|
HC EEG GREATER THAN ONE HOUR
|
Facility
|
IP
|
$5,045.00
|
|
|
Service Code
|
CPT 95813
|
| Hospital Charge Code |
900600207
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,009.00 |
| Max. Negotiated Rate |
$4,540.50 |
| Rate for Payer: Adventist Health Commercial |
$1,009.00
|
| Rate for Payer: Cash Price |
$2,270.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,036.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,018.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,018.00
|
| Rate for Payer: Galaxy Health WC |
$4,288.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,027.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,540.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,365.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,922.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,122.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,009.00
|
| Rate for Payer: Multiplan Commercial |
$3,783.75
|
| Rate for Payer: Networks By Design Commercial |
$3,279.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,288.25
|
|
|
HC EEG MONITOR 16+ CHAN, EA 24 HR
|
Facility
|
OP
|
$10,204.00
|
|
|
Service Code
|
CPT 95953
|
| Hospital Charge Code |
900600212
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,272.00 |
| Max. Negotiated Rate |
$9,183.60 |
| Rate for Payer: Adventist Health Commercial |
$2,040.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,196.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,673.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,612.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,653.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,940.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,992.81
|
| Rate for Payer: Blue Shield of California Commercial |
$6,193.83
|
| Rate for Payer: Blue Shield of California EPN |
$4,050.99
|
| Rate for Payer: Cash Price |
$4,591.80
|
| Rate for Payer: Cash Price |
$4,591.80
|
| Rate for Payer: Central Health Plan Commercial |
$8,163.20
|
| Rate for Payer: Cigna of CA HMO |
$6,530.56
|
| Rate for Payer: Cigna of CA PPO |
$7,550.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,673.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,673.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,673.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,081.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,081.60
|
| Rate for Payer: Galaxy Health WC |
$8,673.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,122.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,183.60
|
| Rate for Payer: InnovAge PACE Commercial |
$5,102.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,806.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,887.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,316.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,040.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7,142.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7,142.80
|
| Rate for Payer: Multiplan Commercial |
$7,653.00
|
| Rate for Payer: Networks By Design Commercial |
$6,632.60
|
| Rate for Payer: Prime Health Services Commercial |
$8,673.40
|
| Rate for Payer: Riverside University Health System MISP |
$4,081.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,122.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,122.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,673.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,673.40
|
| Rate for Payer: Vantage Medical Group Senior |
$8,673.40
|
|
|
HC EEG MONITOR 16+ CHAN, EA 24 HR
|
Facility
|
IP
|
$10,204.00
|
|
|
Service Code
|
CPT 95953
|
| Hospital Charge Code |
900600212
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$2,040.80 |
| Max. Negotiated Rate |
$9,183.60 |
| Rate for Payer: Adventist Health Commercial |
$2,040.80
|
| Rate for Payer: Cash Price |
$4,591.80
|
| Rate for Payer: Central Health Plan Commercial |
$8,163.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,081.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,081.60
|
| Rate for Payer: Galaxy Health WC |
$8,673.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,122.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,183.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,806.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,887.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,316.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,040.80
|
| Rate for Payer: Multiplan Commercial |
$7,653.00
|
| Rate for Payer: Networks By Design Commercial |
$6,632.60
|
| Rate for Payer: Prime Health Services Commercial |
$8,673.40
|
|
|
HC EEG MONITORING/GIVING DRUGS
|
Facility
|
IP
|
$1,326.00
|
|
|
Service Code
|
CPT 95954
|
| Hospital Charge Code |
900600230
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$265.20 |
| Max. Negotiated Rate |
$1,193.40 |
| Rate for Payer: Adventist Health Commercial |
$265.20
|
| Rate for Payer: Cash Price |
$596.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,060.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$530.40
|
| Rate for Payer: EPIC Health Plan Senior |
$530.40
|
| Rate for Payer: Galaxy Health WC |
$1,127.10
|
| Rate for Payer: Global Benefits Group Commercial |
$795.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,193.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$884.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$505.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$820.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$265.20
