|
HC MRI ANGIO HEAD WO CNTRAST
|
Facility
|
IP
|
$10,216.00
|
|
|
Service Code
|
CPT 70544
|
| Hospital Charge Code |
908801083
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$2,043.20 |
| Max. Negotiated Rate |
$9,194.40 |
| Rate for Payer: Adventist Health Commercial |
$2,043.20
|
| Rate for Payer: Cash Price |
$4,597.20
|
| Rate for Payer: Central Health Plan Commercial |
$8,172.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,151.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,086.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,086.40
|
| Rate for Payer: Galaxy Health WC |
$8,683.60
|
| Rate for Payer: Global Benefits Group Commercial |
$6,129.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,194.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,487.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,027.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,043.20
|
| Rate for Payer: Multiplan Commercial |
$7,662.00
|
| Rate for Payer: Networks By Design Commercial |
$6,640.40
|
| Rate for Payer: Prime Health Services Commercial |
$8,683.60
|
|
|
HC MRI ANGIO HEAD WO CNTRAST
|
Facility
|
OP
|
$10,216.00
|
|
|
Service Code
|
CPT 70544
|
| Hospital Charge Code |
908801083
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$306.88 |
| Max. Negotiated Rate |
$9,194.40 |
| Rate for Payer: Adventist Health Commercial |
$2,043.20
|
| Rate for Payer: Adventist Health Commercial |
$1,045.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$306.88
|
| Rate for Payer: Adventist Health Medi-Cal |
$306.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,369.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,369.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,942.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,039.96
|
| Rate for Payer: Blue Shield of California Commercial |
$3,292.38
|
| Rate for Payer: Blue Shield of California Commercial |
$6,436.08
|
| Rate for Payer: Blue Shield of California EPN |
$4,055.75
|
| Rate for Payer: Blue Shield of California EPN |
$2,074.72
|
| Rate for Payer: Cash Price |
$4,597.20
|
| Rate for Payer: Cash Price |
$4,597.20
|
| Rate for Payer: Cash Price |
$4,597.20
|
| Rate for Payer: Cash Price |
$2,351.70
|
| Rate for Payer: Cash Price |
$2,351.70
|
| Rate for Payer: Cash Price |
$2,351.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,180.80
|
| Rate for Payer: Central Health Plan Commercial |
$8,172.80
|
| Rate for Payer: Cigna of CA HMO |
$3,344.64
|
| Rate for Payer: Cigna of CA HMO |
$6,538.24
|
| Rate for Payer: Cigna of CA PPO |
$3,867.24
|
| Rate for Payer: Cigna of CA PPO |
$7,559.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,658.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,151.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: Galaxy Health WC |
$8,683.60
|
| Rate for Payer: Galaxy Health WC |
$4,442.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,135.60
|
| Rate for Payer: Global Benefits Group Commercial |
$6,129.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,703.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,194.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$362.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$362.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,318.51
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,487.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$400.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$400.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,043.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,045.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$411.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$411.22
|
| Rate for Payer: Multiplan Commercial |
$3,919.50
|
| Rate for Payer: Multiplan Commercial |
$7,662.00
|
| Rate for Payer: Networks By Design Commercial |
$6,640.40
|
| Rate for Payer: Networks By Design Commercial |
$3,396.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$306.88
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$306.88
|
| Rate for Payer: Prime Health Services Commercial |
$8,683.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,442.10
|
| Rate for Payer: Prime Health Services Medicare |
$325.29
|
| Rate for Payer: Prime Health Services Medicare |
$325.29
|
| Rate for Payer: Riverside University Health System MISP |
$337.57
|
| Rate for Payer: Riverside University Health System MISP |
$337.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,129.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,135.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,129.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,135.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
|
|
HC MRI ANGIO HEAD WO CNTRAST
|
Facility
|
OP
|
$10,216.00
|
|
|
Service Code
|
CPT 70544
|
| Hospital Charge Code |
908801015
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$306.88 |
| Max. Negotiated Rate |
$9,194.40 |
| Rate for Payer: Adventist Health Commercial |
$2,043.20
|
| Rate for Payer: Adventist Health Commercial |
$1,045.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$306.88
|
| Rate for Payer: Adventist Health Medi-Cal |
$306.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,369.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,369.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,942.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,039.96
|
| Rate for Payer: Blue Shield of California Commercial |
$3,292.38
|
| Rate for Payer: Blue Shield of California Commercial |
$6,436.08
|
| Rate for Payer: Blue Shield of California EPN |
$4,055.75
|
| Rate for Payer: Blue Shield of California EPN |
$2,074.72
|
| Rate for Payer: Cash Price |
$4,597.20
|
| Rate for Payer: Cash Price |
$4,597.20
|
| Rate for Payer: Cash Price |
$4,597.20
|
| Rate for Payer: Cash Price |
$2,351.70
|
| Rate for Payer: Cash Price |
$2,351.70
|
| Rate for Payer: Cash Price |
$2,351.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,180.80
|
| Rate for Payer: Central Health Plan Commercial |
$8,172.80
|
| Rate for Payer: Cigna of CA HMO |
$3,344.64
|
| Rate for Payer: Cigna of CA HMO |
$6,538.24
|
| Rate for Payer: Cigna of CA PPO |
$3,867.24
|
| Rate for Payer: Cigna of CA PPO |
$7,559.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,658.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,151.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: Galaxy Health WC |
$8,683.60
|
| Rate for Payer: Galaxy Health WC |
$4,442.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,135.60
|
| Rate for Payer: Global Benefits Group Commercial |
$6,129.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,703.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,194.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$362.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$362.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,318.51
