|
HC NERVE BLOCK INJ-CERVICAL PLEXU
|
Facility
|
OP
|
$1,701.00
|
|
|
Service Code
|
CPT 64413
|
| Hospital Charge Code |
900501738
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$340.20 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Commercial |
$340.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,445.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$935.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,275.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,685.00
|
| Rate for Payer: Cash Price |
$765.45
|
| Rate for Payer: Cash Price |
$765.45
|
| Rate for Payer: Cash Price |
$765.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,360.80
|
| Rate for Payer: Cigna of CA HMO |
$1,088.64
|
| Rate for Payer: Cigna of CA PPO |
$1,258.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,445.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,445.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,445.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,190.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$680.40
|
| Rate for Payer: EPIC Health Plan Senior |
$680.40
|
| Rate for Payer: Galaxy Health WC |
$1,445.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,020.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,530.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,080.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$617.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,003.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$340.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,190.70
|
| Rate for Payer: Multiplan Commercial |
$1,275.75
|
| Rate for Payer: Networks By Design Commercial |
$1,105.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,445.85
|
| Rate for Payer: Riverside University Health System MISP |
$680.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,020.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$850.50
|
| Rate for Payer: United Healthcare All Other HMO |
$850.50
|
| Rate for Payer: United Healthcare HMO Rider |
$850.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$850.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,445.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,445.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,445.85
|
|
|
HC NERVE TEASING
|
Facility
|
OP
|
$342.00
|
|
|
Service Code
|
CPT 88362
|
| Hospital Charge Code |
903800042
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$68.40 |
| Max. Negotiated Rate |
$1,709.80 |
| Rate for Payer: Adventist Health Commercial |
$68.40
|
| Rate for Payer: Adventist Health Commercial |
$156.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,036.24
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,036.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,111.97
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,111.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,554.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,554.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,139.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,139.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,036.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,036.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$198.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$198.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$276.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$276.17
|
| Rate for Payer: Blue Shield of California Commercial |
$491.40
|
| Rate for Payer: Blue Shield of California Commercial |
$215.46
|
| Rate for Payer: Blue Shield of California EPN |
$309.66
|
| Rate for Payer: Blue Shield of California EPN |
$135.77
|
| Rate for Payer: Cash Price |
$351.00
|
| Rate for Payer: Cash Price |
$351.00
|
| Rate for Payer: Cash Price |
$153.90
|
| Rate for Payer: Cash Price |
$153.90
|
| Rate for Payer: Central Health Plan Commercial |
$273.60
|
| Rate for Payer: Central Health Plan Commercial |
$624.00
|
| Rate for Payer: Cigna of CA HMO |
$499.20
|
| Rate for Payer: Cigna of CA HMO |
$218.88
|
| Rate for Payer: Cigna of CA PPO |
$577.20
|
| Rate for Payer: Cigna of CA PPO |
$253.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,554.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,554.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,139.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,139.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,036.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,036.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$239.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$546.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,709.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,709.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,139.86
|
| Rate for Payer: EPIC Health Plan Senior |
$1,139.86
|
| Rate for Payer: Galaxy Health WC |
$663.00
|
| Rate for Payer: Galaxy Health WC |
$290.70
|
| Rate for Payer: Global Benefits Group Commercial |
$468.00
|
| Rate for Payer: Global Benefits Group Commercial |
$205.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$702.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$307.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,699.43
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,699.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$310.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$310.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,036.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,036.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$217.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$495.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$342.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$342.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,450.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,450.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$156.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,388.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,388.56
|
| Rate for Payer: Multiplan Commercial |
$585.00
|
| Rate for Payer: Multiplan Commercial |
$256.50
|
| Rate for Payer: Networks By Design Commercial |
$222.30
|
| Rate for Payer: Networks By Design Commercial |
$507.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,036.24