|
| Rate for Payer: Multiplan Commercial |
$994.50
|
| Rate for Payer: Networks By Design Commercial |
$861.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,127.10
|
|
|
HC EEG MONITORING/GIVING DRUGS
|
Facility
|
OP
|
$1,326.00
|
|
|
Service Code
|
CPT 95954
|
| Hospital Charge Code |
900600230
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$124.16 |
| Max. Negotiated Rate |
$2,039.00 |
| Rate for Payer: Adventist Health Commercial |
$265.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$674.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$805.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$741.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$674.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$124.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$778.76
|
| Rate for Payer: Blue Shield of California Commercial |
$804.88
|
| Rate for Payer: Blue Shield of California EPN |
$526.42
|
| Rate for Payer: Cash Price |
$596.70
|
| Rate for Payer: Cash Price |
$596.70
|
| Rate for Payer: Cash Price |
$596.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,060.80
|
| Rate for Payer: Cigna of CA HMO |
$848.64
|
| Rate for Payer: Cigna of CA PPO |
$981.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$741.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$674.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$910.14
|
| Rate for Payer: EPIC Health Plan Senior |
$674.18
|
| Rate for Payer: Galaxy Health WC |
$1,127.10
|
| Rate for Payer: Global Benefits Group Commercial |
$795.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,193.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,105.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$674.18
|
| Rate for Payer: InnovAge PACE Commercial |
$1,011.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$884.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$505.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$674.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$265.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$903.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$903.40
|
| Rate for Payer: Multiplan Commercial |
$994.50
|
| Rate for Payer: Networks By Design Commercial |
$861.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$674.18
|
| Rate for Payer: Prime Health Services Commercial |
$1,127.10
|
| Rate for Payer: Prime Health Services Medicare |
$714.63
|
| Rate for Payer: Riverside University Health System MISP |
$741.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$795.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$795.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$674.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$741.60
|
| Rate for Payer: Vantage Medical Group Senior |
$674.18
|
|
|
HC EEG SEIZ MONT CABLE/RADIO 16CH
|
Facility
|
IP
|
$11,099.00
|
|
|
Service Code
|
CPT 95956
|
| Hospital Charge Code |
900600265
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$2,219.80 |
| Max. Negotiated Rate |
$9,989.10 |
| Rate for Payer: Adventist Health Commercial |
$2,219.80
|
| Rate for Payer: Cash Price |
$4,994.55
|
| Rate for Payer: Central Health Plan Commercial |
$8,879.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,439.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,439.60
|
| Rate for Payer: Galaxy Health WC |
$9,434.15
|
| Rate for Payer: Global Benefits Group Commercial |
$6,659.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,989.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,403.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,228.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,870.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,219.80
|
| Rate for Payer: Multiplan Commercial |
$8,324.25
|
| Rate for Payer: Networks By Design Commercial |
$7,214.35
|
| Rate for Payer: Prime Health Services Commercial |
$9,434.15
|
|
|
HC EEG SEIZ MONT CABLE/RADIO 16CH
|
Facility
|
OP
|
$11,099.00
|
|
|
Service Code
|
CPT 95956
|
| Hospital Charge Code |
900600265
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,272.00 |
| Max. Negotiated Rate |
$9,989.10 |
| Rate for Payer: Adventist Health Commercial |
$2,219.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,740.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9,434.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,104.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,324.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,374.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,518.44
|
| Rate for Payer: Blue Shield of California Commercial |
$6,737.09
|
| Rate for Payer: Blue Shield of California EPN |
$4,406.30
|
| Rate for Payer: Cash Price |
$4,994.55
|
| Rate for Payer: Cash Price |
$4,994.55
|
| Rate for Payer: Central Health Plan Commercial |
$8,879.20
|
| Rate for Payer: Cigna of CA HMO |
$7,103.36
|
| Rate for Payer: Cigna of CA PPO |
$8,213.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,434.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,434.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,434.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,439.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,439.60
|
| Rate for Payer: Galaxy Health WC |
$9,434.15
|
| Rate for Payer: Global Benefits Group Commercial |
$6,659.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,989.10
|
| Rate for Payer: InnovAge PACE Commercial |
