|
HC MMR ADMINISTRATION
|
Facility
IP
|
$23.00
|
|
| Hospital Charge Code |
902890244
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$20.70 |
| Rate for Payer: Cash Price |
$10.35
|
| Rate for Payer: Central Health Plan Commercial |
$18.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.20
|
| Rate for Payer: Galaxy Health WC |
$19.55
|
| Rate for Payer: Global Benefits Group Commercial |
$13.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.60
|
| Rate for Payer: Multiplan Commercial |
$17.25
|
| Rate for Payer: Networks By Design Commercial |
$14.95
|
| Rate for Payer: Prime Health Services Commercial |
$19.55
|
|
|
HC MNT RA SUB 2ND RFRL GROUP EA 30 MIN
|
Facility
IP
|
$40.00
|
|
|
Service Code
|
CPT G0271
|
| Hospital Charge Code |
902000271
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$36.00 |
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Central Health Plan Commercial |
$32.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.00
|
| Rate for Payer: Galaxy Health WC |
$34.00
|
| Rate for Payer: Global Benefits Group Commercial |
$24.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.00
|
| Rate for Payer: Multiplan Commercial |
$30.00
|
| Rate for Payer: Networks By Design Commercial |
$26.00
|
| Rate for Payer: Prime Health Services Commercial |
$34.00
|
|
|
HC MNT RA SUB 2ND RFRL GROUP EA 30 MIN
|
Facility
OP
|
$40.00
|
|
|
Service Code
|
CPT G0271
|
| Hospital Charge Code |
902000271
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$785.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$95.96
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$34.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$22.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$22.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.63
|
| Rate for Payer: BCBS Transplant Transplant |
$24.00
|
| Rate for Payer: Blue Shield of California Commercial |
$25.16
|
| Rate for Payer: Blue Shield of California EPN |
$19.56
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Central Health Plan Commercial |
$32.00
|
| Rate for Payer: Cigna of CA HMO |
$25.60
|
| Rate for Payer: Cigna of CA PPO |
$29.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.00
|
| Rate for Payer: Galaxy Health WC |
$34.00
|
| Rate for Payer: Global Benefits Group Commercial |
$24.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$30.00
|
| Rate for Payer: IEHP medi-cal |
$14.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.00
|
| Rate for Payer: Multiplan Commercial |
$30.00
|
| Rate for Payer: Networks By Design Commercial |
$26.00
|
| Rate for Payer: Prime Health Services Commercial |
$34.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$24.00
|
| Rate for Payer: Riverside University Health MISP |
$16.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$602.00
|
| Rate for Payer: United Healthcare All Other HMO |
$785.00
|
| Rate for Payer: United Healthcare HMO Rider |
$593.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$542.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.00
|
| Rate for Payer: Vantage Medical Group Senior |
$34.00
|
|
|
HC MNT RA SUB 2ND RFRL INDIV W PT EA 15 MIN
|
Facility
IP
|
$70.00
|
|
|
Service Code
|
CPT G0270
|
| Hospital Charge Code |
902000270
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Central Health Plan Commercial |
$56.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.00
|
| Rate for Payer: Galaxy Health WC |
$59.50
|
| Rate for Payer: Global Benefits Group Commercial |
$42.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$63.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$46.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.00
|
| Rate for Payer: Multiplan Commercial |
$52.50
|
| Rate for Payer: Networks By Design Commercial |
$45.50
|
| Rate for Payer: Prime Health Services Commercial |
$59.50
|
|
|
HC MNT RA SUB 2ND RFRL INDIV W PT EA 15 MIN
|
Facility
OP
|
$70.00
|
|
|
Service Code
|
CPT G0270
|
| Hospital Charge Code |
902000270
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$785.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$176.71
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$59.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$38.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$38.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$33.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41.36
|
| Rate for Payer: BCBS Transplant Transplant |
$42.00
|
| Rate for Payer: Blue Shield of California Commercial |
$44.03
|
| Rate for Payer: Blue Shield of California EPN |
$34.23
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Central Health Plan Commercial |
$56.00
|
| Rate for Payer: Cigna of CA HMO |
$44.80
|
| Rate for Payer: Cigna of CA PPO |
$51.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$59.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$28.00
|
| Rate for Payer: Galaxy Health WC |
$59.50
|
| Rate for Payer: Global Benefits Group Commercial |
