|
HC GAIT TRAINING 15 MIN PT
|
Facility
|
IP
|
$218.00
|
|
|
Service Code
|
CPT 97116
|
| Hospital Charge Code |
900417116
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$43.60 |
| Max. Negotiated Rate |
$196.20 |
| Rate for Payer: Adventist Health Commercial |
$43.60
|
| Rate for Payer: Cash Price |
$98.10
|
| Rate for Payer: Central Health Plan Commercial |
$174.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$152.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.20
|
| Rate for Payer: EPIC Health Plan Senior |
$87.20
|
| Rate for Payer: Galaxy Health WC |
$185.30
|
| Rate for Payer: Global Benefits Group Commercial |
$130.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$196.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$138.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$128.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.60
|
| Rate for Payer: Multiplan Commercial |
$163.50
|
| Rate for Payer: Networks By Design Commercial |
$141.70
|
| Rate for Payer: Prime Health Services Commercial |
$185.30
|
|
|
HC GAIT TRAINING 15 MIN PT
|
Facility
|
OP
|
$218.00
|
|
|
Service Code
|
CPT 97116
|
| Hospital Charge Code |
905103143
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.40 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$89.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$116.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$185.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$119.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$98.10
|
| Rate for Payer: Cash Price |
$98.10
|
| Rate for Payer: Cash Price |
$98.10
|
| Rate for Payer: Central Health Plan Commercial |
$174.40
|
| Rate for Payer: Cigna of CA HMO |
$139.52
|
| Rate for Payer: Cigna of CA PPO |
$161.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$185.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$185.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$185.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$152.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.20
|
| Rate for Payer: EPIC Health Plan Senior |
$87.20
|
| Rate for Payer: Galaxy Health WC |
$185.30
|
| Rate for Payer: Global Benefits Group Commercial |
$130.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$196.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$138.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$128.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$152.60
|
| Rate for Payer: Multiplan Commercial |
$163.50
|
| Rate for Payer: Networks By Design Commercial |
$141.70
|
| Rate for Payer: Prime Health Services Commercial |
$185.30
|
| Rate for Payer: Riverside University Health System MISP |
$87.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$130.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$130.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$185.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$185.30
|
| Rate for Payer: Vantage Medical Group Senior |
$185.30
|
|
|
HC GAIT TRAINING 15 MIN PT
|
Facility
|
IP
|
$218.00
|
|
|
Service Code
|
CPT 97116
|
| Hospital Charge Code |
905103143
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$43.60 |
| Max. Negotiated Rate |
$196.20 |
| Rate for Payer: Adventist Health Commercial |
$43.60
|
| Rate for Payer: Cash Price |
$98.10
|
| Rate for Payer: Central Health Plan Commercial |
$174.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$152.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.20
|
| Rate for Payer: EPIC Health Plan Senior |
$87.20
|
| Rate for Payer: Galaxy Health WC |
$185.30
|
| Rate for Payer: Global Benefits Group Commercial |
$130.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$196.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$138.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$128.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.60
|
| Rate for Payer: Multiplan Commercial |
$163.50
|
| Rate for Payer: Networks By Design Commercial |
$141.70
|
| Rate for Payer: Prime Health Services Commercial |
$185.30
|
|
|
HC GAIT TRAINING 30 MIN PT
|
Facility
|
OP
|
$327.00
|
|
|
Service Code
|
CPT 97116
|
| Hospital Charge Code |
905103363
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.40 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$134.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$116.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$277.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$179.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$245.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Central Health Plan Commercial |
$261.60
|
| Rate for Payer: Cigna of CA HMO |
$209.28
|
| Rate for Payer: Cigna of CA PPO |
$241.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$277.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$277.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$228.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.80
|
| Rate for Payer: EPIC Health Plan Senior |
$130.80
|
| Rate for Payer: Galaxy Health WC |
$277.95
|
| Rate for Payer: Global Benefits Group Commercial |
$196.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$294.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$207.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$192.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$134.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$228.90
|
| Rate for Payer: Multiplan Commercial |
$245.25
|
| Rate for Payer: Networks By Design Commercial |
$212.55
|
| Rate for Payer: Prime Health Services Commercial |
$277.95
|
| Rate for Payer: Riverside University Health System MISP |
$130.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$196.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$196.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$277.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.95
|
| Rate for Payer: Vantage Medical Group Senior |
$277.95
|
|
|
HC GAIT TRAINING 30 MIN PT
|
Facility
|