$5,549.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,403.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,228.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,870.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,219.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7,769.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7,769.30
|
| Rate for Payer: Multiplan Commercial |
$8,324.25
|
| Rate for Payer: Networks By Design Commercial |
$7,214.35
|
| Rate for Payer: Prime Health Services Commercial |
$9,434.15
|
| Rate for Payer: Riverside University Health System MISP |
$4,439.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,659.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,659.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9,434.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,434.15
|
| Rate for Payer: Vantage Medical Group Senior |
$9,434.15
|
|
|
HC EEG SLEEP ONLY
|
Facility
|
OP
|
$4,171.00
|
|
|
Service Code
|
CPT 95822
|
| Hospital Charge Code |
900600203
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$111.82 |
| Max. Negotiated Rate |
$3,753.90 |
| Rate for Payer: Adventist Health Commercial |
$834.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$395.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,533.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,002.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,449.63
|
| Rate for Payer: Blue Shield of California Commercial |
$2,531.80
|
| Rate for Payer: Blue Shield of California EPN |
$1,655.89
|
| Rate for Payer: Cash Price |
$1,876.95
|
| Rate for Payer: Cash Price |
$1,876.95
|
| Rate for Payer: Cash Price |
$1,876.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,336.80
|
| Rate for Payer: Cigna of CA HMO |
$2,669.44
|
| Rate for Payer: Cigna of CA PPO |
$3,086.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.14
|
| Rate for Payer: EPIC Health Plan Senior |
$395.66
|
| Rate for Payer: Galaxy Health WC |
$3,545.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,502.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,753.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$648.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$111.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: InnovAge PACE Commercial |
$593.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,782.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$123.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$834.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$530.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$530.18
|
| Rate for Payer: Multiplan Commercial |
$3,128.25
|
| Rate for Payer: Networks By Design Commercial |
$2,711.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$395.66
|
| Rate for Payer: Prime Health Services Commercial |
$3,545.35
|
| Rate for Payer: Prime Health Services Medicare |
$419.40
|
| Rate for Payer: Riverside University Health System MISP |
$435.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,502.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,502.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$395.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC EEG SLEEP ONLY
|
Facility
|
IP
|
$4,171.00
|
|
|
Service Code
|
CPT 95822
|
| Hospital Charge Code |
900600203
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$834.20 |
| Max. Negotiated Rate |
$3,753.90 |
| Rate for Payer: Adventist Health Commercial |
$834.20
|
| Rate for Payer: Cash Price |
$1,876.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,336.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,668.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,668.40
|
| Rate for Payer: Galaxy Health WC |
$3,545.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,502.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,753.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,782.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,589.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,581.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$834.20
|
| Rate for Payer: Multiplan Commercial |
$3,128.25
|
| Rate for Payer: Networks By Design Commercial |
$2,711.15
|
| Rate for Payer: Prime Health Services Commercial |
$3,545.35
|
|
|
HC EEG VIDEO 16+ CHAN 12HR
|
Facility
|
OP
|
$15,926.00
|
|
|
Service Code
|
CPT 95951 52
|
| Hospital Charge Code |
900600621
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,272.00 |
| Max. Negotiated Rate |
$14,333.40 |
| Rate for Payer: Adventist Health Commercial |
$3,185.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,671.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,537.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,759.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11,944.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7,711.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,353.34
|
| Rate for Payer: Blue Shield of California Commercial |
$9,667.08
|
| Rate for Payer: Blue Shield of California EPN |
$6,322.62
|
| Rate for Payer: Cash Price |
$7,166.70
|
| Rate for Payer: Cash Price |
$7,166.70
|
| Rate for Payer: Central Health Plan Commercial |
$12,740.80
|
| Rate for Payer: Cigna of CA HMO |
$10,192.64
|
| Rate for Payer: Cigna of CA PPO |
$11,785.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,537.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$13,537.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,537.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,370.40
