|
HC NEDL BARD TRANS-SEPTAL
|
Facility
|
IP
|
$1,012.00
|
|
| Hospital Charge Code |
906812363
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.40 |
| Max. Negotiated Rate |
$910.80 |
| Rate for Payer: Adventist Health Commercial |
$202.40
|
| Rate for Payer: Cash Price |
$455.40
|
| Rate for Payer: Central Health Plan Commercial |
$809.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$708.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$404.80
|
| Rate for Payer: EPIC Health Plan Senior |
$404.80
|
| Rate for Payer: Galaxy Health WC |
$860.20
|
| Rate for Payer: Global Benefits Group Commercial |
$607.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$910.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$642.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$597.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.40
|
| Rate for Payer: Multiplan Commercial |
$759.00
|
| Rate for Payer: Networks By Design Commercial |
$657.80
|
| Rate for Payer: Prime Health Services Commercial |
$860.20
|
|
|
HC NEDL BARD TRANS-SEPTAL
|
Facility
|
OP
|
$1,012.00
|
|
| Hospital Charge Code |
906812363
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.40 |
| Max. Negotiated Rate |
$910.80 |
| Rate for Payer: Adventist Health Commercial |
$202.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$614.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$860.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$556.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$759.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$490.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$588.68
|
| Rate for Payer: Blue Shield of California Commercial |
$641.61
|
| Rate for Payer: Blue Shield of California EPN |
$403.79
|
| Rate for Payer: Cash Price |
$455.40
|
| Rate for Payer: Central Health Plan Commercial |
$809.60
|
| Rate for Payer: Cigna of CA HMO |
$647.68
|
| Rate for Payer: Cigna of CA PPO |
$748.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$860.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$860.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$860.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$708.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$404.80
|
| Rate for Payer: EPIC Health Plan Senior |
$404.80
|
| Rate for Payer: Galaxy Health WC |
$860.20
|
| Rate for Payer: Global Benefits Group Commercial |
$607.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$910.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$642.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$367.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$597.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$708.40
|
| Rate for Payer: Multiplan Commercial |
$759.00
|
| Rate for Payer: Networks By Design Commercial |
$657.80
|
| Rate for Payer: Prime Health Services Commercial |
$860.20
|
| Rate for Payer: Riverside University Health System MISP |
$404.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$607.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$607.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$506.00
|
| Rate for Payer: United Healthcare HMO Rider |
$506.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$506.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$860.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$860.20
|
| Rate for Payer: Vantage Medical Group Senior |
$860.20
|
|
|
HC NEDL BAYLIS RF TRANSEPTAL
|
Facility
|
IP
|
$2,277.00
|
|
| Hospital Charge Code |
906812470
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$455.40 |
| Max. Negotiated Rate |
$2,049.30 |
| Rate for Payer: Adventist Health Commercial |
$455.40
|
| Rate for Payer: Cash Price |
$1,024.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,821.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,593.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$910.80
|
| Rate for Payer: EPIC Health Plan Senior |
$910.80
|
| Rate for Payer: Galaxy Health WC |
$1,935.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,366.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,049.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,445.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,343.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$455.40
|
| Rate for Payer: Multiplan Commercial |
$1,707.75
|
| Rate for Payer: Networks By Design Commercial |
$1,480.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,935.45
|
|
|
HC NEDL BAYLIS RF TRANSEPTAL
|
Facility
|
OP
|
$2,277.00
|
|
| Hospital Charge Code |
906812470
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$455.40 |
| Max. Negotiated Rate |
$2,049.30 |
| Rate for Payer: Adventist Health Commercial |
$455.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,382.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,935.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,252.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,707.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,102.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,324.53
|
| Rate for Payer: Blue Shield of California Commercial |
$1,443.62
|
| Rate for Payer: Blue Shield of California EPN |
$908.52
|
| Rate for Payer: Cash Price |
$1,024.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,821.60
|
| Rate for Payer: Cigna of CA HMO |
$1,457.28
|
| Rate for Payer: Cigna of CA PPO |
$1,684.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,935.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,935.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,935.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,593.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$910.80
|
| Rate for Payer: EPIC Health Plan Senior |
$910.80
|
