|
HC LACER WT BEARING NON-MOLDED
|
Facility
|
OP
|
$486.00
|
|
|
Service Code
|
CPT L2530
|
| Hospital Charge Code |
915352530
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$159.16 |
| Max. Negotiated Rate |
$437.40 |
| Rate for Payer: Adventist Health Commercial |
$199.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$413.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$267.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$364.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$285.43
|
| Rate for Payer: Blue Shield of California Commercial |
$375.68
|
| Rate for Payer: Blue Shield of California EPN |
$244.94
|
| Rate for Payer: Cash Price |
$218.70
|
| Rate for Payer: Cash Price |
$218.70
|
| Rate for Payer: Central Health Plan Commercial |
$388.80
|
| Rate for Payer: Cigna of CA HMO |
$340.20
|
| Rate for Payer: Cigna of CA PPO |
$340.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$413.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$413.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$413.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$194.40
|
| Rate for Payer: EPIC Health Plan Senior |
$194.40
|
| Rate for Payer: Galaxy Health WC |
$413.10
|
| Rate for Payer: Global Benefits Group Commercial |
$291.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$437.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$260.15
|
| Rate for Payer: InnovAge PACE Commercial |
$243.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$324.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$287.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$300.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$199.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$340.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$340.20
|
| Rate for Payer: Multiplan Commercial |
$364.50
|
| Rate for Payer: Networks By Design Commercial |
$243.00
|
| Rate for Payer: Prime Health Services Commercial |
$413.10
|
| Rate for Payer: Riverside University Health System MISP |
$194.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$291.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$291.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$182.40
|
| Rate for Payer: United Healthcare All Other HMO |
$177.54
|
| Rate for Payer: United Healthcare HMO Rider |
$173.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$159.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$413.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$413.10
|
| Rate for Payer: Vantage Medical Group Senior |
$413.10
|
|
|
HC LACER WT BEARING NON-MOLDED
|
Facility
|
IP
|
$486.00
|
|
|
Service Code
|
CPT L2530
|
| Hospital Charge Code |
915352530
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$97.20 |
| Max. Negotiated Rate |
$437.40 |
| Rate for Payer: Adventist Health Commercial |
$97.20
|
| Rate for Payer: Blue Shield of California Commercial |
$375.68
|
| Rate for Payer: Blue Shield of California EPN |
$244.94
|
| Rate for Payer: Cash Price |
$218.70
|
| Rate for Payer: Central Health Plan Commercial |
$388.80
|
| Rate for Payer: Cigna of CA HMO |
$340.20
|
| Rate for Payer: Cigna of CA PPO |
$340.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$194.40
|
| Rate for Payer: EPIC Health Plan Senior |
$194.40
|
| Rate for Payer: Galaxy Health WC |
$413.10
|
| Rate for Payer: Global Benefits Group Commercial |
$291.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$437.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$324.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$185.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$300.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.20
|
| Rate for Payer: Multiplan Commercial |
$364.50
|
| Rate for Payer: Networks By Design Commercial |
$315.90
|
| Rate for Payer: Prime Health Services Commercial |
$413.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$182.40
|
| Rate for Payer: United Healthcare All Other HMO |
$177.54
|
| Rate for Payer: United Healthcare HMO Rider |
$173.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$159.16
|
|
|
HC LACER WT BEARING NON-MOLDED
|
Facility
|
OP
|
$486.00
|
|
|
Service Code
|
CPT L2530
|
| Hospital Charge Code |
905352530
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$159.16 |
| Max. Negotiated Rate |
$437.40 |
| Rate for Payer: Adventist Health Commercial |
$199.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$413.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$267.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$364.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$285.43
|
| Rate for Payer: Blue Shield of California Commercial |
$375.68
|
| Rate for Payer: Blue Shield of California EPN |
$244.94
|
| Rate for Payer: Cash Price |
$218.70
|
| Rate for Payer: Cash Price |
$218.70
|
| Rate for Payer: Central Health Plan Commercial |
$388.80
|
| Rate for Payer: Cigna of CA HMO |
$340.20
|
| Rate for Payer: Cigna of CA PPO |
$340.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$413.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$413.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$413.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$194.40
|
| Rate for Payer: EPIC Health Plan Senior |
$194.40
|
| Rate for Payer: Galaxy Health WC |
$413.10
|
| Rate for Payer: Global Benefits Group Commercial |
$291.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$437.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$260.15
|
| Rate for Payer: InnovAge PACE Commercial |
$243.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$324.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$287.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$300.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$199.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$340.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$340.20
|
| Rate for Payer: Multiplan Commercial |
$364.50
|
| Rate for Payer: Networks By Design Commercial |
$243.00
|