|
| Rate for Payer: EPIC Health Plan Senior |
$6,370.40
|
| Rate for Payer: Galaxy Health WC |
$13,537.10
|
| Rate for Payer: Global Benefits Group Commercial |
$9,555.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,333.40
|
| Rate for Payer: InnovAge PACE Commercial |
$7,963.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,622.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,067.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,858.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,185.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,148.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,148.20
|
| Rate for Payer: Multiplan Commercial |
$11,944.50
|
| Rate for Payer: Networks By Design Commercial |
$10,351.90
|
| Rate for Payer: Prime Health Services Commercial |
$13,537.10
|
| Rate for Payer: Riverside University Health System MISP |
$6,370.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,555.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,555.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,537.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13,537.10
|
| Rate for Payer: Vantage Medical Group Senior |
$13,537.10
|
|
|
HC EEG VIDEO 16+ CHAN 12HR
|
Facility
|
IP
|
$15,926.00
|
|
|
Service Code
|
CPT 95951 52
|
| Hospital Charge Code |
900600621
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$3,185.20 |
| Max. Negotiated Rate |
$14,333.40 |
| Rate for Payer: Adventist Health Commercial |
$3,185.20
|
| Rate for Payer: Cash Price |
$7,166.70
|
| Rate for Payer: Central Health Plan Commercial |
$12,740.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,370.40
|
| Rate for Payer: EPIC Health Plan Senior |
$6,370.40
|
| Rate for Payer: Galaxy Health WC |
$13,537.10
|
| Rate for Payer: Global Benefits Group Commercial |
$9,555.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,333.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,622.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,067.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,858.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,185.20
|
| Rate for Payer: Multiplan Commercial |
$11,944.50
|
| Rate for Payer: Networks By Design Commercial |
$10,351.90
|
| Rate for Payer: Prime Health Services Commercial |
$13,537.10
|
|
|
HC EEG VIDEO 16+ CHAN 24HR
|
Facility
|
IP
|
$15,926.00
|
|
|
Service Code
|
CPT 95951
|
| Hospital Charge Code |
900600620
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$3,185.20 |
| Max. Negotiated Rate |
$14,333.40 |
| Rate for Payer: Adventist Health Commercial |
$3,185.20
|
| Rate for Payer: Cash Price |
$7,166.70
|
| Rate for Payer: Central Health Plan Commercial |
$12,740.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,370.40
|
| Rate for Payer: EPIC Health Plan Senior |
$6,370.40
|
| Rate for Payer: Galaxy Health WC |
$13,537.10
|
| Rate for Payer: Global Benefits Group Commercial |
$9,555.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,333.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,622.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,067.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,858.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,185.20
|
| Rate for Payer: Multiplan Commercial |
$11,944.50
|
| Rate for Payer: Networks By Design Commercial |
$10,351.90
|
| Rate for Payer: Prime Health Services Commercial |
$13,537.10
|
|
|
HC EEG VIDEO 16+ CHAN 24HR
|
Facility
|
OP
|
$15,926.00
|
|
|
Service Code
|
CPT 95951
|
| Hospital Charge Code |
900600620
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,272.00 |
| Max. Negotiated Rate |
$14,333.40 |
| Rate for Payer: Adventist Health Commercial |
$3,185.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,671.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,537.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,759.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11,944.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7,711.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,353.34
|
| Rate for Payer: Blue Shield of California Commercial |
$9,667.08
|
| Rate for Payer: Blue Shield of California EPN |
$6,322.62
|
| Rate for Payer: Cash Price |
$7,166.70
|
| Rate for Payer: Cash Price |
$7,166.70
|
| Rate for Payer: Central Health Plan Commercial |
$12,740.80
|
| Rate for Payer: Cigna of CA HMO |
$10,192.64
|
| Rate for Payer: Cigna of CA PPO |
$11,785.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,537.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$13,537.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,537.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,370.40
|
| Rate for Payer: EPIC Health Plan Senior |
$6,370.40
|
| Rate for Payer: Galaxy Health WC |
$13,537.10
|
| Rate for Payer: Global Benefits Group Commercial |
$9,555.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,333.40
|
| Rate for Payer: InnovAge PACE Commercial |
$7,963.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,622.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,067.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,858.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,185.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,148.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,148.20
|
| Rate for Payer: Multiplan Commercial |
$11,944.50
|
| Rate for Payer: Networks By Design Commercial |
