|
HC N BLOCK,SPHENOPALATINE GANGLIN
|
Facility
|
IP
|
$1,827.00
|
|
|
Service Code
|
CPT 64505
|
| Hospital Charge Code |
900501686
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$365.40 |
| Max. Negotiated Rate |
$1,644.30 |
| Rate for Payer: Adventist Health Commercial |
$365.40
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,461.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$730.80
|
| Rate for Payer: EPIC Health Plan Senior |
$730.80
|
| Rate for Payer: Galaxy Health WC |
$1,552.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,096.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,644.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,218.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$696.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,130.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$365.40
|
| Rate for Payer: Multiplan Commercial |
$1,370.25
|
| Rate for Payer: Networks By Design Commercial |
$1,187.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,552.95
|
|
|
HC N BLOCK,SPHENOPALATINE GANGLIN
|
Facility
|
OP
|
$1,827.00
|
|
|
Service Code
|
CPT 64505
|
| Hospital Charge Code |
900501686
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$115.29 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$365.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$562.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$412.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$375.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$597.61
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,461.60
|
| Rate for Payer: Cigna of CA HMO |
$1,169.28
|
| Rate for Payer: Cigna of CA PPO |
$1,351.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$562.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$412.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$375.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.34
|
| Rate for Payer: EPIC Health Plan Senior |
$375.07
|
| Rate for Payer: Galaxy Health WC |
$1,552.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,096.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,644.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$615.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$375.07
|
| Rate for Payer: InnovAge PACE Commercial |
$562.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,218.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$115.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$375.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$365.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$502.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$502.59
|
| Rate for Payer: Multiplan Commercial |
$1,370.25
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: Networks By Design Commercial |
$1,187.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$375.07
|
| Rate for Payer: Preferred Health Network WC |
$609.81
|
| Rate for Payer: Prime Health Services Commercial |
$1,552.95
|
| Rate for Payer: Prime Health Services Medicare |
$397.57
|
| Rate for Payer: Prime Health Services WC |
$591.52
|
| Rate for Payer: Riverside University Health System MISP |
$412.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,096.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$913.50
|
| Rate for Payer: United Healthcare All Other HMO |
$913.50
|
| Rate for Payer: United Healthcare HMO Rider |
$913.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$913.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$375.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$562.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$412.58
|
| Rate for Payer: Vantage Medical Group Senior |
$375.07
|
|
|
HC N-CARDIAC VASC FLOW IMAG
|
Facility
|
IP
|
$1,556.00
|
|
|
Service Code
|
CPT 78445
|
| Hospital Charge Code |
909301349
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$311.20 |
| Max. Negotiated Rate |
$1,400.40 |
| Rate for Payer: Adventist Health Commercial |
$311.20
|
| Rate for Payer: Cash Price |
$700.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,244.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$622.40
|
| Rate for Payer: EPIC Health Plan Senior |
$622.40
|
| Rate for Payer: Galaxy Health WC |
$1,322.60
|
| Rate for Payer: Global Benefits Group Commercial |
$933.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,400.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,037.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$592.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$963.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$311.20
|
| Rate for Payer: Multiplan Commercial |
$1,167.00
|
| Rate for Payer: Networks By Design Commercial |
$1,011.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,322.60
|
|
|
HC N-CARDIAC VASC FLOW IMAG
|
Facility
|
OP
|
$1,556.00
|
|
|
Service Code
|
CPT 78445
|
| Hospital Charge Code |
909301349
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$207.83 |
| Max. Negotiated Rate |
$1,400.40 |
| Rate for Payer: Adventist Health Commercial |
$311.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$510.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$944.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$765.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$561.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$510.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$384.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$913.84
|
| Rate for Payer: Blue Shield of California Commercial |
$944.49
|
| Rate for Payer: Blue Shield of California EPN |
$617.73
|
| Rate for Payer: Cash Price |
$700.20
|
| Rate for Payer: Cash Price |
$700.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,244.80
|
| Rate for Payer: Cigna of CA HMO |
$995.84
|
| Rate for Payer: Cigna of CA PPO |
$1,151.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$765.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$561.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$510.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$689.27