| Rate for Payer: Prime Health Services Commercial |
$413.10
|
| Rate for Payer: Riverside University Health System MISP |
$194.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$291.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$291.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$182.40
|
| Rate for Payer: United Healthcare All Other HMO |
$177.54
|
| Rate for Payer: United Healthcare HMO Rider |
$173.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$159.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$413.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$413.10
|
| Rate for Payer: Vantage Medical Group Senior |
$413.10
|
|
|
HC LACER WT BEARING NON-MOLDED
|
Facility
|
IP
|
$486.00
|
|
|
Service Code
|
CPT L2530
|
| Hospital Charge Code |
905352530
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$97.20 |
| Max. Negotiated Rate |
$437.40 |
| Rate for Payer: Adventist Health Commercial |
$97.20
|
| Rate for Payer: Blue Shield of California Commercial |
$375.68
|
| Rate for Payer: Blue Shield of California EPN |
$244.94
|
| Rate for Payer: Cash Price |
$218.70
|
| Rate for Payer: Central Health Plan Commercial |
$388.80
|
| Rate for Payer: Cigna of CA HMO |
$340.20
|
| Rate for Payer: Cigna of CA PPO |
$340.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$194.40
|
| Rate for Payer: EPIC Health Plan Senior |
$194.40
|
| Rate for Payer: Galaxy Health WC |
$413.10
|
| Rate for Payer: Global Benefits Group Commercial |
$291.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$437.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$324.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$185.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$300.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.20
|
| Rate for Payer: Multiplan Commercial |
$364.50
|
| Rate for Payer: Networks By Design Commercial |
$315.90
|
| Rate for Payer: Prime Health Services Commercial |
$413.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$182.40
|
| Rate for Payer: United Healthcare All Other HMO |
$177.54
|
| Rate for Payer: United Healthcare HMO Rider |
$173.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$159.16
|
|
|
HC LACTATE (CSF/POC)
|
Facility
|
IP
|
$308.00
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
900910245
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$61.60 |
| Max. Negotiated Rate |
$277.20 |
| Rate for Payer: Adventist Health Commercial |
$61.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Central Health Plan Commercial |
$246.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.20
|
| Rate for Payer: EPIC Health Plan Senior |
$123.20
|
| Rate for Payer: Galaxy Health WC |
$261.80
|
| Rate for Payer: Global Benefits Group Commercial |
$184.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$277.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$205.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$117.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$190.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.60
|
| Rate for Payer: Multiplan Commercial |
$231.00
|
| Rate for Payer: Networks By Design Commercial |
$200.20
|
| Rate for Payer: Prime Health Services Commercial |
$261.80
|
|
|
HC LACTATE (CSF/POC)
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
900910245
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.37 |
| Max. Negotiated Rate |
$77.68 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$11.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$49.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$77.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.76
|
| Rate for Payer: Blue Shield of California Commercial |
$49.77
|
| Rate for Payer: Blue Shield of California EPN |
$32.55
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.62
|
| Rate for Payer: EPIC Health Plan Senior |
$11.57
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$16.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.57
|
| Rate for Payer: InnovAge PACE Commercial |
$17.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.50
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11.57
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Prime Health Services Medicare |
$12.26
|
| Rate for Payer: Riverside University Health System MISP |
$12.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.37
|
| Rate for Payer: United Healthcare All Other HMO |
$9.37
|
| Rate for Payer: United Healthcare HMO Rider |
$9.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.37
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.73
|
| Rate for Payer: Vantage Medical Group Senior |
$11.57
|
|
|
HC LACTATE DEHYDROGENASE
|
Facility
|
IP
|
$152.00
|
|
|
Service Code
|
CPT 83615
|
| Hospital Charge Code |
900910229
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.40 |
| Max. Negotiated Rate |
$136.80 |
| Rate for Payer: Adventist Health Commercial |
$30.40
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Central Health Plan Commercial |
$121.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.80
|
| Rate for Payer: EPIC Health Plan Senior |
$60.80
|
| Rate for Payer: Galaxy Health WC |
$129.20
|
| Rate for Payer: Global Benefits Group Commercial |
$91.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$136.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$101.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$94.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.40
|
| Rate for Payer: Multiplan Commercial |
$114.00
|
| Rate for Payer: Networks By Design Commercial |
$98.80
|
| Rate for Payer: Prime Health Services Commercial |
$129.20
|
|
|
HC LACTATE DEHYDROGENASE
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
CPT 83615
|
| Hospital Charge Code |
900910229
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$6.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$43.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.89
|
| Rate for Payer: Blue Shield of California Commercial |
$36.42
|
| Rate for Payer: Blue Shield of California EPN |
