|
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 |
$405.35
|
| 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 |
$405.35
|
| Rate for Payer: Cash Price |
$405.35
|
| 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 |
$1,082.95
|
| 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 |
$1,082.95
|
| Rate for Payer: Cash Price |
$1,082.95
|
| Rate for Payer: Cash Price |
$1,082.95
|
| 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 |
$1,188.00
|
| 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 |
$1,188.00
|
| Rate for Payer: Cash Price |
$1,188.00
|
| Rate for Payer: Cash Price |
$1,188.00
|
| 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 |
$565.95
|
| Rate for Payer: Cash Price |
$565.95
|
| Rate for Payer: Cash Price |
$565.95
|
| 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 |
$565.95
|
| 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
|
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 |
$1,079.10
|
| 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
|
|
|
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 |
$1,079.10
|
| Rate for Payer: Cash Price |
$1,079.10
|
| 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 DOPPLER F/U
|
Facility
|
IP
|
$1,774.00
|
|
|
Service Code
|
CPT 76828
|
| Hospital Charge Code |
900200234
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$354.80 |
| Max. Negotiated Rate |
$1,596.60 |
| Rate for Payer: Adventist Health Commercial |
$354.80
|
| Rate for Payer: Cash Price |
$975.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,419.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$709.60
|
| Rate for Payer: EPIC Health Plan Senior |
$709.60
|
| Rate for Payer: Galaxy Health WC |
$1,507.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,064.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,596.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,183.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$675.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,098.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$354.80
|
| Rate for Payer: Multiplan Commercial |
$1,330.50
|
| Rate for Payer: Networks By Design Commercial |
$1,153.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,507.90
|
|
|
HC ECHO-F FETAL DOPPLER F/U
|
Facility
|
OP
|
$1,774.00
|
|
|
Service Code
|
CPT 76828
|
| Hospital Charge Code |
900200234
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$78.72 |
| Max. Negotiated Rate |
$1,596.60 |
| Rate for Payer: Adventist Health Commercial |
$354.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$135.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,077.35
|
| 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 |
$202.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,041.87
|
| Rate for Payer: Blue Shield of California Commercial |
$1,076.82
|
| Rate for Payer: Blue Shield of California EPN |
$704.28
|
| Rate for Payer: Cash Price |
$975.70
|
| Rate for Payer: Cash Price |
$975.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,419.20
|
| Rate for Payer: Cigna of CA HMO |
$1,135.36
|
| Rate for Payer: Cigna of CA PPO |
$1,312.76
|
| 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 |
$1,507.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,064.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,596.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$221.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$78.72
|
| 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 |
$1,183.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$86.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$135.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$354.80
|
| 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 |
$1,330.50
|
| Rate for Payer: Networks By Design Commercial |
$1,153.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$135.12
|
| Rate for Payer: Prime Health Services Commercial |
$1,507.90
|
| 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 |
$1,064.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,064.40
|
| 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 STRESS MONITORED
|
Facility
|
IP
|
$2,765.00
|
|
|
Service Code
|
CPT 93350
|
| Hospital Charge Code |
900200216
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$553.00 |
| Max. Negotiated Rate |
$2,488.50 |
| Rate for Payer: Adventist Health Commercial |
$553.00
|
| Rate for Payer: Cash Price |
$1,520.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,212.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,106.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,106.00
|
| Rate for Payer: Galaxy Health WC |
$2,350.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,659.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,488.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,844.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,053.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,711.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$553.00
|
| Rate for Payer: Multiplan Commercial |
$2,073.75
|
| Rate for Payer: Networks By Design Commercial |
$1,797.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,350.25
|
|
|
HC ECHO STRESS MONITORED
|
Facility
|
OP
|
$2,765.00
|
|
|
Service Code
|
CPT 93350
|
| Hospital Charge Code |
900200216
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$165.33 |
| Max. Negotiated Rate |
$2,488.50 |
| Rate for Payer: Adventist Health Commercial |
$553.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$696.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,679.18
|
| 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 |
$460.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,623.88
|
| Rate for Payer: Blue Shield of California Commercial |
$1,678.36
|
| Rate for Payer: Blue Shield of California EPN |
$1,097.70
|
| Rate for Payer: Cash Price |
$1,520.75
|
| Rate for Payer: Cash Price |
$1,520.75
|
| Rate for Payer: Cash Price |
$1,520.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,212.00
|
| Rate for Payer: Cigna of CA HMO |
$1,769.60
|
| Rate for Payer: Cigna of CA PPO |
$2,046.10
|
| 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 |
$2,350.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,659.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,488.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,142.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$165.33
