|
HC MONOSPOT (INFECT. MONO TEST)
|
Facility
|
OP
|
$17.00
|
|
|
Service Code
|
CPT 86308
|
| Hospital Charge Code |
900910867
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45.88
|
| Rate for Payer: Blue Distinction Transplant |
$10.20
|
| Rate for Payer: Blue Shield of California Commercial |
$10.51
|
| Rate for Payer: Blue Shield of California EPN |
$8.26
|
| Rate for Payer: Caremore Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Central Health Plan Commercial |
$13.60
|
| Rate for Payer: Cigna of CA HMO |
$10.88
|
| Rate for Payer: Cigna of CA PPO |
$12.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Media |
$5.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.18
|
| Rate for Payer: Galaxy Health WC |
$14.45
|
| Rate for Payer: Global Benefits Group Commercial |
$10.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$12.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: InnovAge PACE Commercial |
$7.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$12.75
|
| Rate for Payer: Networks By Design Commercial |
$11.05
|
| Rate for Payer: Prime Health Services Commercial |
$14.45
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Riverside University Health System MISP |
$5.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC MONOSPOT (INFECT. MONO TEST)
|
Facility
|
IP
|
$150.00
|
|
|
Service Code
|
CPT 86308
|
| Hospital Charge Code |
900910867
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Cash Price |
$67.50
|
| Rate for Payer: Central Health Plan Commercial |
$120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.00
|
| Rate for Payer: Galaxy Health WC |
$127.50
|
| Rate for Payer: Global Benefits Group Commercial |
$90.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$135.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$100.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.00
|
| Rate for Payer: Multiplan Commercial |
$112.50
|
| Rate for Payer: Networks By Design Commercial |
$97.50
|
| Rate for Payer: Prime Health Services Commercial |
$127.50
|
|
|
HC MOTOR NCS W/F-WAVES
|
Facility
|
OP
|
$237.00
|
|
|
Service Code
|
CPT 95905
|
| Hospital Charge Code |
900600257
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$47.40 |
| Max. Negotiated Rate |
$1,231.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$497.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$493.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$746.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$547.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$497.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$374.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$140.02
|
| Rate for Payer: Blue Distinction Transplant |
$142.20
|
| Rate for Payer: Blue Shield of California Commercial |
$146.47
|
| Rate for Payer: Blue Shield of California EPN |
$115.18
|
| Rate for Payer: Caremore Medicare Advantage |
$497.82
|
| Rate for Payer: Cash Price |
$106.65
|
| Rate for Payer: Cash Price |
$106.65
|
| Rate for Payer: Cash Price |
$106.65
|
| Rate for Payer: Central Health Plan Commercial |
$189.60
|
| Rate for Payer: Cigna of CA HMO |
$151.68
|
| Rate for Payer: Cigna of CA PPO |
$175.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$746.73
|
| Rate for Payer: Dignity Health Media |
$497.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$547.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$672.06
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$497.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$497.82
|
| Rate for Payer: Galaxy Health WC |
$201.45
|
| Rate for Payer: Global Benefits Group Commercial |
$142.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$213.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$177.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$816.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$821.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$497.82
|
| Rate for Payer: InnovAge PACE Commercial |
$746.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$158.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$134.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$497.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$667.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$667.08
|
| Rate for Payer: Multiplan Commercial |
$177.75
|
| Rate for Payer: Networks By Design Commercial |
$154.05
|
| Rate for Payer: Prime Health Services Commercial |
$201.45
|
| Rate for Payer: Prime Health Services Medicare |
$527.69
|
| Rate for Payer: Riverside University Health System MISP |
$547.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$142.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$142.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,231.00
|
| Rate for Payer: United Healthcare All Other HMO |
$975.00
|
| Rate for Payer: United Healthcare HMO Rider |
$739.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$746.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$547.60
|
| Rate for Payer: Vantage Medical Group Senior |
$497.82
|
|
|
HC MOTOR NCS W/F-WAVES
|
Facility
|
IP
|
$237.00
|
|
|
Service Code
|
CPT 95905
|
| Hospital Charge Code |
900600257
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$47.40 |
| Max. Negotiated Rate |
$213.30 |
| Rate for Payer: Cash Price |
$106.65
|
| Rate for Payer: Central Health Plan Commercial |
$189.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.80
|
| Rate for Payer: Galaxy Health WC |
$201.45
|
| Rate for Payer: Global Benefits Group Commercial |
