|
HC MUMPS ANTIBODY
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
900913663
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.57 |
| Max. Negotiated Rate |
$133.39 |
| Rate for Payer: Adventist Health Commercial |
$21.00
|
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$13.05
|
| Rate for Payer: Adventist Health Medi-Cal |
$13.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$95.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$95.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$95.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$95.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$133.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$133.39
|
| Rate for Payer: Blue Shield of California Commercial |
$84.42
|
| Rate for Payer: Blue Shield of California Commercial |
$66.15
|
| Rate for Payer: Blue Shield of California EPN |
$53.20
|
| Rate for Payer: Blue Shield of California EPN |
$41.69
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Central Health Plan Commercial |
$84.00
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Cigna of CA HMO |
$85.76
|
| Rate for Payer: Cigna of CA HMO |
$67.20
|
| Rate for Payer: Cigna of CA PPO |
$99.16
|
| Rate for Payer: Cigna of CA PPO |
$77.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.36
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$73.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.53
|
| Rate for Payer: EPIC Health Plan Senior |
$14.36
|
| Rate for Payer: EPIC Health Plan Senior |
$14.36
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Galaxy Health WC |
$89.25
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Global Benefits Group Commercial |
$63.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$94.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$66.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.49
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Multiplan Commercial |
$78.75
|
| Rate for Payer: Networks By Design Commercial |
$68.25
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13.05
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
| Rate for Payer: Prime Health Services Commercial |
$89.25
|
| Rate for Payer: Prime Health Services Medicare |
$13.83
|
| Rate for Payer: Prime Health Services Medicare |
$13.83
|
| Rate for Payer: Riverside University Health System MISP |
$14.36
|
| Rate for Payer: Riverside University Health System MISP |
$14.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$80.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$80.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.57
|
| Rate for Payer: United Healthcare All Other HMO |
$10.57
|
| Rate for Payer: United Healthcare All Other HMO |
$10.57
|
| Rate for Payer: United Healthcare HMO Rider |
$10.57
|
| Rate for Payer: United Healthcare HMO Rider |
$10.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.57
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.05
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Vantage Medical Group Senior |
$13.05
|
| Rate for Payer: Vantage Medical Group Senior |
$13.05
|
|
|
HC MUMPS ANTIBODY
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
900913663
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.60
|
| Rate for Payer: EPIC Health Plan Senior |
$53.60
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$79.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
|
|
HC MUSCLE BIOPSY, PERCUTANEOUS
|
Facility
|
IP
|
$3,779.00
|
|
|
Service Code
|
CPT 20206
|
| Hospital Charge Code |
909000105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$755.80 |
| Max. Negotiated Rate |
$3,401.10 |
| Rate for Payer: Adventist Health Commercial |
$755.80
|
| Rate for Payer: Cash Price |
$1,700.55
|
| Rate for Payer: Central Health Plan Commercial |
$3,023.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,645.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,511.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,511.60
|
| Rate for Payer: Galaxy Health WC |
$3,212.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,267.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,401.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,399.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,229.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$755.80
|
| Rate for Payer: Multiplan Commercial |
$2,834.25
|
| Rate for Payer: Networks By Design Commercial |
$2,456.35
|
| Rate for Payer: Prime Health Services Commercial |
$3,212.15
|
|
|
HC MUSCLE BIOPSY, PERCUTANEOUS
|
Facility
|
OP
|
$3,779.00
|
|
|
Service Code
|
CPT 20206
|
| Hospital Charge Code |
909000105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$113.35 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$755.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,124.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,700.55
|
| Rate for Payer: Cash Price |
$1,700.55
|
| Rate for Payer: Cash Price |
$1,700.55
|
| Rate for Payer: Central Health Plan Commercial |
$3,023.20
|
| Rate for Payer: Cigna of CA HMO |
$2,418.56
|
| Rate for Payer: Cigna of CA PPO |
$2,796.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,645.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Galaxy Health WC |
$3,212.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,267.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,401.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$113.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,399.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$125.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,973.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$755.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$2,834.25
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$2,456.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$3,212.15
|
| Rate for Payer: Prime Health Services Medicare |
$2,251.68
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,336.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,267.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,889.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
|
HC MUSCLE TEST MANUAL W RPT
|
Facility
|
OP
|
$435.00
|
|
|
Service Code
|
CPT 95831
|
| Hospital Charge Code |
900895831