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,036.24
|
| Rate for Payer: Prime Health Services Commercial |
$663.00
|
| Rate for Payer: Prime Health Services Commercial |
$290.70
|
| Rate for Payer: Prime Health Services Medicare |
$1,098.41
|
| Rate for Payer: Prime Health Services Medicare |
$1,098.41
|
| Rate for Payer: Riverside University Health System MISP |
$1,139.86
|
| Rate for Payer: Riverside University Health System MISP |
$1,139.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$205.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$468.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$468.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$205.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$542.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$542.12
|
| Rate for Payer: United Healthcare All Other HMO |
$542.12
|
| Rate for Payer: United Healthcare All Other HMO |
$542.12
|
| Rate for Payer: United Healthcare HMO Rider |
$542.12
|
| Rate for Payer: United Healthcare HMO Rider |
$542.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$542.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$542.12
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,036.24
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,036.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,554.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,554.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,139.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,139.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,036.24
|
| Rate for Payer: Vantage Medical Group Senior |
$1,036.24
|
|
|
HC NERVE TEASING
|
Facility
|
IP
|
$780.00
|
|
|
Service Code
|
CPT 88362
|
| Hospital Charge Code |
903800042
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$156.00 |
| Max. Negotiated Rate |
$702.00 |
| Rate for Payer: Adventist Health Commercial |
$156.00
|
| Rate for Payer: Cash Price |
$351.00
|
| Rate for Payer: Central Health Plan Commercial |
$624.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$546.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$312.00
|
| Rate for Payer: EPIC Health Plan Senior |
$312.00
|
| Rate for Payer: Galaxy Health WC |
$663.00
|
| Rate for Payer: Global Benefits Group Commercial |
$468.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$702.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$495.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$460.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$156.00
|
| Rate for Payer: Multiplan Commercial |
$585.00
|
| Rate for Payer: Networks By Design Commercial |
$507.00
|
| Rate for Payer: Prime Health Services Commercial |
$663.00
|
|
|
HC NERVOUS SYSTEM PROC
|
Facility
|
OP
|
$10,251.00
|
|
|
Service Code
|
CPT 64999
|
| Hospital Charge Code |
907201138
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$394.79 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,050.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$394.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$394.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,963.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,963.01
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$597.61
|
| 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 |
$4,612.95
|
| Rate for Payer: Cash Price |
$4,612.95
|
| Rate for Payer: Cash Price |
$4,612.95
|
| Rate for Payer: Central Health Plan Commercial |
$8,200.80
|
| Rate for Payer: Cigna of CA HMO |
$6,560.64
|
| Rate for Payer: Cigna of CA PPO |
$7,585.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$394.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,175.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$651.40
|
| Rate for Payer: EPIC Health Plan Senior |
$434.27
|
| Rate for Payer: Galaxy Health WC |
$8,713.35
|
| Rate for Payer: Global Benefits Group Commercial |
$6,150.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,225.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$647.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$394.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,509.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$552.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,050.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$529.02
|
| Rate for Payer: Multiplan Commercial |
$7,688.25
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: Networks By Design Commercial |
$6,663.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$394.79
|
| Rate for Payer: Preferred Health Network WC |
$609.81
|
| Rate for Payer: Prime Health Services Commercial |
$8,713.35
|
| Rate for Payer: Prime Health Services Medicare |
$418.48
|
| Rate for Payer: Prime Health Services WC |
$591.52
|
| Rate for Payer: Riverside University Health System MISP |
$434.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,150.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,125.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$394.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Vantage Medical Group Senior |
$394.79
|
|
|
HC NERVOUS SYSTEM PROC
|
Facility
|
IP
|
$10,251.00
|
|
|
Service Code
|
CPT 64999
|
| Hospital Charge Code |
907201138
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,050.20 |
| Max. Negotiated Rate |
$9,225.90 |
| Rate for Payer: Adventist Health Commercial |
$2,050.20
|
| Rate for Payer: Cash Price |
$4,612.95
|
| Rate for Payer: Central Health Plan Commercial |
$8,200.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,175.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,100.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,100.40
|
| Rate for Payer: Galaxy Health WC |
$8,713.35
|
| Rate for Payer: Global Benefits Group Commercial |
$6,150.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,225.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,509.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,048.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,050.20
|
| Rate for Payer: Multiplan Commercial |
$7,688.25
|
| Rate for Payer: Networks By Design Commercial |
$6,663.15
|
| Rate for Payer: Prime Health Services Commercial |
$8,713.35
|
|
|
HC NEUROBEHAV STATUS W/RPT 60 MIN
|
Facility
|
OP
|
$1,383.00
|
|
|
Service Code
|
CPT 96116
|
| Hospital Charge Code |
905601804
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$96.66 |