$42.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$63.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$52.50
|
| Rate for Payer: IEHP medi-cal |
$24.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$46.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.00
|
| Rate for Payer: Multiplan Commercial |
$52.50
|
| Rate for Payer: Networks By Design Commercial |
$45.50
|
| Rate for Payer: Prime Health Services Commercial |
$59.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$42.00
|
| Rate for Payer: Riverside University Health MISP |
$28.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$42.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$42.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$602.00
|
| Rate for Payer: United Healthcare All Other HMO |
$785.00
|
| Rate for Payer: United Healthcare HMO Rider |
$593.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$542.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$59.50
|
| Rate for Payer: Vantage Medical Group Senior |
$59.50
|
|
|
HC MOD/TRAIN IN USE VOICE PROSTHE
|
Facility
OP
|
$301.00
|
|
|
Service Code
|
CPT 92609
|
| Hospital Charge Code |
905601759
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$105.35 |
| Max. Negotiated Rate |
$680.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$680.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$255.85
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$165.55
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$165.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$180.60
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Central Health Plan Commercial |
$240.80
|
| Rate for Payer: Cigna of CA HMO |
$192.64
|
| Rate for Payer: Cigna of CA PPO |
$222.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$255.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$120.40
|
| Rate for Payer: Galaxy Health WC |
$255.85
|
| Rate for Payer: Global Benefits Group Commercial |
$180.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$270.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$225.75
|
| Rate for Payer: IEHP medi-cal |
$105.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$200.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.41
|
| Rate for Payer: Multiplan Commercial |
$225.75
|
| Rate for Payer: Networks By Design Commercial |
$195.65
|
| Rate for Payer: Prime Health Services Commercial |
$255.85
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$180.60
|
| Rate for Payer: Riverside University Health MISP |
$120.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$180.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$180.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$255.85
|
| Rate for Payer: Vantage Medical Group Senior |
$255.85
|
|
|
HC MOD/TRAIN IN USE VOICE PROSTHE
|
Facility
IP
|
$301.00
|
|
|
Service Code
|
CPT 92609
|
| Hospital Charge Code |
905601759
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$60.20 |
| Max. Negotiated Rate |
$270.90 |
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Central Health Plan Commercial |
$240.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.40
|
| Rate for Payer: Galaxy Health WC |
$255.85
|
| Rate for Payer: Global Benefits Group Commercial |
$180.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$270.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$200.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.20
|
| Rate for Payer: Multiplan Commercial |
$225.75
|
| Rate for Payer: Networks By Design Commercial |
$195.65
|
| Rate for Payer: Prime Health Services Commercial |
$255.85
|
|
|
HC MOD/TRAIN IN USE VOICE PROSTHE MCAL
|
Facility
OP
|
$301.00
|
|
|
Service Code
|
CPT 92609
|
| Hospital Charge Code |
907000029
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$105.35 |
| Max. Negotiated Rate |
$680.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$680.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$255.85
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$165.55
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$165.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$180.60
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Central Health Plan Commercial |
$240.80
|
| Rate for Payer: Cigna of CA HMO |
$192.64
|
| Rate for Payer: Cigna of CA PPO |
$222.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$255.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$120.40
|
| Rate for Payer: Galaxy Health WC |
$255.85
|
| Rate for Payer: Global Benefits Group Commercial |
$180.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$270.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$225.75
|
| Rate for Payer: IEHP medi-cal |
$105.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$200.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.41
|
| Rate for Payer: Multiplan Commercial |
$225.75
|
| Rate for Payer: Networks By Design Commercial |
$195.65
|
