|
HC ECHO-C 2D/M-MODE COMPLETE
|
Facility
|
OP
|
$2,420.00
|
|
|
Service Code
|
CPT 93307
|
| Hospital Charge Code |
900200204
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$285.19 |
| Max. Negotiated Rate |
$2,178.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$306.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$610.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$459.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$336.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$998.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,429.74
|
| Rate for Payer: Blue Distinction Transplant |
$1,452.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,495.56
|
| Rate for Payer: Blue Shield of California EPN |
$1,176.12
|
| Rate for Payer: Caremore Medicare Advantage |
$306.16
|
| Rate for Payer: Cash Price |
$1,089.00
|
| Rate for Payer: Cash Price |
$1,089.00
|
| Rate for Payer: Cash Price |
$1,089.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,936.00
|
| Rate for Payer: Cigna of CA HMO |
$1,548.80
|
| Rate for Payer: Cigna of CA PPO |
$1,790.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$459.24
|
| Rate for Payer: Dignity Health Media |
$306.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$336.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$413.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$306.16
|
| Rate for Payer: EPIC Health Plan Transplant |
$306.16
|
| Rate for Payer: Galaxy Health WC |
$2,057.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,452.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,178.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,815.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$502.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$505.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.16
|
| Rate for Payer: InnovAge PACE Commercial |
$459.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,614.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$285.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$306.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$484.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$410.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$410.25
|
| Rate for Payer: Multiplan Commercial |
$1,815.00
|
| Rate for Payer: Networks By Design Commercial |
$1,573.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,057.00
|
| Rate for Payer: Prime Health Services Medicare |
$324.53
|
| Rate for Payer: Riverside University Health System MISP |
$336.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,452.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,452.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$919.00
|
| Rate for Payer: United Healthcare All Other HMO |
$935.00
|
| Rate for Payer: United Healthcare HMO Rider |
$792.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$724.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$459.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$336.78
|
| Rate for Payer: Vantage Medical Group Senior |
$306.16
|
|
|
HC ECHO-C 2D/M-MODE COMPLETE
|
Facility
|
IP
|
$2,420.00
|
|
|
Service Code
|
CPT 93307
|
| Hospital Charge Code |
900200204
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$484.00 |
| Max. Negotiated Rate |
$2,178.00 |
| Rate for Payer: Cash Price |
$1,089.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,936.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$968.00
|
| Rate for Payer: Galaxy Health WC |
$2,057.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,452.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,178.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,614.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$922.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$484.00
|
| Rate for Payer: Multiplan Commercial |
$1,815.00
|
| Rate for Payer: Networks By Design Commercial |
$1,573.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,057.00
|
|
|
HC ECHO-C CONG 2D COMPLETE CONGEN
|
Facility
|
OP
|
$3,129.00
|
|
|
Service Code
|
CPT 93303
|
| Hospital Charge Code |
900200225
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$290.04 |
| Max. Negotiated Rate |
$2,816.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$689.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$875.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,033.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$758.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$689.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$891.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,848.61
|
| Rate for Payer: Blue Distinction Transplant |
$1,877.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,933.72
|
| Rate for Payer: Blue Shield of California EPN |
$1,520.69
|
| Rate for Payer: Caremore Medicare Advantage |
$689.28
|
| Rate for Payer: Cash Price |
$1,408.05
|
| Rate for Payer: Cash Price |
$1,408.05
|
| Rate for Payer: Cash Price |
$1,408.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,503.20
|
| Rate for Payer: Cigna of CA HMO |
$2,002.56
|
| Rate for Payer: Cigna of CA PPO |
$2,315.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,033.92
|
| Rate for Payer: Dignity Health Media |
$689.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$758.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$930.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$689.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$689.28
|
| Rate for Payer: Galaxy Health WC |