| Max. Negotiated Rate |
$1,244.70 |
| Rate for Payer: Adventist Health Commercial |
$567.03
|
| Rate for Payer: Adventist Health Medi-Cal |
$277.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$487.48
|
| 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 |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$622.35
|
| Rate for Payer: Cash Price |
$622.35
|
| Rate for Payer: Cash Price |
$622.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,106.40
|
| Rate for Payer: Cigna of CA HMO |
$885.12
|
| Rate for Payer: Cigna of CA PPO |
$1,023.42
|
| 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 |
$968.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$458.22
|
| Rate for Payer: EPIC Health Plan Senior |
$305.48
|
| Rate for Payer: Galaxy Health WC |
$1,175.55
|
| Rate for Payer: Global Benefits Group Commercial |
$829.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,244.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$455.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$96.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$277.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$878.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$106.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$388.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$567.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$372.13
|
| Rate for Payer: Multiplan Commercial |
$1,037.25
|
| Rate for Payer: Networks By Design Commercial |
$898.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$277.71
|
| Rate for Payer: Prime Health Services Commercial |
$1,175.55
|
| 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 |
$829.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$333.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: 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 NEUROBEHAV STATUS W/RPT 60 MIN
|
Facility
|
IP
|
$1,383.00
|
|
|
Service Code
|
CPT 96116
|
| Hospital Charge Code |
905601804
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$276.60 |
| Max. Negotiated Rate |
$1,244.70 |
| Rate for Payer: Adventist Health Commercial |
$276.60
|
| Rate for Payer: Cash Price |
$622.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,106.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$968.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$553.20
|
| Rate for Payer: EPIC Health Plan Senior |
$553.20
|
| Rate for Payer: Galaxy Health WC |
$1,175.55
|
| Rate for Payer: Global Benefits Group Commercial |
$829.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,244.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$878.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$815.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$276.60
|
| Rate for Payer: Multiplan Commercial |
$1,037.25
|
| Rate for Payer: Networks By Design Commercial |
$898.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,175.55
|
|
|
HC NEUROBEHAV STATUS W/RPT 60 MIN MCAL
|
Facility
|
IP
|
$1,383.00
|
|
|
Service Code
|
CPT 96116
|
| Hospital Charge Code |
907000032
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$276.60 |
| Max. Negotiated Rate |
$1,244.70 |
| Rate for Payer: Adventist Health Commercial |
$276.60
|
| Rate for Payer: Cash Price |
$622.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,106.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$968.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$553.20
|
| Rate for Payer: EPIC Health Plan Senior |
$553.20
|
| Rate for Payer: Galaxy Health WC |
$1,175.55
|
| Rate for Payer: Global Benefits Group Commercial |
$829.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,244.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$878.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$815.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$276.60
|
| Rate for Payer: Multiplan Commercial |
$1,037.25
|
| Rate for Payer: Networks By Design Commercial |
$898.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,175.55
|
|
|
HC NEUROBEHAV STATUS W/RPT 60 MIN MCAL
|
Facility
|
OP
|
$1,383.00
|
|
|
Service Code
|
CPT 96116
|
| Hospital Charge Code |
907000032
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$96.66 |
| Max. Negotiated Rate |
$1,244.70 |
| Rate for Payer: Adventist Health Commercial |
$567.03
|
| Rate for Payer: Adventist Health Medi-Cal |
$277.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$487.48
|
| 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 |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$622.35
|
| Rate for Payer: Cash Price |
$622.35
|
| Rate for Payer: Cash Price |
$622.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,106.40
|
| Rate for Payer: Cigna of CA HMO |
$885.12
|
| Rate for Payer: Cigna of CA PPO |
$1,023.42
|
| 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 |
$968.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$458.22
|
| Rate for Payer: EPIC Health Plan Senior |
$305.48
|
| Rate for Payer: Galaxy Health WC |
$1,175.55
|
| Rate for Payer: Global Benefits Group Commercial |
$829.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,244.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$455.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$96.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$277.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$878.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$106.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$388.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$567.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$372.13
|
| Rate for Payer: Multiplan Commercial |
$1,037.25
|
| Rate for Payer: Networks By Design Commercial |
$898.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$277.71
|
| Rate for Payer: Prime Health Services Commercial |
$1,175.55
|
| 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 |
$829.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$333.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: 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 NEUROINTERVENTIONAL CATH J&J
|
Facility
|
IP
|
$138.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909081812
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.60 |
| Max. Negotiated Rate |
$124.20 |
| Rate for Payer: Adventist Health Commercial |
$27.60
|
| Rate for Payer: Cash Price |
