|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
OP
|
$526.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
947100111
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$85.69 |
| Max. Negotiated Rate |
$990.00 |
| Rate for Payer: Adventist Health Commercial |
$105.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$267.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$319.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$401.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$294.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$267.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$990.00
|
| Rate for Payer: Cash Price |
$289.30
|
| Rate for Payer: Cash Price |
$289.30
|
| Rate for Payer: Cash Price |
$289.30
|
| Rate for Payer: Central Health Plan Commercial |
$420.80
|
| Rate for Payer: Cigna of CA HMO |
$336.64
|
| Rate for Payer: Cigna of CA PPO |
$389.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$401.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$294.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$267.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.39
|
| Rate for Payer: EPIC Health Plan Senior |
$267.70
|
| Rate for Payer: Galaxy Health WC |
$447.10
|
| Rate for Payer: Global Benefits Group Commercial |
$315.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$473.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$439.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$85.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$267.70
|
| Rate for Payer: InnovAge PACE Commercial |
$401.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$350.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$358.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.72
|
| Rate for Payer: Multiplan Commercial |
$394.50
|
| Rate for Payer: Networks By Design Commercial |
$341.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$267.70
|
| Rate for Payer: Prime Health Services Commercial |
$447.10
|
| Rate for Payer: Prime Health Services Medicare |
$283.76
|
| Rate for Payer: Riverside University Health System MISP |
$294.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$315.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$321.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$676.00
|
| Rate for Payer: United Healthcare All Other HMO |
$663.00
|
| Rate for Payer: United Healthcare HMO Rider |
$662.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$605.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$267.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$401.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$294.47
|
| Rate for Payer: Vantage Medical Group Senior |
$267.70
|
|
|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
IP
|
$598.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
947000111
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$538.20 |
| Rate for Payer: Adventist Health Commercial |
$119.60
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Central Health Plan Commercial |
$478.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$239.20
|
| Rate for Payer: EPIC Health Plan Senior |
$239.20
|
| Rate for Payer: Galaxy Health WC |
$508.30
|
| Rate for Payer: Global Benefits Group Commercial |
$358.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$538.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$398.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$227.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.60
|
| Rate for Payer: Multiplan Commercial |
$448.50
|
| Rate for Payer: Networks By Design Commercial |
$388.70
|
| Rate for Payer: Prime Health Services Commercial |
$508.30
|
|
|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
OP
|
$598.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
907296374
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$85.69 |
| Max. Negotiated Rate |
$990.00 |
| Rate for Payer: Adventist Health Commercial |
$119.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$267.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$363.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$401.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$294.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$267.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$990.00
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Central Health Plan Commercial |
$478.40
|
| Rate for Payer: Cigna of CA HMO |
$382.72
|
| Rate for Payer: Cigna of CA PPO |
$442.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$401.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$294.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$267.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.39
|
| Rate for Payer: EPIC Health Plan Senior |
$267.70
|
| Rate for Payer: Galaxy Health WC |
$508.30
|
| Rate for Payer: Global Benefits Group Commercial |
$358.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$538.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$439.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$85.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$267.70
|
| Rate for Payer: InnovAge PACE Commercial |
$401.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$398.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$358.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.72
|
| Rate for Payer: Multiplan Commercial |
$448.50
|
| Rate for Payer: Networks By Design Commercial |
$388.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$267.70
|
| Rate for Payer: Prime Health Services Commercial |
$508.30
|
| Rate for Payer: Prime Health Services Medicare |
$283.76
|
| Rate for Payer: Riverside University Health System MISP |
$294.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$358.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$321.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$676.00
|
| Rate for Payer: United Healthcare All Other HMO |
$663.00
|
| Rate for Payer: United Healthcare HMO Rider |
$662.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$605.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$267.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$401.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$294.47
|
