|
HC INFRARED PT
|
Facility
IP
|
$154.00
|
|
|
Service Code
|
CPT 97026
|
| Hospital Charge Code |
900417040
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$138.60 |
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Central Health Plan Commercial |
$123.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.60
|
| Rate for Payer: Galaxy Health WC |
$130.90
|
| Rate for Payer: Global Benefits Group Commercial |
$92.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$138.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$102.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.80
|
| Rate for Payer: Multiplan Commercial |
$115.50
|
| Rate for Payer: Networks By Design Commercial |
$100.10
|
| Rate for Payer: Prime Health Services Commercial |
$130.90
|
|
|
HC INFUSION EA ADD HOUR
|
Facility
IP
|
$214.00
|
|
|
Service Code
|
CPT 96366
|
| Hospital Charge Code |
910196366
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$42.80 |
| Max. Negotiated Rate |
$192.60 |
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Central Health Plan Commercial |
$171.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.60
|
| Rate for Payer: Galaxy Health WC |
$181.90
|
| Rate for Payer: Global Benefits Group Commercial |
$128.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$192.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$142.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.80
|
| Rate for Payer: Multiplan Commercial |
$160.50
|
| Rate for Payer: Networks By Design Commercial |
$139.10
|
| Rate for Payer: Prime Health Services Commercial |
$181.90
|
|
|
HC INFUSION EA ADD HOUR
|
Facility
IP
|
$214.00
|
|
|
Service Code
|
CPT 96366
|
| Hospital Charge Code |
910196366
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$42.80 |
| Max. Negotiated Rate |
$192.60 |
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Central Health Plan Commercial |
$171.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.60
|
| Rate for Payer: Galaxy Health WC |
$181.90
|
| Rate for Payer: Global Benefits Group Commercial |
$128.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$192.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$142.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.80
|
| Rate for Payer: Multiplan Commercial |
$160.50
|
| Rate for Payer: Networks By Design Commercial |
$139.10
|
| Rate for Payer: Prime Health Services Commercial |
$181.90
|
|
|
HC INFUSION EA ADD HOUR
|
Facility
OP
|
$214.00
|
|
|
Service Code
|
CPT 96366
|
| Hospital Charge Code |
910196366
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$42.80 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$89.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$65.28
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$59.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$128.40
|
| Rate for Payer: Caremore Medicare Advantage |
$59.35
|
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Central Health Plan Commercial |
$171.20
|
| Rate for Payer: Cigna of CA PPO |
$158.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$89.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$59.35
|
| Rate for Payer: EPIC Health Plan Transplant |
$59.35
|
| Rate for Payer: Galaxy Health WC |
$181.90
|
| Rate for Payer: Global Benefits Group Commercial |
$128.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$192.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$160.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$97.33
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$59.35
|
| Rate for Payer: Innovage PACE Commercial |
$89.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$142.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$79.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79.53
|
| Rate for Payer: Multiplan Commercial |
$160.50
|
| Rate for Payer: Networks By Design Commercial |
$139.10
|
| Rate for Payer: Prime Health Services Commercial |
$181.90
|
| Rate for Payer: Prime Health Services Medicare |
$62.91
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$128.40
|
| Rate for Payer: Riverside University Health MISP |
$65.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$128.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$107.00
|
| Rate for Payer: United Healthcare All Other HMO |
$107.00
|
| Rate for Payer: United Healthcare HMO Rider |
$107.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$107.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$89.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$65.28
|
| Rate for Payer: Vantage Medical Group Senior |
$59.35
|
|
|
HC INFUSION EA ADD HOUR
|
Facility
IP
|
$214.00
|
|
|
Service Code
|
CPT 96366
|
| Hospital Charge Code |
906820338
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$42.80 |
| Max. Negotiated Rate |
$192.60 |
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Central Health Plan Commercial |
$171.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.60
|
| Rate for Payer: Galaxy Health WC |
$181.90
|
| Rate for Payer: Global Benefits Group Commercial |
$128.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$192.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$142.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.80
|
| Rate for Payer: Multiplan Commercial |
$160.50
|
| Rate for Payer: Networks By Design Commercial |
$139.10
|