$2,659.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,877.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,816.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,346.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,130.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,137.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$689.28
|
| Rate for Payer: InnovAge PACE Commercial |
$1,033.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,087.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$290.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$689.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$625.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$923.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$923.64
|
| Rate for Payer: Multiplan Commercial |
$2,346.75
|
| Rate for Payer: Networks By Design Commercial |
$2,033.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,659.65
|
| Rate for Payer: Prime Health Services Medicare |
$730.64
|
| Rate for Payer: Riverside University Health System MISP |
$758.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,877.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,877.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$919.00
|
| Rate for Payer: United Healthcare All Other HMO |
$935.00
|
| Rate for Payer: United Healthcare HMO Rider |
$792.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$724.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,033.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$758.21
|
| Rate for Payer: Vantage Medical Group Senior |
$689.28
|
|
|
HC ECHO-C CONG 2D COMPLETE CONGEN
|
Facility
|
IP
|
$3,129.00
|
|
|
Service Code
|
CPT 93303
|
| Hospital Charge Code |
900200225
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$625.80 |
| Max. Negotiated Rate |
$2,816.10 |
| Rate for Payer: Cash Price |
$1,408.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,503.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,251.60
|
| Rate for Payer: Galaxy Health WC |
$2,659.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,877.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,816.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,087.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,192.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$625.80
|
| Rate for Payer: Multiplan Commercial |
$2,346.75
|
| Rate for Payer: Networks By Design Commercial |
$2,033.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,659.65
|
|
|
HC ECHO-C DOPPLER COMPLETE
|
Facility
|
IP
|
$1,622.00
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
900200205
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$324.40 |
| Max. Negotiated Rate |
$1,459.80 |
| Rate for Payer: Cash Price |
$729.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,297.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$648.80
|
| Rate for Payer: Galaxy Health WC |
$1,378.70
|
| Rate for Payer: Global Benefits Group Commercial |
$973.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,459.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,081.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$617.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$324.40
|
| Rate for Payer: Multiplan Commercial |
$1,216.50
|
| Rate for Payer: Networks By Design Commercial |
$1,054.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,378.70
|
|
|
HC ECHO-C DOPPLER COMPLETE
|
Facility
|
OP
|
$1,622.00
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
900200205
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$145.48 |
| Max. Negotiated Rate |
$1,459.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$261.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,378.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$892.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$892.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$444.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$958.28
|
| Rate for Payer: Blue Distinction Transplant |
$973.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,002.40
|
| Rate for Payer: Blue Shield of California EPN |
$788.29
|
| Rate for Payer: Cash Price |
$729.90
|
| Rate for Payer: Cash Price |
$729.90
|
| Rate for Payer: Cash Price |
$729.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,297.60
|
| Rate for Payer: Cigna of CA HMO |
$1,038.08
|
| Rate for Payer: Cigna of CA PPO |
$1,200.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,378.70
|
| Rate for Payer: Dignity Health Media |
$1,378.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,378.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$648.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$648.80
|
| Rate for Payer: Galaxy Health WC |
$1,378.70
|
| Rate for Payer: Global Benefits Group Commercial |
$973.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,459.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,216.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$567.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,081.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$145.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$324.40
|
| Rate for Payer: Multiplan Commercial |
$1,216.50
|
| Rate for Payer: Networks By Design Commercial |
$1,054.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,378.70
|
| Rate for Payer: Riverside University Health System MISP |
$648.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$973.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$973.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$919.00
|
| Rate for Payer: United Healthcare All Other HMO |
$935.00
|
| Rate for Payer: United Healthcare HMO Rider |
$792.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$724.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,378.70