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,487.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$400.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$400.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,043.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,045.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$411.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$411.22
|
| Rate for Payer: Multiplan Commercial |
$3,919.50
|
| Rate for Payer: Multiplan Commercial |
$7,662.00
|
| Rate for Payer: Networks By Design Commercial |
$6,640.40
|
| Rate for Payer: Networks By Design Commercial |
$3,396.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$306.88
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$306.88
|
| Rate for Payer: Prime Health Services Commercial |
$8,683.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,442.10
|
| Rate for Payer: Prime Health Services Medicare |
$325.29
|
| Rate for Payer: Prime Health Services Medicare |
$325.29
|
| Rate for Payer: Riverside University Health System MISP |
$337.57
|
| Rate for Payer: Riverside University Health System MISP |
$337.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,129.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,135.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,129.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,135.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
|
|
HC MRI ANGIO HEAD W WO CONTRAST
|
Facility
|
OP
|
$13,390.00
|
|
|
Service Code
|
CPT 70546
|
| Hospital Charge Code |
908801085
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$448.71 |
| Max. Negotiated Rate |
$12,051.00 |
| Rate for Payer: Adventist Health Commercial |
$2,678.00
|
| Rate for Payer: Adventist Health Commercial |
$1,254.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,659.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,659.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,788.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,647.26
|
| Rate for Payer: Blue Shield of California Commercial |
$3,950.10
|
| Rate for Payer: Blue Shield of California Commercial |
$8,435.70
|
| Rate for Payer: Blue Shield of California EPN |
$5,315.83
|
| Rate for Payer: Blue Shield of California EPN |
$2,489.19
|
| Rate for Payer: Cash Price |
$6,025.50
|
| Rate for Payer: Cash Price |
$6,025.50
|
| Rate for Payer: Cash Price |
$6,025.50
|
| Rate for Payer: Cash Price |
$2,821.50
|
| Rate for Payer: Cash Price |
$2,821.50
|
| Rate for Payer: Cash Price |
$2,821.50
|
| Rate for Payer: Central Health Plan Commercial |
$5,016.00
|
| Rate for Payer: Central Health Plan Commercial |
$10,712.00
|
| Rate for Payer: Cigna of CA HMO |
$4,012.80
|
| Rate for Payer: Cigna of CA HMO |
$8,569.60
|
| Rate for Payer: Cigna of CA PPO |
$4,639.80
|
| Rate for Payer: Cigna of CA PPO |
$9,908.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,389.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,373.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$11,381.50
|
| Rate for Payer: Galaxy Health WC |
$5,329.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,762.00
|
| Rate for Payer: Global Benefits Group Commercial |
$8,034.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,643.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,051.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$557.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$557.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,981.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,502.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$615.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$615.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,678.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,254.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$4,702.50
|
| Rate for Payer: Multiplan Commercial |
$10,042.50
|
| Rate for Payer: Networks By Design Commercial |
$8,703.50
|
| Rate for Payer: Networks By Design Commercial |
$4,075.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: Prime Health Services Commercial |
$11,381.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,329.50
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,034.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,762.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,034.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,762.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,367.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,367.12
|
| Rate for Payer: United Healthcare All Other HMO |
$1,367.12
|
| Rate for Payer: United Healthcare All Other HMO |
$1,367.12
|
| Rate for Payer: United Healthcare HMO Rider |
$1,367.12
|
| Rate for Payer: United Healthcare HMO Rider |
$1,367.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,367.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,367.12
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC MRI ANGIO HEAD W WO CONTRAST
|
Facility
|
IP
|
$13,390.00
|
|
|
Service Code
|
CPT 70546
|
| Hospital Charge Code |
908801085
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$2,678.00 |
| Max. Negotiated Rate |
$12,051.00 |
| Rate for Payer: Adventist Health Commercial |
$2,678.00
|
| Rate for Payer: Cash Price |
$6,025.50
|
| Rate for Payer: Central Health Plan Commercial |
$10,712.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,373.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,356.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,356.00
|
| Rate for Payer: Galaxy Health WC |
$11,381.50
|
| Rate for Payer: Global Benefits Group Commercial |
$8,034.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,051.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,502.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,900.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,678.00
|
| Rate for Payer: Multiplan Commercial |
$10,042.50
|
| Rate for Payer: Networks By Design Commercial |
$8,703.50
|
| Rate for Payer: Prime Health Services Commercial |
$11,381.50
|
|
|
HC MRI ANGIO NECK W CONTRAST
|
Facility
|
OP
|
$10,094.00
|
|
|
Service Code
|
CPT 70548
|
| Hospital Charge Code |
908801087
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$413.80 |
| Max. Negotiated Rate |
$9,084.60 |
| Rate for Payer: Adventist Health Commercial |
$2,018.80
|
| Rate for Payer: Adventist Health Commercial |
$1,170.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,369.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,369.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,871.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,404.69
|
| Rate for Payer: Blue Shield of California Commercial |
$3,687.39
|
| Rate for Payer: Blue Shield of California Commercial |
$6,359.22
|
| Rate for Payer: Blue Shield of California EPN |
$4,007.32
|
| Rate for Payer: Blue Shield of California EPN |
$2,323.64
|
| Rate for Payer: Cash Price |
$4,542.30
|
| Rate for Payer: Cash Price |
$4,542.30
|
| Rate for Payer: Cash Price |
$4,542.30