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$87.00 |
| Max. Negotiated Rate |
$1,021.00 |
| Rate for Payer: Adventist Health Commercial |
$87.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$264.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$369.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$239.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$326.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$148.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$253.04
|
| Rate for Payer: Blue Shield of California Commercial |
$274.05
|
| Rate for Payer: Blue Shield of California EPN |
$172.69
|
| Rate for Payer: Cash Price |
$195.75
|
| Rate for Payer: Cash Price |
$195.75
|
| Rate for Payer: Cash Price |
$195.75
|
| Rate for Payer: Central Health Plan Commercial |
$348.00
|
| Rate for Payer: Cigna of CA HMO |
$278.40
|
| Rate for Payer: Cigna of CA PPO |
$321.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$369.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$369.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$369.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$304.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$174.00
|
| Rate for Payer: EPIC Health Plan Senior |
$174.00
|
| Rate for Payer: Galaxy Health WC |
$369.75
|
| Rate for Payer: Global Benefits Group Commercial |
$261.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$391.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$276.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$157.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$256.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$304.50
|
| Rate for Payer: Multiplan Commercial |
$326.25
|
| Rate for Payer: Networks By Design Commercial |
$282.75
|
| Rate for Payer: Prime Health Services Commercial |
$369.75
|
| Rate for Payer: Riverside University Health System MISP |
$174.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$261.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$261.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,021.00
|
| Rate for Payer: United Healthcare All Other HMO |
$803.00
|
| Rate for Payer: United Healthcare HMO Rider |
$608.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$558.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$369.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$369.75
|
| Rate for Payer: Vantage Medical Group Senior |
$369.75
|
|
|
HC MUSCLE TEST MANUAL W RPT
|
Facility
|
IP
|
$435.00
|
|
|
Service Code
|
CPT 95831
|
| Hospital Charge Code |
900895831
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$87.00 |
| Max. Negotiated Rate |
$391.50 |
| Rate for Payer: Adventist Health Commercial |
$87.00
|
| Rate for Payer: Cash Price |
$195.75
|
| Rate for Payer: Central Health Plan Commercial |
$348.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$304.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$174.00
|
| Rate for Payer: EPIC Health Plan Senior |
$174.00
|
| Rate for Payer: Galaxy Health WC |
$369.75
|
| Rate for Payer: Global Benefits Group Commercial |
$261.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$391.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$276.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$256.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.00
|
| Rate for Payer: Multiplan Commercial |
$326.25
|
| Rate for Payer: Networks By Design Commercial |
$282.75
|
| Rate for Payer: Prime Health Services Commercial |
$369.75
|
|
|
HC MYELOAB
|
Facility
|
OP
|
$22.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913707
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$236.61 |
| Rate for Payer: Adventist Health Commercial |
$4.40
|
| Rate for Payer: Adventist Health Commercial |
$5.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$11.53
|
| Rate for Payer: Adventist Health Medi-Cal |
$11.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$170.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$170.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$236.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$236.61
|
| Rate for Payer: Blue Shield of California Commercial |
$16.38
|
| Rate for Payer: Blue Shield of California Commercial |
$13.86
|
| Rate for Payer: Blue Shield of California EPN |
$10.32
|
| Rate for Payer: Blue Shield of California EPN |
$8.73
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Central Health Plan Commercial |
$17.60
|
| Rate for Payer: Central Health Plan Commercial |
$20.80
|
| Rate for Payer: Cigna of CA HMO |
$16.64
|
| Rate for Payer: Cigna of CA HMO |
$14.08
|
| Rate for Payer: Cigna of CA PPO |
$19.24
|
| Rate for Payer: Cigna of CA PPO |
$16.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Senior |
$12.68
|
| Rate for Payer: EPIC Health Plan Senior |
$12.68
|
| Rate for Payer: Galaxy Health WC |
$22.10
|
| Rate for Payer: Galaxy Health WC |
$18.70
|
| Rate for Payer: Global Benefits Group Commercial |
$15.60
|
| Rate for Payer: Global Benefits Group Commercial |
$13.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.91
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15.45
|
| Rate for Payer: Multiplan Commercial |
$19.50
|
| Rate for Payer: Multiplan Commercial |
$16.50
|
| Rate for Payer: Networks By Design Commercial |
$14.30
|
| Rate for Payer: Networks By Design Commercial |
$16.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11.53
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11.53
|
| Rate for Payer: Prime Health Services Commercial |
$22.10
|
| Rate for Payer: Prime Health Services Commercial |
$18.70
|
| Rate for Payer: Prime Health Services Medicare |
$12.22
|
| Rate for Payer: Prime Health Services Medicare |
$12.22
|
| Rate for Payer: Riverside University Health System MISP |
$12.68
|
| Rate for Payer: Riverside University Health System MISP |
$12.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
|
|
HC MYELOAB
|
Facility
|
IP
|
$26.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913707
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.20 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Adventist Health Commercial |
$5.20
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Central Health Plan Commercial |