IP
|
$327.00
|
|
|
Service Code
|
CPT 97116
|
| Hospital Charge Code |
905103363
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$65.40 |
| Max. Negotiated Rate |
$294.30 |
| Rate for Payer: Adventist Health Commercial |
$65.40
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Central Health Plan Commercial |
$261.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$228.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.80
|
| Rate for Payer: EPIC Health Plan Senior |
$130.80
|
| Rate for Payer: Galaxy Health WC |
$277.95
|
| Rate for Payer: Global Benefits Group Commercial |
$196.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$294.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$207.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$192.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.40
|
| Rate for Payer: Multiplan Commercial |
$245.25
|
| Rate for Payer: Networks By Design Commercial |
$212.55
|
| Rate for Payer: Prime Health Services Commercial |
$277.95
|
|
|
HC GAL D 1 (EGG WHITE), IGE
|
Facility
|
OP
|
$11.06
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913722
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.21 |
| Max. Negotiated Rate |
$167.30 |
| Rate for Payer: Adventist Health Commercial |
$2.21
|
| Rate for Payer: Adventist Health Commercial |
$2.65
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Blue Shield of California Commercial |
$8.36
|
| Rate for Payer: Blue Shield of California Commercial |
$6.97
|
| Rate for Payer: Blue Shield of California EPN |
$5.27
|
| Rate for Payer: Blue Shield of California EPN |
$4.39
|
| Rate for Payer: Cash Price |
$5.97
|
| Rate for Payer: Cash Price |
$5.97
|
| Rate for Payer: Cash Price |
$4.98
|
| Rate for Payer: Cash Price |
$4.98
|
| Rate for Payer: Central Health Plan Commercial |
$8.85
|
| Rate for Payer: Central Health Plan Commercial |
$10.62
|
| Rate for Payer: Cigna of CA HMO |
$8.49
|
| Rate for Payer: Cigna of CA HMO |
$7.08
|
| Rate for Payer: Cigna of CA PPO |
$9.82
|
| Rate for Payer: Cigna of CA PPO |
$8.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: Galaxy Health WC |
$11.28
|
| Rate for Payer: Galaxy Health WC |
$9.40
|
| Rate for Payer: Global Benefits Group Commercial |
$7.96
|
| Rate for Payer: Global Benefits Group Commercial |
$6.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.95
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$9.95
|
| Rate for Payer: Multiplan Commercial |
$8.29
|
| Rate for Payer: Networks By Design Commercial |
$7.19
|
| Rate for Payer: Networks By Design Commercial |
$8.63
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: Prime Health Services Commercial |
$11.28
|
| Rate for Payer: Prime Health Services Commercial |
$9.40
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC GAL D 1 (EGG WHITE), IGE
|
Facility
|
IP
|
$13.27
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913722
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.65 |
| Max. Negotiated Rate |
$11.94 |
| Rate for Payer: Adventist Health Commercial |
$2.65
|
| Rate for Payer: Cash Price |
$5.97
|
| Rate for Payer: Central Health Plan Commercial |
$10.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.31
|
| Rate for Payer: EPIC Health Plan Senior |
$5.31
|
| Rate for Payer: Galaxy Health WC |
$11.28
|
| Rate for Payer: Global Benefits Group Commercial |
$7.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.65
|
| Rate for Payer: Multiplan Commercial |
$9.95
|
| Rate for Payer: Networks By Design Commercial |
$8.63
|
| Rate for Payer: Prime Health Services Commercial |
$11.28
|
|
|
HC GAL D 2 (EGG WHITE), IGE
|
Facility
|
OP
|
$11.06
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913723
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.21 |
| Max. Negotiated Rate |
$167.30 |
| Rate for Payer: Adventist Health Commercial |
$2.21
|
| Rate for Payer: Adventist Health Commercial |
$2.65
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Blue Shield of California Commercial |
$8.36
|
| Rate for Payer: Blue Shield of California Commercial |
$6.97
|
| Rate for Payer: Blue Shield of California EPN |
$5.27
|
| Rate for Payer: Blue Shield of California EPN |
$4.39
|
| Rate for Payer: Cash Price |
$5.97
|
| Rate for Payer: Cash Price |
$5.97
|
| Rate for Payer: Cash Price |
$4.98
|
| Rate for Payer: Cash Price |
$4.98
|
| Rate for Payer: Central Health Plan Commercial |
$8.85
|
| Rate for Payer: Central Health Plan Commercial |
$10.62
|
| Rate for Payer: Cigna of CA HMO |
$8.49
|
| Rate for Payer: Cigna of CA HMO |
$7.08
|
| Rate for Payer: Cigna of CA PPO |
$9.82
|
| Rate for Payer: Cigna of CA PPO |
$8.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: Galaxy Health WC |
$11.28
|
| Rate for Payer: Galaxy Health WC |
$9.40
|
| Rate for Payer: Global Benefits Group Commercial |
$7.96
|
| Rate for Payer: Global Benefits Group Commercial |
$6.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.95
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$9.95
|
| Rate for Payer: Multiplan Commercial |
$8.29
|
| Rate for Payer: Networks By Design Commercial |
$7.19
|
| Rate for Payer: Networks By Design Commercial |
$8.63
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: Prime Health Services Commercial |
$11.28
|
| Rate for Payer: Prime Health Services Commercial |
$9.40
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC GAL D 2 (EGG WHITE), IGE
|
Facility
|
IP
|
$13.27
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913723
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.65 |
| Max. Negotiated Rate |
$11.94 |
| Rate for Payer: Adventist Health Commercial |
$2.65
|
| Rate for Payer: Cash Price |
$5.97
|
| Rate for Payer: Central Health Plan Commercial |
$10.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.31
|
| Rate for Payer: EPIC Health Plan Senior |
$5.31
|
| Rate for Payer: Galaxy Health WC |
$11.28
|
| Rate for Payer: Global Benefits Group Commercial |