| Rate for Payer: Prime Health Services Commercial |
$181.90
|
|
|
HC INFUSION EA ADD HOUR
|
Facility
OP
|
$214.00
|
|
|
Service Code
|
CPT 96366
|
| Hospital Charge Code |
910196366
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$42.80 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$59.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$129.16
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$89.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$65.28
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$59.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$128.40
|
| Rate for Payer: Blue Shield of California Commercial |
$134.61
|
| Rate for Payer: Blue Shield of California EPN |
$104.65
|
| Rate for Payer: Caremore Medicare Advantage |
$59.35
|
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Central Health Plan Commercial |
$171.20
|
| Rate for Payer: Cigna of CA HMO |
$136.96
|
| Rate for Payer: Cigna of CA PPO |
$158.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$89.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$59.35
|
| Rate for Payer: EPIC Health Plan Transplant |
$59.35
|
| Rate for Payer: Galaxy Health WC |
$181.90
|
| Rate for Payer: Global Benefits Group Commercial |
$128.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$192.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$160.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$97.33
|
| Rate for Payer: IEHP medi-cal |
$97.93
|
| Rate for Payer: IEHP Medicare Advantage |
$59.35
|
| Rate for Payer: Innovage PACE Commercial |
$89.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$142.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$79.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79.53
|
| Rate for Payer: Multiplan Commercial |
$160.50
|
| Rate for Payer: Networks By Design Commercial |
$139.10
|
| Rate for Payer: Prime Health Services Commercial |
$181.90
|
| Rate for Payer: Prime Health Services Medicare |
$62.91
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$128.40
|
| Rate for Payer: Riverside University Health MISP |
$65.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$128.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$128.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$107.00
|
| Rate for Payer: United Healthcare All Other HMO |
$107.00
|
| Rate for Payer: United Healthcare HMO Rider |
$107.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$107.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$89.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$65.28
|
| Rate for Payer: Vantage Medical Group Senior |
$59.35
|
|
|
HC INFUSION EA ADD HOUR
|
Facility
IP
|
$214.00
|
|
|
Service Code
|
CPT 96366
|
| Hospital Charge Code |
910196366
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$42.80 |
| Max. Negotiated Rate |
$192.60 |
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Central Health Plan Commercial |
$171.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.60
|
| Rate for Payer: Galaxy Health WC |
$181.90
|
| Rate for Payer: Global Benefits Group Commercial |
$128.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$192.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$142.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.80
|
| Rate for Payer: Multiplan Commercial |
$160.50
|
| Rate for Payer: Networks By Design Commercial |
$139.10
|
| Rate for Payer: Prime Health Services Commercial |
$181.90
|
|
|
HC INFUSION EA ADD HOUR
|
Facility
IP
|
$214.00
|
|
|
Service Code
|
CPT 96366
|
| Hospital Charge Code |
910196366
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$42.80 |
| Max. Negotiated Rate |
$192.60 |
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Central Health Plan Commercial |
$171.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.60
|
| Rate for Payer: Galaxy Health WC |
$181.90
|
| Rate for Payer: Global Benefits Group Commercial |
$128.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$192.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$142.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.80
|
| Rate for Payer: Multiplan Commercial |
$160.50
|
| Rate for Payer: Networks By Design Commercial |
$139.10
|
| Rate for Payer: Prime Health Services Commercial |
$181.90
|
|
|
HC INFUSION EA ADD HOUR
|
Facility
OP
|
$214.00
|
|
|
Service Code
|
CPT 96366
|
| Hospital Charge Code |
910196366
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$42.80 |
| Max. Negotiated Rate |
$903.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$59.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$129.16
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$89.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$65.28
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$59.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$903.00
|
| Rate for Payer: BCBS Transplant Transplant |
$128.40
|
| Rate for Payer: Caremore Medicare Advantage |
$59.35
|
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Central Health Plan Commercial |
$171.20
|
| Rate for Payer: Cigna of CA HMO |
$136.96
|
| Rate for Payer: Cigna of CA PPO |
$158.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$89.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$59.35
|
| Rate for Payer: EPIC Health Plan Transplant |
$59.35
|
| Rate for Payer: Galaxy Health WC |
$181.90
|