$62.10
|
| Rate for Payer: Central Health Plan Commercial |
$110.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$96.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.20
|
| Rate for Payer: EPIC Health Plan Senior |
$55.20
|
| Rate for Payer: Galaxy Health WC |
$117.30
|
| Rate for Payer: Global Benefits Group Commercial |
$82.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$124.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$87.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$81.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.60
|
| Rate for Payer: Multiplan Commercial |
$103.50
|
| Rate for Payer: Networks By Design Commercial |
$89.70
|
| Rate for Payer: Prime Health Services Commercial |
$117.30
|
|
|
HC NEUROINTERVENTIONAL CATH J&J
|
Facility
|
OP
|
$138.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909081812
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.60 |
| Max. Negotiated Rate |
$188.37 |
| Rate for Payer: Adventist Health Commercial |
$27.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$188.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$117.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$75.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$103.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$66.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$80.27
|
| Rate for Payer: Blue Shield of California Commercial |
$87.49
|
| Rate for Payer: Blue Shield of California EPN |
$55.06
|
| Rate for Payer: Cash Price |
$62.10
|
| Rate for Payer: Cash Price |
$62.10
|
| Rate for Payer: Central Health Plan Commercial |
$110.40
|
| Rate for Payer: Cigna of CA HMO |
$88.32
|
| Rate for Payer: Cigna of CA PPO |
$102.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$117.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$117.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$117.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$96.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.20
|
| Rate for Payer: EPIC Health Plan Senior |
$55.20
|
| Rate for Payer: Galaxy Health WC |
$117.30
|
| Rate for Payer: Global Benefits Group Commercial |
$82.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$124.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$87.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$50.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$81.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$96.60
|
| Rate for Payer: Multiplan Commercial |
$103.50
|
| Rate for Payer: Networks By Design Commercial |
$89.70
|
| Rate for Payer: Prime Health Services Commercial |
$117.30
|
| Rate for Payer: Riverside University Health System MISP |
$55.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$69.00
|
| Rate for Payer: United Healthcare All Other HMO |
$69.00
|
| Rate for Payer: United Healthcare HMO Rider |
$69.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$69.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$117.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$117.30
|
| Rate for Payer: Vantage Medical Group Senior |
$117.30
|
|
|
HC NEUROLYSIS OF CELIA
|
Facility
|
IP
|
$8,508.00
|
|
|
Service Code
|
CPT 64680
|
| Hospital Charge Code |
906764680
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,701.60 |
| Max. Negotiated Rate |
$7,657.20 |
| Rate for Payer: Adventist Health Commercial |
$1,701.60
|
| Rate for Payer: Cash Price |
$3,828.60
|
| Rate for Payer: Central Health Plan Commercial |
$6,806.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,955.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,403.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,403.20
|
| Rate for Payer: Galaxy Health WC |
$7,231.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5,104.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,657.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,402.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,019.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,701.60
|
| Rate for Payer: Multiplan Commercial |
$6,381.00
|
| Rate for Payer: Networks By Design Commercial |
$5,530.20
|
| Rate for Payer: Prime Health Services Commercial |
$7,231.80
|
|
|
HC NEUROLYSIS OF CELIA
|
Facility
|
OP
|
$8,508.00
|
|
|
Service Code
|
CPT 64680
|
| Hospital Charge Code |
906764680
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$202.99 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,701.60
|
| Rate for Payer: Adventist Health Commercial |
$933.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,137.58
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,137.58
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,251.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,251.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,137.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,137.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| 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 HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,802.37
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,802.37
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$2,099.70
|
| Rate for Payer: Cash Price |
$2,099.70
|
| Rate for Payer: Cash Price |
$2,099.70
|
| Rate for Payer: Cash Price |
$3,828.60
|
| Rate for Payer: Cash Price |
$3,828.60
|
| Rate for Payer: Cash Price |
$3,828.60
|
| Rate for Payer: Central Health Plan Commercial |
$6,806.40
|
| Rate for Payer: Central Health Plan Commercial |
$3,732.80
|
| Rate for Payer: Cigna of CA HMO |
$2,986.24
|
| Rate for Payer: Cigna of CA HMO |
$5,445.12
|
| Rate for Payer: Cigna of CA PPO |
$6,295.92
|
| Rate for Payer: Cigna of CA PPO |
$3,452.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,251.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,251.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,137.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,137.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,266.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,955.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,877.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,877.01
|
| Rate for Payer: EPIC Health Plan Senior |
$1,251.34
|
| Rate for Payer: EPIC Health Plan Senior |
$1,251.34
|
| Rate for Payer: Galaxy Health WC |
$7,231.80
|
| Rate for Payer: Galaxy Health WC |