| Rate for Payer: Prime Health Services Commercial |
$255.85
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$180.60
|
| Rate for Payer: Riverside University Health MISP |
$120.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$180.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$180.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$255.85
|
| Rate for Payer: Vantage Medical Group Senior |
$255.85
|
|
|
HC MOD/TRAIN IN USE VOICE PROSTHE MCAL
|
Facility
IP
|
$301.00
|
|
|
Service Code
|
CPT 92609
|
| Hospital Charge Code |
907000029
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$60.20 |
| Max. Negotiated Rate |
$270.90 |
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Central Health Plan Commercial |
$240.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.40
|
| Rate for Payer: Galaxy Health WC |
$255.85
|
| Rate for Payer: Global Benefits Group Commercial |
$180.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$270.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$200.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.20
|
| Rate for Payer: Multiplan Commercial |
$225.75
|
| Rate for Payer: Networks By Design Commercial |
$195.65
|
| Rate for Payer: Prime Health Services Commercial |
$255.85
|
|
|
HC MOD VOICE/AUG DVC MCAL
|
Facility
IP
|
$229.00
|
|
|
Service Code
|
CPT 92606
|
| Hospital Charge Code |
907000027
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$45.80 |
| Max. Negotiated Rate |
$206.10 |
| Rate for Payer: Cash Price |
$103.05
|
| Rate for Payer: Central Health Plan Commercial |
$183.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.60
|
| Rate for Payer: Galaxy Health WC |
$194.65
|
| Rate for Payer: Global Benefits Group Commercial |
$137.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$206.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$152.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.80
|
| Rate for Payer: Multiplan Commercial |
$171.75
|
| Rate for Payer: Networks By Design Commercial |
$148.85
|
| Rate for Payer: Prime Health Services Commercial |
$194.65
|
|
|
HC MOD VOICE/AUG DVC MCAL
|
Facility
OP
|
$229.00
|
|
|
Service Code
|
CPT 92606
|
| Hospital Charge Code |
907000027
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$80.15 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$406.24
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$194.65
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$125.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$125.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$137.40
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$103.05
|
| Rate for Payer: Cash Price |
$103.05
|
| Rate for Payer: Cash Price |
$103.05
|
| Rate for Payer: Cash Price |
$103.05
|
| Rate for Payer: Central Health Plan Commercial |
$183.20
|
| Rate for Payer: Cigna of CA HMO |
$146.56
|
| Rate for Payer: Cigna of CA PPO |
$169.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$194.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$91.60
|
| Rate for Payer: Galaxy Health WC |
$194.65
|
| Rate for Payer: Global Benefits Group Commercial |
$137.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$206.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$171.75
|
| Rate for Payer: IEHP medi-cal |
$80.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$152.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.89
|
| Rate for Payer: Multiplan Commercial |
$171.75
|
| Rate for Payer: Networks By Design Commercial |
$148.85
|
| Rate for Payer: Prime Health Services Commercial |
$194.65
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$137.40
|
| Rate for Payer: Riverside University Health MISP |
$91.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$137.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$137.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$194.65
|
| Rate for Payer: Vantage Medical Group Senior |
$194.65
|
|
|
HC MOHC LNAR DISK
|
Facility
OP
|
$34.00
|
|
| Hospital Charge Code |
909001084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20.65
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$28.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$18.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.09
|
| Rate for Payer: BCBS Transplant Transplant |
$20.40
|
| Rate for Payer: Blue Shield of California Commercial |
$21.39
|
| Rate for Payer: Blue Shield of California EPN |
$16.63
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Central Health Plan Commercial |
$27.20
|
| Rate for Payer: Cigna of CA HMO |
$21.76
|
| Rate for Payer: Cigna of CA PPO |
$25.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.60
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$25.50
|
| Rate for Payer: IEHP medi-cal |
$11.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.80
|
| Rate for Payer: Multiplan Commercial |
$25.50
|
| Rate for Payer: Networks By Design Commercial |
$22.10
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$20.40