| Rate for Payer: Global Benefits Group Commercial |
$128.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$192.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$160.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$97.33
|
| Rate for Payer: IEHP medi-cal |
$97.93
|
| Rate for Payer: IEHP Medicare Advantage |
$59.35
|
| Rate for Payer: Innovage PACE Commercial |
$89.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$142.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$79.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79.53
|
| Rate for Payer: Multiplan Commercial |
$160.50
|
| Rate for Payer: Networks By Design Commercial |
$139.10
|
| Rate for Payer: Prime Health Services Commercial |
$181.90
|
| Rate for Payer: Prime Health Services Medicare |
$62.91
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$65.28
|
| Rate for Payer: Riverside University Health MISP |
$65.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$128.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$71.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$642.00
|
| Rate for Payer: United Healthcare All Other HMO |
$631.00
|
| Rate for Payer: United Healthcare HMO Rider |
$630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$89.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$65.28
|
| Rate for Payer: Vantage Medical Group Senior |
$59.35
|
|
|
HC INFUSION EA ADD HOUR
|
Facility
OP
|
$214.00
|
|
|
Service Code
|
CPT 96366
|
| Hospital Charge Code |
910196366
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$42.80 |
| Max. Negotiated Rate |
$903.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$59.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$129.16
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$89.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$65.28
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$59.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$903.00
|
| Rate for Payer: BCBS Transplant Transplant |
$128.40
|
| Rate for Payer: Blue Shield of California Commercial |
$134.61
|
| Rate for Payer: Blue Shield of California EPN |
$104.65
|
| Rate for Payer: Caremore Medicare Advantage |
$59.35
|
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Central Health Plan Commercial |
$171.20
|
| Rate for Payer: Cigna of CA HMO |
$136.96
|
| Rate for Payer: Cigna of CA PPO |
$158.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$89.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$59.35
|
| Rate for Payer: EPIC Health Plan Transplant |
$59.35
|
| Rate for Payer: Galaxy Health WC |
$181.90
|
| Rate for Payer: Global Benefits Group Commercial |
$128.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$192.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$160.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$97.33
|
| Rate for Payer: IEHP medi-cal |
$97.93
|
| Rate for Payer: IEHP Medicare Advantage |
$59.35
|
| Rate for Payer: Innovage PACE Commercial |
$89.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$142.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$79.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79.53
|
| Rate for Payer: Multiplan Commercial |
$160.50
|
| Rate for Payer: Networks By Design Commercial |
$139.10
|
| Rate for Payer: Prime Health Services Commercial |
$181.90
|
| Rate for Payer: Prime Health Services Medicare |
$62.91
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$128.40
|
| Rate for Payer: Riverside University Health MISP |
$65.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$128.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$128.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$107.00
|
| Rate for Payer: United Healthcare All Other HMO |
$107.00
|
| Rate for Payer: United Healthcare HMO Rider |
$107.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$107.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$89.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$65.28
|
| Rate for Payer: Vantage Medical Group Senior |
$59.35
|
|
|
HC INFUSION EA ADD HOUR
|
Facility
OP
|
$214.00
|
|
|
Service Code
|
CPT 96366
|
| Hospital Charge Code |
906820338
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$42.80 |
| Max. Negotiated Rate |
$903.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$59.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$129.16
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$89.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$65.28
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$59.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$903.00
|
| Rate for Payer: BCBS Transplant Transplant |
$128.40
|
| Rate for Payer: Caremore Medicare Advantage |
$59.35
|
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Central Health Plan Commercial |
$171.20
|
| Rate for Payer: Cigna of CA HMO |
$136.96
|
| Rate for Payer: Cigna of CA PPO |
$158.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$89.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$59.35
|
| Rate for Payer: EPIC Health Plan Transplant |
$59.35
|
| Rate for Payer: Galaxy Health WC |
$181.90
|
| Rate for Payer: Global Benefits Group Commercial |
$128.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$192.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$160.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$97.33
|