$142.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$213.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$158.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$90.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.40
|
| Rate for Payer: Multiplan Commercial |
$177.75
|
| Rate for Payer: Networks By Design Commercial |
$154.05
|
| Rate for Payer: Prime Health Services Commercial |
$201.45
|
|
|
HC MOTOR & SENS 11-12 NRV CNDJ TEST
|
Facility
|
OP
|
$1,242.00
|
|
|
Service Code
|
CPT 95912
|
| Hospital Charge Code |
900600329
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$248.40 |
| Max. Negotiated Rate |
$1,117.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$669.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$636.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,004.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$736.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$669.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$654.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$733.77
|
| Rate for Payer: Blue Distinction Transplant |
$745.20
|
| Rate for Payer: Blue Shield of California Commercial |
$767.56
|
| Rate for Payer: Blue Shield of California EPN |
$603.61
|
| Rate for Payer: Caremore Medicare Advantage |
$669.68
|
| Rate for Payer: Cash Price |
$558.90
|
| Rate for Payer: Cash Price |
$558.90
|
| Rate for Payer: Cash Price |
$558.90
|
| Rate for Payer: Central Health Plan Commercial |
$993.60
|
| Rate for Payer: Cigna of CA HMO |
$794.88
|
| Rate for Payer: Cigna of CA PPO |
$919.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,004.52
|
| Rate for Payer: Dignity Health Media |
$669.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$736.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$904.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$669.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$669.68
|
| Rate for Payer: Galaxy Health WC |
$1,055.70
|
| Rate for Payer: Global Benefits Group Commercial |
$745.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,117.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$931.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,098.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,104.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$669.68
|
| Rate for Payer: InnovAge PACE Commercial |
$1,004.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$828.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$432.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$669.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$897.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$897.37
|
| Rate for Payer: Multiplan Commercial |
$931.50
|
| Rate for Payer: Networks By Design Commercial |
$807.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,055.70
|
| Rate for Payer: Prime Health Services Medicare |
$709.86
|
| Rate for Payer: Riverside University Health System MISP |
$736.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$745.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$745.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$969.00
|
| Rate for Payer: United Healthcare All Other HMO |
$765.00
|
| Rate for Payer: United Healthcare HMO Rider |
$579.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$530.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,004.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$736.65
|
| Rate for Payer: Vantage Medical Group Senior |
$669.68
|
|
|
HC MOTOR & SENS 11-12 NRV CNDJ TEST
|
Facility
|
IP
|
$1,242.00
|
|
|
Service Code
|
CPT 95912
|
| Hospital Charge Code |
900600329
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$248.40 |
| Max. Negotiated Rate |
$1,117.80 |
| Rate for Payer: Cash Price |
$558.90
|
| Rate for Payer: Central Health Plan Commercial |
$993.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$496.80
|
| Rate for Payer: Galaxy Health WC |
$1,055.70
|
| Rate for Payer: Global Benefits Group Commercial |
$745.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,117.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$828.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$473.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.40
|
| Rate for Payer: Multiplan Commercial |
$931.50
|
| Rate for Payer: Networks By Design Commercial |
$807.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,055.70
|
|
|
HC MOTOR & SENS 1-2 NRV CNDJ TEST
|
Facility
|
IP
|
$276.00
|
|
|
Service Code
|
CPT 95907
|
| Hospital Charge Code |
900600324
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$55.20 |
| Max. Negotiated Rate |
$248.40 |
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Central Health Plan Commercial |
$220.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$110.40
|
| Rate for Payer: Galaxy Health WC |
$234.60
|
| Rate for Payer: Global Benefits Group Commercial |
$165.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$248.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$184.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$105.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.20
|
| Rate for Payer: Multiplan Commercial |
$207.00
|
| Rate for Payer: Networks By Design Commercial |
$179.40
|
| Rate for Payer: Prime Health Services Commercial |
$234.60
|
|
|
HC MOTOR & SENS 1-2 NRV CNDJ TEST
|
Facility
|
OP
|
$276.00
|
|
|
Service Code
|
CPT 95907
|
| Hospital Charge Code |
900600324
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$55.20 |
| Max. Negotiated Rate |