|
| Rate for Payer: Vantage Medical Group Senior |
$1,378.70
|
|
|
HC ECHO-C FETAL 2D COMPLETE
|
Facility
|
OP
|
$3,072.00
|
|
|
Service Code
|
CPT 76825
|
| Hospital Charge Code |
900200231
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$154.81 |
| Max. Negotiated Rate |
$2,764.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$689.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$765.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,033.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$758.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$689.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,814.94
|
| Rate for Payer: Blue Distinction Transplant |
$1,843.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,898.50
|
| Rate for Payer: Blue Shield of California EPN |
$1,492.99
|
| Rate for Payer: Caremore Medicare Advantage |
$689.28
|
| Rate for Payer: Cash Price |
$1,382.40
|
| Rate for Payer: Cash Price |
$1,382.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,457.60
|
| Rate for Payer: Cigna of CA HMO |
$1,966.08
|
| Rate for Payer: Cigna of CA PPO |
$2,273.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,033.92
|
| Rate for Payer: Dignity Health Media |
$689.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$758.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$930.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$689.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$689.28
|
| Rate for Payer: Galaxy Health WC |
$2,611.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,843.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,764.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,304.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,130.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,137.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$689.28
|
| Rate for Payer: InnovAge PACE Commercial |
$1,033.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,049.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$154.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$689.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$614.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$923.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$923.64
|
| Rate for Payer: Multiplan Commercial |
$2,304.00
|
| Rate for Payer: Networks By Design Commercial |
$1,996.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,611.20
|
| Rate for Payer: Prime Health Services Medicare |
$730.64
|
| Rate for Payer: Riverside University Health System MISP |
$758.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,843.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,843.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$566.19
|
| Rate for Payer: United Healthcare All Other HMO |
$566.19
|
| Rate for Payer: United Healthcare HMO Rider |
$566.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$566.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,033.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$758.21
|
| Rate for Payer: Vantage Medical Group Senior |
$689.28
|
|
|
HC ECHO-C FETAL 2D COMPLETE
|
Facility
|
IP
|
$3,072.00
|
|
|
Service Code
|
CPT 76825
|
| Hospital Charge Code |
900200231
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$614.40 |
| Max. Negotiated Rate |
$2,764.80 |
| Rate for Payer: Cash Price |
$1,382.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,457.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,228.80
|
| Rate for Payer: Galaxy Health WC |
$2,611.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,843.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,764.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,049.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,170.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$614.40
|
| Rate for Payer: Multiplan Commercial |
$2,304.00
|
| Rate for Payer: Networks By Design Commercial |
$1,996.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,611.20
|
|
|
HC ECHO-C FETAL DOPPLER COMPLETE
|
Facility
|
IP
|
$2,009.00
|
|
|
Service Code
|
CPT 76827
|
| Hospital Charge Code |
900200233
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$401.80 |
| Max. Negotiated Rate |
$1,808.10 |
| Rate for Payer: Cash Price |
$904.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,607.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$803.60
|
| Rate for Payer: Galaxy Health WC |
$1,707.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,205.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,808.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,340.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$765.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$401.80
|
| Rate for Payer: Multiplan Commercial |
$1,506.75
|
| Rate for Payer: Networks By Design Commercial |
$1,305.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,707.65
|
|
|
HC ECHO-C FETAL DOPPLER COMPLETE
|
Facility
|
OP
|
$2,009.00
|
|
|
Service Code
|
CPT 76827
|
| Hospital Charge Code |
900200233
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$109.38 |
| Max. Negotiated Rate |
$1,808.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$137.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$214.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$173.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,186.92
|
| Rate for Payer: Blue Distinction Transplant |
$1,205.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,241.56
|
| Rate for Payer: Blue Shield of California EPN |
$976.37
|
| Rate for Payer: Caremore Medicare Advantage |
$137.36
|
| Rate for Payer: Cash Price |
$904.05