$20.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10.40
|
| Rate for Payer: Galaxy Health WC |
$22.10
|
| Rate for Payer: Global Benefits Group Commercial |
$15.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.20
|
| Rate for Payer: Multiplan Commercial |
$19.50
|
| Rate for Payer: Networks By Design Commercial |
$16.90
|
| Rate for Payer: Prime Health Services Commercial |
$22.10
|
|
|
HC MYELOGRAM, CERVICAL
|
Facility
|
IP
|
$2,872.00
|
|
|
Service Code
|
CPT 72240
|
| Hospital Charge Code |
909001363
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$574.40 |
| Max. Negotiated Rate |
$2,584.80 |
| Rate for Payer: Adventist Health Commercial |
$574.40
|
| Rate for Payer: Cash Price |
$1,292.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,297.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,010.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,148.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,148.80
|
| Rate for Payer: Galaxy Health WC |
$2,441.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,723.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,584.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,823.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,694.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$574.40
|
| Rate for Payer: Multiplan Commercial |
$2,154.00
|
| Rate for Payer: Networks By Design Commercial |
$1,866.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,441.20
|
|
|
HC MYELOGRAM, CERVICAL
|
Facility
|
OP
|
$2,872.00
|
|
|
Service Code
|
CPT 72240
|
| Hospital Charge Code |
909001363
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$150.59 |
| Max. Negotiated Rate |
$2,584.80 |
| Rate for Payer: Adventist Health Commercial |
$574.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,008.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$634.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,008.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$982.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,366.57
|
| Rate for Payer: Blue Shield of California Commercial |
$1,809.36
|
| Rate for Payer: Blue Shield of California EPN |
$1,140.18
|
| Rate for Payer: Cash Price |
$1,292.40
|
| Rate for Payer: Cash Price |
$1,292.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,297.60
|
| Rate for Payer: Cigna of CA HMO |
$1,838.08
|
| Rate for Payer: Cigna of CA PPO |
$2,125.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,109.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,008.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,010.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,663.61
|
| Rate for Payer: EPIC Health Plan Senior |
$1,109.08
|
| Rate for Payer: Galaxy Health WC |
$2,441.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,723.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,584.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,653.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$150.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,823.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$166.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,411.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$574.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,351.06
|
| Rate for Payer: Multiplan Commercial |
$2,154.00
|
| Rate for Payer: Networks By Design Commercial |
$1,866.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,441.20
|
| Rate for Payer: Prime Health Services Medicare |
$1,068.74
|
| Rate for Payer: Riverside University Health System MISP |
$1,109.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,723.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,723.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,265.49
|
| Rate for Payer: United Healthcare All Other HMO |
$1,265.49
|
| Rate for Payer: United Healthcare HMO Rider |
$1,265.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,265.49
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,008.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,008.25
|
|
|
HC MYELOGRAM, COMPLETE
|
Facility
|
OP
|
$3,162.00
|
|
|
Service Code
|
CPT 72270
|
| Hospital Charge Code |
909001364
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$194.22 |
| Max. Negotiated Rate |
$2,845.80 |
| Rate for Payer: Adventist Health Commercial |
$632.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,008.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$950.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,008.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,263.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,755.97
|
| Rate for Payer: Blue Shield of California Commercial |
$1,992.06
|
| Rate for Payer: Blue Shield of California EPN |
$1,255.31
|
| Rate for Payer: Cash Price |
$1,422.90
|
| Rate for Payer: Cash Price |
$1,422.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,529.60
|
| Rate for Payer: Cigna of CA HMO |
$2,023.68
|
| Rate for Payer: Cigna of CA PPO |
$2,339.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,109.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,008.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,213.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,663.61
|
| Rate for Payer: EPIC Health Plan Senior |
$1,109.08
|
| Rate for Payer: Galaxy Health WC |
$2,687.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,897.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,845.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,653.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$194.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,007.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$214.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,411.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$632.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,351.06
|
| Rate for Payer: Multiplan Commercial |
$2,371.50
|
| Rate for Payer: Networks By Design Commercial |
$2,055.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,687.70
|
| Rate for Payer: Prime Health Services Medicare |
$1,068.74
|
| Rate for Payer: Riverside University Health System MISP |
$1,109.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,897.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,897.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,265.49