|
| Rate for Payer: Riverside University Health MISP |
$13.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.00
|
| Rate for Payer: United Healthcare All Other HMO |
$17.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.90
|
| Rate for Payer: Vantage Medical Group Senior |
$28.90
|
|
|
HC MOHC LNAR DISK
|
Facility
IP
|
$34.00
|
|
| Hospital Charge Code |
909001084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Central Health Plan Commercial |
$27.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.60
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.80
|
| Rate for Payer: Multiplan Commercial |
$25.50
|
| Rate for Payer: Networks By Design Commercial |
$22.10
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
|
|
HC MOLDED INNER BOOT ADDITION LE
|
Facility
IP
|
$974.00
|
|
|
Service Code
|
CPT L2280
|
| Hospital Charge Code |
905352280
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$194.80 |
| Max. Negotiated Rate |
$876.60 |
| Rate for Payer: Blue Shield of California EPN |
$520.12
|
| Rate for Payer: Cash Price |
$438.30
|
| Rate for Payer: Central Health Plan Commercial |
$779.20
|
| Rate for Payer: Cigna of CA HMO |
$681.80
|
| Rate for Payer: Cigna of CA PPO |
$681.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$389.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$389.60
|
| Rate for Payer: Galaxy Health WC |
$827.90
|
| Rate for Payer: Global Benefits Group Commercial |
$584.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$876.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$649.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$194.80
|
| Rate for Payer: Multiplan Commercial |
$730.50
|
| Rate for Payer: Networks By Design Commercial |
$487.00
|
| Rate for Payer: Prime Health Services Commercial |
$827.90
|
|
|
HC MOLDED INNER BOOT ADDITION LE
|
Facility
OP
|
$974.00
|
|
|
Service Code
|
CPT L2280
|
| Hospital Charge Code |
905352280
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$340.90 |
| Max. Negotiated Rate |
$1,879.92 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,879.92
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$827.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$535.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$535.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$471.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$575.44
|
| Rate for Payer: BCBS Transplant Transplant |
$584.40
|
| Rate for Payer: Blue Shield of California Commercial |
$730.50
|
| Rate for Payer: Blue Shield of California EPN |
$529.86
|
| Rate for Payer: Cash Price |
$438.30
|
| Rate for Payer: Cash Price |
$438.30
|
| Rate for Payer: Central Health Plan Commercial |
$779.20
|
| Rate for Payer: Cigna of CA HMO |
$681.80
|
| Rate for Payer: Cigna of CA PPO |
$681.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$827.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$389.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$389.60
|
| Rate for Payer: Galaxy Health WC |
$827.90
|
| Rate for Payer: Global Benefits Group Commercial |
$584.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$876.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$730.50
|
| Rate for Payer: IEHP medi-cal |
$340.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$649.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$399.34
|
| Rate for Payer: Multiplan Commercial |
$730.50
|
| Rate for Payer: Networks By Design Commercial |
$487.00
|
| Rate for Payer: Prime Health Services Commercial |
$827.90
|
| Rate for Payer: Riverside University Health MISP |
$389.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$584.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$584.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$487.00
|
| Rate for Payer: United Healthcare All Other HMO |
$487.00
|
| Rate for Payer: United Healthcare HMO Rider |
$487.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$487.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$827.90
|
| Rate for Payer: Vantage Medical Group Senior |
$827.90
|
|
|
HC MOLDED LACER KAFO ADDITION LE
|
Facility
IP
|
$844.00
|
|
|
Service Code
|
CPT L2330
|
| Hospital Charge Code |
905352330
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$168.80 |
| Max. Negotiated Rate |
$759.60 |
| Rate for Payer: Blue Shield of California EPN |
$450.70
|
| Rate for Payer: Cash Price |
$379.80
|
| Rate for Payer: Central Health Plan Commercial |
$675.20
|
| Rate for Payer: Cigna of CA HMO |
$590.80
|
| Rate for Payer: Cigna of CA PPO |
$590.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$337.60
|
| Rate for Payer: Galaxy Health WC |
$717.40
|
| Rate for Payer: Global Benefits Group Commercial |
$506.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$759.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$562.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.80
|
| Rate for Payer: Multiplan Commercial |