|
| Rate for Payer: Cash Price |
$904.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,607.20
|
| Rate for Payer: Cigna of CA HMO |
$1,285.76
|
| Rate for Payer: Cigna of CA PPO |
$1,486.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Media |
$137.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
| Rate for Payer: Galaxy Health WC |
$1,707.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,205.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,808.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,506.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$225.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$226.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$137.36
|
| Rate for Payer: InnovAge PACE Commercial |
$206.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,340.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$401.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$184.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
| Rate for Payer: Multiplan Commercial |
$1,506.75
|
| Rate for Payer: Networks By Design Commercial |
$1,305.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,707.65
|
| Rate for Payer: Prime Health Services Medicare |
$145.60
|
| Rate for Payer: Riverside University Health System MISP |
$151.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,205.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,205.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$161.07
|
| Rate for Payer: United Healthcare All Other HMO |
$161.07
|
| Rate for Payer: United Healthcare HMO Rider |
$161.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$161.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC ECHO CHD TEE IMG ACQ, INT AND RPT ONLY
|
Facility
|
OP
|
$2,007.00
|
|
|
Service Code
|
CPT 93317
|
| Hospital Charge Code |
900200317
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$401.40 |
| Max. Negotiated Rate |
$1,806.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$562.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,705.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,103.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,103.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$704.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,185.74
|
| Rate for Payer: Blue Distinction Transplant |
$1,204.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,240.33
|
| Rate for Payer: Blue Shield of California EPN |
$975.40
|
| Rate for Payer: Cash Price |
$903.15
|
| Rate for Payer: Cash Price |
$903.15
|
| Rate for Payer: Cash Price |
$903.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,605.60
|
| Rate for Payer: Cigna of CA HMO |
$1,284.48
|
| Rate for Payer: Cigna of CA PPO |
$1,485.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,705.95
|
| Rate for Payer: Dignity Health Media |
$1,705.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,705.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$802.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$802.80
|
| Rate for Payer: Galaxy Health WC |
$1,705.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,204.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,806.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,505.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$702.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,338.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$764.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$401.40
|
| Rate for Payer: Multiplan Commercial |
$1,505.25
|
| Rate for Payer: Networks By Design Commercial |
$1,304.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,705.95
|
| Rate for Payer: Riverside University Health System MISP |
$802.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,204.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,204.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$919.00
|
| Rate for Payer: United Healthcare All Other HMO |
$935.00
|
| Rate for Payer: United Healthcare HMO Rider |
$792.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$724.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,705.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,705.95
|
|
|
HC ECHO CHD TEE IMG ACQ, INT AND RPT ONLY
|
Facility
|
IP
|
$2,007.00
|
|
|
Service Code
|
CPT 93317
|
| Hospital Charge Code |
900200317
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$401.40 |
| Max. Negotiated Rate |
$1,806.30 |
| Rate for Payer: Cash Price |
$903.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,605.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$802.80
|
| Rate for Payer: Galaxy Health WC |
$1,705.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,204.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,806.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,338.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$764.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$401.40
|
| Rate for Payer: Multiplan Commercial |
$1,505.25
|
| Rate for Payer: Networks By Design Commercial |
$1,304.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,705.95
|
|
|
HC ECHO CHD TEE TRANSESOPHAGEAL
|
Facility
|
OP
|
$4,473.00
|
|
|
Service Code
|
CPT 93315
|
| Hospital Charge Code |
900200227
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$367.14 |
| Max. Negotiated Rate |
$4,025.70 |
| Rate for Payer: Adventist Health Medi-Cal |
$689.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,420.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,033.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$758.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$689.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$763.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,642.65