$969.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$195.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$259.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$195.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$266.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$163.06
|
| Rate for Payer: Blue Distinction Transplant |
$165.60
|
| Rate for Payer: Blue Shield of California Commercial |
$170.57
|
| Rate for Payer: Blue Shield of California EPN |
$134.14
|
| Rate for Payer: Caremore Medicare Advantage |
$195.17
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Central Health Plan Commercial |
$220.80
|
| Rate for Payer: Cigna of CA HMO |
$176.64
|
| Rate for Payer: Cigna of CA PPO |
$204.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| Rate for Payer: Dignity Health Media |
$195.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$263.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$195.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$195.17
|
| Rate for Payer: Galaxy Health WC |
$234.60
|
| Rate for Payer: Global Benefits Group Commercial |
$165.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$248.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$207.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$320.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$322.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$195.17
|
| Rate for Payer: InnovAge PACE Commercial |
$292.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$184.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$157.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$195.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$261.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$261.53
|
| Rate for Payer: Multiplan Commercial |
$207.00
|
| Rate for Payer: Networks By Design Commercial |
$179.40
|
| Rate for Payer: Prime Health Services Commercial |
$234.60
|
| Rate for Payer: Prime Health Services Medicare |
$206.88
|
| Rate for Payer: Riverside University Health System MISP |
$214.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$165.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$165.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$969.00
|
| Rate for Payer: United Healthcare All Other HMO |
$765.00
|
| Rate for Payer: United Healthcare HMO Rider |
$579.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$530.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Vantage Medical Group Senior |
$195.17
|
|
|
HC MOTOR & SENS 13 NRV CNDJ TEST
|
Facility
|
IP
|
$1,305.00
|
|
|
Service Code
|
CPT 95913
|
| Hospital Charge Code |
900600330
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$261.00 |
| Max. Negotiated Rate |
$1,174.50 |
| Rate for Payer: Cash Price |
$587.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,044.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$522.00
|
| Rate for Payer: Galaxy Health WC |
$1,109.25
|
| Rate for Payer: Global Benefits Group Commercial |
$783.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,174.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$870.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$497.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$261.00
|
| Rate for Payer: Multiplan Commercial |
$978.75
|
| Rate for Payer: Networks By Design Commercial |
$848.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,109.25
|
|
|
HC MOTOR & SENS 13 NRV CNDJ TEST
|
Facility
|
OP
|
$1,305.00
|
|
|
Service Code
|
CPT 95913
|
| Hospital Charge Code |
900600330
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$261.00 |
| Max. Negotiated Rate |
$1,174.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$669.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$711.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,004.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$736.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$669.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$731.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$770.99
|
| Rate for Payer: Blue Distinction Transplant |
$783.00
|
| Rate for Payer: Blue Shield of California Commercial |
$806.49
|
| Rate for Payer: Blue Shield of California EPN |
$634.23
|
| Rate for Payer: Caremore Medicare Advantage |
$669.68
|
| Rate for Payer: Cash Price |
$587.25
|
| Rate for Payer: Cash Price |
$587.25
|
| Rate for Payer: Cash Price |
$587.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,044.00
|
| Rate for Payer: Cigna of CA HMO |
$835.20
|
| Rate for Payer: Cigna of CA PPO |
$965.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,004.52
|
| Rate for Payer: Dignity Health Media |
$669.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$736.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$904.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$669.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$669.68
|
| Rate for Payer: Galaxy Health WC |
$1,109.25
|
| Rate for Payer: Global Benefits Group Commercial |
$783.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,174.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$978.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,098.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,104.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$669.68
|
| Rate for Payer: InnovAge PACE Commercial |
$1,004.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$870.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$500.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$669.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$261.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$897.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$897.37