| Rate for Payer: Vantage Medical Group Senior |
$267.70
|
|
|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
OP
|
$598.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
945100111
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$85.69 |
| Max. Negotiated Rate |
$990.00 |
| Rate for Payer: Adventist Health Commercial |
$119.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$267.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$363.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$401.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$294.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$267.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$990.00
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Central Health Plan Commercial |
$478.40
|
| Rate for Payer: Cigna of CA HMO |
$382.72
|
| Rate for Payer: Cigna of CA PPO |
$442.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$401.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$294.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$267.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.39
|
| Rate for Payer: EPIC Health Plan Senior |
$267.70
|
| Rate for Payer: Galaxy Health WC |
$508.30
|
| Rate for Payer: Global Benefits Group Commercial |
$358.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$538.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$439.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$85.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$267.70
|
| Rate for Payer: InnovAge PACE Commercial |
$401.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$398.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$358.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.72
|
| Rate for Payer: Multiplan Commercial |
$448.50
|
| Rate for Payer: Networks By Design Commercial |
$388.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$267.70
|
| Rate for Payer: Prime Health Services Commercial |
$508.30
|
| Rate for Payer: Prime Health Services Medicare |
$283.76
|
| Rate for Payer: Riverside University Health System MISP |
$294.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$358.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$321.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$676.00
|
| Rate for Payer: United Healthcare All Other HMO |
$663.00
|
| Rate for Payer: United Healthcare HMO Rider |
$662.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$605.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$267.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$401.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$294.47
|
| Rate for Payer: Vantage Medical Group Senior |
$267.70
|
|
|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
IP
|
$598.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
907296374
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$538.20 |
| Rate for Payer: Adventist Health Commercial |
$119.60
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Central Health Plan Commercial |
$478.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$239.20
|
| Rate for Payer: EPIC Health Plan Senior |
$239.20
|
| Rate for Payer: Galaxy Health WC |
$508.30
|
| Rate for Payer: Global Benefits Group Commercial |
$358.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$538.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$398.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$227.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.60
|
| Rate for Payer: Multiplan Commercial |
$448.50
|
| Rate for Payer: Networks By Design Commercial |
$388.70
|
| Rate for Payer: Prime Health Services Commercial |
$508.30
|
|
|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
OP
|
$598.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
907296374
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$85.69 |
| Max. Negotiated Rate |
$1,091.00 |
| Rate for Payer: Adventist Health Commercial |
$119.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$267.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$363.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$401.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$294.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$267.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$990.00
|
| Rate for Payer: Blue Shield of California Commercial |
$365.38
|
| Rate for Payer: Blue Shield of California EPN |
$238.60
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Central Health Plan Commercial |
$478.40
|
| Rate for Payer: Cigna of CA HMO |
$382.72
|
| Rate for Payer: Cigna of CA PPO |
$442.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$401.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$294.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$267.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.39
|
| Rate for Payer: EPIC Health Plan Senior |
$267.70
|
| Rate for Payer: Galaxy Health WC |
$508.30
|
| Rate for Payer: Global Benefits Group Commercial |
$358.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$538.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$439.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$85.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$267.70
|
| Rate for Payer: InnovAge PACE Commercial |
$401.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$398.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$358.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.72
|
| Rate for Payer: Multiplan Commercial |
$448.50
|
| Rate for Payer: Networks By Design Commercial |
$388.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$267.70
|
| Rate for Payer: Prime Health Services Commercial |
$508.30
|
| Rate for Payer: Prime Health Services Medicare |
$283.76
|
| Rate for Payer: Riverside University Health System MISP |
$294.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$358.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$358.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,091.00
|
| Rate for Payer: United Healthcare All Other HMO |
$839.00
|
| Rate for Payer: United Healthcare HMO Rider |
$635.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$581.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$267.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$401.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$294.47