|
| Rate for Payer: EPIC Health Plan Senior |
$510.57
|
| Rate for Payer: Galaxy Health WC |
$1,322.60
|
| Rate for Payer: Global Benefits Group Commercial |
$933.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,400.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$837.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$207.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$510.57
|
| Rate for Payer: InnovAge PACE Commercial |
$765.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,037.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$229.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$510.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$311.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$684.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$684.16
|
| Rate for Payer: Multiplan Commercial |
$1,167.00
|
| Rate for Payer: Networks By Design Commercial |
$1,011.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$510.57
|
| Rate for Payer: Prime Health Services Commercial |
$1,322.60
|
| Rate for Payer: Prime Health Services Medicare |
$541.20
|
| Rate for Payer: Riverside University Health System MISP |
$561.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$933.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$933.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.46
|
| Rate for Payer: United Healthcare All Other HMO |
$396.46
|
| Rate for Payer: United Healthcare HMO Rider |
$396.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$396.46
|
| Rate for Payer: Upland Medical Group Pediatric |
$510.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$765.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$561.63
|
| Rate for Payer: Vantage Medical Group Senior |
$510.57
|
|
|
HC NECK SOFT TISSUE
|
Facility
|
OP
|
$657.00
|
|
|
Service Code
|
CPT 70360
|
| Hospital Charge Code |
909001201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$17.95 |
| Max. Negotiated Rate |
$591.30 |
| Rate for Payer: Adventist Health Commercial |
$131.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$111.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$399.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$88.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.95
|
| Rate for Payer: Blue Shield of California Commercial |
$398.80
|
| Rate for Payer: Blue Shield of California EPN |
$260.83
|
| Rate for Payer: Cash Price |
$295.65
|
| Rate for Payer: Cash Price |
$295.65
|
| Rate for Payer: Central Health Plan Commercial |
$525.60
|
| Rate for Payer: Cigna of CA HMO |
$420.48
|
| Rate for Payer: Cigna of CA PPO |
$486.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$151.04
|
| Rate for Payer: EPIC Health Plan Senior |
$111.88
|
| Rate for Payer: Galaxy Health WC |
$558.45
|
| Rate for Payer: Global Benefits Group Commercial |
$394.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$591.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$183.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$29.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.88
|
| Rate for Payer: InnovAge PACE Commercial |
$167.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$438.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$111.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$131.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$149.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$149.92
|
| Rate for Payer: Multiplan Commercial |
$492.75
|
| Rate for Payer: Networks By Design Commercial |
$427.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$111.88
|
| Rate for Payer: Prime Health Services Commercial |
$558.45
|
| Rate for Payer: Prime Health Services Medicare |
$118.59
|
| Rate for Payer: Riverside University Health System MISP |
$123.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$394.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$394.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$111.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Vantage Medical Group Senior |
$111.88
|
|
|
HC NECK SOFT TISSUE
|
Facility
|
IP
|
$657.00
|
|
|
Service Code
|
CPT 70360
|
| Hospital Charge Code |
909001201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$131.40 |
| Max. Negotiated Rate |
$591.30 |
| Rate for Payer: Adventist Health Commercial |
$131.40
|
| Rate for Payer: Cash Price |
$295.65
|
| Rate for Payer: Central Health Plan Commercial |
$525.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$262.80
|
| Rate for Payer: EPIC Health Plan Senior |
$262.80
|
| Rate for Payer: Galaxy Health WC |
$558.45
|
| Rate for Payer: Global Benefits Group Commercial |
$394.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$591.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$438.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$250.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$406.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$131.40
|
| Rate for Payer: Multiplan Commercial |
$492.75
|
| Rate for Payer: Networks By Design Commercial |
$427.05
|
| Rate for Payer: Prime Health Services Commercial |
$558.45
|
|
|
HC NEDL ASPIR 22GA
|
Facility
|
IP
|
$1,835.40
|
|
| Hospital Charge Code |
900100326
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$367.08 |
| Max. Negotiated Rate |
$1,651.86 |
| Rate for Payer: Adventist Health Commercial |
$367.08
|
| Rate for Payer: Cash Price |
$825.93
|
| Rate for Payer: Central Health Plan Commercial |
$1,468.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$734.16
|
| Rate for Payer: EPIC Health Plan Senior |
$734.16
|
| Rate for Payer: Galaxy Health WC |
$1,560.09
|
| Rate for Payer: Global Benefits Group Commercial |
$1,101.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,651.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,224.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$699.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,136.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$367.08