$633.00
|
| Rate for Payer: Networks By Design Commercial |
$422.00
|
| Rate for Payer: Prime Health Services Commercial |
$717.40
|
|
|
HC MOLDED LACER KAFO ADDITION LE
|
Facility
OP
|
$844.00
|
|
|
Service Code
|
CPT L2330
|
| Hospital Charge Code |
905352330
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$295.40 |
| Max. Negotiated Rate |
$1,630.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,630.19
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$717.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$464.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$464.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$408.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$498.64
|
| Rate for Payer: BCBS Transplant Transplant |
$506.40
|
| Rate for Payer: Blue Shield of California Commercial |
$633.00
|
| Rate for Payer: Blue Shield of California EPN |
$459.14
|
| Rate for Payer: Cash Price |
$379.80
|
| Rate for Payer: Cash Price |
$379.80
|
| Rate for Payer: Central Health Plan Commercial |
$675.20
|
| Rate for Payer: Cigna of CA HMO |
$590.80
|
| Rate for Payer: Cigna of CA PPO |
$590.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$717.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$337.60
|
| Rate for Payer: Galaxy Health WC |
$717.40
|
| Rate for Payer: Global Benefits Group Commercial |
$506.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$759.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$633.00
|
| Rate for Payer: IEHP medi-cal |
$295.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$562.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$346.04
|
| Rate for Payer: Multiplan Commercial |
$633.00
|
| Rate for Payer: Networks By Design Commercial |
$422.00
|
| Rate for Payer: Prime Health Services Commercial |
$717.40
|
| Rate for Payer: Riverside University Health MISP |
$337.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$506.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$506.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$422.00
|
| Rate for Payer: United Healthcare All Other HMO |
$422.00
|
| Rate for Payer: United Healthcare HMO Rider |
$422.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$422.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$717.40
|
| Rate for Payer: Vantage Medical Group Senior |
$717.40
|
|
|
HC MOLDED SHLDR ARM FOREARM &WRST
|
Facility
OP
|
$1,860.00
|
|
| Hospital Charge Code |
903203963
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$651.00 |
| Max. Negotiated Rate |
$1,674.00 |
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,581.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,023.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,023.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$900.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,098.89
|
| Rate for Payer: BCBS Transplant Transplant |
$1,116.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,395.00
|
| Rate for Payer: Blue Shield of California EPN |
$1,011.84
|
| Rate for Payer: Cash Price |
$837.00
|
| Rate for Payer: Cash Price |
$837.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,488.00
|
| Rate for Payer: Cigna of CA HMO |
$1,302.00
|
| Rate for Payer: Cigna of CA PPO |
$1,302.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,581.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$744.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$744.00
|
| Rate for Payer: Galaxy Health WC |
$1,581.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,116.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,674.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,395.00
|
| Rate for Payer: IEHP medi-cal |
$651.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,240.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$762.60
|
| Rate for Payer: Multiplan Commercial |
$1,395.00
|
| Rate for Payer: Networks By Design Commercial |
$930.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,581.00
|
| Rate for Payer: Riverside University Health MISP |
$744.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,116.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,116.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$930.00
|
| Rate for Payer: United Healthcare All Other HMO |
$930.00
|
| Rate for Payer: United Healthcare HMO Rider |
$930.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$930.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,581.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,581.00
|
|
|
HC MOLDED SHLDR ARM FOREARM &WRST
|
Facility
IP
|
$1,860.00
|
|
| Hospital Charge Code |
903203963
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$372.00 |
| Max. Negotiated Rate |
$1,674.00 |
| Rate for Payer: Blue Shield of California EPN |
$993.24
|
| Rate for Payer: Cash Price |
$837.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,488.00
|
| Rate for Payer: Cigna of CA HMO |
$1,302.00
|
| Rate for Payer: Cigna of CA PPO |