$10,351.90
|
| Rate for Payer: Prime Health Services Commercial |
$13,537.10
|
| Rate for Payer: Riverside University Health System MISP |
$6,370.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,555.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,555.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,537.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13,537.10
|
| Rate for Payer: Vantage Medical Group Senior |
$13,537.10
|
|
|
HC EEG W/O VID 2-12HR CONT MNTR
|
Facility
|
OP
|
$1,249.00
|
|
|
Service Code
|
CPT 95707
|
| Hospital Charge Code |
900605707
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$249.80 |
| Max. Negotiated Rate |
$3,209.17 |
| Rate for Payer: Adventist Health Commercial |
$249.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$395.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$758.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,209.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$733.54
|
| Rate for Payer: Blue Shield of California Commercial |
$758.14
|
| Rate for Payer: Blue Shield of California EPN |
$495.85
|
| Rate for Payer: Cash Price |
$562.05
|
| Rate for Payer: Cash Price |
$562.05
|
| Rate for Payer: Cash Price |
$562.05
|
| Rate for Payer: Central Health Plan Commercial |
$999.20
|
| Rate for Payer: Cigna of CA HMO |
$799.36
|
| Rate for Payer: Cigna of CA PPO |
$924.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.14
|
| Rate for Payer: EPIC Health Plan Senior |
$395.66
|
| Rate for Payer: Galaxy Health WC |
$1,061.65
|
| Rate for Payer: Global Benefits Group Commercial |
$749.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,124.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$648.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,100.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: InnovAge PACE Commercial |
$593.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$833.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,215.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$249.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$530.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$530.18
|
| Rate for Payer: Multiplan Commercial |
$936.75
|
| Rate for Payer: Networks By Design Commercial |
$811.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$395.66
|
| Rate for Payer: Prime Health Services Commercial |
$1,061.65
|
| Rate for Payer: Prime Health Services Medicare |
$419.40
|
| Rate for Payer: Riverside University Health System MISP |
$435.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$749.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$749.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$395.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC EEG W/O VID 2-12HR CONT MNTR
|
Facility
|
IP
|
$1,249.00
|
|
|
Service Code
|
CPT 95707
|
| Hospital Charge Code |
900605707
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$249.80 |
| Max. Negotiated Rate |
$1,124.10 |
| Rate for Payer: Adventist Health Commercial |
$249.80
|
| Rate for Payer: Cash Price |
$562.05
|
| Rate for Payer: Central Health Plan Commercial |
$999.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.60
|
| Rate for Payer: EPIC Health Plan Senior |
$499.60
|
| Rate for Payer: Galaxy Health WC |
$1,061.65
|
| Rate for Payer: Global Benefits Group Commercial |
$749.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,124.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$833.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$475.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$773.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$249.80
|
| Rate for Payer: Multiplan Commercial |
$936.75
|
| Rate for Payer: Networks By Design Commercial |
$811.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,061.65
|
|
|
HC EEG W/O VID 2-12HR INTMT MNTRD
|
Facility
|
OP
|
$1,249.00
|
|
|
Service Code
|
CPT 95706
|
| Hospital Charge Code |
900605706
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$249.80 |
| Max. Negotiated Rate |
$3,209.17 |
| Rate for Payer: Adventist Health Commercial |
$249.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$395.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$758.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,209.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$733.54
|
| Rate for Payer: Blue Shield of California Commercial |
$758.14
|
| Rate for Payer: Blue Shield of California EPN |
$495.85
|
| Rate for Payer: Cash Price |
$562.05
|
| Rate for Payer: Cash Price |
$562.05
|
| Rate for Payer: Cash Price |
$562.05
|
| Rate for Payer: Central Health Plan Commercial |
$999.20
|
| Rate for Payer: Cigna of CA HMO |
$799.36
|
| Rate for Payer: Cigna of CA PPO |
$924.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.14
|
| Rate for Payer: EPIC Health Plan Senior |
$395.66
|
| Rate for Payer: Galaxy Health WC |
$1,061.65
|
| Rate for Payer: Global Benefits Group Commercial |
$749.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,124.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$648.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$567.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: InnovAge PACE Commercial |
$593.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$833.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$626.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$249.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$530.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$530.18