|
| Rate for Payer: Blue Distinction Transplant |
$2,683.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,764.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,173.88
|
| Rate for Payer: Caremore Medicare Advantage |
$689.28
|
| Rate for Payer: Cash Price |
$2,012.85
|
| Rate for Payer: Cash Price |
$2,012.85
|
| Rate for Payer: Cash Price |
$2,012.85
|
| Rate for Payer: Central Health Plan Commercial |
$3,578.40
|
| Rate for Payer: Cigna of CA HMO |
$2,862.72
|
| Rate for Payer: Cigna of CA PPO |
$3,310.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,033.92
|
| Rate for Payer: Dignity Health Media |
$689.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$758.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$930.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$689.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$689.28
|
| Rate for Payer: Galaxy Health WC |
$3,802.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,683.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,025.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,354.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,130.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,137.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$689.28
|
| Rate for Payer: InnovAge PACE Commercial |
$1,033.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,983.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$367.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$689.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$894.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$923.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$923.64
|
| Rate for Payer: Multiplan Commercial |
$3,354.75
|
| Rate for Payer: Networks By Design Commercial |
$2,907.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,802.05
|
| Rate for Payer: Prime Health Services Medicare |
$730.64
|
| Rate for Payer: Riverside University Health System MISP |
$758.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,683.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,683.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$919.00
|
| Rate for Payer: United Healthcare All Other HMO |
$935.00
|
| Rate for Payer: United Healthcare HMO Rider |
$792.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$724.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,033.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$758.21
|
| Rate for Payer: Vantage Medical Group Senior |
$689.28
|
|
|
HC ECHO CHD TEE TRANSESOPHAGEAL
|
Facility
|
IP
|
$4,473.00
|
|
|
Service Code
|
CPT 93315
|
| Hospital Charge Code |
900200227
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$894.60 |
| Max. Negotiated Rate |
$4,025.70 |
| Rate for Payer: Cash Price |
$2,012.85
|
| Rate for Payer: Central Health Plan Commercial |
$3,578.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,789.20
|
| Rate for Payer: Galaxy Health WC |
$3,802.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,683.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,025.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,983.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,704.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$894.60
|
| Rate for Payer: Multiplan Commercial |
$3,354.75
|
| Rate for Payer: Networks By Design Commercial |
$2,907.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,802.05
|
|
|
HC ECHO COLOR FLOW MAPPING DOPPLE
|
Facility
|
IP
|
$1,342.00
|
|
|
Service Code
|
CPT 93325
|
| Hospital Charge Code |
900200208
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$268.40 |
| Max. Negotiated Rate |
$1,207.80 |
| Rate for Payer: Cash Price |
$603.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,073.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$536.80
|
| Rate for Payer: Galaxy Health WC |
$1,140.70
|
| Rate for Payer: Global Benefits Group Commercial |
$805.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,207.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$895.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$511.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$268.40
|
| Rate for Payer: Multiplan Commercial |
$1,006.50
|
| Rate for Payer: Networks By Design Commercial |
$872.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,140.70
|
|
|
HC ECHO COLOR FLOW MAPPING DOPPLE
|
Facility
|
OP
|
$1,342.00
|
|
|
Service Code
|
CPT 93325
|
| Hospital Charge Code |
900200208
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$147.97 |
| Max. Negotiated Rate |
$1,207.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$193.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,140.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$738.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$738.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$654.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$792.85
|
| Rate for Payer: Blue Distinction Transplant |
$805.20
|
| Rate for Payer: Blue Shield of California Commercial |
$829.36
|
| Rate for Payer: Blue Shield of California EPN |
$652.21
|
| Rate for Payer: Cash Price |
$603.90
|
| Rate for Payer: Cash Price |
$603.90
|
| Rate for Payer: Cash Price |
$603.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,073.60
|
| Rate for Payer: Cigna of CA HMO |
$858.88
|
| Rate for Payer: Cigna of CA PPO |
$993.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,140.70
|
| Rate for Payer: Dignity Health Media |
$1,140.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,140.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$536.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$536.80