$3,966.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,104.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,799.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,199.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,657.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,865.63
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,865.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$202.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$202.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,137.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,137.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,402.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,962.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$224.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$224.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,592.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,592.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$933.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,701.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,524.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,524.36
|
| Rate for Payer: Multiplan Commercial |
$6,381.00
|
| Rate for Payer: Multiplan Commercial |
$3,499.50
|
| Rate for Payer: Multiplan WC |
$1,802.37
|
| Rate for Payer: Multiplan WC |
$1,802.37
|
| Rate for Payer: Networks By Design Commercial |
$3,032.90
|
| Rate for Payer: Networks By Design Commercial |
$5,530.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,137.58
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,137.58
|
| Rate for Payer: Preferred Health Network WC |
$1,839.15
|
| Rate for Payer: Preferred Health Network WC |
$1,839.15
|
| Rate for Payer: Prime Health Services Commercial |
$7,231.80
|
| Rate for Payer: Prime Health Services Commercial |
$3,966.10
|
| Rate for Payer: Prime Health Services Medicare |
$1,205.83
|
| Rate for Payer: Prime Health Services Medicare |
$1,205.83
|
| Rate for Payer: Prime Health Services WC |
$1,783.98
|
| Rate for Payer: Prime Health Services WC |
$1,783.98
|
| Rate for Payer: Riverside University Health System MISP |
$1,251.34
|
| Rate for Payer: Riverside University Health System MISP |
$1,251.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,104.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,799.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,333.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,254.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| 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 HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,137.58
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,137.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,251.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,251.34
|
| Rate for Payer: Vantage Medical Group Senior |
$1,137.58
|
| Rate for Payer: Vantage Medical Group Senior |
$1,137.58
|
|
|
HC NEUROLYSIS OF CELIA
|
Facility
|
IP
|
$8,508.00
|
|
|
Service Code
|
CPT 64680
|
| Hospital Charge Code |
906764680
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,701.60 |
| Max. Negotiated Rate |
$7,657.20 |
| Rate for Payer: Adventist Health Commercial |
$1,701.60
|
| Rate for Payer: Cash Price |
$3,828.60
|
| Rate for Payer: Central Health Plan Commercial |
$6,806.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,955.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,403.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,403.20
|
| Rate for Payer: Galaxy Health WC |
$7,231.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5,104.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,657.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,402.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,019.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,701.60
|
| Rate for Payer: Multiplan Commercial |
$6,381.00
|
| Rate for Payer: Networks By Design Commercial |
$5,530.20
|
| Rate for Payer: Prime Health Services Commercial |
$7,231.80
|
|
|
HC NEUROLYSIS OF CELIA
|
Facility
|
OP
|
$8,508.00
|
|
|
Service Code
|
CPT 64680
|
| Hospital Charge Code |
906764680
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$202.99 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,701.60
|
| Rate for Payer: Adventist Health Commercial |
$933.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,137.58
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,137.58
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,251.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,251.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,137.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,137.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| 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 HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$3,828.60
|
| Rate for Payer: Cash Price |
$3,828.60
|
| Rate for Payer: Cash Price |
$2,099.70
|
| Rate for Payer: Cash Price |
$3,828.60
|
| Rate for Payer: Cash Price |
$2,099.70
|
| Rate for Payer: Cash Price |
$2,099.70
|
| Rate for Payer: Central Health Plan Commercial |
$3,732.80
|
| Rate for Payer: Central Health Plan Commercial |
$6,806.40
|
| Rate for Payer: Cigna of CA HMO |
$2,986.24
|
| Rate for Payer: Cigna of CA HMO |
$5,445.12
|
| Rate for Payer: Cigna of CA PPO |
$6,295.92
|
| Rate for Payer: Cigna of CA PPO |
$3,452.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,251.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,251.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,137.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,137.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,266.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,955.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,877.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,877.01
|
| Rate for Payer: EPIC Health Plan Senior |
$1,251.34
|
| Rate for Payer: EPIC Health Plan Senior |
$1,251.34
|
| Rate for Payer: Galaxy Health WC |
$7,231.80
|
| Rate for Payer: Galaxy Health WC |
$3,966.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,799.60
|
| Rate for Payer: Global Benefits Group Commercial |
$5,104.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,199.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,657.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,865.63