|
| Rate for Payer: Cash Price |
$2,633.85
|
| Rate for Payer: Cash Price |
$2,633.85
|
| Rate for Payer: Cash Price |
$2,633.85
|
| Rate for Payer: Central Health Plan Commercial |
$4,682.40
|
| Rate for Payer: Central Health Plan Commercial |
$8,075.20
|
| Rate for Payer: Cigna of CA HMO |
$3,745.92
|
| Rate for Payer: Cigna of CA HMO |
$6,460.16
|
| Rate for Payer: Cigna of CA PPO |
$4,331.22
|
| Rate for Payer: Cigna of CA PPO |
$7,469.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,097.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,065.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$8,579.90
|
| Rate for Payer: Galaxy Health WC |
$4,975.05
|
| Rate for Payer: Global Benefits Group Commercial |
$3,511.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,056.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,267.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,084.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$413.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$413.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,716.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,409.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$457.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$457.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,018.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,170.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$4,389.75
|
| Rate for Payer: Multiplan Commercial |
$7,570.50
|
| Rate for Payer: Networks By Design Commercial |
$6,561.10
|
| Rate for Payer: Networks By Design Commercial |
$3,804.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: Prime Health Services Commercial |
$8,579.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,975.05
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,056.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,511.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,056.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,511.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,115.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,115.74
|
| Rate for Payer: United Healthcare All Other HMO |
$1,115.74
|
| Rate for Payer: United Healthcare All Other HMO |
$1,115.74
|
| Rate for Payer: United Healthcare HMO Rider |
$1,115.74
|
| Rate for Payer: United Healthcare HMO Rider |
$1,115.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,115.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,115.74
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC MRI ANGIO NECK W CONTRAST
|
Facility
|
IP
|
$10,094.00
|
|
|
Service Code
|
CPT 70548
|
| Hospital Charge Code |
908801087
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$2,018.80 |
| Max. Negotiated Rate |
$9,084.60 |
| Rate for Payer: Adventist Health Commercial |
$2,018.80
|
| Rate for Payer: Cash Price |
$4,542.30
|
| Rate for Payer: Central Health Plan Commercial |
$8,075.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,065.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,037.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,037.60
|
| Rate for Payer: Galaxy Health WC |
$8,579.90
|
| Rate for Payer: Global Benefits Group Commercial |
$6,056.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,084.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,409.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,955.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,018.80
|
| Rate for Payer: Multiplan Commercial |
$7,570.50
|
| Rate for Payer: Networks By Design Commercial |
$6,561.10
|
| Rate for Payer: Prime Health Services Commercial |
$8,579.90
|
|
|
HC MRI ANGIO NECK WO CONTRAST
|
Facility
|
IP
|
$9,749.00
|
|
|
Service Code
|
CPT 70547
|
| Hospital Charge Code |
908801018
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$1,949.80 |
| Max. Negotiated Rate |
$8,774.10 |
| Rate for Payer: Adventist Health Commercial |
$1,949.80
|
| Rate for Payer: Cash Price |
$4,387.05
|
| Rate for Payer: Central Health Plan Commercial |
$7,799.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,824.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,899.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,899.60
|
| Rate for Payer: Galaxy Health WC |
$8,286.65
|
| Rate for Payer: Global Benefits Group Commercial |
$5,849.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,774.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,190.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,751.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,949.80
|
| Rate for Payer: Multiplan Commercial |
$7,311.75
|
| Rate for Payer: Networks By Design Commercial |
$6,336.85
|
| Rate for Payer: Prime Health Services Commercial |
$8,286.65
|
|
|
HC MRI ANGIO NECK WO CONTRAST
|
Facility
|
IP
|
$9,749.00
|
|
|
Service Code
|
CPT 70547
|
| Hospital Charge Code |
908801086
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$1,949.80 |
| Max. Negotiated Rate |
$8,774.10 |
| Rate for Payer: Adventist Health Commercial |
$1,949.80
|
| Rate for Payer: Cash Price |
$4,387.05
|
| Rate for Payer: Central Health Plan Commercial |
$7,799.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,824.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,899.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,899.60
|
| Rate for Payer: Galaxy Health WC |
$8,286.65
|
| Rate for Payer: Global Benefits Group Commercial |
$5,849.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,774.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,190.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,751.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,949.80
|
| Rate for Payer: Multiplan Commercial |
$7,311.75
|
| Rate for Payer: Networks By Design Commercial |
$6,336.85
|
| Rate for Payer: Prime Health Services Commercial |
$8,286.65
|
|
|
HC MRI ANGIO NECK WO CONTRAST
|
Facility
|
OP
|
$5,651.00
|
|
|
Service Code
|
CPT 70547
|
| Hospital Charge Code |
908801086
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$306.88 |
| Max. Negotiated Rate |
$5,085.90 |
| Rate for Payer: Adventist Health Commercial |
$1,130.20
|
| Rate for Payer: Adventist Health Commercial |
$1,949.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$306.88
|
| Rate for Payer: Adventist Health Medi-Cal |
$306.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,369.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,369.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,287.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,670.99
|
| Rate for Payer: Blue Shield of California Commercial |
$6,141.87
|
| Rate for Payer: Blue Shield of California Commercial |
$3,560.13
|
| Rate for Payer: Blue Shield of California EPN |
$2,243.45
|
| Rate for Payer: Blue Shield of California EPN |
$3,870.35
|
| Rate for Payer: Cash Price |
$2,542.95
|
| Rate for Payer: Cash Price |
$2,542.95
|
| Rate for Payer: Cash Price |
$2,542.95
|
| Rate for Payer: Cash Price |
$4,387.05