|
| Rate for Payer: Vantage Medical Group Senior |
$267.70
|
|
|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
OP
|
$598.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
947300111
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$85.69 |
| Max. Negotiated Rate |
$990.00 |
| Rate for Payer: Adventist Health Commercial |
$119.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$267.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$363.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$401.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$294.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$267.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$990.00
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Central Health Plan Commercial |
$478.40
|
| Rate for Payer: Cigna of CA HMO |
$382.72
|
| Rate for Payer: Cigna of CA PPO |
$442.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$401.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$294.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$267.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.39
|
| Rate for Payer: EPIC Health Plan Senior |
$267.70
|
| Rate for Payer: Galaxy Health WC |
$508.30
|
| Rate for Payer: Global Benefits Group Commercial |
$358.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$538.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$439.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$85.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$267.70
|
| Rate for Payer: InnovAge PACE Commercial |
$401.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$398.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$358.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.72
|
| Rate for Payer: Multiplan Commercial |
$448.50
|
| Rate for Payer: Networks By Design Commercial |
$388.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$267.70
|
| Rate for Payer: Prime Health Services Commercial |
$508.30
|
| Rate for Payer: Prime Health Services Medicare |
$283.76
|
| Rate for Payer: Riverside University Health System MISP |
$294.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$358.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$321.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$676.00
|
| Rate for Payer: United Healthcare All Other HMO |
$663.00
|
| Rate for Payer: United Healthcare HMO Rider |
$662.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$605.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$267.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$401.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$294.47
|
| Rate for Payer: Vantage Medical Group Senior |
$267.70
|
|
|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
IP
|
$598.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
946000111
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$538.20 |
| Rate for Payer: Adventist Health Commercial |
$119.60
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Central Health Plan Commercial |
$478.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$239.20
|
| Rate for Payer: EPIC Health Plan Senior |
$239.20
|
| Rate for Payer: Galaxy Health WC |
$508.30
|
| Rate for Payer: Global Benefits Group Commercial |
$358.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$538.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$398.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$227.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.60
|
| Rate for Payer: Multiplan Commercial |
$448.50
|
| Rate for Payer: Networks By Design Commercial |
$388.70
|
| Rate for Payer: Prime Health Services Commercial |
$508.30
|
|
|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
IP
|
$598.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
946100111
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$538.20 |
| Rate for Payer: Adventist Health Commercial |
$119.60
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Central Health Plan Commercial |
$478.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$239.20
|
| Rate for Payer: EPIC Health Plan Senior |
$239.20
|
| Rate for Payer: Galaxy Health WC |
$508.30
|
| Rate for Payer: Global Benefits Group Commercial |
$358.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$538.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$398.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$227.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.60
|
| Rate for Payer: Multiplan Commercial |
$448.50
|
| Rate for Payer: Networks By Design Commercial |
$388.70
|
| Rate for Payer: Prime Health Services Commercial |
$508.30
|
|
|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
IP
|
$598.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
945100111
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$538.20 |
| Rate for Payer: Adventist Health Commercial |
$119.60
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Central Health Plan Commercial |
$478.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$239.20
|
| Rate for Payer: EPIC Health Plan Senior |
$239.20
|
| Rate for Payer: Galaxy Health WC |
$508.30
|
| Rate for Payer: Global Benefits Group Commercial |
$358.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$538.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$398.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$227.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.60
|
| Rate for Payer: Multiplan Commercial |
$448.50
|
| Rate for Payer: Networks By Design Commercial |
$388.70
|
| Rate for Payer: Prime Health Services Commercial |
$508.30
|
|
|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
IP
|
$598.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
940100111
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$538.20 |
| Rate for Payer: Adventist Health Commercial |
$119.60
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Central Health Plan Commercial |
$478.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$239.20
|
| Rate for Payer: EPIC Health Plan Senior |
$239.20
|
| Rate for Payer: Galaxy Health WC |
$508.30
|
| Rate for Payer: Global Benefits Group Commercial |