| Rate for Payer: IEHP medi-cal |
$97.93
|
| Rate for Payer: IEHP Medicare Advantage |
$59.35
|
| Rate for Payer: Innovage PACE Commercial |
$89.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$142.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$79.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79.53
|
| Rate for Payer: Multiplan Commercial |
$160.50
|
| Rate for Payer: Networks By Design Commercial |
$139.10
|
| Rate for Payer: Prime Health Services Commercial |
$181.90
|
| Rate for Payer: Prime Health Services Medicare |
$62.91
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$65.28
|
| Rate for Payer: Riverside University Health MISP |
$65.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$128.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$71.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$642.00
|
| Rate for Payer: United Healthcare All Other HMO |
$631.00
|
| Rate for Payer: United Healthcare HMO Rider |
$630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$89.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$65.28
|
| Rate for Payer: Vantage Medical Group Senior |
$59.35
|
|
|
HC INFUSION INITAL HOUR GT 16MIN
|
Facility
IP
|
$1,098.00
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
949000306
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$219.60 |
| Max. Negotiated Rate |
$988.20 |
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Central Health Plan Commercial |
$878.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$439.20
|
| Rate for Payer: Galaxy Health WC |
$933.30
|
| Rate for Payer: Global Benefits Group Commercial |
$658.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$988.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$732.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.60
|
| Rate for Payer: Multiplan Commercial |
$823.50
|
| Rate for Payer: Networks By Design Commercial |
$713.70
|
| Rate for Payer: Prime Health Services Commercial |
$933.30
|
|
|
HC INFUSION INITAL HOUR GT 16MIN
|
Facility
OP
|
$1,098.00
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
949000306
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$219.60 |
| Max. Negotiated Rate |
$988.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$267.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$426.55
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$267.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$903.00
|
| Rate for Payer: BCBS Transplant Transplant |
$658.80
|
| Rate for Payer: Caremore Medicare Advantage |
$267.80
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Central Health Plan Commercial |
$878.40
|
| Rate for Payer: Cigna of CA HMO |
$702.72
|
| Rate for Payer: Cigna of CA PPO |
$812.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$401.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$267.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$267.80
|
| Rate for Payer: Galaxy Health WC |
$933.30
|
| Rate for Payer: Global Benefits Group Commercial |
$658.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$988.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$823.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$439.19
|
| Rate for Payer: IEHP medi-cal |
$441.87
|
| Rate for Payer: IEHP Medicare Advantage |
$267.80
|
| Rate for Payer: Innovage PACE Commercial |
$401.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$732.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$358.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.85
|
| Rate for Payer: Multiplan Commercial |
$823.50
|
| Rate for Payer: Networks By Design Commercial |
$713.70
|
| Rate for Payer: Prime Health Services Commercial |
$933.30
|
| Rate for Payer: Prime Health Services Medicare |
$283.87
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$294.58
|
| Rate for Payer: Riverside University Health MISP |
$294.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$658.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$321.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$642.00
|
| Rate for Payer: United Healthcare All Other HMO |
$631.00
|
| Rate for Payer: United Healthcare HMO Rider |
$630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: Vantage Medical Group Senior |
$267.80
|
|
|
HC INFUSION INITAL HOUR GT 16MIN
|
Facility
IP
|
$1,098.00
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
940100114
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$219.60 |
| Max. Negotiated Rate |
$988.20 |
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Central Health Plan Commercial |
$878.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$439.20
|
| Rate for Payer: Galaxy Health WC |
$933.30
|
| Rate for Payer: Global Benefits Group Commercial |
$658.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$988.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$732.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.60
|
| Rate for Payer: Multiplan Commercial |
$823.50
|
| Rate for Payer: Networks By Design Commercial |
$713.70
|
| Rate for Payer: Prime Health Services Commercial |
$933.30
|
|
|
HC INFUSION INITAL HOUR GT 16MIN
|
Facility
OP
|
$1,098.00
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
940100114
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$219.60 |
| Max. Negotiated Rate |