| Rate for Payer: Galaxy Health WC |
$1,935.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,366.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,049.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,445.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$826.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,343.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$455.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,593.90
|
| Rate for Payer: Multiplan Commercial |
$1,707.75
|
| Rate for Payer: Networks By Design Commercial |
$1,480.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,935.45
|
| Rate for Payer: Riverside University Health System MISP |
$910.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,366.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,366.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,138.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,138.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,138.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,138.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,935.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,935.45
|
| Rate for Payer: Vantage Medical Group Senior |
$1,935.45
|
|
|
HC NEDL COOK TRANSSEPTAL
|
Facility
|
OP
|
$288.00
|
|
| Hospital Charge Code |
906811779
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$259.20 |
| Rate for Payer: Adventist Health Commercial |
$57.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$174.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$244.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$158.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$216.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$139.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.53
|
| Rate for Payer: Blue Shield of California Commercial |
$182.59
|
| Rate for Payer: Blue Shield of California EPN |
$114.91
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Central Health Plan Commercial |
$230.40
|
| Rate for Payer: Cigna of CA HMO |
$184.32
|
| Rate for Payer: Cigna of CA PPO |
$213.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$244.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$244.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$244.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$201.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$259.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$182.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$104.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$169.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$201.60
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
| Rate for Payer: Riverside University Health System MISP |
$115.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$144.00
|
| Rate for Payer: United Healthcare All Other HMO |
$144.00
|
| Rate for Payer: United Healthcare HMO Rider |
$144.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$144.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$244.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$244.80
|
| Rate for Payer: Vantage Medical Group Senior |
$244.80
|
|
|
HC NEDL COOK TRANSSEPTAL
|
Facility
|
IP
|
$288.00
|
|
| Hospital Charge Code |
906811779
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$259.20 |
| Rate for Payer: Adventist Health Commercial |
$57.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Central Health Plan Commercial |
$230.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$201.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$259.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$182.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$169.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.60
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
|
|
HC NEDL PD ACCESS DOPPLER
|
Facility
|
OP
|
$551.00
|
|
| Hospital Charge Code |
906811790
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$110.20 |
| Max. Negotiated Rate |
$495.90 |
| Rate for Payer: Adventist Health Commercial |
$110.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$334.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$468.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$303.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$413.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$266.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$320.52
|
| Rate for Payer: Blue Shield of California Commercial |
$349.33
|
| Rate for Payer: Blue Shield of California EPN |
$219.85
|
| Rate for Payer: Cash Price |
$247.95
|
| Rate for Payer: Central Health Plan Commercial |
$440.80
|
| Rate for Payer: Cigna of CA HMO |
$352.64
|
| Rate for Payer: Cigna of CA PPO |
$407.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$468.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$468.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$468.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$385.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.40
|
| Rate for Payer: EPIC Health Plan Senior |
$220.40
|
| Rate for Payer: Galaxy Health WC |
$468.35
|
| Rate for Payer: Global Benefits Group Commercial |
$330.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$495.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$349.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$200.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$325.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$385.70
|
| Rate for Payer: Multiplan Commercial |
$413.25
|
| Rate for Payer: Networks By Design Commercial |
$358.15
|
| Rate for Payer: Prime Health Services Commercial |
$468.35
|
| Rate for Payer: Riverside University Health System MISP |