$358.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$538.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$398.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$227.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.60
|
| Rate for Payer: Multiplan Commercial |
$448.50
|
| Rate for Payer: Networks By Design Commercial |
$388.70
|
| Rate for Payer: Prime Health Services Commercial |
$508.30
|
|
|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
IP
|
$598.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
907296374
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$538.20 |
| Rate for Payer: Adventist Health Commercial |
$119.60
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Central Health Plan Commercial |
$478.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$239.20
|
| Rate for Payer: EPIC Health Plan Senior |
$239.20
|
| Rate for Payer: Galaxy Health WC |
$508.30
|
| Rate for Payer: Global Benefits Group Commercial |
$358.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$538.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$398.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$227.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.60
|
| Rate for Payer: Multiplan Commercial |
$448.50
|
| Rate for Payer: Networks By Design Commercial |
$388.70
|
| Rate for Payer: Prime Health Services Commercial |
$508.30
|
|
|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
IP
|
$526.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
947100111
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$105.20 |
| Max. Negotiated Rate |
$473.40 |
| Rate for Payer: Adventist Health Commercial |
$105.20
|
| Rate for Payer: Cash Price |
$289.30
|
| Rate for Payer: Central Health Plan Commercial |
$420.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$210.40
|
| Rate for Payer: EPIC Health Plan Senior |
$210.40
|
| Rate for Payer: Galaxy Health WC |
$447.10
|
| Rate for Payer: Global Benefits Group Commercial |
$315.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$473.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$350.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$200.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$325.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.20
|
| Rate for Payer: Multiplan Commercial |
$394.50
|
| Rate for Payer: Networks By Design Commercial |
$341.90
|
| Rate for Payer: Prime Health Services Commercial |
$447.10
|
|
|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
OP
|
$598.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
946100111
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$85.69 |
| Max. Negotiated Rate |
$990.00 |
| Rate for Payer: Adventist Health Commercial |
$119.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$267.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$363.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$401.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$294.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$267.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$990.00
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Central Health Plan Commercial |
$478.40
|
| Rate for Payer: Cigna of CA HMO |
$382.72
|
| Rate for Payer: Cigna of CA PPO |
$442.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$401.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$294.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$267.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.39
|
| Rate for Payer: EPIC Health Plan Senior |
$267.70
|
| Rate for Payer: Galaxy Health WC |
$508.30
|
| Rate for Payer: Global Benefits Group Commercial |
$358.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$538.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$439.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$85.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$267.70
|
| Rate for Payer: InnovAge PACE Commercial |
$401.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$398.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$358.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.72
|
| Rate for Payer: Multiplan Commercial |
$448.50
|
| Rate for Payer: Networks By Design Commercial |
$388.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$267.70
|
| Rate for Payer: Prime Health Services Commercial |
$508.30
|
| Rate for Payer: Prime Health Services Medicare |
$283.76
|
| Rate for Payer: Riverside University Health System MISP |
$294.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$358.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$321.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$676.00
|
| Rate for Payer: United Healthcare All Other HMO |
$663.00
|
| Rate for Payer: United Healthcare HMO Rider |
$662.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$605.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$267.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$401.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$294.47
|
| Rate for Payer: Vantage Medical Group Senior |
$267.70
|
|
|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
OP
|
$598.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
907296374
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$85.69 |
| Max. Negotiated Rate |
$990.00 |
| Rate for Payer: Adventist Health Commercial |
$119.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$267.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$363.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$401.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$294.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$267.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$990.00
|
| Rate for Payer: Blue Shield of California Commercial |
$365.38
|
| Rate for Payer: Blue Shield of California EPN |
$238.60
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Central Health Plan Commercial |
$478.40
|
| Rate for Payer: Cigna of CA HMO |
$382.72
|
| Rate for Payer: Cigna of CA PPO |
$442.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$401.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$294.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$267.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.39
|
| Rate for Payer: EPIC Health Plan Senior |