|
| Rate for Payer: Multiplan Commercial |
$1,376.55
|
| Rate for Payer: Networks By Design Commercial |
$1,193.01
|
| Rate for Payer: Prime Health Services Commercial |
$1,560.09
|
|
|
HC NEDL ASPIR 22GA
|
Facility
|
OP
|
$1,835.40
|
|
| Hospital Charge Code |
900100326
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$367.08 |
| Max. Negotiated Rate |
$1,651.86 |
| Rate for Payer: Adventist Health Commercial |
$367.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,114.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,560.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,009.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,376.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$888.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,077.93
|
| Rate for Payer: Blue Shield of California Commercial |
$1,121.43
|
| Rate for Payer: Blue Shield of California EPN |
$732.32
|
| Rate for Payer: Cash Price |
$825.93
|
| Rate for Payer: Central Health Plan Commercial |
$1,468.32
|
| Rate for Payer: Cigna of CA HMO |
$1,174.66
|
| Rate for Payer: Cigna of CA PPO |
$1,358.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,560.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,560.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,560.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$734.16
|
| Rate for Payer: EPIC Health Plan Senior |
$734.16
|
| Rate for Payer: Galaxy Health WC |
$1,560.09
|
| Rate for Payer: Global Benefits Group Commercial |
$1,101.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,651.86
|
| Rate for Payer: InnovAge PACE Commercial |
$917.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,224.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$699.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,136.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$367.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,284.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,284.78
|
| Rate for Payer: Multiplan Commercial |
$1,376.55
|
| Rate for Payer: Networks By Design Commercial |
$1,193.01
|
| Rate for Payer: Prime Health Services Commercial |
$1,560.09
|
| Rate for Payer: Riverside University Health System MISP |
$734.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,101.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,101.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$917.70
|
| Rate for Payer: United Healthcare All Other HMO |
$917.70
|
| Rate for Payer: United Healthcare HMO Rider |
$917.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$917.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,560.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,560.09
|
| Rate for Payer: Vantage Medical Group Senior |
$1,560.09
|
|
|
HC NEDL ASPIR 25GA
|
Facility
|
IP
|
$1,835.40
|
|
| Hospital Charge Code |
900100327
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$367.08 |
| Max. Negotiated Rate |
$1,651.86 |
| Rate for Payer: Adventist Health Commercial |
$367.08
|
| Rate for Payer: Cash Price |
$825.93
|
| Rate for Payer: Central Health Plan Commercial |
$1,468.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$734.16
|
| Rate for Payer: EPIC Health Plan Senior |
$734.16
|
| Rate for Payer: Galaxy Health WC |
$1,560.09
|
| Rate for Payer: Global Benefits Group Commercial |
$1,101.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,651.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,224.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$699.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,136.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$367.08
|
| Rate for Payer: Multiplan Commercial |
$1,376.55
|
| Rate for Payer: Networks By Design Commercial |
$1,193.01
|
| Rate for Payer: Prime Health Services Commercial |
$1,560.09
|
|
|
HC NEDL ASPIR 25GA
|
Facility
|
OP
|
$1,835.40
|
|
| Hospital Charge Code |
900100327
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$367.08 |
| Max. Negotiated Rate |
$1,651.86 |
| Rate for Payer: Adventist Health Commercial |
$367.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,114.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,560.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,009.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,376.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$888.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,077.93
|
| Rate for Payer: Blue Shield of California Commercial |
$1,121.43
|
| Rate for Payer: Blue Shield of California EPN |
$732.32
|
| Rate for Payer: Cash Price |
$825.93
|
| Rate for Payer: Central Health Plan Commercial |
$1,468.32
|
| Rate for Payer: Cigna of CA HMO |
$1,174.66
|
| Rate for Payer: Cigna of CA PPO |
$1,358.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,560.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,560.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,560.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$734.16
|
| Rate for Payer: EPIC Health Plan Senior |
$734.16
|
| Rate for Payer: Galaxy Health WC |
$1,560.09
|
| Rate for Payer: Global Benefits Group Commercial |
$1,101.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,651.86
|
| Rate for Payer: InnovAge PACE Commercial |
$917.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,224.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$699.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,136.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$367.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,284.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,284.78
|
| Rate for Payer: Multiplan Commercial |
$1,376.55
|
| Rate for Payer: Networks By Design Commercial |
$1,193.01
|
| Rate for Payer: Prime Health Services Commercial |
$1,560.09
|
| Rate for Payer: Riverside University Health System MISP |
$734.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,101.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,101.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$917.70