$23.82
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Central Health Plan Commercial |
$48.00
|
| Rate for Payer: Cigna of CA HMO |
$38.40
|
| Rate for Payer: Cigna of CA PPO |
$44.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.15
|
| Rate for Payer: EPIC Health Plan Senior |
$6.04
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$54.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.04
|
| Rate for Payer: InnovAge PACE Commercial |
$9.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.09
|
| Rate for Payer: Multiplan Commercial |
$45.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6.04
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
| Rate for Payer: Prime Health Services Medicare |
$6.40
|
| Rate for Payer: Riverside University Health System MISP |
$6.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.90
|
| Rate for Payer: United Healthcare All Other HMO |
$4.90
|
| Rate for Payer: United Healthcare HMO Rider |
$4.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.90
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.64
|
| Rate for Payer: Vantage Medical Group Senior |
$6.04
|
|
|
HC LACTATE DEHYDROGENASE BODY FL
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
CPT 83615
|
| Hospital Charge Code |
900912243
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$48.60 |
| Rate for Payer: Adventist Health Commercial |
$10.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$6.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$43.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.89
|
| Rate for Payer: Blue Shield of California Commercial |
$32.78
|
| Rate for Payer: Blue Shield of California EPN |
$21.44
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Central Health Plan Commercial |
$43.20
|
| Rate for Payer: Cigna of CA HMO |
$34.56
|
| Rate for Payer: Cigna of CA PPO |
$39.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.15
|
| Rate for Payer: EPIC Health Plan Senior |
$6.04
|
| Rate for Payer: Galaxy Health WC |
$45.90
|
| Rate for Payer: Global Benefits Group Commercial |
$32.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$48.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.04
|
| Rate for Payer: InnovAge PACE Commercial |
$9.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.09
|
| Rate for Payer: Multiplan Commercial |
$40.50
|
| Rate for Payer: Networks By Design Commercial |
$35.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6.04
|
| Rate for Payer: Prime Health Services Commercial |
$45.90
|
| Rate for Payer: Prime Health Services Medicare |
$6.40
|
| Rate for Payer: Riverside University Health System MISP |
$6.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$32.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.90
|
| Rate for Payer: United Healthcare All Other HMO |
$4.90
|
| Rate for Payer: United Healthcare HMO Rider |
$4.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.90
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.64
|
| Rate for Payer: Vantage Medical Group Senior |
$6.04
|
|
|
HC LACTATE DEHYDROGENASE BODY FL
|
Facility
|
IP
|
$56.00
|
|
|
Service Code
|
CPT 83615
|
| Hospital Charge Code |
900912243
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$50.40 |
| Rate for Payer: Adventist Health Commercial |
$11.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Central Health Plan Commercial |
$44.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.40
|
| Rate for Payer: EPIC Health Plan Senior |
$22.40
|
| Rate for Payer: Galaxy Health WC |
$47.60
|
| Rate for Payer: Global Benefits Group Commercial |
$33.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.20
|
| Rate for Payer: Multiplan Commercial |
$42.00
|
| Rate for Payer: Networks By Design Commercial |
$36.40
|
| Rate for Payer: Prime Health Services Commercial |
$47.60
|
|
|
HC LACTOSE TOLERANCE
|
Facility
|
IP
|
$226.00
|
|
|
Service Code
|
CPT 82951
|
| Hospital Charge Code |
900910313
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.20 |
| Max. Negotiated Rate |
$203.40 |
| Rate for Payer: Adventist Health Commercial |
$45.20
|
| Rate for Payer: Cash Price |
$101.70
|
| Rate for Payer: Central Health Plan Commercial |
$180.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$90.40
|
| Rate for Payer: EPIC Health Plan Senior |
$90.40
|
| Rate for Payer: Galaxy Health WC |
$192.10
|
| Rate for Payer: Global Benefits Group Commercial |
$135.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$203.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$150.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$86.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$139.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.20
|
| Rate for Payer: Multiplan Commercial |
$169.50
|
| Rate for Payer: Networks By Design Commercial |
$146.90
|
| Rate for Payer: Prime Health Services Commercial |
$192.10
|
|
|
HC LACTOSE TOLERANCE
|
Facility
|
OP
|
$118.00
|
|
|
Service Code
|
CPT 82951
|
| Hospital Charge Code |
900910313
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.42 |
| Max. Negotiated Rate |
$106.20 |
| Rate for Payer: Adventist Health Commercial |
$23.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$12.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$71.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$93.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.01
|
| Rate for Payer: Blue Shield of California Commercial |
$71.63
|
| Rate for Payer: Blue Shield of California EPN |
$46.85
|
| Rate for Payer: Cash Price |
$53.10
|
| Rate for Payer: Cash Price |
$53.10
|
| Rate for Payer: Central Health Plan Commercial |
$94.40
|
| Rate for Payer: Cigna of CA HMO |
$75.52
|
| Rate for Payer: Cigna of CA PPO |
$87.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.37
|
| Rate for Payer: EPIC Health Plan Senior |
$12.87
|
| Rate for Payer: Galaxy Health WC |
$100.30
|
| Rate for Payer: Global Benefits Group Commercial |
