$648.40
|
| Rate for Payer: EPIC Health Plan Senior |
$648.40
|
| Rate for Payer: Galaxy Health WC |
$1,377.85
|
| Rate for Payer: Global Benefits Group Commercial |
$972.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,458.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,081.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$617.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,003.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$324.20
|
| Rate for Payer: Multiplan Commercial |
$1,215.75
|
| Rate for Payer: Networks By Design Commercial |
$1,053.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,377.85
|
|
|
HC ECHO CHD TEE TRANSESOPHAGEAL
|
Facility
|
OP
|
$3,612.00
|
|
|
Service Code
|
CPT 93315
|
| Hospital Charge Code |
900200227
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$332.36 |
| Max. Negotiated Rate |
$3,250.80 |
| Rate for Payer: Adventist Health Commercial |
$722.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$696.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,193.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,045.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$766.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$696.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$763.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,121.33
|
| Rate for Payer: Blue Shield of California Commercial |
$2,192.48
|
| Rate for Payer: Blue Shield of California EPN |
$1,433.96
|
| Rate for Payer: Cash Price |
$1,625.40
|
| Rate for Payer: Cash Price |
$1,625.40
|
| Rate for Payer: Cash Price |
$1,625.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,889.60
|
| Rate for Payer: Cigna of CA HMO |
$2,311.68
|
| Rate for Payer: Cigna of CA PPO |
$2,672.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,045.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$766.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$696.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$940.50
|
| Rate for Payer: EPIC Health Plan Senior |
$696.67
|
| Rate for Payer: Galaxy Health WC |
$3,070.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,167.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,250.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,142.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$332.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$696.67
|
| Rate for Payer: InnovAge PACE Commercial |
$1,045.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,409.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$367.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$696.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$722.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$933.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$933.54
|
| Rate for Payer: Multiplan Commercial |
$2,709.00
|
| Rate for Payer: Networks By Design Commercial |
$2,347.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$696.67
|
| Rate for Payer: Prime Health Services Commercial |
$3,070.20
|
| Rate for Payer: Prime Health Services Medicare |
$738.47
|
| Rate for Payer: Riverside University Health System MISP |
$766.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,167.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,167.20
|
| 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 |
$696.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,045.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$766.34
|
| Rate for Payer: Vantage Medical Group Senior |
$696.67
|
|
|
HC ECHO CHD TEE TRANSESOPHAGEAL
|
Facility
|
IP
|
$3,612.00
|
|
|
Service Code
|
CPT 93315
|
| Hospital Charge Code |
900200227
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$722.40 |
| Max. Negotiated Rate |
$3,250.80 |
| Rate for Payer: Adventist Health Commercial |
$722.40
|
| Rate for Payer: Cash Price |
$1,625.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,889.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,444.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,444.80
|
| Rate for Payer: Galaxy Health WC |
$3,070.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,167.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,250.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,409.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,376.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,235.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$722.40
|
| Rate for Payer: Multiplan Commercial |
$2,709.00
|
| Rate for Payer: Networks By Design Commercial |
$2,347.80
|
| Rate for Payer: Prime Health Services Commercial |
$3,070.20
|
|
|
HC ECHO COLOR FLOW MAPPING DOPPLE
|
Facility
|
OP
|
$1,084.00
|
|
|
Service Code
|
CPT 93325
|
| Hospital Charge Code |
900200208
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$133.95 |
| Max. Negotiated Rate |
$982.00 |
| Rate for Payer: Adventist Health Commercial |
$216.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$658.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$921.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$596.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$813.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$654.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$636.63
|
| Rate for Payer: Blue Shield of California Commercial |
$657.99
|
| Rate for Payer: Blue Shield of California EPN |
$430.35
|
| Rate for Payer: Cash Price |
$487.80
|
| Rate for Payer: Cash Price |
$487.80
|
| Rate for Payer: Cash Price |
$487.80
|
| Rate for Payer: Central Health Plan Commercial |
$867.20
|
| Rate for Payer: Cigna of CA HMO |
$693.76
|
| Rate for Payer: Cigna of CA PPO |
$802.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$921.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$921.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$921.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$433.60