|
| Rate for Payer: Multiplan Commercial |
$978.75
|
| Rate for Payer: Networks By Design Commercial |
$848.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,109.25
|
| Rate for Payer: Prime Health Services Medicare |
$709.86
|
| Rate for Payer: Riverside University Health System MISP |
$736.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$783.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$783.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$969.00
|
| Rate for Payer: United Healthcare All Other HMO |
$765.00
|
| Rate for Payer: United Healthcare HMO Rider |
$579.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$530.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,004.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$736.65
|
| Rate for Payer: Vantage Medical Group Senior |
$669.68
|
|
|
HC MOTOR & SENS 3-4 NRV CNDJ TEST
|
Facility
|
OP
|
$688.00
|
|
|
Service Code
|
CPT 95908
|
| Hospital Charge Code |
900600325
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$137.60 |
| Max. Negotiated Rate |
$969.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$392.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$313.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$392.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$322.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$406.47
|
| Rate for Payer: Blue Distinction Transplant |
$412.80
|
| Rate for Payer: Blue Shield of California Commercial |
$425.18
|
| Rate for Payer: Blue Shield of California EPN |
$334.37
|
| Rate for Payer: Caremore Medicare Advantage |
$392.17
|
| Rate for Payer: Cash Price |
$309.60
|
| Rate for Payer: Cash Price |
$309.60
|
| Rate for Payer: Cash Price |
$309.60
|
| Rate for Payer: Central Health Plan Commercial |
$550.40
|
| Rate for Payer: Cigna of CA HMO |
$440.32
|
| Rate for Payer: Cigna of CA PPO |
$509.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.26
|
| Rate for Payer: Dignity Health Media |
$392.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$529.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$392.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$392.17
|
| Rate for Payer: Galaxy Health WC |
$584.80
|
| Rate for Payer: Global Benefits Group Commercial |
$412.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$619.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$516.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$643.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$647.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$392.17
|
| Rate for Payer: InnovAge PACE Commercial |
$588.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$458.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$194.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$137.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$525.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$525.51
|
| Rate for Payer: Multiplan Commercial |
$516.00
|
| Rate for Payer: Networks By Design Commercial |
$447.20
|
| Rate for Payer: Prime Health Services Commercial |
$584.80
|
| Rate for Payer: Prime Health Services Medicare |
$415.70
|
| Rate for Payer: Riverside University Health System MISP |
$431.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$412.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$412.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$969.00
|
| Rate for Payer: United Healthcare All Other HMO |
$765.00
|
| Rate for Payer: United Healthcare HMO Rider |
$579.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$530.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Vantage Medical Group Senior |
$392.17
|
|
|
HC MOTOR & SENS 3-4 NRV CNDJ TEST
|
Facility
|
IP
|
$688.00
|
|
|
Service Code
|
CPT 95908
|
| Hospital Charge Code |
900600325
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$137.60 |
| Max. Negotiated Rate |
$619.20 |
| Rate for Payer: Cash Price |
$309.60
|
| Rate for Payer: Central Health Plan Commercial |
$550.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$275.20
|
| Rate for Payer: Galaxy Health WC |
$584.80
|
| Rate for Payer: Global Benefits Group Commercial |
$412.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$619.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$458.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$262.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$137.60
|
| Rate for Payer: Multiplan Commercial |
$516.00
|
| Rate for Payer: Networks By Design Commercial |
$447.20
|
| Rate for Payer: Prime Health Services Commercial |
$584.80
|
|
|
HC MOTOR & SENS 5-6 NRV CNDJ TEST
|
Facility
|
IP
|
$607.00
|
|
|
Service Code
|
CPT 95909
|
| Hospital Charge Code |
900600326
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$121.40 |
| Max. Negotiated Rate |
$546.30 |
| Rate for Payer: Cash Price |
$273.15
|
| Rate for Payer: Central Health Plan Commercial |
$485.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$242.80
|
| Rate for Payer: Galaxy Health WC |
$515.95
|
| Rate for Payer: Global Benefits Group Commercial |
$364.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$546.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$404.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$231.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.40
|
| Rate for Payer: Multiplan Commercial |
$455.25
|
| Rate for Payer: Networks By Design Commercial |
$394.55
|
| Rate for Payer: Prime Health Services Commercial |
$515.95
|
|
|
HC MOTOR & SENS 5-6 NRV CNDJ TEST
|
Facility
|
OP
|
$607.00
|
|
|
Service Code
|
CPT 95909
|
| Hospital Charge Code |
900600326