$7.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.65
|
| Rate for Payer: Multiplan Commercial |
$9.95
|
| Rate for Payer: Networks By Design Commercial |
$8.63
|
| Rate for Payer: Prime Health Services Commercial |
$11.28
|
|
|
HC GALLBLDR/LIVER FUNC
|
Facility
|
IP
|
$2,375.00
|
|
|
Service Code
|
CPT 78226
|
| Hospital Charge Code |
909301353
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$475.00 |
| Max. Negotiated Rate |
$2,137.50 |
| Rate for Payer: Adventist Health Commercial |
$475.00
|
| Rate for Payer: Cash Price |
$1,068.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,900.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,662.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$950.00
|
| Rate for Payer: EPIC Health Plan Senior |
$950.00
|
| Rate for Payer: Galaxy Health WC |
$2,018.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,425.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,137.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,508.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,401.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$475.00
|
| Rate for Payer: Multiplan Commercial |
$1,781.25
|
| Rate for Payer: Networks By Design Commercial |
$1,543.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,018.75
|
|
|
HC GALLBLDR/LIVER FUNC
|
Facility
|
OP
|
$2,375.00
|
|
|
Service Code
|
CPT 78226
|
| Hospital Charge Code |
909301353
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$475.00 |
| Max. Negotiated Rate |
$2,455.87 |
| Rate for Payer: Adventist Health Commercial |
$475.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$514.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,763.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$514.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,766.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,455.87
|
| Rate for Payer: Blue Shield of California Commercial |
$1,496.25
|
| Rate for Payer: Blue Shield of California EPN |
$942.88
|
| Rate for Payer: Cash Price |
$1,068.75
|
| Rate for Payer: Cash Price |
$1,068.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,900.00
|
| Rate for Payer: Cigna of CA HMO |
$1,520.00
|
| Rate for Payer: Cigna of CA PPO |
$1,757.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$771.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$565.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$514.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,662.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$848.38
|
| Rate for Payer: EPIC Health Plan Senior |
$565.59
|
| Rate for Payer: Galaxy Health WC |
$2,018.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,425.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,137.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$843.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$500.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$514.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,508.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$552.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$719.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$475.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$688.99
|
| Rate for Payer: Multiplan Commercial |
$1,781.25
|
| Rate for Payer: Networks By Design Commercial |
$1,543.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$514.17
|
| Rate for Payer: Prime Health Services Commercial |
$2,018.75
|
| Rate for Payer: Prime Health Services Medicare |
$545.02
|
| Rate for Payer: Riverside University Health System MISP |
$565.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,425.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,425.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$751.01
|
| Rate for Payer: United Healthcare All Other HMO |
$751.01
|
| Rate for Payer: United Healthcare HMO Rider |
$751.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$751.01
|
| Rate for Payer: Upland Medical Group Pediatric |
$514.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Vantage Medical Group Senior |
$514.17
|
|
|
HC GALLIUM SCAN LIMITED
|
Facility
|
OP
|
$1,413.00
|
|
|
Service Code
|
CPT 78800
|
| Hospital Charge Code |
909301446
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$153.29 |
| Max. Negotiated Rate |
$1,271.70 |
| Rate for Payer: Adventist Health Commercial |
$282.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$514.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$980.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$514.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$700.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$821.94
|
| Rate for Payer: Blue Shield of California Commercial |
$890.19
|
| Rate for Payer: Blue Shield of California EPN |
$560.96
|
| Rate for Payer: Cash Price |
$635.85
|
| Rate for Payer: Cash Price |
$635.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,130.40
|
| Rate for Payer: Cigna of CA HMO |
$904.32
|
| Rate for Payer: Cigna of CA PPO |
$1,045.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$771.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$565.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$514.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$989.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$848.38
|
| Rate for Payer: EPIC Health Plan Senior |
$565.59
|
| Rate for Payer: Galaxy Health WC |
$1,201.05
|
| Rate for Payer: Global Benefits Group Commercial |
$847.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,271.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$843.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$153.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$514.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$897.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$169.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$719.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$282.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$688.99
