|
HC CONG RT HEART CONG NML NAT
|
Facility
|
IP
|
$7,034.00
|
|
|
Service Code
|
CPT 93593
|
| Hospital Charge Code |
906820095
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,406.80 |
| Max. Negotiated Rate |
$6,330.60 |
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,627.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,813.60
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,330.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,679.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,406.80
|
| Rate for Payer: Multiplan Commercial |
$5,275.50
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
|
|
HC CONG RT HEART CONG NML NAT
|
Facility
|
OP
|
$7,034.00
|
|
|
Service Code
|
CPT 93593
|
| Hospital Charge Code |
906811593
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,406.80 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,071.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,220.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$4,071.36
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,627.20
|
| Rate for Payer: Cigna of CA PPO |
$5,205.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Dignity Health Media |
$4,071.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,478.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,330.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,275.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,677.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,717.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,071.36
|
| Rate for Payer: InnovAge PACE Commercial |
$6,107.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,406.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,455.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$5,275.50
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
| Rate for Payer: Prime Health Services Medicare |
$4,315.64
|
| Rate for Payer: Riverside University Health System MISP |
$4,478.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,220.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC CONG RT HEART CONG NML NAT
|
Facility
|
IP
|
$7,034.00
|
|
|
Service Code
|
CPT 93593
|
| Hospital Charge Code |
906811593
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,406.80 |
| Max. Negotiated Rate |
$6,330.60 |
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,627.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,813.60
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,330.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,679.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,406.80
|
| Rate for Payer: Multiplan Commercial |
$5,275.50
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
|
|
HC CONG RT HEART CONG NML NAT
|
Facility
|
OP
|
$7,034.00
|
|
|
Service Code
|
CPT 93593
|
| Hospital Charge Code |
906820095
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,406.80 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,071.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,220.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$4,071.36
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,627.20
|
| Rate for Payer: Cigna of CA PPO |
$5,205.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Dignity Health Media |
$4,071.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,478.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,330.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,275.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,677.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,717.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,071.36
|
| Rate for Payer: InnovAge PACE Commercial |
$6,107.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,406.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,455.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$5,275.50
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
| Rate for Payer: Prime Health Services Medicare |
$4,315.64
|
| Rate for Payer: Riverside University Health System MISP |
$4,478.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,220.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC CONIZATION CERVIX LOOP ELECTRODE EXCISSION
|
Facility
|
OP
|
$9,455.00
|
|
|
Service Code
|
CPT 57522
|
| Hospital Charge Code |
900100035
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$426.49 |
| Max. Negotiated Rate |
$8,509.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,906.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,859.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,296.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,906.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,673.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,947.20
|
| Rate for Payer: Blue Shield of California EPN |
$4,623.50
|
| Rate for Payer: Caremore Medicare Advantage |
$3,906.18
|
| Rate for Payer: Cash Price |
$4,254.75
|
| Rate for Payer: Cash Price |
$4,254.75
|
| Rate for Payer: Central Health Plan Commercial |
$7,564.00
|
| Rate for Payer: Cigna of CA HMO |
$6,051.20
|
| Rate for Payer: Cigna of CA PPO |
$6,996.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,859.27
|
| Rate for Payer: Dignity Health Media |
$3,906.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,296.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,273.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,906.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,906.18
|
| Rate for Payer: Galaxy Health WC |
$8,036.75
|
| Rate for Payer: Global Benefits Group Commercial |
$5,673.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,509.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,091.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,406.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,445.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,906.18
|
| Rate for Payer: InnovAge PACE Commercial |
$5,859.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,306.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$426.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,906.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,891.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,234.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,234.28
|
| Rate for Payer: Multiplan Commercial |