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$121.40 |
| Max. Negotiated Rate |
$969.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$392.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$376.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$392.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$386.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$358.62
|
| Rate for Payer: Blue Distinction Transplant |
$364.20
|
| Rate for Payer: Blue Shield of California Commercial |
$375.13
|
| Rate for Payer: Blue Shield of California EPN |
$295.00
|
| Rate for Payer: Caremore Medicare Advantage |
$392.17
|
| Rate for Payer: Cash Price |
$273.15
|
| Rate for Payer: Cash Price |
$273.15
|
| Rate for Payer: Cash Price |
$273.15
|
| Rate for Payer: Central Health Plan Commercial |
$485.60
|
| Rate for Payer: Cigna of CA HMO |
$388.48
|
| Rate for Payer: Cigna of CA PPO |
$449.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.26
|
| Rate for Payer: Dignity Health Media |
$392.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$529.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$392.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$392.17
|
| Rate for Payer: Galaxy Health WC |
$515.95
|
| Rate for Payer: Global Benefits Group Commercial |
$364.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$546.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$455.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$643.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$647.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$392.17
|
| Rate for Payer: InnovAge PACE Commercial |
$588.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$404.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$232.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$525.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$525.51
|
| Rate for Payer: Multiplan Commercial |
$455.25
|
| Rate for Payer: Networks By Design Commercial |
$394.55
|
| Rate for Payer: Prime Health Services Commercial |
$515.95
|
| Rate for Payer: Prime Health Services Medicare |
$415.70
|
| Rate for Payer: Riverside University Health System MISP |
$431.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$364.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$364.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$969.00
|
| Rate for Payer: United Healthcare All Other HMO |
$765.00
|
| Rate for Payer: United Healthcare HMO Rider |
$579.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$530.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Vantage Medical Group Senior |
$392.17
|
|
|
HC MOTOR & SENS 7-8 NRV CNDJ TEST
|
Facility
|
IP
|
$1,087.00
|
|
|
Service Code
|
CPT 95910
|
| Hospital Charge Code |
900600327
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$217.40 |
| Max. Negotiated Rate |
$978.30 |
| Rate for Payer: Cash Price |
$489.15
|
| Rate for Payer: Central Health Plan Commercial |
$869.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$434.80
|
| Rate for Payer: Galaxy Health WC |
$923.95
|
| Rate for Payer: Global Benefits Group Commercial |
$652.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$978.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$725.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$414.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$217.40
|
| Rate for Payer: Multiplan Commercial |
$815.25
|
| Rate for Payer: Networks By Design Commercial |
$706.55
|
| Rate for Payer: Prime Health Services Commercial |
$923.95
|
|
|
HC MOTOR & SENS 7-8 NRV CNDJ TEST
|
Facility
|
OP
|
$1,087.00
|
|
|
Service Code
|
CPT 95910
|
| Hospital Charge Code |
900600327
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$217.40 |
| Max. Negotiated Rate |
$978.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$392.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$485.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$392.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$499.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$642.20
|
| Rate for Payer: Blue Distinction Transplant |
$652.20
|
| Rate for Payer: Blue Shield of California Commercial |
$671.77
|
| Rate for Payer: Blue Shield of California EPN |
$528.28
|
| Rate for Payer: Caremore Medicare Advantage |
$392.17
|
| Rate for Payer: Cash Price |
$489.15
|
| Rate for Payer: Cash Price |
$489.15
|
| Rate for Payer: Cash Price |
$489.15
|
| Rate for Payer: Central Health Plan Commercial |
$869.60
|
| Rate for Payer: Cigna of CA HMO |
$695.68
|
| Rate for Payer: Cigna of CA PPO |
$804.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.26
|
| Rate for Payer: Dignity Health Media |
$392.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$529.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$392.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$392.17
|
| Rate for Payer: Galaxy Health WC |
$923.95
|
| Rate for Payer: Global Benefits Group Commercial |
$652.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$978.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$815.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$643.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$647.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$392.17
|
| Rate for Payer: InnovAge PACE Commercial |
$588.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$725.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$305.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$217.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$525.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$525.51