$220.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$330.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$330.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$275.50
|
| Rate for Payer: United Healthcare All Other HMO |
$275.50
|
| Rate for Payer: United Healthcare HMO Rider |
$275.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$275.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$468.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$468.35
|
| Rate for Payer: Vantage Medical Group Senior |
$468.35
|
|
|
HC NEDL PD ACCESS DOPPLER
|
Facility
|
IP
|
$551.00
|
|
| Hospital Charge Code |
906811790
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$110.20 |
| Max. Negotiated Rate |
$495.90 |
| Rate for Payer: Adventist Health Commercial |
$110.20
|
| Rate for Payer: Cash Price |
$247.95
|
| Rate for Payer: Central Health Plan Commercial |
$440.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$385.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.40
|
| Rate for Payer: EPIC Health Plan Senior |
$220.40
|
| Rate for Payer: Galaxy Health WC |
$468.35
|
| Rate for Payer: Global Benefits Group Commercial |
$330.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$495.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$349.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$325.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.20
|
| Rate for Payer: Multiplan Commercial |
$413.25
|
| Rate for Payer: Networks By Design Commercial |
$358.15
|
| Rate for Payer: Prime Health Services Commercial |
$468.35
|
|
|
HC NEDL PERI-CARD CENTISIS COOK
|
Facility
|
OP
|
$527.56
|
|
| Hospital Charge Code |
906811776
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.51 |
| Max. Negotiated Rate |
$474.80 |
| Rate for Payer: Adventist Health Commercial |
$105.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$320.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$448.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$290.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$255.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.88
|
| Rate for Payer: Blue Shield of California Commercial |
$334.47
|
| Rate for Payer: Blue Shield of California EPN |
$210.50
|
| Rate for Payer: Cash Price |
$237.40
|
| Rate for Payer: Central Health Plan Commercial |
$422.05
|
| Rate for Payer: Cigna of CA HMO |
$337.64
|
| Rate for Payer: Cigna of CA PPO |
$390.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$448.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$448.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$369.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$211.02
|
| Rate for Payer: EPIC Health Plan Senior |
$211.02
|
| Rate for Payer: Galaxy Health WC |
$448.43
|
| Rate for Payer: Global Benefits Group Commercial |
$316.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$474.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$335.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$191.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$311.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$369.29
|
| Rate for Payer: Multiplan Commercial |
$395.67
|
| Rate for Payer: Networks By Design Commercial |
$342.91
|
| Rate for Payer: Prime Health Services Commercial |
$448.43
|
| Rate for Payer: Riverside University Health System MISP |
$211.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$316.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$316.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$263.78
|
| Rate for Payer: United Healthcare All Other HMO |
$263.78
|
| Rate for Payer: United Healthcare HMO Rider |
$263.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$263.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$448.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$448.43
|
| Rate for Payer: Vantage Medical Group Senior |
$448.43
|
|
|
HC NEDL PERI-CARD CENTISIS COOK
|
Facility
|
IP
|
$527.56
|
|
| Hospital Charge Code |
906811776
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.51 |
| Max. Negotiated Rate |
$474.80 |
| Rate for Payer: Adventist Health Commercial |
$105.51
|
| Rate for Payer: Cash Price |
$237.40
|
| Rate for Payer: Central Health Plan Commercial |
$422.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$369.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$211.02
|
| Rate for Payer: EPIC Health Plan Senior |
$211.02
|
| Rate for Payer: Galaxy Health WC |
$448.43
|
| Rate for Payer: Global Benefits Group Commercial |
$316.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$474.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$335.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$311.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.51
|
| Rate for Payer: Multiplan Commercial |
$395.67
|
| Rate for Payer: Networks By Design Commercial |
$342.91
|
| Rate for Payer: Prime Health Services Commercial |
$448.43
|
|
|
HC NEEDLE ELEC CRANI NERVE UNI
|
Facility
|
OP
|
$482.00
|
|
|
Service Code
|
CPT 95867
|
| Hospital Charge Code |
900600252
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$82.96 |
| Max. Negotiated Rate |
$1,297.00 |
| Rate for Payer: Adventist Health Commercial |
$96.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$277.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$255.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$277.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$152.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$280.38
|
| Rate for Payer: Blue Shield of California Commercial |
$303.66
|
| Rate for Payer: Blue Shield of California EPN |
$191.35
|
| Rate for Payer: Cash Price |
$216.90
|
| Rate for Payer: Cash Price |
$216.90
|
| Rate for Payer: Cash Price |
$216.90
|