|
| Rate for Payer: EPIC Health Plan Senior |
$433.60
|
| Rate for Payer: Galaxy Health WC |
$921.40
|
| Rate for Payer: Global Benefits Group Commercial |
$650.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$975.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$133.95
|
| Rate for Payer: InnovAge PACE Commercial |
$542.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$723.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$147.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$671.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$216.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$758.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$758.80
|
| Rate for Payer: Multiplan Commercial |
$813.00
|
| Rate for Payer: Networks By Design Commercial |
$704.60
|
| Rate for Payer: Prime Health Services Commercial |
$921.40
|
| Rate for Payer: Riverside University Health System MISP |
$433.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$650.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$650.40
|
| 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: Vantage Medical Group Commercial/Exchange |
$921.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$921.40
|
| Rate for Payer: Vantage Medical Group Senior |
$921.40
|
|
|
HC ECHO COLOR FLOW MAPPING DOPPLE
|
Facility
|
IP
|
$1,084.00
|
|
|
Service Code
|
CPT 93325
|
| Hospital Charge Code |
900200208
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$216.80 |
| Max. Negotiated Rate |
$975.60 |
| Rate for Payer: Adventist Health Commercial |
$216.80
|
| Rate for Payer: Cash Price |
$487.80
|
| Rate for Payer: Central Health Plan Commercial |
$867.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$433.60
|
| Rate for Payer: EPIC Health Plan Senior |
$433.60
|
| Rate for Payer: Galaxy Health WC |
$921.40
|
| Rate for Payer: Global Benefits Group Commercial |
$650.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$975.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$723.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$413.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$671.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$216.80
|
| Rate for Payer: Multiplan Commercial |
$813.00
|
| Rate for Payer: Networks By Design Commercial |
$704.60
|
| Rate for Payer: Prime Health Services Commercial |
$921.40
|
|
|
HC ECHO CONTRAST DEFINITY
|
Facility
|
IP
|
$595.00
|
|
|
Service Code
|
CPT Q9957
|
| Hospital Charge Code |
912000220
|
|
Hospital Revenue Code
|
254
|
| Min. Negotiated Rate |
$119.00 |
| Max. Negotiated Rate |
$535.50 |
| Rate for Payer: Adventist Health Commercial |
$119.00
|
| Rate for Payer: Blue Shield of California Commercial |
$459.94
|
| Rate for Payer: Blue Shield of California EPN |
$299.88
|
| Rate for Payer: Cash Price |
$267.75
|
| Rate for Payer: Central Health Plan Commercial |
$476.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$238.00
|
| Rate for Payer: EPIC Health Plan Senior |
$238.00
|
| Rate for Payer: Galaxy Health WC |
$505.75
|
| Rate for Payer: Global Benefits Group Commercial |
$357.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$535.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$396.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$226.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$368.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.00
|
| Rate for Payer: Multiplan Commercial |
$446.25
|
| Rate for Payer: Networks By Design Commercial |
$386.75
|
| Rate for Payer: Prime Health Services Commercial |
$505.75
|
|
|
HC ECHO CONTRAST DEFINITY
|
Facility
|
OP
|
$595.00
|
|
|
Service Code
|
CPT Q9957
|
| Hospital Charge Code |
912000220
|
|
Hospital Revenue Code
|
254
|
| Min. Negotiated Rate |
$41.88 |
| Max. Negotiated Rate |
$535.50 |
| Rate for Payer: Adventist Health Commercial |
$119.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$361.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$505.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$327.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$446.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$340.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$104.61
|
| Rate for Payer: Blue Shield of California Commercial |
$363.55
|
| Rate for Payer: Blue Shield of California EPN |
$237.41
|
| Rate for Payer: Cash Price |
$267.75
|
| Rate for Payer: Cash Price |
$267.75
|
| Rate for Payer: Central Health Plan Commercial |
$476.00
|
| Rate for Payer: Cigna of CA HMO |
$380.80
|
| Rate for Payer: Cigna of CA PPO |
$440.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$505.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$505.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$505.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$238.00
|
| Rate for Payer: EPIC Health Plan Senior |
$238.00
|
| Rate for Payer: Galaxy Health WC |
$505.75
|
| Rate for Payer: Global Benefits Group Commercial |
$357.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$535.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$41.88
|
| Rate for Payer: InnovAge PACE Commercial |
$297.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$396.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$95.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$368.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$416.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$416.50
|
| Rate for Payer: Multiplan Commercial |
$446.25
|
| Rate for Payer: Networks By Design Commercial |
$386.75
|
| Rate for Payer: Prime Health Services Commercial |
$505.75
|
| Rate for Payer: Riverside University Health System MISP |
$238.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$357.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$357.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$297.50