|
| Rate for Payer: Cash Price |
$4,387.05
|
| Rate for Payer: Cash Price |
$4,387.05
|
| Rate for Payer: Central Health Plan Commercial |
$7,799.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,520.80
|
| Rate for Payer: Cigna of CA HMO |
$6,239.36
|
| Rate for Payer: Cigna of CA HMO |
$3,616.64
|
| Rate for Payer: Cigna of CA PPO |
$7,214.26
|
| Rate for Payer: Cigna of CA PPO |
$4,181.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,824.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,955.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: Galaxy Health WC |
$4,803.35
|
| Rate for Payer: Galaxy Health WC |
$8,286.65
|
| Rate for Payer: Global Benefits Group Commercial |
$5,849.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,390.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,774.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,085.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$363.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$363.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,190.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,588.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$402.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$402.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,130.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,949.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$411.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$411.22
|
| Rate for Payer: Multiplan Commercial |
$7,311.75
|
| Rate for Payer: Multiplan Commercial |
$4,238.25
|
| Rate for Payer: Networks By Design Commercial |
$3,673.15
|
| Rate for Payer: Networks By Design Commercial |
$6,336.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$306.88
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$306.88
|
| Rate for Payer: Prime Health Services Commercial |
$4,803.35
|
| Rate for Payer: Prime Health Services Commercial |
$8,286.65
|
| Rate for Payer: Prime Health Services Medicare |
$325.29
|
| Rate for Payer: Prime Health Services Medicare |
$325.29
|
| Rate for Payer: Riverside University Health System MISP |
$337.57
|
| Rate for Payer: Riverside University Health System MISP |
$337.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,390.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,849.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,390.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,849.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
|
|
HC MRI ANGIO NECK WO CONTRAST
|
Facility
|
OP
|
$5,651.00
|
|
|
Service Code
|
CPT 70547
|
| Hospital Charge Code |
908801018
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$306.88 |
| Max. Negotiated Rate |
$5,085.90 |
| Rate for Payer: Adventist Health Commercial |
$1,130.20
|
| Rate for Payer: Adventist Health Commercial |
$1,949.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$306.88
|
| Rate for Payer: Adventist Health Medi-Cal |
$306.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,369.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,369.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,287.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,670.99
|
| Rate for Payer: Blue Shield of California Commercial |
$6,141.87
|
| Rate for Payer: Blue Shield of California Commercial |
$3,560.13
|
| Rate for Payer: Blue Shield of California EPN |
$2,243.45
|
| Rate for Payer: Blue Shield of California EPN |
$3,870.35
|
| Rate for Payer: Cash Price |
$2,542.95
|
| Rate for Payer: Cash Price |
$2,542.95
|
| Rate for Payer: Cash Price |
$2,542.95
|
| Rate for Payer: Cash Price |
$4,387.05
|
| Rate for Payer: Cash Price |
$4,387.05
|
| Rate for Payer: Cash Price |
$4,387.05
|
| Rate for Payer: Central Health Plan Commercial |
$7,799.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,520.80
|
| Rate for Payer: Cigna of CA HMO |
$6,239.36
|
| Rate for Payer: Cigna of CA HMO |
$3,616.64
|
| Rate for Payer: Cigna of CA PPO |
$7,214.26
|
| Rate for Payer: Cigna of CA PPO |
$4,181.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,824.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,955.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: Galaxy Health WC |
$4,803.35
|
| Rate for Payer: Galaxy Health WC |
$8,286.65
|
| Rate for Payer: Global Benefits Group Commercial |
$5,849.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,390.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,774.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,085.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$363.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$363.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,190.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,588.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$402.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$402.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,130.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,949.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$411.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$411.22
|
| Rate for Payer: Multiplan Commercial |
$7,311.75
|
| Rate for Payer: Multiplan Commercial |
$4,238.25
|
| Rate for Payer: Networks By Design Commercial |
$3,673.15
|
| Rate for Payer: Networks By Design Commercial |
$6,336.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$306.88
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$306.88
|
| Rate for Payer: Prime Health Services Commercial |
$4,803.35
|
| Rate for Payer: Prime Health Services Commercial |
$8,286.65
|
| Rate for Payer: Prime Health Services Medicare |
$325.29
|
| Rate for Payer: Prime Health Services Medicare |
$325.29
|
| Rate for Payer: Riverside University Health System MISP |
$337.57
|
| Rate for Payer: Riverside University Health System MISP |
$337.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,390.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,849.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,390.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,849.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
|
|
HC MRI ANGIO NECK W WO CONTRAST
|
Facility
|
OP
|
$11,975.00
|
|
|
Service Code
|
CPT 70549
|
| Hospital Charge Code |
908801088
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$448.71 |
| Max. Negotiated Rate |
$10,777.50 |
| Rate for Payer: Adventist Health Commercial |
$2,395.00
|
| Rate for Payer: Adventist Health Commercial |
$1,294.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,659.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,659.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,965.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,764.76
|
| Rate for Payer: Blue Shield of California Commercial |
$4,077.36
|
| Rate for Payer: Blue Shield of California Commercial |
$7,544.25
|
| Rate for Payer: Blue Shield of California EPN |
$4,754.07
|
| Rate for Payer: Blue Shield of California EPN |
$2,569.38