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,865.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$202.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$202.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,137.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,137.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,962.91
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,402.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$224.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$224.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,592.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,592.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,701.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$933.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,524.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,524.36
|
| Rate for Payer: Multiplan Commercial |
$6,381.00
|
| Rate for Payer: Multiplan Commercial |
$3,499.50
|
| Rate for Payer: Networks By Design Commercial |
$5,530.20
|
| Rate for Payer: Networks By Design Commercial |
$3,032.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,137.58
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,137.58
|
| Rate for Payer: Prime Health Services Commercial |
$3,966.10
|
| Rate for Payer: Prime Health Services Commercial |
$7,231.80
|
| Rate for Payer: Prime Health Services Medicare |
$1,205.83
|
| Rate for Payer: Prime Health Services Medicare |
$1,205.83
|
| Rate for Payer: Riverside University Health System MISP |
$1,251.34
|
| Rate for Payer: Riverside University Health System MISP |
$1,251.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,799.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,104.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,365.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,365.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,254.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,333.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| 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 HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,137.58
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,137.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,706.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,251.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,251.34
|
| Rate for Payer: Vantage Medical Group Senior |
$1,137.58
|
| Rate for Payer: Vantage Medical Group Senior |
$1,137.58
|
|
|
HC NEUROMUSC RE-ED 15 MIN OT
|
Facility
|
OP
|
$254.00
|
|
|
Service Code
|
CPT 97112
|
| Hospital Charge Code |
905104141
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$21.02 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$104.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$138.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$215.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$139.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$190.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$114.30
|
| Rate for Payer: Cash Price |
$114.30
|
| Rate for Payer: Cash Price |
$114.30
|
| Rate for Payer: Central Health Plan Commercial |
$203.20
|
| Rate for Payer: Cigna of CA HMO |
$162.56
|
| Rate for Payer: Cigna of CA PPO |
$187.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$215.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$215.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$215.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$177.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.60
|
| Rate for Payer: EPIC Health Plan Senior |
$101.60
|
| Rate for Payer: Galaxy Health WC |
$215.90
|
| Rate for Payer: Global Benefits Group Commercial |
$152.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$228.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$21.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$161.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$149.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$104.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$177.80
|
| Rate for Payer: Multiplan Commercial |
$190.50
|
| Rate for Payer: Networks By Design Commercial |
$165.10
|
| Rate for Payer: Prime Health Services Commercial |
$215.90
|
| Rate for Payer: Riverside University Health System MISP |
$101.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$152.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$152.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$215.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$215.90
|
| Rate for Payer: Vantage Medical Group Senior |
$215.90
|
|
|
HC NEUROMUSC RE-ED 15 MIN OT
|
Facility
|
IP
|
$254.00
|
|
|
Service Code
|
CPT 97112
|
| Hospital Charge Code |
905104141
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$50.80 |
| Max. Negotiated Rate |
$228.60 |
| Rate for Payer: Adventist Health Commercial |
$50.80
|
| Rate for Payer: Cash Price |
$114.30
|
| Rate for Payer: Central Health Plan Commercial |
$203.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$177.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.60
|
| Rate for Payer: EPIC Health Plan Senior |
$101.60
|
| Rate for Payer: Galaxy Health WC |
$215.90
|
| Rate for Payer: Global Benefits Group Commercial |
$152.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$228.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$161.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$149.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.80
|
| Rate for Payer: Multiplan Commercial |
$190.50
|
| Rate for Payer: Networks By Design Commercial |
$165.10
|
| Rate for Payer: Prime Health Services Commercial |
$215.90
|
|
|
HC NEUROMUSC RE ED 15MIN PT
|
Facility
|
IP
|
$254.00
|
|
|
Service Code
|
CPT 97112
|
| Hospital Charge Code |
905103141
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$50.80 |
| Max. Negotiated Rate |
$228.60 |
| Rate for Payer: Adventist Health Commercial |
$50.80
|
| Rate for Payer: Cash Price |
$114.30
|
| Rate for Payer: Central Health Plan Commercial |
$203.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$177.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.60
|
| Rate for Payer: EPIC Health Plan Senior |
$101.60
|
| Rate for Payer: Galaxy Health WC |
$215.90
|
| Rate for Payer: Global Benefits Group Commercial |