|
| Rate for Payer: United Healthcare All Other HMO |
$917.70
|
| Rate for Payer: United Healthcare HMO Rider |
$917.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$917.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,560.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,560.09
|
| Rate for Payer: Vantage Medical Group Senior |
$1,560.09
|
|
|
HC NEDL BARD TRANS-SEPTAL
|
Facility
|
OP
|
$1,012.00
|
|
| Hospital Charge Code |
906812363
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.40 |
| Max. Negotiated Rate |
$910.80 |
| Rate for Payer: Adventist Health Commercial |
$202.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$614.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$860.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$556.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$759.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$490.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$594.35
|
| Rate for Payer: Blue Shield of California Commercial |
$618.33
|
| Rate for Payer: Blue Shield of California EPN |
$403.79
|
| Rate for Payer: Cash Price |
$455.40
|
| Rate for Payer: Central Health Plan Commercial |
$809.60
|
| Rate for Payer: Cigna of CA HMO |
$647.68
|
| Rate for Payer: Cigna of CA PPO |
$748.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$860.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$860.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$860.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$404.80
|
| Rate for Payer: EPIC Health Plan Senior |
$404.80
|
| Rate for Payer: Galaxy Health WC |
$860.20
|
| Rate for Payer: Global Benefits Group Commercial |
$607.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$910.80
|
| Rate for Payer: InnovAge PACE Commercial |
$506.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$675.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$385.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$626.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$708.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$708.40
|
| Rate for Payer: Multiplan Commercial |
$759.00
|
| Rate for Payer: Networks By Design Commercial |
$657.80
|
| Rate for Payer: Prime Health Services Commercial |
$860.20
|
| Rate for Payer: Riverside University Health System MISP |
$404.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$607.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$607.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$506.00
|
| Rate for Payer: United Healthcare HMO Rider |
$506.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$506.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$860.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$860.20
|
| Rate for Payer: Vantage Medical Group Senior |
$860.20
|
|
|
HC NEDL BARD TRANS-SEPTAL
|
Facility
|
IP
|
$1,012.00
|
|
| Hospital Charge Code |
906812363
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.40 |
| Max. Negotiated Rate |
$910.80 |
| Rate for Payer: Adventist Health Commercial |
$202.40
|
| Rate for Payer: Cash Price |
$455.40
|
| Rate for Payer: Central Health Plan Commercial |
$809.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$404.80
|
| Rate for Payer: EPIC Health Plan Senior |
$404.80
|
| Rate for Payer: Galaxy Health WC |
$860.20
|
| Rate for Payer: Global Benefits Group Commercial |
$607.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$910.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$675.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$385.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$626.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.40
|
| Rate for Payer: Multiplan Commercial |
$759.00
|
| Rate for Payer: Networks By Design Commercial |
$657.80
|
| Rate for Payer: Prime Health Services Commercial |
$860.20
|
|
|
HC NEDL BAYLIS RF TRANSEPTAL
|
Facility
|
IP
|
$2,277.00
|
|
| Hospital Charge Code |
906812470
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$455.40 |
| Max. Negotiated Rate |
$2,049.30 |
| Rate for Payer: Adventist Health Commercial |
$455.40
|
| Rate for Payer: Cash Price |
$1,024.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,821.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$910.80
|
| Rate for Payer: EPIC Health Plan Senior |
$910.80
|
| Rate for Payer: Galaxy Health WC |
$1,935.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,366.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,049.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,518.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$867.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,409.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$455.40
|
| Rate for Payer: Multiplan Commercial |
$1,707.75
|
| Rate for Payer: Networks By Design Commercial |
$1,480.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,935.45
|
|
|
HC NEDL BAYLIS RF TRANSEPTAL
|
Facility
|
OP
|
$2,277.00
|
|
| Hospital Charge Code |
906812470
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$455.40 |
| Max. Negotiated Rate |
$2,049.30 |
| Rate for Payer: Adventist Health Commercial |
$455.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,382.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,935.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,252.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,707.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,102.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,337.28
|
| Rate for Payer: Blue Shield of California Commercial |
$1,391.25
|
| Rate for Payer: Blue Shield of California EPN |
$908.52
|
| Rate for Payer: Cash Price |
$1,024.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,821.60
|
| Rate for Payer: Cigna of CA HMO |
$1,457.28
|
| Rate for Payer: Cigna of CA PPO |
$1,684.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,935.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,935.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,935.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$910.80