|
| Rate for Payer: Cash Price |
$5,388.75
|
| Rate for Payer: Cash Price |
$5,388.75
|
| Rate for Payer: Cash Price |
$5,388.75
|
| Rate for Payer: Cash Price |
$2,912.40
|
| Rate for Payer: Cash Price |
$2,912.40
|
| Rate for Payer: Cash Price |
$2,912.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,177.60
|
| Rate for Payer: Central Health Plan Commercial |
$9,580.00
|
| Rate for Payer: Cigna of CA HMO |
$4,142.08
|
| Rate for Payer: Cigna of CA HMO |
$7,664.00
|
| Rate for Payer: Cigna of CA PPO |
$4,789.28
|
| Rate for Payer: Cigna of CA PPO |
$8,861.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,530.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,382.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$10,178.75
|
| Rate for Payer: Galaxy Health WC |
$5,501.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,883.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7,185.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,824.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,777.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$583.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$583.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,109.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,604.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$644.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$644.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,395.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,294.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$4,854.00
|
| Rate for Payer: Multiplan Commercial |
$8,981.25
|
| Rate for Payer: Networks By Design Commercial |
$7,783.75
|
| Rate for Payer: Networks By Design Commercial |
$4,206.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: Prime Health Services Commercial |
$10,178.75
|
| Rate for Payer: Prime Health Services Commercial |
$5,501.20
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,185.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,883.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,185.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,883.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,367.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,367.12
|
| Rate for Payer: United Healthcare All Other HMO |
$1,367.12
|
| Rate for Payer: United Healthcare All Other HMO |
$1,367.12
|
| Rate for Payer: United Healthcare HMO Rider |
$1,367.12
|
| Rate for Payer: United Healthcare HMO Rider |
$1,367.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,367.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,367.12
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC MRI ANGIO NECK W WO CONTRAST
|
Facility
|
IP
|
$11,975.00
|
|
|
Service Code
|
CPT 70549
|
| Hospital Charge Code |
908801088
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$2,395.00 |
| Max. Negotiated Rate |
$10,777.50 |
| Rate for Payer: Adventist Health Commercial |
$2,395.00
|
| Rate for Payer: Cash Price |
$5,388.75
|
| Rate for Payer: Central Health Plan Commercial |
$9,580.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,382.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,790.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,790.00
|
| Rate for Payer: Galaxy Health WC |
$10,178.75
|
| Rate for Payer: Global Benefits Group Commercial |
$7,185.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,777.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,604.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,065.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,395.00
|
| Rate for Payer: Multiplan Commercial |
$8,981.25
|
| Rate for Payer: Networks By Design Commercial |
$7,783.75
|
| Rate for Payer: Prime Health Services Commercial |
$10,178.75
|
|
|
HC MRI BILATERAL TMJ
|
Facility
|
OP
|
$11,701.00
|
|
|
Service Code
|
CPT 70336
|
| Hospital Charge Code |
908801055
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$306.88 |
| Max. Negotiated Rate |
$10,530.90 |
| Rate for Payer: Adventist Health Commercial |
$2,340.20
|
| Rate for Payer: Adventist Health Commercial |
$1,130.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$306.88
|
| Rate for Payer: Adventist Health Medi-Cal |
$306.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,044.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,044.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,806.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,288.35
|
| Rate for Payer: Blue Shield of California Commercial |
$3,561.39
|
| Rate for Payer: Blue Shield of California Commercial |
$7,371.63
|
| Rate for Payer: Blue Shield of California EPN |
$2,244.24
|
| Rate for Payer: Blue Shield of California EPN |
$4,645.30
|
| Rate for Payer: Cash Price |
$5,265.45
|
| Rate for Payer: Cash Price |
$2,543.85
|
| Rate for Payer: Cash Price |
$2,543.85
|
| Rate for Payer: Cash Price |
$5,265.45
|
| Rate for Payer: Cash Price |
$5,265.45
|
| Rate for Payer: Cash Price |
$2,543.85
|
| Rate for Payer: Central Health Plan Commercial |
$9,360.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,522.40
|
| Rate for Payer: Cigna of CA HMO |
$7,488.64
|
| Rate for Payer: Cigna of CA HMO |
$3,617.92
|
| Rate for Payer: Cigna of CA PPO |
$8,658.74
|
| Rate for Payer: Cigna of CA PPO |
$4,183.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,190.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,957.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: Galaxy Health WC |
$4,805.05
|
| Rate for Payer: Galaxy Health WC |
$9,945.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,391.80
|
| Rate for Payer: Global Benefits Group Commercial |
$7,020.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,087.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,530.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,589.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,430.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,052.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,247.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,130.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,340.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$411.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$411.22
|
| Rate for Payer: Multiplan Commercial |
$8,775.75
|
| Rate for Payer: Multiplan Commercial |
$4,239.75
|
| Rate for Payer: Networks By Design Commercial |
$7,605.65
|
| Rate for Payer: Networks By Design Commercial |
$3,674.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$306.88
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$306.88
|
| Rate for Payer: Prime Health Services Commercial |
$4,805.05
|
| Rate for Payer: Prime Health Services Commercial |
$9,945.85
|
| Rate for Payer: Prime Health Services Medicare |
$325.29
|
| Rate for Payer: Prime Health Services Medicare |
$325.29
|
| Rate for Payer: Riverside University Health System MISP |
$337.57
|
| Rate for Payer: Riverside University Health System MISP |