|
| Rate for Payer: Multiplan Commercial |
$1,059.75
|
| Rate for Payer: Networks By Design Commercial |
$918.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$514.17
|
| Rate for Payer: Prime Health Services Commercial |
$1,201.05
|
| Rate for Payer: Prime Health Services Medicare |
$545.02
|
| Rate for Payer: Riverside University Health System MISP |
$565.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$847.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$847.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$717.15
|
| Rate for Payer: United Healthcare All Other HMO |
$717.15
|
| Rate for Payer: United Healthcare HMO Rider |
$717.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$717.15
|
| Rate for Payer: Upland Medical Group Pediatric |
$514.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Vantage Medical Group Senior |
$514.17
|
|
|
HC GALLIUM SCAN LIMITED
|
Facility
|
IP
|
$1,413.00
|
|
|
Service Code
|
CPT 78800
|
| Hospital Charge Code |
909301446
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$282.60 |
| Max. Negotiated Rate |
$1,271.70 |
| Rate for Payer: Adventist Health Commercial |
$282.60
|
| Rate for Payer: Cash Price |
$635.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,130.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$989.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$565.20
|
| Rate for Payer: EPIC Health Plan Senior |
$565.20
|
| Rate for Payer: Galaxy Health WC |
$1,201.05
|
| Rate for Payer: Global Benefits Group Commercial |
$847.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,271.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$897.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$833.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$282.60
|
| Rate for Payer: Multiplan Commercial |
$1,059.75
|
| Rate for Payer: Networks By Design Commercial |
$918.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,201.05
|
|
|
HC GAMMA GLUTAMYL TRANSFERASE
|
Facility
|
OP
|
$270.00
|
|
|
Service Code
|
CPT 82977
|
| Hospital Charge Code |
900910225
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.83 |
| Max. Negotiated Rate |
$243.00 |
| Rate for Payer: Adventist Health Commercial |
$54.00
|
| Rate for Payer: Adventist Health Commercial |
$8.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$7.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$7.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$52.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$52.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$52.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$52.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$73.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$73.13
|
| Rate for Payer: Blue Shield of California Commercial |
$27.72
|
| Rate for Payer: Blue Shield of California Commercial |
$170.10
|
| Rate for Payer: Blue Shield of California EPN |
$17.47
|
| Rate for Payer: Blue Shield of California EPN |
$107.19
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cash Price |
$121.50
|
| Rate for Payer: Cash Price |
$121.50
|
| Rate for Payer: Central Health Plan Commercial |
$216.00
|
| Rate for Payer: Central Health Plan Commercial |
$35.20
|
| Rate for Payer: Cigna of CA HMO |
$28.16
|
| Rate for Payer: Cigna of CA HMO |
$172.80
|
| Rate for Payer: Cigna of CA PPO |
$32.56
|
| Rate for Payer: Cigna of CA PPO |
$199.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$189.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.88
|
| Rate for Payer: EPIC Health Plan Senior |
$7.92
|
| Rate for Payer: EPIC Health Plan Senior |
$7.92
|
| Rate for Payer: Galaxy Health WC |
$37.40
|
| Rate for Payer: Galaxy Health WC |
$229.50
|
| Rate for Payer: Global Benefits Group Commercial |
$26.40
|
| Rate for Payer: Global Benefits Group Commercial |
$162.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$39.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$243.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11.81
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$171.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9.65
|
| Rate for Payer: Multiplan Commercial |
$33.00
|
| Rate for Payer: Multiplan Commercial |
$202.50
|
| Rate for Payer: Networks By Design Commercial |
$175.50
|
| Rate for Payer: Networks By Design Commercial |
$28.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7.20
|
| Rate for Payer: Prime Health Services Commercial |
$37.40
|
| Rate for Payer: Prime Health Services Commercial |
$229.50
|
| Rate for Payer: Prime Health Services Medicare |
$7.63
|
| Rate for Payer: Prime Health Services Medicare |
$7.63
|
| Rate for Payer: Riverside University Health System MISP |
$7.92
|
| Rate for Payer: Riverside University Health System MISP |
$7.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$162.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$26.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$162.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.83
|
| Rate for Payer: United Healthcare All Other HMO |
$5.83
|
| Rate for Payer: United Healthcare All Other HMO |
$5.83
|
| Rate for Payer: United Healthcare HMO Rider |
$5.83
|
| Rate for Payer: United Healthcare HMO Rider |
$5.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.83
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.20
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.92
|
| Rate for Payer: Vantage Medical Group Senior |
$7.20
|
| Rate for Payer: Vantage Medical Group Senior |
$7.20
|
|
|
HC GAMMA GLUTAMYL TRANSFERASE
|
Facility
|
IP
|
$270.00
|
|
|
Service Code
|
CPT 82977
|
| Hospital Charge Code |
900910225
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.00 |
| Max. Negotiated Rate |
$243.00 |
| Rate for Payer: Adventist Health Commercial |
$54.00
|
| Rate for Payer: Cash Price |
$121.50
|
| Rate for Payer: Central Health Plan Commercial |