$1,302.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$744.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$744.00
|
| Rate for Payer: Galaxy Health WC |
$1,581.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,116.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,674.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,240.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$372.00
|
| Rate for Payer: Multiplan Commercial |
$1,395.00
|
| Rate for Payer: Networks By Design Commercial |
$930.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,581.00
|
|
|
HC MOLECULAR PATH INTERPRETATION
|
Facility
OP
|
$322.00
|
|
|
Service Code
|
CPT G0452
|
| Hospital Charge Code |
903800940
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$2.52 |
| Max. Negotiated Rate |
$289.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$95.53
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$273.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$177.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$177.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$82.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$100.66
|
| Rate for Payer: BCBS Transplant Transplant |
$193.20
|
| Rate for Payer: Blue Shield of California Commercial |
$199.00
|
| Rate for Payer: Blue Shield of California EPN |
$156.49
|
| Rate for Payer: Cash Price |
$144.90
|
| Rate for Payer: Cash Price |
$144.90
|
| Rate for Payer: Central Health Plan Commercial |
$257.60
|
| Rate for Payer: Cigna of CA HMO |
$206.08
|
| Rate for Payer: Cigna of CA PPO |
$238.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$273.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$128.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$128.80
|
| Rate for Payer: Galaxy Health WC |
$273.70
|
| Rate for Payer: Global Benefits Group Commercial |
$193.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$289.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$241.50
|
| Rate for Payer: IEHP medi-cal |
$112.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$214.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.40
|
| Rate for Payer: Multiplan Commercial |
$241.50
|
| Rate for Payer: Networks By Design Commercial |
$209.30
|
| Rate for Payer: Prime Health Services Commercial |
$273.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$193.20
|
| Rate for Payer: Riverside University Health MISP |
$128.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$193.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$193.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.52
|
| Rate for Payer: United Healthcare All Other HMO |
$2.52
|
| Rate for Payer: United Healthcare HMO Rider |
$2.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$252.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$273.70
|
| Rate for Payer: Vantage Medical Group Senior |
$273.70
|
|
|
HC MOLECULAR PATH INTERPRETATION
|
Facility
IP
|
$322.00
|
|
|
Service Code
|
CPT G0452
|
| Hospital Charge Code |
903800940
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$64.40 |
| Max. Negotiated Rate |
$289.80 |
| Rate for Payer: Cash Price |
$144.90
|
| Rate for Payer: Central Health Plan Commercial |
$257.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$128.80
|
| Rate for Payer: Galaxy Health WC |
$273.70
|
| Rate for Payer: Global Benefits Group Commercial |
$193.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$289.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$214.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.40
|
| Rate for Payer: Multiplan Commercial |
$241.50
|
| Rate for Payer: Networks By Design Commercial |
$209.30
|
| Rate for Payer: Prime Health Services Commercial |
$273.70
|
|
|
HC MONITRNG FLUID PRESSURE/MUSCLE
|
Facility
IP
|
$995.00
|
|
|
Service Code
|
CPT 20950
|
| Hospital Charge Code |
900501343
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$199.00 |
| Max. Negotiated Rate |
$895.50 |
| Rate for Payer: Cash Price |
$447.75
|
| Rate for Payer: Central Health Plan Commercial |
$796.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$398.00
|
| Rate for Payer: Galaxy Health WC |
$845.75
|
| Rate for Payer: Global Benefits Group Commercial |
$597.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$895.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$663.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$199.00
|
| Rate for Payer: Multiplan Commercial |
$746.25
|
| Rate for Payer: Networks By Design Commercial |
$646.75
|
| Rate for Payer: Prime Health Services Commercial |
$845.75
|
|
|
HC MONITRNG FLUID PRESSURE/MUSCLE
|
Facility
OP
|
$995.00
|
|
|
Service Code
|
CPT 20950
|
| Hospital Charge Code |
900501343
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$199.00 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$879.07
|
| 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 |
$597.00
|
| Rate for Payer: Caremore Medicare Advantage |
$879.07