|
| Rate for Payer: EPIC Health Plan Senior |
$910.80
|
| Rate for Payer: Galaxy Health WC |
$1,935.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,366.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,049.30
|
| Rate for Payer: InnovAge PACE Commercial |
$1,138.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,518.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$867.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,409.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$455.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,593.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,593.90
|
| Rate for Payer: Multiplan Commercial |
$1,707.75
|
| Rate for Payer: Networks By Design Commercial |
$1,480.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,935.45
|
| Rate for Payer: Riverside University Health System MISP |
$910.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,366.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,366.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,138.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,138.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,138.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,138.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,935.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,935.45
|
| Rate for Payer: Vantage Medical Group Senior |
$1,935.45
|
|
|
HC NEDL COOK TRANSSEPTAL
|
Facility
|
IP
|
$288.00
|
|
| Hospital Charge Code |
906811779
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$259.20 |
| Rate for Payer: Adventist Health Commercial |
$57.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Central Health Plan Commercial |
$230.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$259.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$192.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$178.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.60
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
|
|
HC NEDL COOK TRANSSEPTAL
|
Facility
|
OP
|
$288.00
|
|
| Hospital Charge Code |
906811779
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$259.20 |
| Rate for Payer: Adventist Health Commercial |
$57.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$174.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$244.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$158.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$216.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$139.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$169.14
|
| Rate for Payer: Blue Shield of California Commercial |
$175.97
|
| Rate for Payer: Blue Shield of California EPN |
$114.91
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Central Health Plan Commercial |
$230.40
|
| Rate for Payer: Cigna of CA HMO |
$184.32
|
| Rate for Payer: Cigna of CA PPO |
$213.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$244.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$244.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$244.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$259.20
|
| Rate for Payer: InnovAge PACE Commercial |
$144.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$192.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$178.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$201.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$201.60
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
| Rate for Payer: Riverside University Health System MISP |
$115.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$144.00
|
| Rate for Payer: United Healthcare All Other HMO |
$144.00
|
| Rate for Payer: United Healthcare HMO Rider |
$144.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$144.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$244.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$244.80
|
| Rate for Payer: Vantage Medical Group Senior |
$244.80
|
|
|
HC NEDL PD ACCESS DOPPLER
|
Facility
|
IP
|
$551.00
|
|
| Hospital Charge Code |
906811790
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$110.20 |
| Max. Negotiated Rate |
$495.90 |
| Rate for Payer: Adventist Health Commercial |
$110.20
|
| Rate for Payer: Cash Price |
$247.95
|
| Rate for Payer: Central Health Plan Commercial |
$440.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.40
|
| Rate for Payer: EPIC Health Plan Senior |
$220.40
|
| Rate for Payer: Galaxy Health WC |
$468.35
|
| Rate for Payer: Global Benefits Group Commercial |
$330.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$495.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$367.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$341.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.20
|
| Rate for Payer: Multiplan Commercial |
$413.25
|
| Rate for Payer: Networks By Design Commercial |
$358.15
|
| Rate for Payer: Prime Health Services Commercial |
$468.35
|
|
|
HC NEDL PD ACCESS DOPPLER
|
Facility
|
OP
|
$551.00
|
|
| Hospital Charge Code |
906811790
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$110.20 |
| Max. Negotiated Rate |
$495.90 |
| Rate for Payer: Adventist Health Commercial |
$110.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$334.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$468.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$303.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$413.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$266.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$323.60
|
| Rate for Payer: Blue Shield of California Commercial |
$336.66
|
| Rate for Payer: Blue Shield of California EPN |
$219.85
|
| Rate for Payer: Cash Price |
$247.95
|
| Rate for Payer: Central Health Plan Commercial |
$440.80
|
| Rate for Payer: Cigna of CA HMO |
$352.64
|
| Rate for Payer: Cigna of CA PPO |
$407.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$468.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$468.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$468.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.40