| Rate for Payer: Central Health Plan Commercial |
$385.60
|
| Rate for Payer: Cigna of CA HMO |
$308.48
|
| Rate for Payer: Cigna of CA PPO |
$356.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$416.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$305.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$277.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$337.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$458.22
|
| Rate for Payer: EPIC Health Plan Senior |
$305.48
|
| Rate for Payer: Galaxy Health WC |
$409.70
|
| Rate for Payer: Global Benefits Group Commercial |
$289.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$433.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$455.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$82.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$277.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$306.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$91.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$388.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$372.13
|
| Rate for Payer: Multiplan Commercial |
$361.50
|
| Rate for Payer: Networks By Design Commercial |
$313.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$277.71
|
| Rate for Payer: Prime Health Services Commercial |
$409.70
|
| Rate for Payer: Prime Health Services Medicare |
$294.37
|
| Rate for Payer: Riverside University Health System MISP |
$305.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$289.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$289.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,297.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,024.00
|
| Rate for Payer: United Healthcare HMO Rider |
$776.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$711.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$277.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Vantage Medical Group Senior |
$277.71
|
|
|
HC NEEDLE ELEC CRANI NERVE UNI
|
Facility
|
IP
|
$482.00
|
|
|
Service Code
|
CPT 95867
|
| Hospital Charge Code |
900600252
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$96.40 |
| Max. Negotiated Rate |
$433.80 |
| Rate for Payer: Adventist Health Commercial |
$96.40
|
| Rate for Payer: Cash Price |
$216.90
|
| Rate for Payer: Central Health Plan Commercial |
$385.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$337.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.80
|
| Rate for Payer: EPIC Health Plan Senior |
$192.80
|
| Rate for Payer: Galaxy Health WC |
$409.70
|
| Rate for Payer: Global Benefits Group Commercial |
$289.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$433.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$306.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$284.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.40
|
| Rate for Payer: Multiplan Commercial |
$361.50
|
| Rate for Payer: Networks By Design Commercial |
$313.30
|
| Rate for Payer: Prime Health Services Commercial |
$409.70
|
|
|
HC NEEDLE ELEC LIMIT STUDY 1 SITE
|
Facility
|
OP
|
$279.00
|
|
|
Service Code
|
CPT 95870
|
| Hospital Charge Code |
900600255
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$34.83 |
| Max. Negotiated Rate |
$2,039.00 |
| Rate for Payer: Adventist Health Commercial |
$55.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$171.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$249.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$48.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$162.29
|
| Rate for Payer: Blue Shield of California Commercial |
$175.77
|
| Rate for Payer: Blue Shield of California EPN |
$110.76
|
| Rate for Payer: Cash Price |
$125.55
|
| Rate for Payer: Cash Price |
$125.55
|
| Rate for Payer: Cash Price |
$125.55
|
| Rate for Payer: Central Health Plan Commercial |
$223.20
|
| Rate for Payer: Cigna of CA HMO |
$178.56
|
| Rate for Payer: Cigna of CA PPO |
$206.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$195.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$237.15
|
| Rate for Payer: Global Benefits Group Commercial |
$167.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$251.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$34.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$177.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$38.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$239.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$209.25
|
| Rate for Payer: Networks By Design Commercial |
$181.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$171.12
|
| Rate for Payer: Prime Health Services Commercial |
$237.15
|
| Rate for Payer: Prime Health Services Medicare |
$181.39
|
| Rate for Payer: Riverside University Health System MISP |
$188.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$167.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$167.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
|
HC NEEDLE ELEC LIMIT STUDY 1 SITE
|
Facility
|
IP
|
$279.00
|
|
|
Service Code
|
CPT 95870
|
| Hospital Charge Code |
900600255
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$55.80 |
| Max. Negotiated Rate |
$251.10 |
| Rate for Payer: Adventist Health Commercial |
$55.80
|
| Rate for Payer: Cash Price |
$125.55
|
| Rate for Payer: Central Health Plan Commercial |
$223.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$195.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$111.60
|
| Rate for Payer: EPIC Health Plan Senior |
$111.60
|
| Rate for Payer: Galaxy Health WC |
$237.15
|
| Rate for Payer: Global Benefits Group Commercial |
$167.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$251.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$177.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$164.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.80