$988.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$267.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$426.55
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$267.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$903.00
|
| Rate for Payer: BCBS Transplant Transplant |
$658.80
|
| Rate for Payer: Caremore Medicare Advantage |
$267.80
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Central Health Plan Commercial |
$878.40
|
| Rate for Payer: Cigna of CA HMO |
$702.72
|
| Rate for Payer: Cigna of CA PPO |
$812.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$401.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$267.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$267.80
|
| Rate for Payer: Galaxy Health WC |
$933.30
|
| Rate for Payer: Global Benefits Group Commercial |
$658.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$988.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$823.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$439.19
|
| Rate for Payer: IEHP medi-cal |
$441.87
|
| Rate for Payer: IEHP Medicare Advantage |
$267.80
|
| Rate for Payer: Innovage PACE Commercial |
$401.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$732.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$358.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.85
|
| Rate for Payer: Multiplan Commercial |
$823.50
|
| Rate for Payer: Networks By Design Commercial |
$713.70
|
| Rate for Payer: Prime Health Services Commercial |
$933.30
|
| Rate for Payer: Prime Health Services Medicare |
$283.87
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$294.58
|
| Rate for Payer: Riverside University Health MISP |
$294.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$658.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$321.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$642.00
|
| Rate for Payer: United Healthcare All Other HMO |
$631.00
|
| Rate for Payer: United Healthcare HMO Rider |
$630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: Vantage Medical Group Senior |
$267.80
|
|
|
HC INFUSION INITIAL GT 16 MIN TO HR
|
Facility
OP
|
$1,098.00
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
947000114
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$219.60 |
| Max. Negotiated Rate |
$988.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$267.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$426.55
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$267.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$903.00
|
| Rate for Payer: BCBS Transplant Transplant |
$658.80
|
| Rate for Payer: Caremore Medicare Advantage |
$267.80
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Central Health Plan Commercial |
$878.40
|
| Rate for Payer: Cigna of CA HMO |
$702.72
|
| Rate for Payer: Cigna of CA PPO |
$812.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$401.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$267.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$267.80
|
| Rate for Payer: Galaxy Health WC |
$933.30
|
| Rate for Payer: Global Benefits Group Commercial |
$658.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$988.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$823.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$439.19
|
| Rate for Payer: IEHP medi-cal |
$441.87
|
| Rate for Payer: IEHP Medicare Advantage |
$267.80
|
| Rate for Payer: Innovage PACE Commercial |
$401.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$732.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$358.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.85
|
| Rate for Payer: Multiplan Commercial |
$823.50
|
| Rate for Payer: Networks By Design Commercial |
$713.70
|
| Rate for Payer: Prime Health Services Commercial |
$933.30
|
| Rate for Payer: Prime Health Services Medicare |
$283.87
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$294.58
|
| Rate for Payer: Riverside University Health MISP |
$294.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$658.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$321.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$642.00
|
| Rate for Payer: United Healthcare All Other HMO |
$631.00
|
| Rate for Payer: United Healthcare HMO Rider |
$630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: Vantage Medical Group Senior |
$267.80
|
|
|
HC INFUSION INITIAL GT 16 MIN TO HR
|
Facility
IP
|
$1,098.00
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
947000114
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$219.60 |
| Max. Negotiated Rate |
$988.20 |
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Central Health Plan Commercial |
$878.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$439.20
|
| Rate for Payer: Galaxy Health WC |
$933.30
|
| Rate for Payer: Global Benefits Group Commercial |
$658.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$988.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$732.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.60
|
| Rate for Payer: Multiplan Commercial |
$823.50
|
| Rate for Payer: Networks By Design Commercial |
$713.70
|
| Rate for Payer: Prime Health Services Commercial |
$933.30
|
|
|
HC INFUSION INITIAL HOUR GT 16MIN
|
Facility
IP
|
$1,098.00
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
910196365
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$219.60 |
| Max. Negotiated Rate |