|
| Rate for Payer: Cash Price |
$447.75
|
| Rate for Payer: Cash Price |
$447.75
|
| Rate for Payer: Cash Price |
$447.75
|
| Rate for Payer: Cash Price |
$447.75
|
| Rate for Payer: Central Health Plan Commercial |
$796.00
|
| Rate for Payer: Cigna of CA PPO |
$736.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,186.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.07
|
| Rate for Payer: Galaxy Health WC |
$845.75
|
| Rate for Payer: Global Benefits Group Commercial |
$597.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$895.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$746.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,441.67
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$879.07
|
| Rate for Payer: Innovage PACE Commercial |
$1,318.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$663.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$199.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,177.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,177.95
|
| Rate for Payer: Multiplan Commercial |
$746.25
|
| Rate for Payer: Networks By Design Commercial |
$646.75
|
| Rate for Payer: Prime Health Services Commercial |
$845.75
|
| Rate for Payer: Prime Health Services Medicare |
$931.81
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$597.00
|
| Rate for Payer: Riverside University Health MISP |
$966.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$597.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$497.50
|
| Rate for Payer: United Healthcare All Other HMO |
$497.50
|
| Rate for Payer: United Healthcare HMO Rider |
$497.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$497.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
|
HC MONITRNG FLUID PRESSURE/MUSCLE
|
Facility
OP
|
$995.00
|
|
|
Service Code
|
CPT 20950
|
| Hospital Charge Code |
900501343
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$199.00 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$879.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$879.07
|
| 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 |
$597.00
|
| Rate for Payer: Blue Shield of California Commercial |
$625.86
|
| Rate for Payer: Blue Shield of California EPN |
$486.56
|
| Rate for Payer: Caremore Medicare Advantage |
$879.07
|
| Rate for Payer: Cash Price |
$447.75
|
| Rate for Payer: Cash Price |
$447.75
|
| Rate for Payer: Cash Price |
$447.75
|
| Rate for Payer: Central Health Plan Commercial |
$796.00
|
| Rate for Payer: Cigna of CA HMO |
$636.80
|
| Rate for Payer: Cigna of CA PPO |
$736.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,186.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.07
|
| Rate for Payer: Galaxy Health WC |
$845.75
|
| Rate for Payer: Global Benefits Group Commercial |
$597.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$895.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$746.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,441.67
|
| Rate for Payer: IEHP medi-cal |
$1,450.47
|
| Rate for Payer: IEHP Medicare Advantage |
$879.07
|
| Rate for Payer: Innovage PACE Commercial |
$1,318.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$663.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$199.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,177.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,177.95
|
| Rate for Payer: Multiplan Commercial |
$746.25
|
| Rate for Payer: Networks By Design Commercial |
$646.75
|
| Rate for Payer: Prime Health Services Commercial |
$845.75
|
| Rate for Payer: Prime Health Services Medicare |
$931.81
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$597.00
|
| Rate for Payer: Riverside University Health MISP |
$966.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$597.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$597.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$497.50
|
| Rate for Payer: United Healthcare All Other HMO |
$497.50
|
| Rate for Payer: United Healthcare HMO Rider |
$497.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$497.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
|
HC MONITRNG FLUID PRESSURE/MUSCLE
|
Facility
IP
|
$995.00
|
|
|
Service Code
|
CPT 20950
|
| Hospital Charge Code |
900501343
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$199.00 |
| Max. Negotiated Rate |
$895.50 |
| Rate for Payer: Cash Price |
$447.75
|
| Rate for Payer: Central Health Plan Commercial |
$796.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$398.00
|
| Rate for Payer: Galaxy Health WC |
$845.75
|
| Rate for Payer: Global Benefits Group Commercial |
$597.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$895.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$663.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$199.00
|
| Rate for Payer: Multiplan Commercial |
$746.25
|
| Rate for Payer: Networks By Design Commercial |
$646.75
|
| Rate for Payer: Prime Health Services Commercial |
$845.75
|
|