$267.70
|
| Rate for Payer: Galaxy Health WC |
$508.30
|
| Rate for Payer: Global Benefits Group Commercial |
$358.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$538.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$439.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$85.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$267.70
|
| Rate for Payer: InnovAge PACE Commercial |
$401.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$398.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$358.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.72
|
| Rate for Payer: Multiplan Commercial |
$448.50
|
| Rate for Payer: Networks By Design Commercial |
$388.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$267.70
|
| Rate for Payer: Prime Health Services Commercial |
$508.30
|
| Rate for Payer: Prime Health Services Medicare |
$283.76
|
| Rate for Payer: Riverside University Health System MISP |
$294.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$358.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$358.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$299.00
|
| Rate for Payer: United Healthcare All Other HMO |
$299.00
|
| Rate for Payer: United Healthcare HMO Rider |
$299.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$299.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$267.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$401.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$294.47
|
| Rate for Payer: Vantage Medical Group Senior |
$267.70
|
|
|
HC IV PUSH SINGLER OR INIT DRUG
|
Facility
|
IP
|
$598.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
910196374
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$538.20 |
| Rate for Payer: Adventist Health Commercial |
$119.60
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Central Health Plan Commercial |
$478.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$239.20
|
| Rate for Payer: EPIC Health Plan Senior |
$239.20
|
| Rate for Payer: Galaxy Health WC |
$508.30
|
| Rate for Payer: Global Benefits Group Commercial |
$358.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$538.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$398.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$227.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.60
|
| Rate for Payer: Multiplan Commercial |
$448.50
|
| Rate for Payer: Networks By Design Commercial |
$388.70
|
| Rate for Payer: Prime Health Services Commercial |
$508.30
|
|
|
HC IV PUSH SINGLER OR INIT DRUG
|
Facility
|
OP
|
$598.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
910196374
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$85.69 |
| Max. Negotiated Rate |
$990.00 |
| Rate for Payer: Adventist Health Commercial |
$119.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$267.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$363.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$401.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$294.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$267.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$990.00
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Central Health Plan Commercial |
$478.40
|
| Rate for Payer: Cigna of CA HMO |
$382.72
|
| Rate for Payer: Cigna of CA PPO |
$442.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$401.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$294.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$267.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.39
|
| Rate for Payer: EPIC Health Plan Senior |
$267.70
|
| Rate for Payer: Galaxy Health WC |
$508.30
|
| Rate for Payer: Global Benefits Group Commercial |
$358.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$538.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$439.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$85.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$267.70
|
| Rate for Payer: InnovAge PACE Commercial |
$401.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$398.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$358.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.72
|
| Rate for Payer: Multiplan Commercial |
$448.50
|
| Rate for Payer: Networks By Design Commercial |
$388.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$267.70
|
| Rate for Payer: Prime Health Services Commercial |
$508.30
|
| Rate for Payer: Prime Health Services Medicare |
$283.76
|
| Rate for Payer: Riverside University Health System MISP |
$294.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$358.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$321.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$676.00
|
| Rate for Payer: United Healthcare All Other HMO |
$663.00
|
| Rate for Payer: United Healthcare HMO Rider |
$662.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$605.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$267.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$401.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$294.47
|
| Rate for Payer: Vantage Medical Group Senior |
$267.70
|
|
|
HC IVPW ADDL VES PRESSUREWIRE SEN
|
Facility
|
OP
|
$7,172.00
|
|
|
Service Code
|
CPT 93572
|
| Hospital Charge Code |
906820080
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$386.60 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,434.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,096.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,944.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,379.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,472.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,212.12
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,944.60
|
| Rate for Payer: Cash Price |
$3,944.60
|
| Rate for Payer: Cash Price |
$3,944.60
|
| Rate for Payer: Central Health Plan Commercial |
$5,737.60
|
| Rate for Payer: Cigna of CA HMO |
$4,661.80
|
| Rate for Payer: Cigna of CA PPO |
$5,307.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,096.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,096.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,096.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,868.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,868.80
|