$152.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$228.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$161.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$149.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.80
|
| Rate for Payer: Multiplan Commercial |
$190.50
|
| Rate for Payer: Networks By Design Commercial |
$165.10
|
| Rate for Payer: Prime Health Services Commercial |
$215.90
|
|
|
HC NEUROMUSC RE ED 15MIN PT
|
Facility
|
OP
|
$254.00
|
|
|
Service Code
|
CPT 97112
|
| Hospital Charge Code |
905103141
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$21.02 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$104.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$138.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$215.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$139.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$190.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$114.30
|
| Rate for Payer: Cash Price |
$114.30
|
| Rate for Payer: Cash Price |
$114.30
|
| Rate for Payer: Central Health Plan Commercial |
$203.20
|
| Rate for Payer: Cigna of CA HMO |
$162.56
|
| Rate for Payer: Cigna of CA PPO |
$187.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$215.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$215.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$215.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$177.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.60
|
| Rate for Payer: EPIC Health Plan Senior |
$101.60
|
| Rate for Payer: Galaxy Health WC |
$215.90
|
| Rate for Payer: Global Benefits Group Commercial |
$152.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$228.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$21.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$161.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$149.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$104.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$177.80
|
| Rate for Payer: Multiplan Commercial |
$190.50
|
| Rate for Payer: Networks By Design Commercial |
$165.10
|
| Rate for Payer: Prime Health Services Commercial |
$215.90
|
| Rate for Payer: Riverside University Health System MISP |
$101.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$152.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$152.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$215.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$215.90
|
| Rate for Payer: Vantage Medical Group Senior |
$215.90
|
|
|
HC NEUROMUSC RE-ED 15 MIN PT
|
Facility
|
IP
|
$254.00
|
|
|
Service Code
|
CPT 97112
|
| Hospital Charge Code |
900417112
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$50.80 |
| Max. Negotiated Rate |
$228.60 |
| Rate for Payer: Adventist Health Commercial |
$50.80
|
| Rate for Payer: Cash Price |
$114.30
|
| Rate for Payer: Central Health Plan Commercial |
$203.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$177.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.60
|
| Rate for Payer: EPIC Health Plan Senior |
$101.60
|
| Rate for Payer: Galaxy Health WC |
$215.90
|
| Rate for Payer: Global Benefits Group Commercial |
$152.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$228.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$161.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$149.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.80
|
| Rate for Payer: Multiplan Commercial |
$190.50
|
| Rate for Payer: Networks By Design Commercial |
$165.10
|
| Rate for Payer: Prime Health Services Commercial |
$215.90
|
|
|
HC NEUROMUSC RE-ED 15 MIN PT
|
Facility
|
OP
|
$254.00
|
|
|
Service Code
|
CPT 97112
|
| Hospital Charge Code |
900417112
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$21.02 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$104.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$138.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$215.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$139.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$190.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$114.30
|
| Rate for Payer: Cash Price |
$114.30
|
| Rate for Payer: Cash Price |
$114.30
|
| Rate for Payer: Central Health Plan Commercial |
$203.20
|
| Rate for Payer: Cigna of CA HMO |
$162.56
|
| Rate for Payer: Cigna of CA PPO |
$187.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$215.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$215.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$215.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$177.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.60
|
| Rate for Payer: EPIC Health Plan Senior |
$101.60
|
| Rate for Payer: Galaxy Health WC |
$215.90
|
| Rate for Payer: Global Benefits Group Commercial |
$152.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$228.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$21.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$161.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$149.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$104.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$177.80
|
| Rate for Payer: Multiplan Commercial |
$190.50
|
| Rate for Payer: Networks By Design Commercial |
$165.10
|
| Rate for Payer: Prime Health Services Commercial |
$215.90
|
| Rate for Payer: Riverside University Health System MISP |
$101.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$152.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$152.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$215.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$215.90
|
| Rate for Payer: Vantage Medical Group Senior |
$215.90
|
|
|
HC NEUROMUSCULAR JUNCTION TEST
|
Facility
|
OP
|
$516.00
|
|
|
Service Code
|
CPT 95937
|
| Hospital Charge Code |
900600260
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$38.34 |
| Max. Negotiated Rate |
$2,039.00 |
| Rate for Payer: Adventist Health Commercial |
$103.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$165.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$202.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$82.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$300.16
|
| Rate for Payer: Blue Shield of California Commercial |
$325.08
|
| Rate for Payer: Blue Shield of California EPN |
$204.85
|
| Rate for Payer: Cash Price |
$232.20