|
| Rate for Payer: United Healthcare All Other HMO |
$297.50
|
| Rate for Payer: United Healthcare HMO Rider |
$297.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$297.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$505.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$505.75
|
| Rate for Payer: Vantage Medical Group Senior |
$505.75
|
|
|
HC ECHO CONTRAST OPTISON
|
Facility
|
IP
|
$737.00
|
|
|
Service Code
|
CPT Q9956
|
| Hospital Charge Code |
912000219
|
|
Hospital Revenue Code
|
254
|
| Min. Negotiated Rate |
$147.40 |
| Max. Negotiated Rate |
$663.30 |
| Rate for Payer: Adventist Health Commercial |
$147.40
|
| Rate for Payer: Blue Shield of California Commercial |
$569.70
|
| Rate for Payer: Blue Shield of California EPN |
$371.45
|
| Rate for Payer: Cash Price |
$331.65
|
| Rate for Payer: Central Health Plan Commercial |
$589.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$294.80
|
| Rate for Payer: EPIC Health Plan Senior |
$294.80
|
| Rate for Payer: Galaxy Health WC |
$626.45
|
| Rate for Payer: Global Benefits Group Commercial |
$442.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$663.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$491.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$280.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$456.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.40
|
| Rate for Payer: Multiplan Commercial |
$552.75
|
| Rate for Payer: Networks By Design Commercial |
$479.05
|
| Rate for Payer: Prime Health Services Commercial |
$626.45
|
|
|
HC ECHO CONTRAST OPTISON
|
Facility
|
OP
|
$737.00
|
|
|
Service Code
|
CPT Q9956
|
| Hospital Charge Code |
912000219
|
|
Hospital Revenue Code
|
254
|
| Min. Negotiated Rate |
$41.88 |
| Max. Negotiated Rate |
$663.30 |
| Rate for Payer: Adventist Health Commercial |
$147.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$447.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$626.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$405.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$552.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$356.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$432.84
|
| Rate for Payer: Blue Shield of California Commercial |
$450.31
|
| Rate for Payer: Blue Shield of California EPN |
$294.06
|
| Rate for Payer: Cash Price |
$331.65
|
| Rate for Payer: Cash Price |
$331.65
|
| Rate for Payer: Central Health Plan Commercial |
$589.60
|
| Rate for Payer: Cigna of CA HMO |
$471.68
|
| Rate for Payer: Cigna of CA PPO |
$545.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$626.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$626.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$626.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$294.80
|
| Rate for Payer: EPIC Health Plan Senior |
$294.80
|
| Rate for Payer: Galaxy Health WC |
$626.45
|
| Rate for Payer: Global Benefits Group Commercial |
$442.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$663.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$41.88
|
| Rate for Payer: InnovAge PACE Commercial |
$368.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$491.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$456.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$515.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$515.90
|
| Rate for Payer: Multiplan Commercial |
$552.75
|
| Rate for Payer: Networks By Design Commercial |
$479.05
|
| Rate for Payer: Prime Health Services Commercial |
$626.45
|
| Rate for Payer: Riverside University Health System MISP |
$294.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$442.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$442.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$368.50
|
| Rate for Payer: United Healthcare All Other HMO |
$368.50
|
| Rate for Payer: United Healthcare HMO Rider |
$368.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$368.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$626.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$626.45
|
| Rate for Payer: Vantage Medical Group Senior |
$626.45
|
|
|
HC ECHO-F 2D/M-MODE FOLLOWUP
|
Facility
|
IP
|
$1,969.00
|
|
|
Service Code
|
CPT 93308
|
| Hospital Charge Code |
900200209
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$393.80 |
| Max. Negotiated Rate |
$1,772.10 |
| Rate for Payer: Adventist Health Commercial |
$393.80
|
| Rate for Payer: Cash Price |
$886.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,575.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$787.60
|
| Rate for Payer: EPIC Health Plan Senior |
$787.60
|
| Rate for Payer: Galaxy Health WC |
$1,673.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,181.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,772.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,313.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$750.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,218.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$393.80
|
| Rate for Payer: Multiplan Commercial |
$1,476.75
|
| Rate for Payer: Networks By Design Commercial |
$1,279.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,673.65
|
|
|
HC ECHO-F 2D/M-MODE FOLLOWUP
|
Facility
|
OP
|
$1,969.00
|
|
|
Service Code
|
CPT 93308
|
| Hospital Charge Code |
900200209
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$129.09 |
| Max. Negotiated Rate |
$1,772.10 |
| Rate for Payer: Adventist Health Commercial |
$393.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$307.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,195.77
|
| 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 |
$503.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,156.39
|
| Rate for Payer: Blue Shield of California Commercial |
$1,195.18
|