| Rate for Payer: Galaxy Health WC |
$6,096.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,303.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,454.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$386.60
|
| Rate for Payer: InnovAge PACE Commercial |
$3,586.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,783.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$427.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,439.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,434.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,020.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,020.40
|
| Rate for Payer: Multiplan Commercial |
$5,379.00
|
| Rate for Payer: Networks By Design Commercial |
$4,661.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,096.20
|
| Rate for Payer: Riverside University Health System MISP |
$2,868.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,303.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,303.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,096.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,096.20
|
| Rate for Payer: Vantage Medical Group Senior |
$6,096.20
|
|
|
HC IVPW ADDL VES PRESSUREWIRE SEN
|
Facility
|
OP
|
$6,096.00
|
|
|
Service Code
|
CPT 93572
|
| Hospital Charge Code |
906812134
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$386.60 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,219.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,181.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,352.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,572.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,951.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,580.18
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,352.80
|
| Rate for Payer: Cash Price |
$3,352.80
|
| Rate for Payer: Cash Price |
$3,352.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,876.80
|
| Rate for Payer: Cigna of CA HMO |
$3,962.40
|
| Rate for Payer: Cigna of CA PPO |
$4,511.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,181.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,181.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,181.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,438.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,438.40
|
| Rate for Payer: Galaxy Health WC |
$5,181.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,657.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,486.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$386.60
|
| Rate for Payer: InnovAge PACE Commercial |
$3,048.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,066.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$427.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,773.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,219.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,267.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,267.20
|
| Rate for Payer: Multiplan Commercial |
$4,572.00
|
| Rate for Payer: Networks By Design Commercial |
$3,962.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,181.60
|
| Rate for Payer: Riverside University Health System MISP |
$2,438.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,657.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,657.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,181.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,181.60
|
| Rate for Payer: Vantage Medical Group Senior |
$5,181.60
|
|
|
HC IVPW ADDL VES PRESSUREWIRE SEN
|
Facility
|
IP
|
$6,096.00
|
|
|
Service Code
|
CPT 93572
|
| Hospital Charge Code |
906812134
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,219.20 |
| Max. Negotiated Rate |
$5,486.40 |
| Rate for Payer: Adventist Health Commercial |
$1,219.20
|
| Rate for Payer: Cash Price |
$3,352.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,876.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,438.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,438.40
|
| Rate for Payer: Galaxy Health WC |
$5,181.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,657.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,486.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,066.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,322.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,773.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,219.20
|
| Rate for Payer: Multiplan Commercial |
$4,572.00
|
| Rate for Payer: Networks By Design Commercial |
$3,962.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,181.60
|
|
|
HC IVPW ADDL VES PRESSUREWIRE SEN
|
Facility
|
IP
|
$7,172.00
|
|
|
Service Code
|
CPT 93572
|
| Hospital Charge Code |
906820080
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,434.40 |
| Max. Negotiated Rate |
$6,454.80 |
| Rate for Payer: Adventist Health Commercial |
$1,434.40
|
| Rate for Payer: Cash Price |
$3,944.60
|
| Rate for Payer: Central Health Plan Commercial |
$5,737.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,868.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,868.80
|
| Rate for Payer: Galaxy Health WC |
$6,096.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,303.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,454.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,783.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,732.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,439.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,434.40
|
| Rate for Payer: Multiplan Commercial |
$5,379.00
|
| Rate for Payer: Networks By Design Commercial |
$4,661.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,096.20
|
|
|
HC IVPW INIT VES PRESSUREWIRE SEN
|
Facility
|
OP
|
$12,360.00
|
|
|
Service Code
|
CPT 93571
|
| Hospital Charge Code |
906820079
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$417.63 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,472.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,506.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,798.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,270.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,984.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,259.03
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$6,798.00
|