|
| Rate for Payer: United Healthcare All Other HMO |
$1,265.49
|
| Rate for Payer: United Healthcare HMO Rider |
$1,265.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,265.49
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,008.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,008.25
|
|
|
HC MYELOGRAM, COMPLETE
|
Facility
|
IP
|
$3,162.00
|
|
|
Service Code
|
CPT 72270
|
| Hospital Charge Code |
909001364
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$632.40 |
| Max. Negotiated Rate |
$2,845.80 |
| Rate for Payer: Adventist Health Commercial |
$632.40
|
| Rate for Payer: Cash Price |
$1,422.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,529.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,213.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,264.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,264.80
|
| Rate for Payer: Galaxy Health WC |
$2,687.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,897.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,845.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,007.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,865.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$632.40
|
| Rate for Payer: Multiplan Commercial |
$2,371.50
|
| Rate for Payer: Networks By Design Commercial |
$2,055.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,687.70
|
|
|
HC MYELOGRAPHY LUMBAR INJECT 2 OR GT LVLS
|
Facility
|
IP
|
$3,621.00
|
|
|
Service Code
|
CPT 62305
|
| Hospital Charge Code |
909062305
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$724.20 |
| Max. Negotiated Rate |
$3,258.90 |
| Rate for Payer: Adventist Health Commercial |
$724.20
|
| Rate for Payer: Cash Price |
$1,629.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,896.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,534.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,448.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,448.40
|
| Rate for Payer: Galaxy Health WC |
$3,077.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,172.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,258.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,299.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,136.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$724.20
|
| Rate for Payer: Multiplan Commercial |
$2,715.75
|
| Rate for Payer: Networks By Design Commercial |
$2,353.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,077.85
|
|
|
HC MYELOGRAPHY LUMBAR INJECT 2 OR GT LVLS
|
Facility
|
OP
|
$3,621.00
|
|
|
Service Code
|
CPT 62305
|
| Hospital Charge Code |
909062305
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$724.20 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$724.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,008.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,008.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,599.45
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,629.45
|
| Rate for Payer: Cash Price |
$1,629.45
|
| Rate for Payer: Cash Price |
$1,629.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,896.80
|
| Rate for Payer: Cigna of CA HMO |
$2,317.44
|
| Rate for Payer: Cigna of CA PPO |
$2,679.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,109.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,008.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,534.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,663.61
|
| Rate for Payer: EPIC Health Plan Senior |
$1,109.08
|
| Rate for Payer: Galaxy Health WC |
$3,077.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,172.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,258.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,653.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,299.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,411.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$724.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,351.06
|
| Rate for Payer: Multiplan Commercial |
$2,715.75
|
| Rate for Payer: Multiplan WC |
$1,599.45
|
| Rate for Payer: Networks By Design Commercial |
$2,353.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Preferred Health Network WC |
$1,632.09
|
| Rate for Payer: Prime Health Services Commercial |
$3,077.85
|
| Rate for Payer: Prime Health Services Medicare |
$1,068.74
|
| Rate for Payer: Prime Health Services WC |
$1,583.13
|
| Rate for Payer: Riverside University Health System MISP |
$1,109.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,172.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,810.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,008.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,008.25
|
|
|
HC MYELOGRAPHY LUMBAR INJECT C-SPINE
|
Facility
|
IP
|
$3,621.00
|
|
|
Service Code
|
CPT 62302
|
| Hospital Charge Code |
909062302
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$724.20 |
| Max. Negotiated Rate |
$3,258.90 |
| Rate for Payer: Adventist Health Commercial |
$724.20
|
| Rate for Payer: Cash Price |
$1,629.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,896.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,534.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,448.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,448.40
|
| Rate for Payer: Galaxy Health WC |
$3,077.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,172.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,258.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,299.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,136.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$724.20
|
| Rate for Payer: Multiplan Commercial |
$2,715.75
|
| Rate for Payer: Networks By Design Commercial |
$2,353.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,077.85
|
|
|
HC MYELOGRAPHY LUMBAR INJECT C-SPINE
|
Facility
|
OP
|
$3,621.00
|
|
|
Service Code
|
CPT 62302
|
| Hospital Charge Code |
909062302
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$186.34 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$724.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,008.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,008.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,599.45