$7,091.25
|
| Rate for Payer: Networks By Design Commercial |
$6,145.75
|
| Rate for Payer: Prime Health Services Commercial |
$8,036.75
|
| Rate for Payer: Prime Health Services Medicare |
$4,140.55
|
| Rate for Payer: Riverside University Health System MISP |
$4,296.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,673.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,673.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,727.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,727.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,727.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,727.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,859.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,296.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,906.18
|
|
|
HC CONIZATION CERVIX LOOP ELECTRODE EXCISSION
|
Facility
|
IP
|
$9,455.00
|
|
|
Service Code
|
CPT 57522
|
| Hospital Charge Code |
900100035
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,891.00 |
| Max. Negotiated Rate |
$8,509.50 |
| Rate for Payer: Cash Price |
$4,254.75
|
| Rate for Payer: Central Health Plan Commercial |
$7,564.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,782.00
|
| Rate for Payer: Galaxy Health WC |
$8,036.75
|
| Rate for Payer: Global Benefits Group Commercial |
$5,673.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,509.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,306.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,602.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,891.00
|
| Rate for Payer: Multiplan Commercial |
$7,091.25
|
| Rate for Payer: Networks By Design Commercial |
$6,145.75
|
| Rate for Payer: Prime Health Services Commercial |
$8,036.75
|
|
|
HC CONSULT WITH SLIDE PREP
|
Facility
|
OP
|
$167.00
|
|
|
Service Code
|
CPT 88323
|
| Hospital Charge Code |
903800034
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$33.40 |
| Max. Negotiated Rate |
$329.55 |
| Rate for Payer: Adventist Health Medi-Cal |
$67.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$329.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$101.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$74.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$76.59
|
| Rate for Payer: Blue Distinction Transplant |
$100.20
|
| Rate for Payer: Blue Shield of California Commercial |
$103.21
|
| Rate for Payer: Blue Shield of California EPN |
$81.16
|
| Rate for Payer: Caremore Medicare Advantage |
$67.70
|
| Rate for Payer: Cash Price |
$75.15
|
| Rate for Payer: Cash Price |
$75.15
|
| Rate for Payer: Central Health Plan Commercial |
$133.60
|
| Rate for Payer: Cigna of CA HMO |
$106.88
|
| Rate for Payer: Cigna of CA PPO |
$123.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$101.55
|
| Rate for Payer: Dignity Health Media |
$67.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$74.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$67.70
|
| Rate for Payer: EPIC Health Plan Transplant |
$67.70
|
| Rate for Payer: Galaxy Health WC |
$141.95
|
| Rate for Payer: Global Benefits Group Commercial |
$100.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$150.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$125.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$111.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$111.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67.70
|
| Rate for Payer: InnovAge PACE Commercial |
$101.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$111.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$167.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$67.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$90.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$90.72
|
| Rate for Payer: Multiplan Commercial |
$125.25
|
| Rate for Payer: Networks By Design Commercial |
$108.55
|
| Rate for Payer: Prime Health Services Commercial |
$141.95
|
| Rate for Payer: Prime Health Services Medicare |
$71.76
|
| Rate for Payer: Riverside University Health System MISP |
$74.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$100.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$100.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.11
|
| Rate for Payer: United Healthcare All Other HMO |
$41.11
|
| Rate for Payer: United Healthcare HMO Rider |
$41.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$101.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$74.47
|
| Rate for Payer: Vantage Medical Group Senior |
$67.70
|
|
|
HC CONSULT WITH SLIDE PREP
|
Facility
|
IP
|
$575.00
|
|
|
Service Code
|
CPT 88323
|
| Hospital Charge Code |
903800034
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$115.00 |
| Max. Negotiated Rate |
$517.50 |
| Rate for Payer: Cash Price |
$258.75
|
| Rate for Payer: Central Health Plan Commercial |
$460.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$230.00
|
| Rate for Payer: Galaxy Health WC |
$488.75
|
| Rate for Payer: Global Benefits Group Commercial |
$345.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$517.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$383.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$219.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.00
|
| Rate for Payer: Multiplan Commercial |
$431.25
|
| Rate for Payer: Networks By Design Commercial |
$373.75
|
| Rate for Payer: Prime Health Services Commercial |
$488.75
|
|
|
HC CONT GLUC MNTR PT PROV EQP
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT 95249
|
| Hospital Charge Code |
900095249
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$969.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$76.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$338.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$76.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$329.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$124.07
|
| Rate for Payer: Blue Distinction Transplant |
$126.00
|
| Rate for Payer: Blue Shield of California Commercial |
$129.78
|
| Rate for Payer: Blue Shield of California EPN |
$102.06
|
| Rate for Payer: Caremore Medicare Advantage |
$76.42
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Central Health Plan Commercial |
$168.00
|
| Rate for Payer: Cigna of CA HMO |