|
| 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 |
$1,844.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$182.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$696.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$553.00
|
| 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 |
$2,073.75
|
| Rate for Payer: Networks By Design Commercial |
$1,797.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$696.67
|
| Rate for Payer: Prime Health Services Commercial |
$2,350.25
|
| 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 |
$1,659.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,659.00
|
| 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 STRESS TTE COMPLETE
|
Facility
|
IP
|
$3,047.00
|
|
|
Service Code
|
CPT 93351
|
| Hospital Charge Code |
900200249
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$609.40 |
| Max. Negotiated Rate |
$2,742.30 |
| Rate for Payer: Adventist Health Commercial |
$609.40
|
| Rate for Payer: Cash Price |
$1,675.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,437.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,218.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,218.80
|
| Rate for Payer: Galaxy Health WC |
$2,589.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,828.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,742.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,032.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,160.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,886.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$609.40
|
| Rate for Payer: Multiplan Commercial |
$2,285.25
|
| Rate for Payer: Networks By Design Commercial |
$1,980.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,589.95
|
|
|
HC ECHO STRESS TTE COMPLETE
|
Facility
|
OP
|
$3,047.00
|
|
|
Service Code
|
CPT 93351
|
| Hospital Charge Code |
900200249
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$425.34 |
| Max. Negotiated Rate |
$2,742.30 |
| Rate for Payer: Adventist Health Commercial |
$609.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$696.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,850.44
|
| 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 |
$1,508.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,789.50
|
| Rate for Payer: Blue Shield of California Commercial |
$1,849.53
|
| Rate for Payer: Blue Shield of California EPN |
$1,209.66
|
| Rate for Payer: Cash Price |
$1,675.85
|
| Rate for Payer: Cash Price |
$1,675.85
|
| Rate for Payer: Cash Price |
$1,675.85
|
| Rate for Payer: Center for Health Promotion Commercial |
$490.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,437.60
|
| Rate for Payer: Cigna of CA HMO |
$1,950.08
|
| Rate for Payer: Cigna of CA PPO |
$2,254.78
|
| 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 |
$2,589.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,828.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,742.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,142.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$425.34
|
| 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 |
$2,032.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$469.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$696.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$609.40
|
| 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 |
$2,285.25
|
| Rate for Payer: Networks By Design Commercial |
$1,980.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$696.67
|
| Rate for Payer: Prime Health Services Commercial |
$2,589.95
|
| 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 |
$1,828.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,828.20
|
| 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 TEE W/CON 2D INT/RPT
|
Facility
|
OP
|
$2,530.00
|
|
|
Service Code
|
CPT C8925
|
| Hospital Charge Code |
900200244
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$506.00 |
| Max. Negotiated Rate |
$2,277.00 |
| Rate for Payer: Adventist Health Commercial |
$506.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,003.85
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,536.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,003.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,431.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,485.87
|
| Rate for Payer: Blue Shield of California Commercial |
$1,535.71
|
| Rate for Payer: Blue Shield of California EPN |
$1,004.41
|
| Rate for Payer: Cash Price |
$1,391.50
|
| Rate for Payer: Cash Price |
$1,391.50
|
| Rate for Payer: Cash Price |
$1,391.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,024.00
|
| Rate for Payer: Cigna of CA HMO |
$1,619.20
|
| Rate for Payer: Cigna of CA PPO |
$1,872.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,104.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,003.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,355.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,003.85
|
| Rate for Payer: Galaxy Health WC |
$2,150.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,518.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,277.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,646.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,003.85
|
| Rate for Payer: InnovAge PACE Commercial |
$1,505.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,687.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$963.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,003.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$506.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,345.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,345.16
|
| Rate for Payer: Multiplan Commercial |
$1,897.50
|
| Rate for Payer: Networks By Design Commercial |
$1,644.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,003.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,150.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,064.08
|
| Rate for Payer: Riverside University Health System MISP |
$1,104.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,518.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,518.00
|
| 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 |