|
| Rate for Payer: Galaxy Health WC |
$1,140.70
|
| Rate for Payer: Global Benefits Group Commercial |
$805.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,207.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,006.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$469.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$895.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$147.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$268.40
|
| Rate for Payer: Multiplan Commercial |
$1,006.50
|
| Rate for Payer: Networks By Design Commercial |
$872.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,140.70
|
| Rate for Payer: Riverside University Health System MISP |
$536.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$805.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$805.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$919.00
|
| Rate for Payer: United Healthcare All Other HMO |
$935.00
|
| Rate for Payer: United Healthcare HMO Rider |
$792.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$724.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,140.70
|
| Rate for Payer: Vantage Medical Group Senior |
$1,140.70
|
|
|
HC ECHO CONTRAST DEFINITY
|
Facility
|
OP
|
$595.00
|
|
|
Service Code
|
CPT Q9957
|
| Hospital Charge Code |
912000220
|
|
Hospital Revenue Code
|
254
|
| Min. Negotiated Rate |
$41.79 |
| Max. Negotiated Rate |
$535.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$261.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$505.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$327.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$327.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$113.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$124.30
|
| Rate for Payer: Blue Distinction Transplant |
$357.00
|
| Rate for Payer: Blue Shield of California Commercial |
$374.26
|
| Rate for Payer: Blue Shield of California EPN |
$290.96
|
| Rate for Payer: Cash Price |
$267.75
|
| Rate for Payer: Cash Price |
$267.75
|
| Rate for Payer: Central Health Plan Commercial |
$476.00
|
| Rate for Payer: Cigna of CA HMO |
$380.80
|
| Rate for Payer: Cigna of CA PPO |
$440.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$505.75
|
| Rate for Payer: Dignity Health Media |
$505.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$505.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$238.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$238.00
|
| Rate for Payer: Galaxy Health WC |
$505.75
|
| Rate for Payer: Global Benefits Group Commercial |
$357.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$535.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$446.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$41.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$396.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$95.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.00
|
| Rate for Payer: Multiplan Commercial |
$446.25
|
| Rate for Payer: Networks By Design Commercial |
$386.75
|
| Rate for Payer: Prime Health Services Commercial |
$505.75
|
| Rate for Payer: Riverside University Health System MISP |
$238.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$357.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$357.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$297.50
|
| Rate for Payer: United Healthcare All Other HMO |
$297.50
|
| Rate for Payer: United Healthcare HMO Rider |
$297.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$297.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$505.75
|
| Rate for Payer: Vantage Medical Group Senior |
$505.75
|
|
|
HC ECHO CONTRAST DEFINITY
|
Facility
|
IP
|
$595.00
|
|
|
Service Code
|
CPT Q9957
|
| Hospital Charge Code |
912000220
|
|
Hospital Revenue Code
|
254
|
| Min. Negotiated Rate |
$119.00 |
| Max. Negotiated Rate |
$535.50 |
| Rate for Payer: Blue Shield of California Commercial |
$446.25
|
| Rate for Payer: Blue Shield of California EPN |
$317.73
|
| Rate for Payer: Cash Price |
$267.75
|
| Rate for Payer: Central Health Plan Commercial |
$476.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$238.00
|
| Rate for Payer: Galaxy Health WC |
$505.75
|
| Rate for Payer: Global Benefits Group Commercial |
$357.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$535.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$396.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$226.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.00
|
| Rate for Payer: Multiplan Commercial |
$446.25
|
| Rate for Payer: Networks By Design Commercial |
$386.75
|
| Rate for Payer: Prime Health Services Commercial |
$505.75
|
|
|
HC ECHO CONTRAST OPTISON
|
Facility
|
OP
|
$737.00
|
|
|
Service Code
|
CPT Q9956
|
| Hospital Charge Code |
912000219
|
|
Hospital Revenue Code
|
254
|
| Min. Negotiated Rate |
$41.79 |
| Max. Negotiated Rate |
$663.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$261.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$626.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$405.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$405.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$84.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$92.56
|
| Rate for Payer: Blue Distinction Transplant |
$442.20
|
| Rate for Payer: Blue Shield of California Commercial |
$463.57
|
| Rate for Payer: Blue Shield of California EPN |
$360.39
|
| Rate for Payer: Cash Price |
$331.65
|
| Rate for Payer: Cash Price |
$331.65
|
| Rate for Payer: Central Health Plan Commercial |
$589.60
|
| Rate for Payer: Cigna of CA HMO |
$471.68
|