|
| Rate for Payer: Multiplan Commercial |
$936.75
|
| Rate for Payer: Networks By Design Commercial |
$811.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$395.66
|
| Rate for Payer: Prime Health Services Commercial |
$1,061.65
|
| Rate for Payer: Prime Health Services Medicare |
$419.40
|
| Rate for Payer: Riverside University Health System MISP |
$435.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$749.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$749.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$395.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC EEG W/O VID 2-12HR INTMT MNTRD
|
Facility
|
IP
|
$1,249.00
|
|
|
Service Code
|
CPT 95706
|
| Hospital Charge Code |
900605706
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$249.80 |
| Max. Negotiated Rate |
$1,124.10 |
| Rate for Payer: Adventist Health Commercial |
$249.80
|
| Rate for Payer: Cash Price |
$562.05
|
| Rate for Payer: Central Health Plan Commercial |
$999.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.60
|
| Rate for Payer: EPIC Health Plan Senior |
$499.60
|
| Rate for Payer: Galaxy Health WC |
$1,061.65
|
| Rate for Payer: Global Benefits Group Commercial |
$749.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,124.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$833.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$475.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$773.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$249.80
|
| Rate for Payer: Multiplan Commercial |
$936.75
|
| Rate for Payer: Networks By Design Commercial |
$811.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,061.65
|
|
|
HC EEG W/O VID 2-12HR UNMNTRD
|
Facility
|
OP
|
$1,249.00
|
|
|
Service Code
|
CPT 95705
|
| Hospital Charge Code |
900605705
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$249.80 |
| Max. Negotiated Rate |
$3,209.17 |
| Rate for Payer: Adventist Health Commercial |
$249.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$395.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$758.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,209.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$733.54
|
| Rate for Payer: Blue Shield of California Commercial |
$758.14
|
| Rate for Payer: Blue Shield of California EPN |
$495.85
|
| Rate for Payer: Cash Price |
$562.05
|
| Rate for Payer: Cash Price |
$562.05
|
| Rate for Payer: Cash Price |
$562.05
|
| Rate for Payer: Central Health Plan Commercial |
$999.20
|
| Rate for Payer: Cigna of CA HMO |
$799.36
|
| Rate for Payer: Cigna of CA PPO |
$924.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.14
|
| Rate for Payer: EPIC Health Plan Senior |
$395.66
|
| Rate for Payer: Galaxy Health WC |
$1,061.65
|
| Rate for Payer: Global Benefits Group Commercial |
$749.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,124.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$648.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$381.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: InnovAge PACE Commercial |
$593.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$833.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$421.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$249.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$530.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$530.18
|
| Rate for Payer: Multiplan Commercial |
$936.75
|
| Rate for Payer: Networks By Design Commercial |
$811.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$395.66
|
| Rate for Payer: Prime Health Services Commercial |
$1,061.65
|
| Rate for Payer: Prime Health Services Medicare |
$419.40
|
| Rate for Payer: Riverside University Health System MISP |
$435.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$749.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$749.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$395.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC EEG W/O VID 2-12HR UNMNTRD
|
Facility
|
IP
|
$1,249.00
|
|
|
Service Code
|
CPT 95705
|
| Hospital Charge Code |
900605705
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$249.80 |
| Max. Negotiated Rate |
$1,124.10 |
| Rate for Payer: Adventist Health Commercial |
$249.80
|
| Rate for Payer: Cash Price |
$562.05
|
| Rate for Payer: Central Health Plan Commercial |
$999.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.60
|
| Rate for Payer: EPIC Health Plan Senior |
$499.60
|
| Rate for Payer: Galaxy Health WC |
$1,061.65
|
| Rate for Payer: Global Benefits Group Commercial |
$749.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,124.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$833.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$475.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$773.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$249.80
|
| Rate for Payer: Multiplan Commercial |
$936.75
|
| Rate for Payer: Networks By Design Commercial |
$811.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,061.65
|
|
|
HC EEG W/O VID EA 12-26HR CNT MNR
|
Facility
|
IP
|
$2,397.00
|
|
|
Service Code
|
CPT 95710
|
| Hospital Charge Code |
900605710
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$479.40 |
| Max. Negotiated Rate |
$2,157.30 |
| Rate for Payer: Adventist Health Commercial |
$479.40
|
| Rate for Payer: Cash Price |
$1,078.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,917.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$958.80