$134.40
|
| Rate for Payer: Cigna of CA PPO |
$155.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$114.63
|
| Rate for Payer: Dignity Health Media |
$76.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$84.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$76.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$76.42
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$157.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$125.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$126.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$76.42
|
| Rate for Payer: InnovAge PACE Commercial |
$114.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$140.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$80.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$102.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$102.40
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
| Rate for Payer: Prime Health Services Medicare |
$81.01
|
| Rate for Payer: Riverside University Health System MISP |
$84.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$126.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$126.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$969.00
|
| Rate for Payer: United Healthcare All Other HMO |
$765.00
|
| Rate for Payer: United Healthcare HMO Rider |
$579.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$530.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: Vantage Medical Group Senior |
$76.42
|
|
|
HC CONT GLUC MNTR PT PROV EQP
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT 95249
|
| Hospital Charge Code |
900095249
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Central Health Plan Commercial |
$168.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$140.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$80.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.00
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
|
|
HC CONT INHAL TRT W/AERO 1ST HR
|
Facility
|
IP
|
$378.00
|
|
|
Service Code
|
CPT 94644
|
| Hospital Charge Code |
900800012
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$75.60 |
| Max. Negotiated Rate |
$340.20 |
| Rate for Payer: Cash Price |
$170.10
|
| Rate for Payer: Central Health Plan Commercial |
$302.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$151.20
|
| Rate for Payer: Galaxy Health WC |
$321.30
|
| Rate for Payer: Global Benefits Group Commercial |
$226.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$340.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$252.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$144.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.60
|
| Rate for Payer: Multiplan Commercial |
$283.50
|
| Rate for Payer: Networks By Design Commercial |
$245.70
|
| Rate for Payer: Prime Health Services Commercial |
$321.30
|
|
|
HC CONT INHAL TRT W/AERO 1ST HR
|
Facility
|
OP
|
$378.00
|
|
|
Service Code
|
CPT 94644
|
| Hospital Charge Code |
900800012
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$32.30 |
| Max. Negotiated Rate |
$509.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$242.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$279.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$226.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$170.10
|
| Rate for Payer: Cash Price |
$170.10
|
| Rate for Payer: Cash Price |
$170.10
|
| Rate for Payer: Cash Price |
$170.10
|
| Rate for Payer: Central Health Plan Commercial |
$302.40
|
| Rate for Payer: Cigna of CA HMO |
$241.92
|
| Rate for Payer: Cigna of CA PPO |
$279.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: Dignity Health Media |
$159.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$321.30
|
| Rate for Payer: Global Benefits Group Commercial |
$226.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$340.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$283.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$263.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$159.60
|
| Rate for Payer: InnovAge PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$252.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$283.50
|
| Rate for Payer: Networks By Design Commercial |
$245.70
|
| Rate for Payer: Prime Health Services Commercial |
$321.30
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Riverside University Health System MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$226.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$226.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$509.00
|
| Rate for Payer: United Healthcare All Other HMO |
$478.00
|
| Rate for Payer: United Healthcare HMO Rider |
$428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$391.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC CONT INHAL TRT W/AERO ADD HR
|
Facility
|
IP
|
$282.00
|
|
|
Service Code
|
CPT 94645
|
| Hospital Charge Code |
900800013
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$56.40 |
| Max. Negotiated Rate |
$253.80 |
| Rate for Payer: Cash Price |
$126.90
|
| Rate for Payer: Central Health Plan Commercial |
$225.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$112.80
|
| Rate for Payer: Galaxy Health WC |
$239.70
|
| Rate for Payer: Global Benefits Group Commercial |
$169.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$253.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$188.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$107.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.40
|
| Rate for Payer: Multiplan Commercial |
$211.50
|
| Rate for Payer: Networks By Design Commercial |
$183.30
|
| Rate for Payer: Prime Health Services Commercial |
$239.70
|
|
|
HC CONT INHAL TRT W/AERO ADD HR
|
Facility
|
OP
|
$282.00
|
|
|
Service Code
|
CPT 94645
|
| Hospital Charge Code |
900800013
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$23.56 |
| Max. Negotiated Rate |
$509.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$87.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$239.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$155.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$155.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$106.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$169.20
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$126.90