| Rate for Payer: Cigna of CA PPO |
$545.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$626.45
|
| Rate for Payer: Dignity Health Media |
$626.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$626.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$294.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.80
|
| Rate for Payer: Galaxy Health WC |
$626.45
|
| Rate for Payer: Global Benefits Group Commercial |
$442.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$663.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$552.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$41.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$491.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.40
|
| Rate for Payer: Multiplan Commercial |
$552.75
|
| Rate for Payer: Networks By Design Commercial |
$479.05
|
| Rate for Payer: Prime Health Services Commercial |
$626.45
|
| Rate for Payer: Riverside University Health System MISP |
$294.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$442.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$442.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$368.50
|
| Rate for Payer: United Healthcare All Other HMO |
$368.50
|
| Rate for Payer: United Healthcare HMO Rider |
$368.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$368.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$626.45
|
| Rate for Payer: Vantage Medical Group Senior |
$626.45
|
|
|
HC ECHO CONTRAST OPTISON
|
Facility
|
IP
|
$737.00
|
|
|
Service Code
|
CPT Q9956
|
| Hospital Charge Code |
912000219
|
|
Hospital Revenue Code
|
254
|
| Min. Negotiated Rate |
$147.40 |
| Max. Negotiated Rate |
$663.30 |
| Rate for Payer: Blue Shield of California Commercial |
$552.75
|
| Rate for Payer: Blue Shield of California EPN |
$393.56
|
| Rate for Payer: Cash Price |
$331.65
|
| Rate for Payer: Central Health Plan Commercial |
$589.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$294.80
|
| Rate for Payer: Galaxy Health WC |
$626.45
|
| Rate for Payer: Global Benefits Group Commercial |
$442.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$663.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$491.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$280.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.40
|
| Rate for Payer: Multiplan Commercial |
$552.75
|
| Rate for Payer: Networks By Design Commercial |
$479.05
|
| Rate for Payer: Prime Health Services Commercial |
$626.45
|
|
|
HC ECHO-F 2D/M-MODE FOLLOWUP
|
Facility
|
OP
|
$2,439.00
|
|
|
Service Code
|
CPT 93308
|
| Hospital Charge Code |
900200209
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$142.60 |
| Max. Negotiated Rate |
$2,195.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$306.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$474.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$459.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$336.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$503.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,440.96
|
| Rate for Payer: Blue Distinction Transplant |
$1,463.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,507.30
|
| Rate for Payer: Blue Shield of California EPN |
$1,185.35
|
| Rate for Payer: Caremore Medicare Advantage |
$306.16
|
| Rate for Payer: Cash Price |
$1,097.55
|
| Rate for Payer: Cash Price |
$1,097.55
|
| Rate for Payer: Cash Price |
$1,097.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,951.20
|
| Rate for Payer: Cigna of CA HMO |
$1,560.96
|
| Rate for Payer: Cigna of CA PPO |
$1,804.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$459.24
|
| Rate for Payer: Dignity Health Media |
$306.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$336.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$413.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$306.16
|
| Rate for Payer: EPIC Health Plan Transplant |
$306.16
|
| Rate for Payer: Galaxy Health WC |
$2,073.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,463.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,195.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,829.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$502.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$505.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.16
|
| Rate for Payer: InnovAge PACE Commercial |
$459.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,626.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$306.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$487.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$410.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$410.25
|
| Rate for Payer: Multiplan Commercial |
$1,829.25
|
| Rate for Payer: Networks By Design Commercial |
$1,585.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,073.15
|
| Rate for Payer: Prime Health Services Medicare |
$324.53
|
| Rate for Payer: Riverside University Health System MISP |
$336.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,463.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,463.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$919.00
|
| Rate for Payer: United Healthcare All Other HMO |
$935.00
|
| Rate for Payer: United Healthcare HMO Rider |
$792.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$724.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$459.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$336.78
|
| Rate for Payer: Vantage Medical Group Senior |
$306.16
|
|
|
HC ECHO-F 2D/M-MODE FOLLOWUP
|
Facility
|
IP
|
$2,439.00
|
|
|
Service Code
|
CPT 93308
|
| Hospital Charge Code |
900200209
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$487.80 |