|
| Rate for Payer: EPIC Health Plan Senior |
$958.80
|
| Rate for Payer: Galaxy Health WC |
$2,037.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,438.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,157.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,598.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$913.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,483.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$479.40
|
| Rate for Payer: Multiplan Commercial |
$1,797.75
|
| Rate for Payer: Networks By Design Commercial |
$1,558.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,037.45
|
|
|
HC EEG W/O VID EA 12-26HR CNT MNR
|
Facility
|
OP
|
$2,397.00
|
|
|
Service Code
|
CPT 95710
|
| Hospital Charge Code |
900605710
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$479.40 |
| Max. Negotiated Rate |
$2,157.30 |
| Rate for Payer: Adventist Health Commercial |
$479.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$674.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,455.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$741.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$674.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,242.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,407.76
|
| Rate for Payer: Blue Shield of California Commercial |
$1,454.98
|
| Rate for Payer: Blue Shield of California EPN |
$951.61
|
| Rate for Payer: Cash Price |
$1,078.65
|
| Rate for Payer: Cash Price |
$1,078.65
|
| Rate for Payer: Cash Price |
$1,078.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,917.60
|
| Rate for Payer: Cigna of CA HMO |
$1,534.08
|
| Rate for Payer: Cigna of CA PPO |
$1,773.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$741.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$674.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$910.14
|
| Rate for Payer: EPIC Health Plan Senior |
$674.18
|
| Rate for Payer: Galaxy Health WC |
$2,037.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,438.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,157.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,105.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,759.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$674.18
|
| Rate for Payer: InnovAge PACE Commercial |
$1,011.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,598.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,944.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$674.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$479.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$903.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$903.40
|
| Rate for Payer: Multiplan Commercial |
$1,797.75
|
| Rate for Payer: Networks By Design Commercial |
$1,558.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$674.18
|
| Rate for Payer: Prime Health Services Commercial |
$2,037.45
|
| Rate for Payer: Prime Health Services Medicare |
$714.63
|
| Rate for Payer: Riverside University Health System MISP |
$741.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,438.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,438.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$674.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$741.60
|
| Rate for Payer: Vantage Medical Group Senior |
$674.18
|
|
|
HC EEG W/O VID EA 12-26HR INT MNR
|
Facility
|
OP
|
$2,397.00
|
|
|
Service Code
|
CPT 95709
|
| Hospital Charge Code |
900605709
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$479.40 |
| Max. Negotiated Rate |
$3,209.17 |
| Rate for Payer: Adventist Health Commercial |
$479.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$674.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,455.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$741.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$674.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,209.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,407.76
|
| Rate for Payer: Blue Shield of California Commercial |
$1,454.98
|
| Rate for Payer: Blue Shield of California EPN |
$951.61
|
| Rate for Payer: Cash Price |
$1,078.65
|
| Rate for Payer: Cash Price |
$1,078.65
|
| Rate for Payer: Cash Price |
$1,078.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,917.60
|
| Rate for Payer: Cigna of CA HMO |
$1,534.08
|
| Rate for Payer: Cigna of CA PPO |
$1,773.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$741.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$674.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$910.14
|
| Rate for Payer: EPIC Health Plan Senior |
$674.18
|
| Rate for Payer: Galaxy Health WC |
$2,037.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,438.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,157.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,105.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,012.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$674.18
|
| Rate for Payer: InnovAge PACE Commercial |
$1,011.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,598.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,118.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$674.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$479.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$903.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$903.40
|
| Rate for Payer: Multiplan Commercial |
$1,797.75
|