$337.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,020.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,391.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,391.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,020.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
|
|
HC MRI BILATERAL TMJ
|
Facility
|
IP
|
$11,701.00
|
|
|
Service Code
|
CPT 70336
|
| Hospital Charge Code |
908801055
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,340.20 |
| Max. Negotiated Rate |
$10,530.90 |
| Rate for Payer: Adventist Health Commercial |
$2,340.20
|
| Rate for Payer: Cash Price |
$5,265.45
|
| Rate for Payer: Central Health Plan Commercial |
$9,360.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,190.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,680.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,680.40
|
| Rate for Payer: Galaxy Health WC |
$9,945.85
|
| Rate for Payer: Global Benefits Group Commercial |
$7,020.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,530.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,430.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,903.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,340.20
|
| Rate for Payer: Multiplan Commercial |
$8,775.75
|
| Rate for Payer: Networks By Design Commercial |
$7,605.65
|
| Rate for Payer: Prime Health Services Commercial |
$9,945.85
|
|
|
HC MRI BN MARROW(2 SEQ)
|
Facility
|
IP
|
$7,672.00
|
|
|
Service Code
|
CPT 77084
|
| Hospital Charge Code |
908801140
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,534.40 |
| Max. Negotiated Rate |
$6,904.80 |
| Rate for Payer: Adventist Health Commercial |
$1,534.40
|
| Rate for Payer: Cash Price |
$3,452.40
|
| Rate for Payer: Central Health Plan Commercial |
$6,137.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,370.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,068.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,068.80
|
| Rate for Payer: Galaxy Health WC |
$6,521.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,603.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,904.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,871.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,526.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,534.40
|
| Rate for Payer: Multiplan Commercial |
$5,754.00
|
| Rate for Payer: Networks By Design Commercial |
$4,986.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,521.20
|
|
|
HC MRI BN MARROW(2 SEQ)
|
Facility
|
OP
|
$3,706.00
|
|
|
Service Code
|
CPT 77084
|
| Hospital Charge Code |
908801140
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$306.88 |
| Max. Negotiated Rate |
$3,335.40 |
| Rate for Payer: Adventist Health Commercial |
$741.20
|
| Rate for Payer: Adventist Health Commercial |
$1,534.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$306.88
|
| Rate for Payer: Adventist Health Medi-Cal |
$306.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,055.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,055.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,305.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,305.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,462.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,155.78
|
| Rate for Payer: Blue Shield of California Commercial |
$4,833.36
|
| Rate for Payer: Blue Shield of California Commercial |
$2,334.78
|
| Rate for Payer: Blue Shield of California EPN |
$3,045.78
|
| Rate for Payer: Blue Shield of California EPN |
$1,471.28
|
| Rate for Payer: Cash Price |
$3,452.40
|
| Rate for Payer: Cash Price |
$1,667.70
|
| Rate for Payer: Cash Price |
$1,667.70
|
| Rate for Payer: Cash Price |
$3,452.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,964.80
|
| Rate for Payer: Central Health Plan Commercial |
$6,137.60
|
| Rate for Payer: Cigna of CA HMO |
$2,371.84
|
| Rate for Payer: Cigna of CA HMO |
$4,910.08
|
| Rate for Payer: Cigna of CA PPO |
$2,742.44
|
| Rate for Payer: Cigna of CA PPO |
$5,677.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,370.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,594.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: Galaxy Health WC |
$3,150.10
|
| Rate for Payer: Galaxy Health WC |
$6,521.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,603.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,223.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,904.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,335.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,871.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,353.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,345.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,784.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$741.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,534.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$411.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$411.22
|
| Rate for Payer: Multiplan Commercial |
$2,779.50
|
| Rate for Payer: Multiplan Commercial |
$5,754.00
|
| Rate for Payer: Networks By Design Commercial |
$2,408.90
|
| Rate for Payer: Networks By Design Commercial |
$4,986.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$306.88
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$306.88
|
| Rate for Payer: Prime Health Services Commercial |
$6,521.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,150.10
|
| Rate for Payer: Prime Health Services Medicare |
$325.29
|
| Rate for Payer: Prime Health Services Medicare |
$325.29
|
| Rate for Payer: Riverside University Health System MISP |
$337.57
|
| Rate for Payer: Riverside University Health System MISP |
$337.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,223.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,603.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,223.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,603.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
|
|
HC MRI BRAIN ASSESS W CONTRAST
|
Facility
|
OP
|
$1,937.00
|
|
|
Service Code
|
CPT 70558
|
| Hospital Charge Code |
908870558
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$225.59 |
| Max. Negotiated Rate |
$2,759.80 |
| Rate for Payer: Adventist Health Commercial |
$387.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$225.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,055.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,759.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,126.75
|
| Rate for Payer: Blue Shield of California Commercial |
$1,220.31
|
| Rate for Payer: Blue Shield of California EPN |
$768.99
|
| Rate for Payer: Cash Price |
$871.65
|
| Rate for Payer: Cash Price |
$871.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,549.60
|
| Rate for Payer: Cigna of CA HMO |
$1,239.68
|
| Rate for Payer: Cigna of CA PPO |
$1,433.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,355.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: Galaxy Health WC |