|
| Rate for Payer: EPIC Health Plan Senior |
$220.40
|
| Rate for Payer: Galaxy Health WC |
$468.35
|
| Rate for Payer: Global Benefits Group Commercial |
$330.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$495.90
|
| Rate for Payer: InnovAge PACE Commercial |
$275.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$367.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$341.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$385.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$385.70
|
| Rate for Payer: Multiplan Commercial |
$413.25
|
| Rate for Payer: Networks By Design Commercial |
$358.15
|
| Rate for Payer: Prime Health Services Commercial |
$468.35
|
| Rate for Payer: Riverside University Health System MISP |
$220.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$330.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$330.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$275.50
|
| Rate for Payer: United Healthcare All Other HMO |
$275.50
|
| Rate for Payer: United Healthcare HMO Rider |
$275.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$275.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$468.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$468.35
|
| Rate for Payer: Vantage Medical Group Senior |
$468.35
|
|
|
HC NEDL PERI-CARD CENTISIS COOK
|
Facility
|
IP
|
$527.56
|
|
| Hospital Charge Code |
906811776
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.51 |
| Max. Negotiated Rate |
$474.80 |
| Rate for Payer: Adventist Health Commercial |
$105.51
|
| Rate for Payer: Cash Price |
$237.40
|
| Rate for Payer: Central Health Plan Commercial |
$422.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$211.02
|
| Rate for Payer: EPIC Health Plan Senior |
$211.02
|
| Rate for Payer: Galaxy Health WC |
$448.43
|
| Rate for Payer: Global Benefits Group Commercial |
$316.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$474.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$351.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$201.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$326.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.51
|
| Rate for Payer: Multiplan Commercial |
$395.67
|
| Rate for Payer: Networks By Design Commercial |
$342.91
|
| Rate for Payer: Prime Health Services Commercial |
$448.43
|
|
|
HC NEDL PERI-CARD CENTISIS COOK
|
Facility
|
OP
|
$527.56
|
|
| Hospital Charge Code |
906811776
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.51 |
| Max. Negotiated Rate |
$474.80 |
| Rate for Payer: Adventist Health Commercial |
$105.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$320.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$448.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$290.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$255.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$309.84
|
| Rate for Payer: Blue Shield of California Commercial |
$322.34
|
| Rate for Payer: Blue Shield of California EPN |
$210.50
|
| Rate for Payer: Cash Price |
$237.40
|
| Rate for Payer: Central Health Plan Commercial |
$422.05
|
| Rate for Payer: Cigna of CA HMO |
$337.64
|
| Rate for Payer: Cigna of CA PPO |
$390.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$448.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$448.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$211.02
|
| Rate for Payer: EPIC Health Plan Senior |
$211.02
|
| Rate for Payer: Galaxy Health WC |
$448.43
|
| Rate for Payer: Global Benefits Group Commercial |
$316.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$474.80
|
| Rate for Payer: InnovAge PACE Commercial |
$263.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$351.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$201.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$326.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$369.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$369.29
|
| Rate for Payer: Multiplan Commercial |
$395.67
|
| Rate for Payer: Networks By Design Commercial |
$342.91
|
| Rate for Payer: Prime Health Services Commercial |
$448.43
|
| Rate for Payer: Riverside University Health System MISP |
$211.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$316.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$316.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$263.78
|
| Rate for Payer: United Healthcare All Other HMO |
$263.78
|
| Rate for Payer: United Healthcare HMO Rider |
$263.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$263.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$448.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$448.43
|
| Rate for Payer: Vantage Medical Group Senior |
$448.43
|
|
|
HC NEEDLE ELEC CRANI NERVE UNI
|
Facility
|
IP
|
$482.00
|
|
|
Service Code
|
CPT 95867
|
| Hospital Charge Code |
900600252
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$96.40 |
| Max. Negotiated Rate |
$433.80 |
| Rate for Payer: Adventist Health Commercial |
$96.40
|
| Rate for Payer: Cash Price |
$216.90
|
| Rate for Payer: Central Health Plan Commercial |
$385.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.80
|
| Rate for Payer: EPIC Health Plan Senior |
$192.80
|
| Rate for Payer: Galaxy Health WC |
$409.70
|
| Rate for Payer: Global Benefits Group Commercial |
$289.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$433.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$321.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$298.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.40
|
| Rate for Payer: Multiplan Commercial |
$361.50
|
| Rate for Payer: Networks By Design Commercial |
$313.30
|
| Rate for Payer: Prime Health Services Commercial |
$409.70
|
|
|
HC NEEDLE ELEC CRANI NERVE UNI
|
Facility
|
OP
|
$482.00
|
|
|
Service Code
|
CPT 95867
|
| Hospital Charge Code |
900600252
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$82.96 |