$70.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$106.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.87
|
| Rate for Payer: InnovAge PACE Commercial |
$19.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$78.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.25
|
| Rate for Payer: Multiplan Commercial |
$88.50
|
| Rate for Payer: Networks By Design Commercial |
$76.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12.87
|
| Rate for Payer: Prime Health Services Commercial |
$100.30
|
| Rate for Payer: Prime Health Services Medicare |
$13.64
|
| Rate for Payer: Riverside University Health System MISP |
$14.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$70.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$70.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.42
|
| Rate for Payer: United Healthcare All Other HMO |
$10.42
|
| Rate for Payer: United Healthcare HMO Rider |
$10.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.42
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Vantage Medical Group Senior |
$12.87
|
|
|
HC LAMELLAR BODY COUNT AMNIOTIC
|
Facility
|
OP
|
$81.00
|
|
|
Service Code
|
CPT 83664
|
| Hospital Charge Code |
900912027
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.97 |
| Max. Negotiated Rate |
$72.90 |
| Rate for Payer: Adventist Health Commercial |
$16.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$19.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$49.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.97
|
| Rate for Payer: Blue Shield of California Commercial |
$49.17
|
| Rate for Payer: Blue Shield of California EPN |
$32.16
|
| Rate for Payer: Cash Price |
$36.45
|
| Rate for Payer: Cash Price |
$36.45
|
| Rate for Payer: Central Health Plan Commercial |
$64.80
|
| Rate for Payer: Cigna of CA HMO |
$51.84
|
| Rate for Payer: Cigna of CA PPO |
$59.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$19.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.08
|
| Rate for Payer: EPIC Health Plan Senior |
$19.32
|
| Rate for Payer: Galaxy Health WC |
$68.85
|
| Rate for Payer: Global Benefits Group Commercial |
$48.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$72.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$31.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$19.32
|
| Rate for Payer: InnovAge PACE Commercial |
$28.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.89
|
| Rate for Payer: Multiplan Commercial |
$60.75
|
| Rate for Payer: Networks By Design Commercial |
$52.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$19.32
|
| Rate for Payer: Prime Health Services Commercial |
$68.85
|
| Rate for Payer: Prime Health Services Medicare |
$20.48
|
| Rate for Payer: Riverside University Health System MISP |
$21.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$48.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$48.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.65
|
| Rate for Payer: United Healthcare All Other HMO |
$15.65
|
| Rate for Payer: United Healthcare HMO Rider |
$15.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.65
|
| Rate for Payer: Upland Medical Group Pediatric |
$19.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.25
|
| Rate for Payer: Vantage Medical Group Senior |
$19.32
|
|
|
HC LAMELLAR BODY COUNT AMNIOTIC
|
Facility
|
IP
|
$128.00
|
|
|
Service Code
|
CPT 83664
|
| Hospital Charge Code |
900912027
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$25.60 |
| Max. Negotiated Rate |
$115.20 |
| Rate for Payer: Adventist Health Commercial |
$25.60
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Central Health Plan Commercial |
$102.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.20
|
| Rate for Payer: EPIC Health Plan Senior |
$51.20
|
| Rate for Payer: Galaxy Health WC |
$108.80
|
| Rate for Payer: Global Benefits Group Commercial |
$76.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$115.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$85.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$79.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.60
|
| Rate for Payer: Multiplan Commercial |
$96.00
|
| Rate for Payer: Networks By Design Commercial |
$83.20
|
| Rate for Payer: Prime Health Services Commercial |
$108.80
|
|
|
HC LANG COMP CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9159
|
| Hospital Charge Code |
900018124
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC LANG COMP CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9159
|
| Hospital Charge Code |
900018124
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC LANG COMP CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9159
|
| Hospital Charge Code |
900018224
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC LANG COMP CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9159
|
| Hospital Charge Code |
900018424
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC LANG COMP CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9159
|
| Hospital Charge Code |
900018224
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC LANG COMP CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9159
|
| Hospital Charge Code |
900018424
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC LANG COMP D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9161
|
| Hospital Charge Code |
900018126
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC LANG COMP D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9161
|
| Hospital Charge Code |
900018426
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC LANG COMP D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9161
|
| Hospital Charge Code |
900018226
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC LANG COMP D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9161
|
| Hospital Charge Code |
900018426
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC LANG COMP D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9161
|
| Hospital Charge Code |
900018126
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