$1,003.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Vantage Medical Group Senior |
$1,003.85
|
|
|
HC ECHO TEE W/CON 2D INT/RPT
|
Facility
|
IP
|
$2,530.00
|
|
|
Service Code
|
CPT C8925
|
| Hospital Charge Code |
900200244
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$506.00 |
| Max. Negotiated Rate |
$2,277.00 |
| Rate for Payer: Adventist Health Commercial |
$506.00
|
| Rate for Payer: Cash Price |
$1,391.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,024.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,012.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,012.00
|
| Rate for Payer: Galaxy Health WC |
$2,150.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,518.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,277.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,687.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$963.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,566.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$506.00
|
| Rate for Payer: Multiplan Commercial |
$1,897.50
|
| Rate for Payer: Networks By Design Commercial |
$1,644.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,150.50
|
|
|
HC ECHO TEE W/CON CONGEN INT/RPT
|
Facility
|
IP
|
$2,025.00
|
|
|
Service Code
|
CPT C8926
|
| Hospital Charge Code |
900200245
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$405.00 |
| Max. Negotiated Rate |
$1,822.50 |
| Rate for Payer: Adventist Health Commercial |
$405.00
|
| Rate for Payer: Cash Price |
$1,113.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,620.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$810.00
|
| Rate for Payer: EPIC Health Plan Senior |
$810.00
|
| Rate for Payer: Galaxy Health WC |
$1,721.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,215.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,822.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,350.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$771.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,253.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$405.00
|
| Rate for Payer: Multiplan Commercial |
$1,518.75
|
| Rate for Payer: Networks By Design Commercial |
$1,316.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,721.25
|
|
|
HC ECHO TEE W/CON CONGEN INT/RPT
|
Facility
|
OP
|
$2,025.00
|
|
|
Service Code
|
CPT C8926
|
| Hospital Charge Code |
900200245
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$405.00 |
| Max. Negotiated Rate |
$1,822.50 |
| Rate for Payer: Adventist Health Commercial |
$405.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,003.85
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,229.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,003.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,439.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,189.28
|
| Rate for Payer: Blue Shield of California Commercial |
$1,229.17
|
| Rate for Payer: Blue Shield of California EPN |
$803.92
|
| Rate for Payer: Cash Price |
$1,113.75
|
| Rate for Payer: Cash Price |
$1,113.75
|
| Rate for Payer: Cash Price |
$1,113.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,620.00
|
| Rate for Payer: Cigna of CA HMO |
$1,296.00
|
| Rate for Payer: Cigna of CA PPO |
$1,498.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,104.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,003.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,355.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,003.85
|
| Rate for Payer: Galaxy Health WC |
$1,721.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,215.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,822.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,646.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,003.85
|
| Rate for Payer: InnovAge PACE Commercial |
$1,505.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,350.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$771.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,003.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$405.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,345.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,345.16
|
| Rate for Payer: Multiplan Commercial |
$1,518.75
|
| Rate for Payer: Networks By Design Commercial |
$1,316.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,003.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,721.25
|
| Rate for Payer: Prime Health Services Medicare |
$1,064.08
|
| Rate for Payer: Riverside University Health System MISP |
$1,104.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,215.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,215.00
|
| 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 |
$1,003.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Vantage Medical Group Senior |
$1,003.85
|
|
|
HC ECHO TEE W/CON MONITOR 2D
|
Facility
|
OP
|
$2,025.00
|
|
|
Service Code
|
CPT C8927
|
| Hospital Charge Code |
900200246
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$405.00 |
| Max. Negotiated Rate |
$1,822.50 |
| Rate for Payer: Adventist Health Commercial |
$405.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,003.85
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,229.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,003.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$980.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,189.28
|
| Rate for Payer: Blue Shield of California Commercial |
$1,229.17
|
| Rate for Payer: Blue Shield of California EPN |
$803.92
|
| Rate for Payer: Cash Price |
$1,113.75
|
| Rate for Payer: Cash Price |
$1,113.75
|
| Rate for Payer: Cash Price |
$1,113.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,620.00
|
| Rate for Payer: Cigna of CA HMO |
$1,296.00
|
| Rate for Payer: Cigna of CA PPO |
$1,498.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,104.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,003.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,355.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,003.85
|
| Rate for Payer: Galaxy Health WC |
$1,721.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,215.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,822.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,646.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,003.85