$1,646.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,162.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,743.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$304.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,229.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$336.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$387.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$302.29
|
| Rate for Payer: Multiplan Commercial |
$1,452.75
|
| Rate for Payer: Networks By Design Commercial |
$1,259.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$225.59
|
| Rate for Payer: Prime Health Services Commercial |
$1,646.45
|
| Rate for Payer: Prime Health Services Medicare |
$239.13
|
| Rate for Payer: Riverside University Health System MISP |
$248.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,162.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,162.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,115.74
|
| Rate for Payer: United Healthcare All Other HMO |
$1,115.74
|
| Rate for Payer: United Healthcare HMO Rider |
$1,115.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,115.74
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
|
|
HC MRI BRAIN ASSESS W CONTRAST
|
Facility
|
IP
|
$1,937.00
|
|
|
Service Code
|
CPT 70558
|
| Hospital Charge Code |
908870558
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$387.40 |
| Max. Negotiated Rate |
$1,743.30 |
| Rate for Payer: Adventist Health Commercial |
$387.40
|
| Rate for Payer: Cash Price |
$871.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,549.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,355.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$774.80
|
| Rate for Payer: EPIC Health Plan Senior |
$774.80
|
| Rate for Payer: Galaxy Health WC |
$1,646.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,162.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,743.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,229.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,142.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$387.40
|
| Rate for Payer: Multiplan Commercial |
$1,452.75
|
| Rate for Payer: Networks By Design Commercial |
$1,259.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,646.45
|
|
|
HC MRI BRAIN ASSESS WO CONTRAST
|
Facility
|
IP
|
$1,027.00
|
|
|
Service Code
|
CPT 70557
|
| Hospital Charge Code |
908870557
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$205.40 |
| Max. Negotiated Rate |
$924.30 |
| Rate for Payer: Adventist Health Commercial |
$205.40
|
| Rate for Payer: Cash Price |
$462.15
|
| Rate for Payer: Central Health Plan Commercial |
$821.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$718.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$410.80
|
| Rate for Payer: EPIC Health Plan Senior |
$410.80
|
| Rate for Payer: Galaxy Health WC |
$872.95
|
| Rate for Payer: Global Benefits Group Commercial |
$616.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$924.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$652.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$605.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$205.40
|
| Rate for Payer: Multiplan Commercial |
$770.25
|
| Rate for Payer: Networks By Design Commercial |
$667.55
|
| Rate for Payer: Prime Health Services Commercial |
$872.95
|
|
|
HC MRI BRAIN ASSESS WO CONTRAST
|
Facility
|
OP
|
$1,027.00
|
|
|
Service Code
|
CPT 70557
|
| Hospital Charge Code |
908870557
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$205.40 |
| Max. Negotiated Rate |
$2,303.98 |
| Rate for Payer: Adventist Health Commercial |
$205.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$702.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,055.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,054.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$773.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$702.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,303.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$597.41
|
| Rate for Payer: Blue Shield of California Commercial |
$647.01
|
| Rate for Payer: Blue Shield of California EPN |
$407.72
|
| Rate for Payer: Cash Price |
$462.15
|
| Rate for Payer: Cash Price |
$462.15
|
| Rate for Payer: Central Health Plan Commercial |
$821.60
|
| Rate for Payer: Cigna of CA HMO |
$657.28
|
| Rate for Payer: Cigna of CA PPO |
$759.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,054.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$773.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$702.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$718.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,159.59
|
| Rate for Payer: EPIC Health Plan Senior |
$773.06
|
| Rate for Payer: Galaxy Health WC |
$872.95
|
| Rate for Payer: Global Benefits Group Commercial |
$616.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$924.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,152.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$295.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$702.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$652.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$326.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$983.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$205.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$941.73
|
| Rate for Payer: Multiplan Commercial |
$770.25
|
| Rate for Payer: Networks By Design Commercial |
$667.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$702.78
|
| Rate for Payer: Prime Health Services Commercial |
$872.95
|
| Rate for Payer: Prime Health Services Medicare |
$744.95
|
| Rate for Payer: Riverside University Health System MISP |
$773.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$616.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$616.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$702.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,054.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$773.06
|
| Rate for Payer: Vantage Medical Group Senior |
$702.78
|
|
|
HC MRI BRAIN ASSESS WO W CONTRAST
|
Facility
|
OP
|
$2,034.00
|
|
|
Service Code
|
CPT 70559
|
| Hospital Charge Code |
908870559
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$225.59 |
| Max. Negotiated Rate |
$4,537.33 |
| Rate for Payer: Adventist Health Commercial |
$406.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$225.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,055.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,537.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,183.18
|
| Rate for Payer: Blue Shield of California Commercial |
$1,281.42
|
| Rate for Payer: Blue Shield of California EPN |
$807.50
|
| Rate for Payer: Cash Price |
$915.30
|
| Rate for Payer: Cash Price |
$915.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,627.20
|
| Rate for Payer: Cigna of CA HMO |