| Rate for Payer: Blue Shield of California EPN |
$781.69
|
| Rate for Payer: Cash Price |
$886.05
|
| Rate for Payer: Cash Price |
$886.05
|
| Rate for Payer: Cash Price |
$886.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,575.20
|
| Rate for Payer: Cigna of CA HMO |
$1,260.16
|
| Rate for Payer: Cigna of CA PPO |
$1,457.06
|
| 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 |
$1,673.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,181.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,772.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$129.09
|
| 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 |
$1,313.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$307.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$393.80
|
| 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 |
$1,476.75
|
| Rate for Payer: Networks By Design Commercial |
$1,279.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$307.13
|
| Rate for Payer: Prime Health Services Commercial |
$1,673.65
|
| 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 |
$1,181.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,181.40
|
| 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-F CONG 2D F/U CONGENITAL
|
Facility
|
IP
|
$2,160.00
|
|
|
Service Code
|
CPT 93304
|
| Hospital Charge Code |
900200226
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$432.00 |
| Max. Negotiated Rate |
$1,944.00 |
| Rate for Payer: Adventist Health Commercial |
$432.00
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,728.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$864.00
|
| Rate for Payer: EPIC Health Plan Senior |
$864.00
|
| Rate for Payer: Galaxy Health WC |
$1,836.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,296.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,944.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,440.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$822.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,337.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$432.00
|
| Rate for Payer: Multiplan Commercial |
$1,620.00
|
| Rate for Payer: Networks By Design Commercial |
$1,404.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,836.00
|
|
|
HC ECHO-F CONG 2D F/U CONGENITAL
|
Facility
|
OP
|
$2,160.00
|
|
|
Service Code
|
CPT 93304
|
| Hospital Charge Code |
900200226
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$143.59 |
| Max. Negotiated Rate |
$1,944.00 |
| Rate for Payer: Adventist Health Commercial |
$432.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$696.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,311.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,045.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$766.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$696.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$449.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,268.57
|
| Rate for Payer: Blue Shield of California Commercial |
$1,311.12
|
| Rate for Payer: Blue Shield of California EPN |
$857.52
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,728.00
|
| Rate for Payer: Cigna of CA HMO |
$1,382.40
|
| Rate for Payer: Cigna of CA PPO |
$1,598.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,045.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$766.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$696.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$940.50
|
| Rate for Payer: EPIC Health Plan Senior |
$696.67
|
| Rate for Payer: Galaxy Health WC |
$1,836.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,296.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,944.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,142.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$143.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$696.67
|
| Rate for Payer: InnovAge PACE Commercial |
$1,045.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,440.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$158.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$696.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$432.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$933.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$933.54
|
| Rate for Payer: Multiplan Commercial |
$1,620.00
|
| Rate for Payer: Networks By Design Commercial |
$1,404.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$696.67
|
| Rate for Payer: Prime Health Services Commercial |
$1,836.00
|
| Rate for Payer: Prime Health Services Medicare |
$738.47
|
| Rate for Payer: Riverside University Health System MISP |
$766.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,296.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,296.00
|
| 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 |
$696.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,045.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$766.34
|
| Rate for Payer: Vantage Medical Group Senior |
$696.67
|
|
|
HC ECHO-F DOPPLER FOLLOWUP
|
Facility
|
OP
|
$1,029.00
|
|
|
Service Code
|
CPT 93321
|
| Hospital Charge Code |
900200210
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$66.98 |
| Max. Negotiated Rate |
$982.00 |
| Rate for Payer: Adventist Health Commercial |
$205.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$624.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$874.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$565.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$771.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$249.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$604.33
|
| Rate for Payer: Blue Shield of California Commercial |
$624.60
|
| Rate for Payer: Blue Shield of California EPN |
$408.51
|
| Rate for Payer: Cash Price |
$463.05
|
| Rate for Payer: Cash Price |
$463.05
|
| Rate for Payer: Cash Price |
$463.05
|