|
| Rate for Payer: Cash Price |
$126.90
|
| Rate for Payer: Cash Price |
$126.90
|
| Rate for Payer: Cash Price |
$126.90
|
| Rate for Payer: Central Health Plan Commercial |
$225.60
|
| Rate for Payer: Cigna of CA HMO |
$180.48
|
| Rate for Payer: Cigna of CA PPO |
$208.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.70
|
| Rate for Payer: Dignity Health Media |
$239.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$239.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$112.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$112.80
|
| Rate for Payer: Galaxy Health WC |
$239.70
|
| Rate for Payer: Global Benefits Group Commercial |
$169.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$253.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$211.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$98.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$188.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.40
|
| Rate for Payer: Multiplan Commercial |
$211.50
|
| Rate for Payer: Networks By Design Commercial |
$183.30
|
| Rate for Payer: Prime Health Services Commercial |
$239.70
|
| Rate for Payer: Riverside University Health System MISP |
$112.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$169.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$169.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$509.00
|
| Rate for Payer: United Healthcare All Other HMO |
$478.00
|
| Rate for Payer: United Healthcare HMO Rider |
$428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$391.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$239.70
|
| Rate for Payer: Vantage Medical Group Senior |
$239.70
|
|
|
HC CONTINOUS RENAL REPLACE THERAPY
|
Facility
|
OP
|
$1,288.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
948000105
|
|
Hospital Revenue Code
|
880
|
| Min. Negotiated Rate |
$137.10 |
| Max. Negotiated Rate |
$1,159.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$553.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$475.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$830.08
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$608.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$553.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$623.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$760.95
|
| Rate for Payer: Blue Distinction Transplant |
$772.80
|
| Rate for Payer: Blue Shield of California Commercial |
$810.15
|
| Rate for Payer: Blue Shield of California EPN |
$629.83
|
| Rate for Payer: Caremore Medicare Advantage |
$553.39
|
| Rate for Payer: Cash Price |
$579.60
|
| Rate for Payer: Cash Price |
$579.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,030.40
|
| Rate for Payer: Cigna of CA HMO |
$824.32
|
| Rate for Payer: Cigna of CA PPO |
$953.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$830.08
|
| Rate for Payer: Dignity Health Media |
$553.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$608.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$747.08
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$553.39
|
| Rate for Payer: EPIC Health Plan Transplant |
$553.39
|
| Rate for Payer: Galaxy Health WC |
$1,094.80
|
| Rate for Payer: Global Benefits Group Commercial |
$772.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,159.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$966.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$907.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$913.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$553.39
|
| Rate for Payer: InnovAge PACE Commercial |
$830.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$859.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$553.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$741.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$741.54
|
| Rate for Payer: Multiplan Commercial |
$966.00
|
| Rate for Payer: Networks By Design Commercial |
$837.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,094.80
|
| Rate for Payer: Prime Health Services Medicare |
$586.59
|
| Rate for Payer: Riverside University Health System MISP |
$608.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$772.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$772.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$644.00
|
| Rate for Payer: United Healthcare All Other HMO |
$644.00
|
| Rate for Payer: United Healthcare HMO Rider |
$644.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$644.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$830.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$608.73
|
| Rate for Payer: Vantage Medical Group Senior |
$553.39
|
|
|
HC CONTINOUS RENAL REPLACE THERAPY
|
Facility
|
IP
|
$1,288.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
948000105
|
|
Hospital Revenue Code
|
880
|
| Min. Negotiated Rate |
$257.60 |
| Max. Negotiated Rate |
$1,159.20 |
| Rate for Payer: Cash Price |
$579.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,030.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$515.20
|
| Rate for Payer: Galaxy Health WC |
$1,094.80
|
| Rate for Payer: Global Benefits Group Commercial |
$772.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,159.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$859.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$490.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.60
|
| Rate for Payer: Multiplan Commercial |
$966.00
|
| Rate for Payer: Networks By Design Commercial |
$837.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,094.80
|
|
|
HC CONT OROPHARYN HEMOR, SIMPLE
|
Facility
|
IP
|
$888.00
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
900501252
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$177.60 |
| Max. Negotiated Rate |
$799.20 |
| Rate for Payer: Cash Price |
$399.60
|
| Rate for Payer: Central Health Plan Commercial |
$710.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$355.20
|
| Rate for Payer: Galaxy Health WC |
$754.80
|
| Rate for Payer: Global Benefits Group Commercial |
$532.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$799.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$592.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$338.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$177.60