|
| Rate for Payer: Multiplan Commercial |
$209.25
|
| Rate for Payer: Networks By Design Commercial |
$181.35
|
| Rate for Payer: Prime Health Services Commercial |
$237.15
|
|
|
HC NEEDLE ELEC LIMIT STUDY 1 SITE
|
Facility
|
IP
|
$279.00
|
|
|
Service Code
|
CPT 95870
|
| Hospital Charge Code |
900600255
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$55.80 |
| Max. Negotiated Rate |
$251.10 |
| Rate for Payer: Adventist Health Commercial |
$55.80
|
| Rate for Payer: Cash Price |
$125.55
|
| Rate for Payer: Central Health Plan Commercial |
$223.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$195.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$111.60
|
| Rate for Payer: EPIC Health Plan Senior |
$111.60
|
| Rate for Payer: Galaxy Health WC |
$237.15
|
| Rate for Payer: Global Benefits Group Commercial |
$167.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$251.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$177.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$164.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.80
|
| Rate for Payer: Multiplan Commercial |
$209.25
|
| Rate for Payer: Networks By Design Commercial |
$181.35
|
| Rate for Payer: Prime Health Services Commercial |
$237.15
|
|
|
HC NEEDLE ELEC LIMIT STUDY 1 SITE
|
Facility
|
OP
|
$279.00
|
|
|
Service Code
|
CPT 95870
|
| Hospital Charge Code |
900600255
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$34.83 |
| Max. Negotiated Rate |
$1,297.00 |
| Rate for Payer: Adventist Health Commercial |
$55.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$171.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$249.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$48.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$162.29
|
| Rate for Payer: Blue Shield of California Commercial |
$175.77
|
| Rate for Payer: Blue Shield of California EPN |
$110.76
|
| Rate for Payer: Cash Price |
$125.55
|
| Rate for Payer: Cash Price |
$125.55
|
| Rate for Payer: Cash Price |
$125.55
|
| Rate for Payer: Central Health Plan Commercial |
$223.20
|
| Rate for Payer: Cigna of CA HMO |
$178.56
|
| Rate for Payer: Cigna of CA PPO |
$206.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$195.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$237.15
|
| Rate for Payer: Global Benefits Group Commercial |
$167.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$251.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$34.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$177.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$38.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$239.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$209.25
|
| Rate for Payer: Networks By Design Commercial |
$181.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$171.12
|
| Rate for Payer: Prime Health Services Commercial |
$237.15
|
| Rate for Payer: Prime Health Services Medicare |
$181.39
|
| Rate for Payer: Riverside University Health System MISP |
$188.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$167.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$167.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,297.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,024.00
|
| Rate for Payer: United Healthcare HMO Rider |
$776.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$711.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
|
HC NEEDLE ELECT CRANI NERVE BI
|
Facility
|
OP
|
$1,006.00
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
900600253
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$140.03 |
| Max. Negotiated Rate |
$1,297.00 |
| Rate for Payer: Adventist Health Commercial |
$201.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$277.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$315.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$277.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$184.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.19
|
| Rate for Payer: Blue Shield of California Commercial |
$633.78
|
| Rate for Payer: Blue Shield of California EPN |
$399.38
|
| Rate for Payer: Cash Price |
$452.70
|
| Rate for Payer: Cash Price |
$452.70
|
| Rate for Payer: Cash Price |
$452.70
|
| Rate for Payer: Central Health Plan Commercial |
$804.80
|
| Rate for Payer: Cigna of CA HMO |
$643.84
|
| Rate for Payer: Cigna of CA PPO |
$744.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$416.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$305.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$277.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$704.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$458.22
|
| Rate for Payer: EPIC Health Plan Senior |
$305.48
|
| Rate for Payer: Galaxy Health WC |
$855.10
|
| Rate for Payer: Global Benefits Group Commercial |
$603.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$905.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$455.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$140.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$277.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$638.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$154.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$388.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$201.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$372.13
|
| Rate for Payer: Multiplan Commercial |
$754.50
|
| Rate for Payer: Networks By Design Commercial |
$653.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$277.71
|
| Rate for Payer: Prime Health Services Commercial |
$855.10
|
| Rate for Payer: Prime Health Services Medicare |