| Rate for Payer: Central Health Plan Commercial |
$823.20
|
| Rate for Payer: Cigna of CA HMO |
$658.56
|
| Rate for Payer: Cigna of CA PPO |
$761.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$874.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$874.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$874.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$411.60
|
| Rate for Payer: EPIC Health Plan Senior |
$411.60
|
| Rate for Payer: Galaxy Health WC |
$874.65
|
| Rate for Payer: Global Benefits Group Commercial |
$617.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$926.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$66.98
|
| Rate for Payer: InnovAge PACE Commercial |
$514.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$686.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$73.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$636.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$205.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$720.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$720.30
|
| Rate for Payer: Multiplan Commercial |
$771.75
|
| Rate for Payer: Networks By Design Commercial |
$668.85
|
| Rate for Payer: Prime Health Services Commercial |
$874.65
|
| Rate for Payer: Riverside University Health System MISP |
$411.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$617.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$617.40
|
| 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: Vantage Medical Group Commercial/Exchange |
$874.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$874.65
|
| Rate for Payer: Vantage Medical Group Senior |
$874.65
|
|
|
HC ECHO-F DOPPLER FOLLOWUP
|
Facility
|
IP
|
$1,029.00
|
|
|
Service Code
|
CPT 93321
|
| Hospital Charge Code |
900200210
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$205.80 |
| Max. Negotiated Rate |
$926.10 |
| Rate for Payer: Adventist Health Commercial |
$205.80
|
| Rate for Payer: Cash Price |
$463.05
|
| Rate for Payer: Central Health Plan Commercial |
$823.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$411.60
|
| Rate for Payer: EPIC Health Plan Senior |
$411.60
|
| Rate for Payer: Galaxy Health WC |
$874.65
|
| Rate for Payer: Global Benefits Group Commercial |
$617.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$926.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$686.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$392.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$636.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$205.80
|
| Rate for Payer: Multiplan Commercial |
$771.75
|
| Rate for Payer: Networks By Design Commercial |
$668.85
|
| Rate for Payer: Prime Health Services Commercial |
$874.65
|
|
|
HC ECHO-F FETAL 2D F/U
|
Facility
|
OP
|
$1,962.00
|
|
|
Service Code
|
CPT 76826
|
| Hospital Charge Code |
900200232
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$127.00 |
| Max. Negotiated Rate |
$1,765.80 |
| Rate for Payer: Adventist Health Commercial |
$392.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$307.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,191.52
|
| 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 |
$127.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,152.28
|
| Rate for Payer: Blue Shield of California Commercial |
$1,190.93
|
| Rate for Payer: Blue Shield of California EPN |
$778.91
|
| Rate for Payer: Cash Price |
$882.90
|
| Rate for Payer: Cash Price |
$882.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,569.60
|
| Rate for Payer: Cigna of CA HMO |
$1,255.68
|
| Rate for Payer: Cigna of CA PPO |
$1,451.88
|
| 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 |
$1,667.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,177.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,765.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$255.71
|
| 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 |
$1,308.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$282.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$307.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$392.40
|
| 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 |
$1,471.50
|
| Rate for Payer: Networks By Design Commercial |
$1,275.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$307.13
|
| Rate for Payer: Prime Health Services Commercial |
$1,667.70
|
| 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 |
$1,177.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,177.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$566.19
|
| Rate for Payer: United Healthcare All Other HMO |
$566.19
|
| Rate for Payer: United Healthcare HMO Rider |
$566.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$566.19
|
| 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-F FETAL 2D F/U
|
Facility
|
IP
|
$1,962.00
|
|
|
Service Code
|
CPT 76826
|
| Hospital Charge Code |
900200232
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$392.40 |
| Max. Negotiated Rate |
$1,765.80 |
| Rate for Payer: Adventist Health Commercial |
$392.40
|
| Rate for Payer: Cash Price |
$882.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,569.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$784.80
|
| Rate for Payer: EPIC Health Plan Senior |
$784.80
|
| Rate for Payer: Galaxy Health WC |
$1,667.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,177.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,765.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,308.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$747.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,214.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$392.40
|
| Rate for Payer: Multiplan Commercial |
$1,471.50
|
| Rate for Payer: Networks By Design Commercial |
$1,275.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,667.70
|
|