|
| Rate for Payer: Multiplan Commercial |
$666.00
|
| Rate for Payer: Networks By Design Commercial |
$577.20
|
| Rate for Payer: Prime Health Services Commercial |
$754.80
|
|
|
HC CONT OROPHARYN HEMOR, SIMPLE
|
Facility
|
OP
|
$888.00
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
900501252
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$140.77 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$687.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,031.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$756.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$687.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$532.80
|
| Rate for Payer: Blue Shield of California Commercial |
$558.55
|
| Rate for Payer: Blue Shield of California EPN |
$434.23
|
| Rate for Payer: Caremore Medicare Advantage |
$687.44
|
| Rate for Payer: Cash Price |
$399.60
|
| Rate for Payer: Cash Price |
$399.60
|
| Rate for Payer: Cash Price |
$399.60
|
| Rate for Payer: Central Health Plan Commercial |
$710.40
|
| Rate for Payer: Cigna of CA HMO |
$568.32
|
| Rate for Payer: Cigna of CA PPO |
$657.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,031.16
|
| Rate for Payer: Dignity Health Media |
$687.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$756.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$928.04
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$687.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$687.44
|
| Rate for Payer: Galaxy Health WC |
$754.80
|
| Rate for Payer: Global Benefits Group Commercial |
$532.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$799.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$666.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,127.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,134.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$687.44
|
| Rate for Payer: InnovAge PACE Commercial |
$1,031.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$592.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$687.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$177.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$921.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$921.17
|
| Rate for Payer: Multiplan Commercial |
$666.00
|
| Rate for Payer: Networks By Design Commercial |
$577.20
|
| Rate for Payer: Prime Health Services Commercial |
$754.80
|
| Rate for Payer: Prime Health Services Medicare |
$728.69
|
| Rate for Payer: Riverside University Health System MISP |
$756.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$532.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$532.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$444.00
|
| Rate for Payer: United Healthcare All Other HMO |
$444.00
|
| Rate for Payer: United Healthcare HMO Rider |
$444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$444.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,031.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$756.18
|
| Rate for Payer: Vantage Medical Group Senior |
$687.44
|
|
|
HC CONT OROPHARYN HEMOR, SIMPLE
|
Facility
|
OP
|
$888.00
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
900501252
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.77 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,031.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$756.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$687.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$532.80
|
| Rate for Payer: Caremore Medicare Advantage |
$687.44
|
| Rate for Payer: Cash Price |
$399.60
|
| Rate for Payer: Cash Price |
$399.60
|
| Rate for Payer: Cash Price |
$399.60
|
| Rate for Payer: Cash Price |
$399.60
|
| Rate for Payer: Central Health Plan Commercial |
$710.40
|
| Rate for Payer: Cigna of CA PPO |
$657.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,031.16
|
| Rate for Payer: Dignity Health Media |
$687.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$756.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$928.04
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$687.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$687.44
|
| Rate for Payer: Galaxy Health WC |
$754.80
|
| Rate for Payer: Global Benefits Group Commercial |
$532.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$799.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$666.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,127.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$687.44
|
| Rate for Payer: InnovAge PACE Commercial |
$1,031.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$592.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$687.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$177.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$921.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$921.17
|
| Rate for Payer: Multiplan Commercial |
$666.00
|
| Rate for Payer: Networks By Design Commercial |
$577.20
|
| Rate for Payer: Prime Health Services Commercial |
$754.80
|
| Rate for Payer: Prime Health Services Medicare |
$728.69
|
| Rate for Payer: Riverside University Health System MISP |
$756.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$532.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$444.00
|
| Rate for Payer: United Healthcare All Other HMO |
$444.00
|
| Rate for Payer: United Healthcare HMO Rider |
$444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$444.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,031.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$756.18
|
| Rate for Payer: Vantage Medical Group Senior |
$687.44
|
|
|
HC CONT OROPHARYN HEMOR, SIMPLE
|
Facility
|
IP
|
$888.00
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
900501252
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$177.60 |
| Max. Negotiated Rate |
$799.20 |
| Rate for Payer: Cash Price |
$399.60
|
| Rate for Payer: Central Health Plan Commercial |
$710.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$355.20
|
| Rate for Payer: Galaxy Health WC |
$754.80
|
| Rate for Payer: Global Benefits Group Commercial |
$532.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$799.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$592.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$338.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$177.60