$988.20 |
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Central Health Plan Commercial |
$878.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$439.20
|
| Rate for Payer: Galaxy Health WC |
$933.30
|
| Rate for Payer: Global Benefits Group Commercial |
$658.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$988.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$732.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.60
|
| Rate for Payer: Multiplan Commercial |
$823.50
|
| Rate for Payer: Networks By Design Commercial |
$713.70
|
| Rate for Payer: Prime Health Services Commercial |
$933.30
|
|
|
HC INFUSION INITIAL HOUR GT 16MIN
|
Facility
IP
|
$1,098.00
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
910196365
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$219.60 |
| Max. Negotiated Rate |
$988.20 |
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Central Health Plan Commercial |
$878.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$439.20
|
| Rate for Payer: Galaxy Health WC |
$933.30
|
| Rate for Payer: Global Benefits Group Commercial |
$658.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$988.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$732.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.60
|
| Rate for Payer: Multiplan Commercial |
$823.50
|
| Rate for Payer: Networks By Design Commercial |
$713.70
|
| Rate for Payer: Prime Health Services Commercial |
$933.30
|
|
|
HC INFUSION INITIAL HOUR GT 16MIN
|
Facility
OP
|
$1,098.00
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
910196365
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$219.60 |
| Max. Negotiated Rate |
$988.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$267.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$426.55
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$267.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$903.00
|
| Rate for Payer: BCBS Transplant Transplant |
$658.80
|
| Rate for Payer: Caremore Medicare Advantage |
$267.80
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Central Health Plan Commercial |
$878.40
|
| Rate for Payer: Cigna of CA HMO |
$702.72
|
| Rate for Payer: Cigna of CA PPO |
$812.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$401.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$267.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$267.80
|
| Rate for Payer: Galaxy Health WC |
$933.30
|
| Rate for Payer: Global Benefits Group Commercial |
$658.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$988.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$823.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$439.19
|
| Rate for Payer: IEHP medi-cal |
$441.87
|
| Rate for Payer: IEHP Medicare Advantage |
$267.80
|
| Rate for Payer: Innovage PACE Commercial |
$401.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$732.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$358.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.85
|
| Rate for Payer: Multiplan Commercial |
$823.50
|
| Rate for Payer: Networks By Design Commercial |
$713.70
|
| Rate for Payer: Prime Health Services Commercial |
$933.30
|
| Rate for Payer: Prime Health Services Medicare |
$283.87
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$294.58
|
| Rate for Payer: Riverside University Health MISP |
$294.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$658.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$321.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$642.00
|
| Rate for Payer: United Healthcare All Other HMO |
$631.00
|
| Rate for Payer: United Healthcare HMO Rider |
$630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: Vantage Medical Group Senior |
$267.80
|
|
|
HC INFUSION INITIAL HOUR GT 16MIN
|
Facility
IP
|
$1,098.00
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
910196365
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$219.60 |
| Max. Negotiated Rate |
$988.20 |
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Central Health Plan Commercial |
$878.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$439.20
|
| Rate for Payer: Galaxy Health WC |
$933.30
|
| Rate for Payer: Global Benefits Group Commercial |
$658.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$988.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$732.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.60
|
| Rate for Payer: Multiplan Commercial |
$823.50
|
| Rate for Payer: Networks By Design Commercial |
$713.70
|
| Rate for Payer: Prime Health Services Commercial |
$933.30
|
|
|
HC INFUSION INITIAL HOUR GT 16MIN
|
Facility
OP
|
$1,098.00
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
910196365
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$219.60 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$267.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$658.80
|
| Rate for Payer: Caremore Medicare Advantage |
$267.80
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Central Health Plan Commercial |
$878.40
|
| Rate for Payer: Cigna of CA PPO |
$812.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$401.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$267.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$267.80
|
| Rate for Payer: Galaxy Health WC |
$933.30
|
| Rate for Payer: Global Benefits Group Commercial |