| Max. Negotiated Rate |
$1,297.00 |
| Rate for Payer: Adventist Health Commercial |
$96.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$395.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$292.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$152.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$283.08
|
| Rate for Payer: Blue Shield of California Commercial |
$292.57
|
| Rate for Payer: Blue Shield of California EPN |
$191.35
|
| Rate for Payer: Cash Price |
$216.90
|
| Rate for Payer: Cash Price |
$216.90
|
| Rate for Payer: Cash Price |
$216.90
|
| Rate for Payer: Central Health Plan Commercial |
$385.60
|
| Rate for Payer: Cigna of CA HMO |
$308.48
|
| Rate for Payer: Cigna of CA PPO |
$356.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.14
|
| Rate for Payer: EPIC Health Plan Senior |
$395.66
|
| Rate for Payer: Galaxy Health WC |
$409.70
|
| Rate for Payer: Global Benefits Group Commercial |
$289.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$433.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$648.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$82.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: InnovAge PACE Commercial |
$593.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$321.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$91.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$530.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$530.18
|
| Rate for Payer: Multiplan Commercial |
$361.50
|
| Rate for Payer: Networks By Design Commercial |
$313.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$395.66
|
| Rate for Payer: Prime Health Services Commercial |
$409.70
|
| Rate for Payer: Prime Health Services Medicare |
$419.40
|
| Rate for Payer: Riverside University Health System MISP |
$435.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$289.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$289.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,297.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,024.00
|
| Rate for Payer: United Healthcare HMO Rider |
$776.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$711.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$395.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC NEEDLE ELEC LIMIT STUDY 1 SITE
|
Facility
|
IP
|
$279.00
|
|
|
Service Code
|
CPT 95870
|
| Hospital Charge Code |
900600255
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$55.80 |
| Max. Negotiated Rate |
$251.10 |
| Rate for Payer: Adventist Health Commercial |
$55.80
|
| Rate for Payer: Cash Price |
$125.55
|
| Rate for Payer: Central Health Plan Commercial |
$223.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$111.60
|
| Rate for Payer: EPIC Health Plan Senior |
$111.60
|
| Rate for Payer: Galaxy Health WC |
$237.15
|
| Rate for Payer: Global Benefits Group Commercial |
$167.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$251.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$186.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$106.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$172.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.80
|
| Rate for Payer: Multiplan Commercial |
$209.25
|
| Rate for Payer: Networks By Design Commercial |
$181.35
|
| Rate for Payer: Prime Health Services Commercial |
$237.15
|
|
|
HC NEEDLE ELEC LIMIT STUDY 1 SITE
|
Facility
|
OP
|
$279.00
|
|
|
Service Code
|
CPT 95870
|
| Hospital Charge Code |
900600255
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$34.83 |
| Max. Negotiated Rate |
$2,039.00 |
| Rate for Payer: Adventist Health Commercial |
$55.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$163.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$169.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$48.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$163.86
|
| Rate for Payer: Blue Shield of California Commercial |
$169.35
|
| Rate for Payer: Blue Shield of California EPN |
$110.76
|
| Rate for Payer: Cash Price |
$125.55
|
| Rate for Payer: Cash Price |
$125.55
|
| Rate for Payer: Cash Price |
$125.55
|
| Rate for Payer: Central Health Plan Commercial |
$223.20
|
| Rate for Payer: Cigna of CA HMO |
$178.56
|
| Rate for Payer: Cigna of CA PPO |
$206.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$237.15
|
| Rate for Payer: Global Benefits Group Commercial |
$167.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$251.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$34.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$186.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$209.25
|
| Rate for Payer: Networks By Design Commercial |
$181.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Prime Health Services Commercial |
$237.15
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$167.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$167.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC NEEDLE ELEC LIMIT STUDY 1 SITE
|
Facility
|
IP
|
$279.00
|
|
|
Service Code
|
CPT 95870
|
| Hospital Charge Code |
900600255
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$55.80 |
| Max. Negotiated Rate |
$251.10 |
| Rate for Payer: Adventist Health Commercial |
$55.80
|
| Rate for Payer: Cash Price |
$125.55
|
| Rate for Payer: Central Health Plan Commercial |
$223.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$111.60
|
| Rate for Payer: EPIC Health Plan Senior |
$111.60
|
| Rate for Payer: Galaxy Health WC |
$237.15
|
| Rate for Payer: Global Benefits Group Commercial |
$167.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$251.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$186.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$106.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$172.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.80
|
| Rate for Payer: Multiplan Commercial |
$209.25
|
| Rate for Payer: Networks By Design Commercial |
$181.35
|
| Rate for Payer: Prime Health Services Commercial |
$237.15
|
|