$216.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$189.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$108.00
|
| Rate for Payer: EPIC Health Plan Senior |
$108.00
|
| Rate for Payer: Galaxy Health WC |
$229.50
|
| Rate for Payer: Global Benefits Group Commercial |
$162.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$243.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$171.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$159.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.00
|
| Rate for Payer: Multiplan Commercial |
$202.50
|
| Rate for Payer: Networks By Design Commercial |
$175.50
|
| Rate for Payer: Prime Health Services Commercial |
$229.50
|
|
|
HC GASTRIC EMPTYING
|
Facility
|
OP
|
$2,603.00
|
|
|
Service Code
|
CPT 78264
|
| Hospital Charge Code |
909301364
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$508.55 |
| Max. Negotiated Rate |
$2,342.70 |
| Rate for Payer: Adventist Health Commercial |
$520.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$514.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,519.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$514.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$748.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,514.17
|
| Rate for Payer: Blue Shield of California Commercial |
$1,639.89
|
| Rate for Payer: Blue Shield of California EPN |
$1,033.39
|
| Rate for Payer: Cash Price |
$1,171.35
|
| Rate for Payer: Cash Price |
$1,171.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,082.40
|
| Rate for Payer: Cigna of CA HMO |
$1,665.92
|
| Rate for Payer: Cigna of CA PPO |
$1,926.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$771.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$565.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$514.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,822.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$848.38
|
| Rate for Payer: EPIC Health Plan Senior |
$565.59
|
| Rate for Payer: Galaxy Health WC |
$2,212.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,561.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,342.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$843.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$508.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$514.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,652.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$561.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$719.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$520.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$688.99
|
| Rate for Payer: Multiplan Commercial |
$1,952.25
|
| Rate for Payer: Networks By Design Commercial |
$1,691.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$514.17
|
| Rate for Payer: Prime Health Services Commercial |
$2,212.55
|
| Rate for Payer: Prime Health Services Medicare |
$545.02
|
| Rate for Payer: Riverside University Health System MISP |
$565.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,561.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,561.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$623.82
|
| Rate for Payer: United Healthcare All Other HMO |
$623.82
|
| Rate for Payer: United Healthcare HMO Rider |
$623.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$623.82
|
| Rate for Payer: Upland Medical Group Pediatric |
$514.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Vantage Medical Group Senior |
$514.17
|
|
|
HC GASTRIC EMPTYING
|
Facility
|
IP
|
$2,603.00
|
|
|
Service Code
|
CPT 78264
|
| Hospital Charge Code |
909301364
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$520.60 |
| Max. Negotiated Rate |
$2,342.70 |
| Rate for Payer: Adventist Health Commercial |
$520.60
|
| Rate for Payer: Cash Price |
$1,171.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,082.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,822.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,041.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,041.20
|
| Rate for Payer: Galaxy Health WC |
$2,212.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,561.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,342.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,652.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,535.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$520.60
|
| Rate for Payer: Multiplan Commercial |
$1,952.25
|
| Rate for Payer: Networks By Design Commercial |
$1,691.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,212.55
|
|
|
HC GASTRIC INTUB W/ASPIRATIOIN
|
Facility
|
OP
|
$1,174.00
|
|
|
Service Code
|
CPT 43753
|
| Hospital Charge Code |
900501762
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$32.55 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$234.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$277.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$630.41
|
| Rate for Payer: Cash Price |
$528.30
|
| Rate for Payer: Cash Price |
$528.30
|
| Rate for Payer: Cash Price |
$528.30
|
| Rate for Payer: Cash Price |
$528.30
|
| Rate for Payer: Central Health Plan Commercial |
$939.20
|
| Rate for Payer: Cigna of CA HMO |
$751.36
|
| Rate for Payer: Cigna of CA PPO |
$868.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$416.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$305.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$277.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$821.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$458.22
|
| Rate for Payer: EPIC Health Plan Senior |
$305.48
|
| Rate for Payer: Galaxy Health WC |
$997.90
|
| Rate for Payer: Global Benefits Group Commercial |
$704.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,056.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$455.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$277.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$745.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$32.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$298.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$234.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$372.13