|
| Rate for Payer: InnovAge PACE Commercial |
$1,505.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,350.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$771.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,003.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$405.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,345.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,345.16
|
| Rate for Payer: Multiplan Commercial |
$1,518.75
|
| Rate for Payer: Networks By Design Commercial |
$1,316.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,003.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,721.25
|
| Rate for Payer: Prime Health Services Medicare |
$1,064.08
|
| Rate for Payer: Riverside University Health System MISP |
$1,104.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,215.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,215.00
|
| 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 |
$1,003.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,505.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.23
|
| Rate for Payer: Vantage Medical Group Senior |
$1,003.85
|
|
|
HC ECHO TEE W/CON MONITOR 2D
|
Facility
|
IP
|
$2,025.00
|
|
|
Service Code
|
CPT C8927
|
| Hospital Charge Code |
900200246
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$405.00 |
| Max. Negotiated Rate |
$1,822.50 |
| Rate for Payer: Adventist Health Commercial |
$405.00
|
| Rate for Payer: Cash Price |
$1,113.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,620.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$810.00
|
| Rate for Payer: EPIC Health Plan Senior |
$810.00
|
| Rate for Payer: Galaxy Health WC |
$1,721.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,215.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,822.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,350.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$771.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,253.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$405.00
|
| Rate for Payer: Multiplan Commercial |
$1,518.75
|
| Rate for Payer: Networks By Design Commercial |
$1,316.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,721.25
|
|
|
HC ECHO TRANSESOPHAGEAL
|
Facility
|
OP
|
$3,947.00
|
|
|
Service Code
|
CPT 93312
|
| Hospital Charge Code |
900200215
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$267.87 |
| Max. Negotiated Rate |
$3,552.30 |
| Rate for Payer: Adventist Health Commercial |
$789.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$696.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,397.01
|
| 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 |
$844.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,318.07
|
| Rate for Payer: Blue Shield of California Commercial |
$2,395.83
|
| Rate for Payer: Blue Shield of California EPN |
$1,566.96
|
| Rate for Payer: Cash Price |
$2,170.85
|
| Rate for Payer: Cash Price |
$2,170.85
|
| Rate for Payer: Cash Price |
$2,170.85
|
| Rate for Payer: Central Health Plan Commercial |
$3,157.60
|
| Rate for Payer: Cigna of CA HMO |
$2,526.08
|
| Rate for Payer: Cigna of CA PPO |
$2,920.78
|
| 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 |
$3,354.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,368.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,552.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,142.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$267.87
|
| 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 |
$2,632.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$295.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$696.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$789.40
|
| 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 |
$2,960.25
|
| Rate for Payer: Networks By Design Commercial |
$2,565.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$696.67
|
| Rate for Payer: Prime Health Services Commercial |
$3,354.95
|
| 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 |
$2,368.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,368.20
|
| 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 TRANSESOPHAGEAL
|
Facility
|
IP
|
$3,947.00
|
|
|
Service Code
|
CPT 93312
|
| Hospital Charge Code |
900200215
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$789.40 |
| Max. Negotiated Rate |
$3,552.30 |
| Rate for Payer: Adventist Health Commercial |
$789.40
|
| Rate for Payer: Cash Price |
$2,170.85
|
| Rate for Payer: Central Health Plan Commercial |
$3,157.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,578.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,578.80
|
| Rate for Payer: Galaxy Health WC |
$3,354.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,368.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,552.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,632.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,503.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,443.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$789.40
|
| Rate for Payer: Multiplan Commercial |
$2,960.25
|
| Rate for Payer: Networks By Design Commercial |
$2,565.55
|
| Rate for Payer: Prime Health Services Commercial |
$3,354.95
|
|
|
HC ECHO TRANSESOPHAGEAL (TEE)
|
Facility
|
IP
|
$10,774.00
|
|
|
Service Code
|
CPT 93355
|
| Hospital Charge Code |
900293355
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$2,154.80 |
| Max. Negotiated Rate |
$9,696.60 |
| Rate for Payer: Adventist Health Commercial |
$2,154.80
|
| Rate for Payer: Cash Price |
$5,925.70
|
| Rate for Payer: Central Health Plan Commercial |
$8,619.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,309.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,309.60
|
| Rate for Payer: Galaxy Health WC |
$9,157.90
|
| Rate for Payer: Global Benefits Group Commercial |
$6,464.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,696.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,186.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,104.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,669.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,154.80
|
| Rate for Payer: Multiplan Commercial |
$8,080.50
|
| Rate for Payer: Networks By Design Commercial |
$7,003.10
|
| Rate for Payer: Prime Health Services Commercial |
$9,157.90
|
|