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,629.45
|
| Rate for Payer: Cash Price |
$1,629.45
|
| Rate for Payer: Cash Price |
$1,629.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,896.80
|
| Rate for Payer: Cigna of CA HMO |
$2,317.44
|
| Rate for Payer: Cigna of CA PPO |
$2,679.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,109.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,008.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,534.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,663.61
|
| Rate for Payer: EPIC Health Plan Senior |
$1,109.08
|
| Rate for Payer: Galaxy Health WC |
$3,077.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,172.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,258.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,653.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$186.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,299.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$205.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,411.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$724.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,351.06
|
| Rate for Payer: Multiplan Commercial |
$2,715.75
|
| Rate for Payer: Multiplan WC |
$1,599.45
|
| Rate for Payer: Networks By Design Commercial |
$2,353.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Preferred Health Network WC |
$1,632.09
|
| Rate for Payer: Prime Health Services Commercial |
$3,077.85
|
| Rate for Payer: Prime Health Services Medicare |
$1,068.74
|
| Rate for Payer: Prime Health Services WC |
$1,583.13
|
| Rate for Payer: Riverside University Health System MISP |
$1,109.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,172.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,810.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,008.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,008.25
|
|
|
HC MYELOGRAPHY LUMBAR INJECT L-SPINE
|
Facility
|
OP
|
$3,621.00
|
|
|
Service Code
|
CPT 62304
|
| Hospital Charge Code |
909062304
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$724.20 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$724.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,008.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,008.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,599.45
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,629.45
|
| Rate for Payer: Cash Price |
$1,629.45
|
| Rate for Payer: Cash Price |
$1,629.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,896.80
|
| Rate for Payer: Cigna of CA HMO |
$2,317.44
|
| Rate for Payer: Cigna of CA PPO |
$2,679.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,109.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,008.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,534.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,663.61
|
| Rate for Payer: EPIC Health Plan Senior |
$1,109.08
|
| Rate for Payer: Galaxy Health WC |
$3,077.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,172.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,258.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,653.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,299.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,411.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$724.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,351.06
|
| Rate for Payer: Multiplan Commercial |
$2,715.75
|
| Rate for Payer: Multiplan WC |
$1,599.45
|
| Rate for Payer: Networks By Design Commercial |
$2,353.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Preferred Health Network WC |
$1,632.09
|
| Rate for Payer: Prime Health Services Commercial |
$3,077.85
|
| Rate for Payer: Prime Health Services Medicare |
$1,068.74
|
| Rate for Payer: Prime Health Services WC |
$1,583.13
|
| Rate for Payer: Riverside University Health System MISP |
$1,109.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,172.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,810.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,008.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,008.25
|
|
|
HC MYELOGRAPHY LUMBAR INJECT L-SPINE
|
Facility
|
IP
|
$3,621.00
|
|
|
Service Code
|
CPT 62304
|
| Hospital Charge Code |
909062304
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$724.20 |
| Max. Negotiated Rate |
$3,258.90 |
| Rate for Payer: Adventist Health Commercial |
$724.20
|
| Rate for Payer: Cash Price |
$1,629.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,896.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,534.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,448.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,448.40
|
| Rate for Payer: Galaxy Health WC |
$3,077.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,172.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,258.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,299.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,136.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$724.20
|
| Rate for Payer: Multiplan Commercial |
$2,715.75
|
| Rate for Payer: Networks By Design Commercial |
$2,353.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,077.85
|
|
|
HC MYELOGRAPHY LUMBAR INJECT T-SPINE
|
Facility
|
IP
|
$3,621.00
|
|
|
Service Code
|
CPT 62303
|
| Hospital Charge Code |
909062303
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$724.20 |
| Max. Negotiated Rate |
$3,258.90 |
| Rate for Payer: Adventist Health Commercial |
$724.20
|
| Rate for Payer: Cash Price |
$1,629.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,896.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,534.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,448.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,448.40
|
| Rate for Payer: Galaxy Health WC |
$3,077.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,172.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,258.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,299.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,136.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$724.20
|
| Rate for Payer: Multiplan Commercial |
$2,715.75
|
| Rate for Payer: Networks By Design Commercial |
$2,353.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,077.85