|
| Rate for Payer: Multiplan Commercial |
$880.50
|
| Rate for Payer: Multiplan WC |
$630.41
|
| Rate for Payer: Networks By Design Commercial |
$763.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$277.71
|
| Rate for Payer: Preferred Health Network WC |
$643.28
|
| Rate for Payer: Prime Health Services Commercial |
$997.90
|
| Rate for Payer: Prime Health Services Medicare |
$294.37
|
| Rate for Payer: Prime Health Services WC |
$623.98
|
| Rate for Payer: Riverside University Health System MISP |
$305.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$704.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$587.00
|
| Rate for Payer: United Healthcare All Other HMO |
$587.00
|
| Rate for Payer: United Healthcare HMO Rider |
$587.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$587.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$277.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Vantage Medical Group Senior |
$277.71
|
|
|
HC GASTRIC INTUB W/ASPIRATIOIN
|
Facility
|
IP
|
$1,174.00
|
|
|
Service Code
|
CPT 43753
|
| Hospital Charge Code |
900501762
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$234.80 |
| Max. Negotiated Rate |
$1,056.60 |
| Rate for Payer: Adventist Health Commercial |
$234.80
|
| Rate for Payer: Cash Price |
$528.30
|
| Rate for Payer: Central Health Plan Commercial |
$939.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$821.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$469.60
|
| Rate for Payer: EPIC Health Plan Senior |
$469.60
|
| Rate for Payer: Galaxy Health WC |
$997.90
|
| Rate for Payer: Global Benefits Group Commercial |
$704.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,056.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$745.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$692.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$234.80
|
| Rate for Payer: Multiplan Commercial |
$880.50
|
| Rate for Payer: Networks By Design Commercial |
$763.10
|
| Rate for Payer: Prime Health Services Commercial |
$997.90
|
|
|
HC GASTRIC MOTIL MANOMETRC STUDY
|
Facility
|
OP
|
$2,376.00
|
|
|
Service Code
|
CPT 91020
|
| Hospital Charge Code |
906791020
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$158.39 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$475.20
|
| Rate for Payer: Adventist Health Commercial |
$320.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$479.94
|
| Rate for Payer: Adventist Health Medi-Cal |
$479.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$479.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$479.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$167.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$167.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,382.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$932.47
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$721.35
|
| Rate for Payer: Cash Price |
$721.35
|
| Rate for Payer: Cash Price |
$1,069.20
|
| Rate for Payer: Cash Price |
$1,069.20
|
| Rate for Payer: Cash Price |
$1,069.20
|
| Rate for Payer: Cash Price |
$721.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,282.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,900.80
|
| Rate for Payer: Cigna of CA HMO |
$1,520.64
|
| Rate for Payer: Cigna of CA HMO |
$1,025.92
|
| Rate for Payer: Cigna of CA PPO |
$1,186.22
|
| Rate for Payer: Cigna of CA PPO |
$1,758.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$719.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$719.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$527.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$527.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$479.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$479.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,663.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,122.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$791.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$791.90
|
| Rate for Payer: EPIC Health Plan Senior |
$527.93
|
| Rate for Payer: EPIC Health Plan Senior |
$527.93
|
| Rate for Payer: Galaxy Health WC |
$1,362.55
|
| Rate for Payer: Galaxy Health WC |
$2,019.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,425.60
|
| Rate for Payer: Global Benefits Group Commercial |
$961.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,138.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,442.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$787.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$787.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$158.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$158.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$479.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$479.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,017.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,508.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$174.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$174.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$671.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$671.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$320.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$475.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$643.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$643.12
|
| Rate for Payer: Multiplan Commercial |
$1,202.25
|
| Rate for Payer: Multiplan Commercial |
$1,782.00
|
| Rate for Payer: Networks By Design Commercial |
$1,041.95
|
| Rate for Payer: Networks By Design Commercial |
$1,544.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$479.94
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$479.94
|
| Rate for Payer: Prime Health Services Commercial |
$2,019.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,362.55