$294.37
|
| Rate for Payer: Riverside University Health System MISP |
$305.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$603.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$603.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,297.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,024.00
|
| Rate for Payer: United Healthcare HMO Rider |
$776.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$711.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$277.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Vantage Medical Group Senior |
$277.71
|
|
|
HC NEEDLE ELECT CRANI NERVE BI
|
Facility
|
IP
|
$1,006.00
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
900600253
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$201.20 |
| Max. Negotiated Rate |
$905.40 |
| Rate for Payer: Adventist Health Commercial |
$201.20
|
| Rate for Payer: Cash Price |
$452.70
|
| Rate for Payer: Central Health Plan Commercial |
$804.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$704.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$402.40
|
| Rate for Payer: EPIC Health Plan Senior |
$402.40
|
| Rate for Payer: Galaxy Health WC |
$855.10
|
| Rate for Payer: Global Benefits Group Commercial |
$603.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$905.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$638.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$593.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$201.20
|
| Rate for Payer: Multiplan Commercial |
$754.50
|
| Rate for Payer: Networks By Design Commercial |
$653.90
|
| Rate for Payer: Prime Health Services Commercial |
$855.10
|
|
|
HC NEEDLE ELECT CRANI NERVE BI
|
Facility
|
OP
|
$1,006.00
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
900600253
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$140.03 |
| Max. Negotiated Rate |
$2,039.00 |
| Rate for Payer: Adventist Health Commercial |
$201.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$277.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$315.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$277.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$184.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.19
|
| Rate for Payer: Blue Shield of California Commercial |
$633.78
|
| Rate for Payer: Blue Shield of California EPN |
$399.38
|
| Rate for Payer: Cash Price |
$452.70
|
| Rate for Payer: Cash Price |
$452.70
|
| Rate for Payer: Cash Price |
$452.70
|
| Rate for Payer: Central Health Plan Commercial |
$804.80
|
| Rate for Payer: Cigna of CA HMO |
$643.84
|
| Rate for Payer: Cigna of CA PPO |
$744.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$416.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$305.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$277.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$704.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$458.22
|
| Rate for Payer: EPIC Health Plan Senior |
$305.48
|
| Rate for Payer: Galaxy Health WC |
$855.10
|
| Rate for Payer: Global Benefits Group Commercial |
$603.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$905.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$455.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$140.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$277.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$638.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$154.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$388.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$201.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$372.13
|
| Rate for Payer: Multiplan Commercial |
$754.50
|
| Rate for Payer: Networks By Design Commercial |
$653.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$277.71
|
| Rate for Payer: Prime Health Services Commercial |
$855.10
|
| Rate for Payer: Prime Health Services Medicare |
$294.37
|
| Rate for Payer: Riverside University Health System MISP |
$305.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$603.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$603.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$277.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Vantage Medical Group Senior |
$277.71
|
|
|
HC NEEDLE ELECT CRANI NERVE BI
|
Facility
|
IP
|
$1,006.00
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
900600253
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$201.20 |
| Max. Negotiated Rate |
$905.40 |
| Rate for Payer: Adventist Health Commercial |
$201.20
|
| Rate for Payer: Cash Price |
$452.70
|
| Rate for Payer: Central Health Plan Commercial |
$804.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$704.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$402.40
|
| Rate for Payer: EPIC Health Plan Senior |
$402.40
|
| Rate for Payer: Galaxy Health WC |
$855.10
|
| Rate for Payer: Global Benefits Group Commercial |
$603.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$905.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$638.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$593.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$201.20
|
| Rate for Payer: Multiplan Commercial |
$754.50
|
| Rate for Payer: Networks By Design Commercial |
$653.90
|
| Rate for Payer: Prime Health Services Commercial |
$855.10
|
|
|
HC NEEDLE ELEC THOR/SPINAL MUSC
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT 95869
|
| Hospital Charge Code |
900600254
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$45.13 |
| Max. Negotiated Rate |
$2,039.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$277.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$255.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$277.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$57.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$203.59