|
|
|
HC MYELOGRAPHY LUMBAR INJECT T-SPINE
|
Facility
|
OP
|
$3,621.00
|
|
|
Service Code
|
CPT 62303
|
| Hospital Charge Code |
909062303
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$188.91 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$724.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,008.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,008.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,599.45
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,629.45
|
| Rate for Payer: Cash Price |
$1,629.45
|
| Rate for Payer: Cash Price |
$1,629.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,896.80
|
| Rate for Payer: Cigna of CA HMO |
$2,317.44
|
| Rate for Payer: Cigna of CA PPO |
$2,679.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,109.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,008.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,534.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,663.61
|
| Rate for Payer: EPIC Health Plan Senior |
$1,109.08
|
| Rate for Payer: Galaxy Health WC |
$3,077.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,172.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,258.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,653.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$188.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,299.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$208.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,411.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$724.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,351.06
|
| Rate for Payer: Multiplan Commercial |
$2,715.75
|
| Rate for Payer: Multiplan WC |
$1,599.45
|
| Rate for Payer: Networks By Design Commercial |
$2,353.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Preferred Health Network WC |
$1,632.09
|
| Rate for Payer: Prime Health Services Commercial |
$3,077.85
|
| Rate for Payer: Prime Health Services Medicare |
$1,068.74
|
| Rate for Payer: Prime Health Services WC |
$1,583.13
|
| Rate for Payer: Riverside University Health System MISP |
$1,109.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,172.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,810.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,008.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,008.25
|
|
|
HC MYELOGRAPHY, LUMBOSACRAL
|
Facility
|
OP
|
$2,872.00
|
|
|
Service Code
|
CPT 72265
|
| Hospital Charge Code |
909001372
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$141.01 |
| Max. Negotiated Rate |
$2,584.80 |
| Rate for Payer: Adventist Health Commercial |
$574.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,008.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$617.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,008.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$844.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,173.46
|
| Rate for Payer: Blue Shield of California Commercial |
$1,809.36
|
| Rate for Payer: Blue Shield of California EPN |
$1,140.18
|
| Rate for Payer: Cash Price |
$1,292.40
|
| Rate for Payer: Cash Price |
$1,292.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,297.60
|
| Rate for Payer: Cigna of CA HMO |
$1,838.08
|
| Rate for Payer: Cigna of CA PPO |
$2,125.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,109.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,008.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,010.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,663.61
|
| Rate for Payer: EPIC Health Plan Senior |
$1,109.08
|
| Rate for Payer: Galaxy Health WC |
$2,441.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,723.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,584.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,653.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$141.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,823.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$155.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,411.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$574.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,351.06
|
| Rate for Payer: Multiplan Commercial |
$2,154.00
|
| Rate for Payer: Networks By Design Commercial |
$1,866.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,441.20
|
| Rate for Payer: Prime Health Services Medicare |
$1,068.74
|
| Rate for Payer: Riverside University Health System MISP |
$1,109.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,723.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,723.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,265.49
|
| Rate for Payer: United Healthcare All Other HMO |
$1,265.49
|
| Rate for Payer: United Healthcare HMO Rider |
$1,265.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,265.49
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,008.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,008.25
|
|
|
HC MYELOGRAPHY, LUMBOSACRAL
|
Facility
|
IP
|
$2,872.00
|
|
|
Service Code
|
CPT 72265
|
| Hospital Charge Code |
909001372
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$574.40 |
| Max. Negotiated Rate |
$2,584.80 |
| Rate for Payer: Adventist Health Commercial |
$574.40
|
| Rate for Payer: Cash Price |
$1,292.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,297.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,010.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,148.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,148.80
|
| Rate for Payer: Galaxy Health WC |
$2,441.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,723.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,584.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,823.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,694.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$574.40
|
| Rate for Payer: Multiplan Commercial |
$2,154.00
|
| Rate for Payer: Networks By Design Commercial |
$1,866.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,441.20
|
|
|
HC MYELOGRAPHY, THORACIC
|
Facility
|
IP
|
$2,873.00
|
|
|
Service Code
|
CPT 72255
|
| Hospital Charge Code |
909001371
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$574.60 |
| Max. Negotiated Rate |
$2,585.70 |