|
| Rate for Payer: Prime Health Services Medicare |
$508.74
|
| Rate for Payer: Prime Health Services Medicare |
$508.74
|
| Rate for Payer: Riverside University Health System MISP |
$527.93
|
| Rate for Payer: Riverside University Health System MISP |
$527.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,425.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$961.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$575.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$575.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,188.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$801.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$479.94
|
| Rate for Payer: Upland Medical Group Pediatric |
$479.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Vantage Medical Group Senior |
$479.94
|
| Rate for Payer: Vantage Medical Group Senior |
$479.94
|
|
|
HC GASTRIC MOTIL MANOMETRC STUDY
|
Facility
|
IP
|
$2,376.00
|
|
|
Service Code
|
CPT 91020
|
| Hospital Charge Code |
906791020
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$475.20 |
| Max. Negotiated Rate |
$2,138.40 |
| Rate for Payer: Adventist Health Commercial |
$475.20
|
| Rate for Payer: Cash Price |
$1,069.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,900.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,663.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$950.40
|
| Rate for Payer: EPIC Health Plan Senior |
$950.40
|
| Rate for Payer: Galaxy Health WC |
$2,019.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,425.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,138.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,508.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,401.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$475.20
|
| Rate for Payer: Multiplan Commercial |
$1,782.00
|
| Rate for Payer: Networks By Design Commercial |
$1,544.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,019.60
|
|
|
HC GASTROESOPHAGEAL REFLUX
|
Facility
|
OP
|
$1,552.00
|
|
|
Service Code
|
CPT 78262
|
| Hospital Charge Code |
909301365
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$186.00 |
| Max. Negotiated Rate |
$1,396.80 |
| Rate for Payer: Adventist Health Commercial |
$310.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$514.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,348.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$514.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$885.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$902.80
|
| Rate for Payer: Blue Shield of California Commercial |
$977.76
|
| Rate for Payer: Blue Shield of California EPN |
$616.14
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,241.60
|
| Rate for Payer: Cigna of CA HMO |
$993.28
|
| Rate for Payer: Cigna of CA PPO |
$1,148.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$771.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$565.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$514.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,086.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$848.38
|
| Rate for Payer: EPIC Health Plan Senior |
$565.59
|
| Rate for Payer: Galaxy Health WC |
$1,319.20
|
| Rate for Payer: Global Benefits Group Commercial |
$931.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,396.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$843.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$186.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$514.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$985.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$205.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$719.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$310.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$688.99
|
| Rate for Payer: Multiplan Commercial |
$1,164.00
|
| Rate for Payer: Networks By Design Commercial |
$1,008.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$514.17
|
| Rate for Payer: Prime Health Services Commercial |
$1,319.20
|
| Rate for Payer: Prime Health Services Medicare |
$545.02
|
| Rate for Payer: Riverside University Health System MISP |
$565.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$931.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$931.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$623.82
|
| Rate for Payer: United Healthcare All Other HMO |
$623.82
|
| Rate for Payer: United Healthcare HMO Rider |
$623.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$623.82
|
| Rate for Payer: Upland Medical Group Pediatric |
$514.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Vantage Medical Group Senior |
$514.17
|
|
|
HC GASTROESOPHAGEAL REFLUX
|
Facility
|
IP
|
$1,552.00
|
|
|
Service Code
|
CPT 78262
|
| Hospital Charge Code |
909301365
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$310.40 |
| Max. Negotiated Rate |
$1,396.80 |
| Rate for Payer: Adventist Health Commercial |
$310.40
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,241.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,086.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$620.80
|
| Rate for Payer: EPIC Health Plan Senior |
$620.80
|
| Rate for Payer: Galaxy Health WC |
$1,319.20
|
| Rate for Payer: Global Benefits Group Commercial |
$931.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,396.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$985.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$915.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$310.40
|
| Rate for Payer: Multiplan Commercial |
$1,164.00
|
| Rate for Payer: Networks By Design Commercial |
$1,008.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,319.20
|
|
|
HC GASTROESOPHAGEAL REFLUX TEST
|
Facility
|
OP
|
$4,700.00
|
|
|
Service Code
|
CPT 91035
|
| Hospital Charge Code |
906791035
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$176.18 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$940.00