| Rate for Payer: Networks By Design Commercial |
$1,558.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$674.18
|
| Rate for Payer: Prime Health Services Commercial |
$2,037.45
|
| Rate for Payer: Prime Health Services Medicare |
$714.63
|
| Rate for Payer: Riverside University Health System MISP |
$741.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,438.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,438.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$674.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$741.60
|
| Rate for Payer: Vantage Medical Group Senior |
$674.18
|
|
|
HC EEG W/O VID EA 12-26HR INT MNR
|
Facility
|
IP
|
$2,397.00
|
|
|
Service Code
|
CPT 95709
|
| Hospital Charge Code |
900605709
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$479.40 |
| Max. Negotiated Rate |
$2,157.30 |
| Rate for Payer: Adventist Health Commercial |
$479.40
|
| Rate for Payer: Cash Price |
$1,078.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,917.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$958.80
|
| Rate for Payer: EPIC Health Plan Senior |
$958.80
|
| Rate for Payer: Galaxy Health WC |
$2,037.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,438.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,157.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,598.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$913.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,483.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$479.40
|
| Rate for Payer: Multiplan Commercial |
$1,797.75
|
| Rate for Payer: Networks By Design Commercial |
$1,558.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,037.45
|
|
|
HC EEG W/O VID EA 12-26HR UNMNTRD
|
Facility
|
OP
|
$4,168.00
|
|
|
Service Code
|
CPT 95708
|
| Hospital Charge Code |
900605708
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$455.92 |
| Max. Negotiated Rate |
$3,751.20 |
| Rate for Payer: Adventist Health Commercial |
$833.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$674.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,531.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$741.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$674.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,209.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,447.87
|
| Rate for Payer: Blue Shield of California Commercial |
$2,529.98
|
| Rate for Payer: Blue Shield of California EPN |
$1,654.70
|
| Rate for Payer: Cash Price |
$1,875.60
|
| Rate for Payer: Cash Price |
$1,875.60
|
| Rate for Payer: Cash Price |
$1,875.60
|
| Rate for Payer: Central Health Plan Commercial |
$3,334.40
|
| Rate for Payer: Cigna of CA HMO |
$2,667.52
|
| Rate for Payer: Cigna of CA PPO |
$3,084.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$741.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$674.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$910.14
|
| Rate for Payer: EPIC Health Plan Senior |
$674.18
|
| Rate for Payer: Galaxy Health WC |
$3,542.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,500.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,751.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,105.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$455.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$674.18
|
| Rate for Payer: InnovAge PACE Commercial |
$1,011.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,780.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$503.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$674.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$833.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$903.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$903.40
|
| Rate for Payer: Multiplan Commercial |
$3,126.00
|
| Rate for Payer: Networks By Design Commercial |
$2,709.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$674.18
|
| Rate for Payer: Prime Health Services Commercial |
$3,542.80
|
| Rate for Payer: Prime Health Services Medicare |
$714.63
|
| Rate for Payer: Riverside University Health System MISP |
$741.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,500.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,500.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$674.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$741.60
|
| Rate for Payer: Vantage Medical Group Senior |
$674.18
|
|
|
HC EEG W/O VID EA 12-26HR UNMNTRD
|
Facility
|
IP
|
$4,168.00
|
|
|
Service Code
|
CPT 95708
|
| Hospital Charge Code |
900605708
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$833.60 |
| Max. Negotiated Rate |
$3,751.20 |
| Rate for Payer: Adventist Health Commercial |
$833.60
|
| Rate for Payer: Cash Price |
$1,875.60
|
| Rate for Payer: Central Health Plan Commercial |
$3,334.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,667.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,667.20
|
| Rate for Payer: Galaxy Health WC |
$3,542.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,500.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,751.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,780.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,588.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,579.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$833.60
|
| Rate for Payer: Multiplan Commercial |
$3,126.00
|
| Rate for Payer: Networks By Design Commercial |
$2,709.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,542.80
|
|