| Max. Negotiated Rate |
$2,195.10 |
| Rate for Payer: Cash Price |
$1,097.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,951.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$975.60
|
| Rate for Payer: Galaxy Health WC |
$2,073.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,463.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,195.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,626.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$929.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$487.80
|
| Rate for Payer: Multiplan Commercial |
$1,829.25
|
| Rate for Payer: Networks By Design Commercial |
$1,585.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,073.15
|
|
|
HC ECHO-F CONG 2D F/U CONGENITAL
|
Facility
|
IP
|
$2,675.00
|
|
|
Service Code
|
CPT 93304
|
| Hospital Charge Code |
900200226
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$535.00 |
| Max. Negotiated Rate |
$2,407.50 |
| Rate for Payer: Cash Price |
$1,203.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,140.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,070.00
|
| Rate for Payer: Galaxy Health WC |
$2,273.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,605.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,407.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,784.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,019.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$535.00
|
| Rate for Payer: Multiplan Commercial |
$2,006.25
|
| Rate for Payer: Networks By Design Commercial |
$1,738.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,273.75
|
|
|
HC ECHO-F CONG 2D F/U CONGENITAL
|
Facility
|
OP
|
$2,675.00
|
|
|
Service Code
|
CPT 93304
|
| Hospital Charge Code |
900200226
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$158.61 |
| Max. Negotiated Rate |
$2,407.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$689.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$584.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,033.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$758.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$689.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$449.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,580.39
|
| Rate for Payer: Blue Distinction Transplant |
$1,605.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,653.15
|
| Rate for Payer: Blue Shield of California EPN |
$1,300.05
|
| Rate for Payer: Caremore Medicare Advantage |
$689.28
|
| Rate for Payer: Cash Price |
$1,203.75
|
| Rate for Payer: Cash Price |
$1,203.75
|
| Rate for Payer: Cash Price |
$1,203.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,140.00
|
| Rate for Payer: Cigna of CA HMO |
$1,712.00
|
| Rate for Payer: Cigna of CA PPO |
$1,979.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,033.92
|
| Rate for Payer: Dignity Health Media |
$689.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$758.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$930.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$689.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$689.28
|
| Rate for Payer: Galaxy Health WC |
$2,273.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,605.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,407.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,006.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,130.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,137.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$689.28
|
| Rate for Payer: InnovAge PACE Commercial |
$1,033.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,784.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$158.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$689.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$535.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$923.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$923.64
|
| Rate for Payer: Multiplan Commercial |
$2,006.25
|
| Rate for Payer: Networks By Design Commercial |
$1,738.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,273.75
|
| Rate for Payer: Prime Health Services Medicare |
$730.64
|
| Rate for Payer: Riverside University Health System MISP |
$758.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,605.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,605.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$919.00
|
| Rate for Payer: United Healthcare All Other HMO |
$935.00
|
| Rate for Payer: United Healthcare HMO Rider |
$792.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$724.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,033.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$758.21
|
| Rate for Payer: Vantage Medical Group Senior |
$689.28
|
|
|
HC ECHO-F DOPPLER FOLLOWUP
|
Facility
|
IP
|
$1,275.00
|
|
|
Service Code
|
CPT 93321
|
| Hospital Charge Code |
900200210
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$255.00 |
| Max. Negotiated Rate |
$1,147.50 |
| Rate for Payer: Cash Price |
$573.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,020.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$510.00
|
| Rate for Payer: Galaxy Health WC |
$1,083.75
|
| Rate for Payer: Global Benefits Group Commercial |
$765.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,147.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$850.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$485.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$255.00
|
| Rate for Payer: Multiplan Commercial |
$956.25
|
| Rate for Payer: Networks By Design Commercial |
$828.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,083.75
|
|