$658.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$988.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$823.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$439.19
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$267.80
|
| Rate for Payer: Innovage PACE Commercial |
$401.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$732.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$358.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.85
|
| Rate for Payer: Multiplan Commercial |
$823.50
|
| Rate for Payer: Networks By Design Commercial |
$713.70
|
| Rate for Payer: Prime Health Services Commercial |
$933.30
|
| Rate for Payer: Prime Health Services Medicare |
$283.87
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$658.80
|
| Rate for Payer: Riverside University Health MISP |
$294.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$658.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$549.00
|
| Rate for Payer: United Healthcare All Other HMO |
$549.00
|
| Rate for Payer: United Healthcare HMO Rider |
$549.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$549.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: Vantage Medical Group Senior |
$267.80
|
|
|
HC INFUSION INITIAL HOUR GT 16MIN
|
Facility
IP
|
$1,098.00
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
910196365
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$219.60 |
| Max. Negotiated Rate |
$988.20 |
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Central Health Plan Commercial |
$878.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$439.20
|
| Rate for Payer: Galaxy Health WC |
$933.30
|
| Rate for Payer: Global Benefits Group Commercial |
$658.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$988.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$732.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.60
|
| Rate for Payer: Multiplan Commercial |
$823.50
|
| Rate for Payer: Networks By Design Commercial |
$713.70
|
| Rate for Payer: Prime Health Services Commercial |
$933.30
|
|
|
HC INFUSION INITIAL HOUR GT 16MIN
|
Facility
OP
|
$1,098.00
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
910196365
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$219.60 |
| Max. Negotiated Rate |
$988.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$267.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$426.55
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$267.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$903.00
|
| Rate for Payer: BCBS Transplant Transplant |
$658.80
|
| Rate for Payer: Blue Shield of California Commercial |
$690.64
|
| Rate for Payer: Blue Shield of California EPN |
$536.92
|
| Rate for Payer: Caremore Medicare Advantage |
$267.80
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Central Health Plan Commercial |
$878.40
|
| Rate for Payer: Cigna of CA HMO |
$702.72
|
| Rate for Payer: Cigna of CA PPO |
$812.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$401.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$267.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$267.80
|
| Rate for Payer: Galaxy Health WC |
$933.30
|
| Rate for Payer: Global Benefits Group Commercial |
$658.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$988.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$823.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$439.19
|
| Rate for Payer: IEHP medi-cal |
$441.87
|
| Rate for Payer: IEHP Medicare Advantage |
$267.80
|
| Rate for Payer: Innovage PACE Commercial |
$401.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$732.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$358.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.85
|
| Rate for Payer: Multiplan Commercial |
$823.50
|
| Rate for Payer: Networks By Design Commercial |
$713.70
|
| Rate for Payer: Prime Health Services Commercial |
$933.30
|
| Rate for Payer: Prime Health Services Medicare |
$283.87
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$658.80
|
| Rate for Payer: Riverside University Health MISP |
$294.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$658.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$658.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$549.00
|
| Rate for Payer: United Healthcare All Other HMO |
$549.00
|
| Rate for Payer: United Healthcare HMO Rider |
$549.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$549.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: Vantage Medical Group Senior |
$267.80
|
|
|
HC INFUSION INITIAL HOUR GT 16MIN
|
Facility
IP
|
$1,098.00
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
906820203
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$219.60 |
| Max. Negotiated Rate |
$988.20 |
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Central Health Plan Commercial |
$878.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$439.20
|
| Rate for Payer: Galaxy Health WC |
$933.30
|
| Rate for Payer: Global Benefits Group Commercial |
$658.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$988.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$732.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.60
|
| Rate for Payer: Multiplan Commercial |
$823.50
|
| Rate for Payer: Networks By Design Commercial |
$713.70
|
| Rate for Payer: Prime Health Services Commercial |
$933.30
|
|