|
| Rate for Payer: Multiplan Commercial |
$666.00
|
| Rate for Payer: Networks By Design Commercial |
$577.20
|
| Rate for Payer: Prime Health Services Commercial |
$754.80
|
|
|
HC CONTRAST BATH 15MIN OT
|
Facility
|
OP
|
$139.00
|
|
|
Service Code
|
CPT 97034
|
| Hospital Charge Code |
905104124
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$14.88 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$67.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$118.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$76.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$76.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$83.40
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$62.55
|
| Rate for Payer: Cash Price |
$62.55
|
| Rate for Payer: Cash Price |
$62.55
|
| Rate for Payer: Cash Price |
$62.55
|
| Rate for Payer: Central Health Plan Commercial |
$111.20
|
| Rate for Payer: Cigna of CA HMO |
$88.96
|
| Rate for Payer: Cigna of CA PPO |
$102.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$118.15
|
| Rate for Payer: Dignity Health Media |
$118.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$118.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$55.60
|
| Rate for Payer: Galaxy Health WC |
$118.15
|
| Rate for Payer: Global Benefits Group Commercial |
$83.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$125.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$104.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$48.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.99
|
| Rate for Payer: Multiplan Commercial |
$104.25
|
| Rate for Payer: Networks By Design Commercial |
$90.35
|
| Rate for Payer: Prime Health Services Commercial |
$118.15
|
| Rate for Payer: Riverside University Health System MISP |
$55.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$83.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$83.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$118.15
|
| Rate for Payer: Vantage Medical Group Senior |
$118.15
|
|
|
HC CONTRAST BATH 15MIN OT
|
Facility
|
IP
|
$139.00
|
|
|
Service Code
|
CPT 97034
|
| Hospital Charge Code |
905104124
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$27.80 |
| Max. Negotiated Rate |
$125.10 |
| Rate for Payer: Cash Price |
$62.55
|
| Rate for Payer: Central Health Plan Commercial |
$111.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.60
|
| Rate for Payer: Galaxy Health WC |
$118.15
|
| Rate for Payer: Global Benefits Group Commercial |
$83.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$125.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.80
|
| Rate for Payer: Multiplan Commercial |
$104.25
|
| Rate for Payer: Networks By Design Commercial |
$90.35
|
| Rate for Payer: Prime Health Services Commercial |
$118.15
|
|
|
HC CONTRAST BATHS 15 MIN MCAL
|
Facility
|
IP
|
$139.00
|
|
|
Service Code
|
CPT 97034
|
| Hospital Charge Code |
901300051
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$27.80 |
| Max. Negotiated Rate |
$125.10 |
| Rate for Payer: Cash Price |
$62.55
|
| Rate for Payer: Central Health Plan Commercial |
$111.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.60
|
| Rate for Payer: Galaxy Health WC |
$118.15
|
| Rate for Payer: Global Benefits Group Commercial |
$83.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$125.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.80
|
| Rate for Payer: Multiplan Commercial |
$104.25
|
| Rate for Payer: Networks By Design Commercial |
$90.35
|
| Rate for Payer: Prime Health Services Commercial |
$118.15
|
|
|
HC CONTRAST BATHS 15 MIN MCAL
|
Facility
|
IP
|
$139.00
|
|
|
Service Code
|
CPT 97034
|
| Hospital Charge Code |
900400028
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$27.80 |
| Max. Negotiated Rate |
$125.10 |
| Rate for Payer: Cash Price |
$62.55
|
| Rate for Payer: Central Health Plan Commercial |
$111.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.60
|
| Rate for Payer: Galaxy Health WC |
$118.15
|
| Rate for Payer: Global Benefits Group Commercial |
$83.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$125.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.80
|
| Rate for Payer: Multiplan Commercial |
$104.25
|
| Rate for Payer: Networks By Design Commercial |
$90.35
|
| Rate for Payer: Prime Health Services Commercial |
$118.15
|
|
|
HC CONTRAST BATHS 15 MIN MCAL
|
Facility
|
OP
|
$139.00
|
|
|
Service Code
|
CPT 97034
|
| Hospital Charge Code |
900400028
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$14.88 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$67.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$118.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$76.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$76.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$83.40
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$62.55
|
| Rate for Payer: Cash Price |
$62.55
|
| Rate for Payer: Cash Price |
$62.55
|
| Rate for Payer: Cash Price |
$62.55
|
| Rate for Payer: Central Health Plan Commercial |
$111.20
|
| Rate for Payer: Cigna of CA HMO |
$88.96
|
| Rate for Payer: Cigna of CA PPO |
$102.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$118.15
|
| Rate for Payer: Dignity Health Media |
$118.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$118.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$55.60
|
| Rate for Payer: Galaxy Health WC |
$118.15
|
| Rate for Payer: Global Benefits Group Commercial |
$83.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$125.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$104.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$48.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.99
|
| Rate for Payer: Multiplan Commercial |
$104.25
|
| Rate for Payer: Networks By Design Commercial |
$90.35
|
| Rate for Payer: Prime Health Services Commercial |
$118.15
|
| Rate for Payer: Riverside University Health System MISP |
$55.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$83.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$83.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$118.15
|
| Rate for Payer: Vantage Medical Group Senior |
$118.15
|
|