|
| Rate for Payer: Blue Shield of California Commercial |
$220.50
|
| Rate for Payer: Blue Shield of California EPN |
$138.95
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$224.00
|
| Rate for Payer: Cigna of CA PPO |
$259.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$416.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$305.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$277.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$458.22
|
| Rate for Payer: EPIC Health Plan Senior |
$305.48
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$455.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$45.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$277.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$49.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$388.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$372.13
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$277.71
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Prime Health Services Medicare |
$294.37
|
| Rate for Payer: Riverside University Health System MISP |
$305.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$277.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Vantage Medical Group Senior |
$277.71
|
|
|
HC NEEDLE ELEC THOR/SPINAL MUSC
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT 95869
|
| Hospital Charge Code |
900600254
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
|
|
HC NEEDLE EMG 1 EXT W/ WO PARASP
|
Facility
|
IP
|
$1,105.00
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
900600233
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$221.00 |
| Max. Negotiated Rate |
$994.50 |
| Rate for Payer: Adventist Health Commercial |
$221.00
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Central Health Plan Commercial |
$884.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$773.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$442.00
|
| Rate for Payer: EPIC Health Plan Senior |
$442.00
|
| Rate for Payer: Galaxy Health WC |
$939.25
|
| Rate for Payer: Global Benefits Group Commercial |
$663.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$994.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$701.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$651.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.00
|
| Rate for Payer: Multiplan Commercial |
$828.75
|
| Rate for Payer: Networks By Design Commercial |
$718.25
|
| Rate for Payer: Prime Health Services Commercial |
$939.25
|
|
|
HC NEEDLE EMG 1 EXT W/ WO PARASP
|
Facility
|
OP
|
$1,105.00
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
900600233
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$101.43 |
| Max. Negotiated Rate |
$1,297.00 |
| Rate for Payer: Adventist Health Commercial |
$221.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$171.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$264.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$101.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$642.78
|
| Rate for Payer: Blue Shield of California Commercial |
$696.15
|
| Rate for Payer: Blue Shield of California EPN |
$438.69
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Central Health Plan Commercial |
$884.00
|
| Rate for Payer: Cigna of CA HMO |
$707.20
|
| Rate for Payer: Cigna of CA PPO |
$817.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$773.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$939.25
|
| Rate for Payer: Global Benefits Group Commercial |
$663.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$994.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$112.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$701.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$124.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$239.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$828.75
|
| Rate for Payer: Networks By Design Commercial |
$718.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$171.12
|
| Rate for Payer: Prime Health Services Commercial |
$939.25
|
| Rate for Payer: Prime Health Services Medicare |
$181.39
|
| Rate for Payer: Riverside University Health System MISP |
$188.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$663.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$663.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,297.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,024.00
|
| Rate for Payer: United Healthcare HMO Rider |
$776.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$711.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
|
HC NEEDLE EMG 2 EXT W/WO PARASP
|
Facility
|
IP
|
$1,887.00
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
900600232
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$377.40 |
| Max. Negotiated Rate |
$1,698.30 |
| Rate for Payer: Adventist Health Commercial |
$377.40
|
| Rate for Payer: Cash Price |
$849.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,509.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,320.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$754.80
|
| Rate for Payer: EPIC Health Plan Senior |
$754.80
|
| Rate for Payer: Galaxy Health WC |
$1,603.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,132.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,698.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,198.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,113.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$377.40
|
| Rate for Payer: Multiplan Commercial |
$1,415.25
|
| Rate for Payer: Networks By Design Commercial |
$1,226.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,603.95
|
|