| Rate for Payer: Adventist Health Commercial |
$574.60
|
| Rate for Payer: Cash Price |
$1,292.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,298.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,011.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,149.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,149.20
|
| Rate for Payer: Galaxy Health WC |
$2,442.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,723.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,585.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,824.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,695.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$574.60
|
| Rate for Payer: Multiplan Commercial |
$2,154.75
|
| Rate for Payer: Networks By Design Commercial |
$1,867.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,442.05
|
|
|
HC MYELOGRAPHY, THORACIC
|
Facility
|
OP
|
$2,873.00
|
|
|
Service Code
|
CPT 72255
|
| Hospital Charge Code |
909001371
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$149.67 |
| Max. Negotiated Rate |
$2,585.70 |
| Rate for Payer: Adventist Health Commercial |
$574.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,008.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$582.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,008.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$897.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,247.41
|
| Rate for Payer: Blue Shield of California Commercial |
$1,809.99
|
| Rate for Payer: Blue Shield of California EPN |
$1,140.58
|
| Rate for Payer: Cash Price |
$1,292.85
|
| Rate for Payer: Cash Price |
$1,292.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,298.40
|
| Rate for Payer: Cigna of CA HMO |
$1,838.72
|
| Rate for Payer: Cigna of CA PPO |
$2,126.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,109.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,008.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,011.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,663.61
|
| Rate for Payer: EPIC Health Plan Senior |
$1,109.08
|
| Rate for Payer: Galaxy Health WC |
$2,442.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,723.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,585.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,653.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$149.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,824.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$165.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,411.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$574.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,351.06
|
| Rate for Payer: Multiplan Commercial |
$2,154.75
|
| Rate for Payer: Networks By Design Commercial |
$1,867.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,008.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,442.05
|
| Rate for Payer: Prime Health Services Medicare |
$1,068.74
|
| Rate for Payer: Riverside University Health System MISP |
$1,109.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,723.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,723.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,265.49
|
| Rate for Payer: United Healthcare All Other HMO |
$1,265.49
|
| Rate for Payer: United Healthcare HMO Rider |
$1,265.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,265.49
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,008.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,512.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,109.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,008.25
|
|
|
HC MYLOPEROXIDASE AB
|
Facility
|
OP
|
$70.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913678
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$236.61 |
| Rate for Payer: Adventist Health Commercial |
$14.00
|
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$11.53
|
| Rate for Payer: Adventist Health Medi-Cal |
$11.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$170.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$170.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$236.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$236.61
|
| Rate for Payer: Blue Shield of California Commercial |
$49.14
|
| Rate for Payer: Blue Shield of California Commercial |
$44.10
|
| Rate for Payer: Blue Shield of California EPN |
$30.97
|
| Rate for Payer: Blue Shield of California EPN |
$27.79
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Central Health Plan Commercial |
$56.00
|
| Rate for Payer: Central Health Plan Commercial |
$62.40
|
| Rate for Payer: Cigna of CA HMO |
$49.92
|
| Rate for Payer: Cigna of CA HMO |
$44.80
|
| Rate for Payer: Cigna of CA PPO |
$57.72
|
| Rate for Payer: Cigna of CA PPO |
$51.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$49.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$54.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Senior |
$12.68
|
| Rate for Payer: EPIC Health Plan Senior |
$12.68
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Galaxy Health WC |
$59.50
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Global Benefits Group Commercial |
$42.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$63.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.91
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$44.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$49.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15.45
|
| Rate for Payer: Multiplan Commercial |
$58.50
|
| Rate for Payer: Multiplan Commercial |
$52.50
|
| Rate for Payer: Networks By Design Commercial |
$45.50
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11.53
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11.53
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
| Rate for Payer: Prime Health Services Commercial |
$59.50
|
| Rate for Payer: Prime Health Services Medicare |
$12.22
|
| Rate for Payer: Prime Health Services Medicare |
$12.22
|
| Rate for Payer: Riverside University Health System MISP |
$12.68
|
| Rate for Payer: Riverside University Health System MISP |
$12.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$42.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$42.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
|