| Rate for Payer: Cash Price |
$6,798.00
|
| Rate for Payer: Cash Price |
$6,798.00
|
| Rate for Payer: Central Health Plan Commercial |
$9,888.00
|
| Rate for Payer: Cigna of CA HMO |
$8,034.00
|
| Rate for Payer: Cigna of CA PPO |
$9,146.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,506.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,506.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,506.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,944.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,944.00
|
| Rate for Payer: Galaxy Health WC |
$10,506.00
|
| Rate for Payer: Global Benefits Group Commercial |
$7,416.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,124.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$417.63
|
| Rate for Payer: InnovAge PACE Commercial |
$6,180.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,244.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$461.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,650.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,472.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,652.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,652.00
|
| Rate for Payer: Multiplan Commercial |
$9,270.00
|
| Rate for Payer: Networks By Design Commercial |
$8,034.00
|
| Rate for Payer: Prime Health Services Commercial |
$10,506.00
|
| Rate for Payer: Riverside University Health System MISP |
$4,944.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,416.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,416.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,506.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,506.00
|
| Rate for Payer: Vantage Medical Group Senior |
$10,506.00
|
|
|
HC IVPW INIT VES PRESSUREWIRE SEN
|
Facility
|
OP
|
$10,506.00
|
|
|
Service Code
|
CPT 93571
|
| Hospital Charge Code |
906812133
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$417.63 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,101.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,930.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,778.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,879.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,087.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,170.17
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$5,778.30
|
| Rate for Payer: Cash Price |
$5,778.30
|
| Rate for Payer: Cash Price |
$5,778.30
|
| Rate for Payer: Central Health Plan Commercial |
$8,404.80
|
| Rate for Payer: Cigna of CA HMO |
$6,828.90
|
| Rate for Payer: Cigna of CA PPO |
$7,774.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,930.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,930.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,930.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,202.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,202.40
|
| Rate for Payer: Galaxy Health WC |
$8,930.10
|
| Rate for Payer: Global Benefits Group Commercial |
$6,303.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,455.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$417.63
|
| Rate for Payer: InnovAge PACE Commercial |
$5,253.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,007.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$461.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,503.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,101.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7,354.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7,354.20
|
| Rate for Payer: Multiplan Commercial |
$7,879.50
|
| Rate for Payer: Networks By Design Commercial |
$6,828.90
|
| Rate for Payer: Prime Health Services Commercial |
$8,930.10
|
| Rate for Payer: Riverside University Health System MISP |
$4,202.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,303.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,303.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,930.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,930.10
|
| Rate for Payer: Vantage Medical Group Senior |
$8,930.10
|
|
|
HC IVPW INIT VES PRESSUREWIRE SEN
|
Facility
|
IP
|
$10,506.00
|
|
|
Service Code
|
CPT 93571
|
| Hospital Charge Code |
906812133
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,101.20 |
| Max. Negotiated Rate |
$9,455.40 |
| Rate for Payer: Adventist Health Commercial |
$2,101.20
|
| Rate for Payer: Cash Price |
$5,778.30
|
| Rate for Payer: Central Health Plan Commercial |
$8,404.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,202.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,202.40
|
| Rate for Payer: Galaxy Health WC |
$8,930.10
|
| Rate for Payer: Global Benefits Group Commercial |
$6,303.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,455.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,007.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,002.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,503.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,101.20
|
| Rate for Payer: Multiplan Commercial |
$7,879.50
|
| Rate for Payer: Networks By Design Commercial |
$6,828.90
|
| Rate for Payer: Prime Health Services Commercial |
$8,930.10
|
|
|
HC IVPW INIT VES PRESSUREWIRE SEN
|
Facility
|
IP
|
$12,360.00
|
|
|
Service Code
|
CPT 93571
|
| Hospital Charge Code |
906820079
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,472.00 |
| Max. Negotiated Rate |
$11,124.00 |
| Rate for Payer: Adventist Health Commercial |
$2,472.00
|
| Rate for Payer: Cash Price |
$6,798.00
|
| Rate for Payer: Central Health Plan Commercial |
$9,888.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,944.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,944.00
|
| Rate for Payer: Galaxy Health WC |
$10,506.00
|
| Rate for Payer: Global Benefits Group Commercial |
$7,416.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,124.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,244.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,709.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,650.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,472.00
|
| Rate for Payer: Multiplan Commercial |
$9,270.00
|
| Rate for Payer: Networks By Design Commercial |
$8,034.00
|
| Rate for Payer: Prime Health Services Commercial |
$10,506.00
|
|