$1,301.76
|
| Rate for Payer: Cigna of CA PPO |
$1,505.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,423.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: Galaxy Health WC |
$1,728.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,830.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$286.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,291.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$316.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$406.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$302.29
|
| Rate for Payer: Multiplan Commercial |
$1,525.50
|
| Rate for Payer: Networks By Design Commercial |
$1,322.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$225.59
|
| Rate for Payer: Prime Health Services Commercial |
$1,728.90
|
| Rate for Payer: Prime Health Services Medicare |
$239.13
|
| Rate for Payer: Riverside University Health System MISP |
$248.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,220.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,220.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,367.12
|
| Rate for Payer: United Healthcare All Other HMO |
$1,367.12
|
| Rate for Payer: United Healthcare HMO Rider |
$1,367.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,367.12
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
|
|
HC MRI BRAIN ASSESS WO W CONTRAST
|
Facility
|
IP
|
$2,034.00
|
|
|
Service Code
|
CPT 70559
|
| Hospital Charge Code |
908870559
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$406.80 |
| Max. Negotiated Rate |
$1,830.60 |
| Rate for Payer: Adventist Health Commercial |
$406.80
|
| Rate for Payer: Cash Price |
$915.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,627.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,423.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$813.60
|
| Rate for Payer: EPIC Health Plan Senior |
$813.60
|
| Rate for Payer: Galaxy Health WC |
$1,728.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,830.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,291.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,200.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$406.80
|
| Rate for Payer: Multiplan Commercial |
$1,525.50
|
| Rate for Payer: Networks By Design Commercial |
$1,322.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,728.90
|
|
|
HC MRI BRAIN WITH CONTRAST
|
Facility
|
OP
|
$11,689.00
|
|
|
Service Code
|
CPT 70552
|
| Hospital Charge Code |
908801012
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$448.71 |
| Max. Negotiated Rate |
$10,520.10 |
| Rate for Payer: Adventist Health Commercial |
$2,337.80
|
| Rate for Payer: Adventist Health Commercial |
$1,084.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,055.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,055.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,759.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,759.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,799.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,153.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,415.23
|
| Rate for Payer: Blue Shield of California Commercial |
$7,364.07
|
| Rate for Payer: Blue Shield of California EPN |
$2,152.14
|
| Rate for Payer: Blue Shield of California EPN |
$4,640.53
|
| Rate for Payer: Cash Price |
$5,260.05
|
| Rate for Payer: Cash Price |
$2,439.45
|
| Rate for Payer: Cash Price |
$5,260.05
|
| Rate for Payer: Cash Price |
$2,439.45
|
| Rate for Payer: Central Health Plan Commercial |
$9,351.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,336.80
|
| Rate for Payer: Cigna of CA HMO |
$7,480.96
|
| Rate for Payer: Cigna of CA HMO |
$3,469.44
|
| Rate for Payer: Cigna of CA PPO |
$4,011.54
|
| Rate for Payer: Cigna of CA PPO |
$8,649.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,182.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,794.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$4,607.85
|
| Rate for Payer: Galaxy Health WC |
$9,935.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,252.60
|
| Rate for Payer: Global Benefits Group Commercial |
$7,013.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,878.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,520.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$454.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$454.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,422.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,442.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$502.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$502.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,337.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,084.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$8,766.75
|
| Rate for Payer: Multiplan Commercial |
$4,065.75
|
| Rate for Payer: Networks By Design Commercial |
$7,597.85
|
| Rate for Payer: Networks By Design Commercial |
$3,523.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: Prime Health Services Commercial |
$9,935.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,607.85
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,013.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,252.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,013.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,252.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,115.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,115.74
|
| Rate for Payer: United Healthcare All Other HMO |
$1,115.74
|
| Rate for Payer: United Healthcare All Other HMO |
$1,115.74
|
| Rate for Payer: United Healthcare HMO Rider |
$1,115.74
|
| Rate for Payer: United Healthcare HMO Rider |
$1,115.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,115.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,115.74
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC MRI BRAIN WITH CONTRAST
|
Facility
|
IP
|
$11,689.00
|
|
|
Service Code
|
CPT 70552
|
| Hospital Charge Code |
908801012
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$2,337.80 |
| Max. Negotiated Rate |
$10,520.10 |
| Rate for Payer: Adventist Health Commercial |
$2,337.80
|
| Rate for Payer: Cash Price |
$5,260.05
|
| Rate for Payer: Central Health Plan Commercial |
$9,351.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,182.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,675.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,675.60
|
| Rate for Payer: Galaxy Health WC |
$9,935.65
|
| Rate for Payer: Global Benefits Group Commercial |
$7,013.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,520.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,422.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,896.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,337.80
|
| Rate for Payer: Multiplan Commercial |
$8,766.75
|
| Rate for Payer: Networks By Design Commercial |
$7,597.85
|
| Rate for Payer: Prime Health Services Commercial |
$9,935.65
|
|