|
| Rate for Payer: Adventist Health Commercial |
$596.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,104.48
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,104.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,656.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,656.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,214.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,214.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,104.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,104.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,884.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,884.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,733.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,735.21
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$1,342.35
|
| Rate for Payer: Cash Price |
$1,342.35
|
| Rate for Payer: Cash Price |
$2,115.00
|
| Rate for Payer: Cash Price |
$2,115.00
|
| Rate for Payer: Cash Price |
$2,115.00
|
| Rate for Payer: Cash Price |
$1,342.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,386.40
|
| Rate for Payer: Central Health Plan Commercial |
$3,760.00
|
| Rate for Payer: Cigna of CA HMO |
$3,008.00
|
| Rate for Payer: Cigna of CA HMO |
$1,909.12
|
| Rate for Payer: Cigna of CA PPO |
$2,207.42
|
| Rate for Payer: Cigna of CA PPO |
$3,478.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,656.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,656.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,214.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,214.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,104.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,104.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,290.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,088.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,822.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,822.39
|
| Rate for Payer: EPIC Health Plan Senior |
$1,214.93
|
| Rate for Payer: EPIC Health Plan Senior |
$1,214.93
|
| Rate for Payer: Galaxy Health WC |
$2,535.55
|
| Rate for Payer: Galaxy Health WC |
$3,995.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,820.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,789.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,230.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,684.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,811.35
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,811.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$176.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$176.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,104.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,104.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,894.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,984.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$194.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$194.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,546.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,546.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$596.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$940.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,480.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,480.00
|
| Rate for Payer: Multiplan Commercial |
$2,237.25
|
| Rate for Payer: Multiplan Commercial |
$3,525.00
|
| Rate for Payer: Networks By Design Commercial |
$1,938.95
|
| Rate for Payer: Networks By Design Commercial |
$3,055.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,104.48
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,104.48
|
| Rate for Payer: Prime Health Services Commercial |
$3,995.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,535.55
|
| Rate for Payer: Prime Health Services Medicare |
$1,170.75
|
| Rate for Payer: Prime Health Services Medicare |
$1,170.75
|
| Rate for Payer: Riverside University Health System MISP |
$1,214.93
|
| Rate for Payer: Riverside University Health System MISP |
$1,214.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,820.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,789.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,325.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,325.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,350.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,491.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,104.48
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,104.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,656.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,656.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,214.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,214.93
|
| Rate for Payer: Vantage Medical Group Senior |
$1,104.48
|
| Rate for Payer: Vantage Medical Group Senior |
$1,104.48
|
|
|
HC GASTROESOPHAGEAL REFLUX TEST
|
Facility
|
IP
|
$4,728.00
|
|
|
Service Code
|
CPT 91034
|
| Hospital Charge Code |
906791034
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$945.60 |
| Max. Negotiated Rate |
$4,255.20 |
| Rate for Payer: Adventist Health Commercial |
$945.60
|
| Rate for Payer: Cash Price |
$2,127.60
|
| Rate for Payer: Central Health Plan Commercial |
$3,782.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,309.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,891.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,891.20
|
| Rate for Payer: Galaxy Health WC |
$4,018.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,836.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,255.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,002.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,789.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$945.60
|
| Rate for Payer: Multiplan Commercial |
$3,546.00
|
| Rate for Payer: Networks By Design Commercial |
$3,073.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,018.80
|
|