|
| Rate for Payer: Cash Price |
$232.20
|
| Rate for Payer: Cash Price |
$232.20
|
| Rate for Payer: Central Health Plan Commercial |
$412.80
|
| Rate for Payer: Cigna of CA HMO |
$330.24
|
| Rate for Payer: Cigna of CA PPO |
$381.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$248.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$165.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$361.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.06
|
| Rate for Payer: EPIC Health Plan Senior |
$182.04
|
| Rate for Payer: Galaxy Health WC |
$438.60
|
| Rate for Payer: Global Benefits Group Commercial |
$309.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$464.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$271.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$38.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$165.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$327.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$42.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$231.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$103.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$221.76
|
| Rate for Payer: Multiplan Commercial |
$387.00
|
| Rate for Payer: Networks By Design Commercial |
$335.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$165.49
|
| Rate for Payer: Prime Health Services Commercial |
$438.60
|
| Rate for Payer: Prime Health Services Medicare |
$175.42
|
| Rate for Payer: Riverside University Health System MISP |
$182.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$309.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$309.60
|
| 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 |
$165.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Vantage Medical Group Senior |
$165.49
|
|
|
HC NEUROMUSCULAR JUNCTION TEST
|
Facility
|
IP
|
$516.00
|
|
|
Service Code
|
CPT 95937
|
| Hospital Charge Code |
900600260
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$103.20 |
| Max. Negotiated Rate |
$464.40 |
| Rate for Payer: Adventist Health Commercial |
$103.20
|
| Rate for Payer: Cash Price |
$232.20
|
| Rate for Payer: Central Health Plan Commercial |
$412.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$361.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$206.40
|
| Rate for Payer: EPIC Health Plan Senior |
$206.40
|
| Rate for Payer: Galaxy Health WC |
$438.60
|
| Rate for Payer: Global Benefits Group Commercial |
$309.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$464.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$327.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$304.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$103.20
|
| Rate for Payer: Multiplan Commercial |
$387.00
|
| Rate for Payer: Networks By Design Commercial |
$335.40
|
| Rate for Payer: Prime Health Services Commercial |
$438.60
|
|
|
HC NEUROSTIM INSERT/REPL GEN
|
Facility
|
IP
|
$143,776.00
|
|
|
Service Code
|
CPT 0427T
|
| Hospital Charge Code |
906810427
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$28,755.20 |
| Max. Negotiated Rate |
$129,398.40 |
| Rate for Payer: Adventist Health Commercial |
$28,755.20
|
| Rate for Payer: Cash Price |
$64,699.20
|
| Rate for Payer: Central Health Plan Commercial |
$115,020.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$100,643.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$57,510.40
|
| Rate for Payer: EPIC Health Plan Senior |
$57,510.40
|
| Rate for Payer: Galaxy Health WC |
$122,209.60
|
| Rate for Payer: Global Benefits Group Commercial |
$86,265.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$129,398.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$91,297.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$84,827.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28,755.20
|
| Rate for Payer: Multiplan Commercial |
$107,832.00
|
| Rate for Payer: Networks By Design Commercial |
$93,454.40
|
| Rate for Payer: Prime Health Services Commercial |
$122,209.60
|
|
|
HC NEUROSTIM INSERT/REPL GEN
|
Facility
|
OP
|
$143,776.00
|
|
|
Service Code
|
CPT 0427T
|
| Hospital Charge Code |
906810427
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,736.00 |
| Max. Negotiated Rate |
$129,398.40 |
| Rate for Payer: Adventist Health Commercial |
$28,755.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$122,209.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$79,076.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$107,832.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$64,699.20
|
| Rate for Payer: Cash Price |
$64,699.20
|
| Rate for Payer: Central Health Plan Commercial |
$115,020.80
|
| Rate for Payer: Cigna of CA HMO |
$92,016.64
|
| Rate for Payer: Cigna of CA PPO |
$106,394.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$122,209.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$122,209.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$122,209.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$100,643.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$57,510.40
|
| Rate for Payer: EPIC Health Plan Senior |
$57,510.40
|
| Rate for Payer: Galaxy Health WC |
$122,209.60
|
| Rate for Payer: Global Benefits Group Commercial |
$86,265.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$129,398.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$91,297.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$52,190.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$84,827.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28,755.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$100,643.20
|
| Rate for Payer: Multiplan Commercial |
$107,832.00
|
| Rate for Payer: Networks By Design Commercial |
$93,454.40
|
| Rate for Payer: Prime Health Services Commercial |
$122,209.60
|
| Rate for Payer: Riverside University Health System MISP |
$57,510.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$86,265.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$71,888.00
|
| Rate for Payer: United Healthcare All Other HMO |
$71,375.00
|
| Rate for Payer: United Healthcare HMO Rider |
$57,385.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52,575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$122,209.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$122,209.60
|
| Rate for Payer: Vantage Medical Group Senior |
$122,209.60
|
|