|
| Rate for Payer: Multiplan Commercial |
$815.25
|
| Rate for Payer: Networks By Design Commercial |
$706.55
|
| Rate for Payer: Prime Health Services Commercial |
$923.95
|
| Rate for Payer: Prime Health Services Medicare |
$415.70
|
| Rate for Payer: Riverside University Health System MISP |
$431.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$652.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$652.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$969.00
|
| Rate for Payer: United Healthcare All Other HMO |
$765.00
|
| Rate for Payer: United Healthcare HMO Rider |
$579.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$530.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Vantage Medical Group Senior |
$392.17
|
|
|
HC MOTOR & SENS 9-10 NRV CNDJ TEST
|
Facility
|
IP
|
$1,183.00
|
|
|
Service Code
|
CPT 95911
|
| Hospital Charge Code |
900600328
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$236.60 |
| Max. Negotiated Rate |
$1,064.70 |
| Rate for Payer: Cash Price |
$532.35
|
| Rate for Payer: Central Health Plan Commercial |
$946.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$473.20
|
| Rate for Payer: Galaxy Health WC |
$1,005.55
|
| Rate for Payer: Global Benefits Group Commercial |
$709.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,064.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$789.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$450.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$236.60
|
| Rate for Payer: Multiplan Commercial |
$887.25
|
| Rate for Payer: Networks By Design Commercial |
$768.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,005.55
|
|
|
HC MOTOR & SENS 9-10 NRV CNDJ TEST
|
Facility
|
OP
|
$1,183.00
|
|
|
Service Code
|
CPT 95911
|
| Hospital Charge Code |
900600328
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$236.60 |
| Max. Negotiated Rate |
$1,104.97 |
| Rate for Payer: Adventist Health Medi-Cal |
$669.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$562.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,004.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$736.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$669.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$579.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$698.92
|
| Rate for Payer: Blue Distinction Transplant |
$709.80
|
| Rate for Payer: Blue Shield of California Commercial |
$731.09
|
| Rate for Payer: Blue Shield of California EPN |
$574.94
|
| Rate for Payer: Caremore Medicare Advantage |
$669.68
|
| Rate for Payer: Cash Price |
$532.35
|
| Rate for Payer: Cash Price |
$532.35
|
| Rate for Payer: Cash Price |
$532.35
|
| Rate for Payer: Central Health Plan Commercial |
$946.40
|
| Rate for Payer: Cigna of CA HMO |
$757.12
|
| Rate for Payer: Cigna of CA PPO |
$875.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,004.52
|
| Rate for Payer: Dignity Health Media |
$669.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$736.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$904.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$669.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$669.68
|
| Rate for Payer: Galaxy Health WC |
$1,005.55
|
| Rate for Payer: Global Benefits Group Commercial |
$709.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,064.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$887.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,098.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,104.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$669.68
|
| Rate for Payer: InnovAge PACE Commercial |
$1,004.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$789.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$369.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$669.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$236.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$897.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$897.37
|
| Rate for Payer: Multiplan Commercial |
$887.25
|
| Rate for Payer: Networks By Design Commercial |
$768.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,005.55
|
| Rate for Payer: Prime Health Services Medicare |
$709.86
|
| Rate for Payer: Riverside University Health System MISP |
$736.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$709.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$709.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$969.00
|
| Rate for Payer: United Healthcare All Other HMO |
$765.00
|
| Rate for Payer: United Healthcare HMO Rider |
$579.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$530.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,004.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$736.65
|
| Rate for Payer: Vantage Medical Group Senior |
$669.68
|
|
|
HC MR ANGIO ABDOMEN W CONTRAST
|
Facility
|
IP
|
$13,080.00
|
|
|
Service Code
|
CPT 74185
|
| Hospital Charge Code |
908801037
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$2,616.00 |
| Max. Negotiated Rate |
$11,772.00 |
| Rate for Payer: Cash Price |
$5,886.00
|
| Rate for Payer: Central Health Plan Commercial |
$10,464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,232.00
|
| Rate for Payer: Galaxy Health WC |
$11,118.00
|
| Rate for Payer: Global Benefits Group Commercial |
$7,848.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,772.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,724.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,983.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,616.00
|
| Rate for Payer: Multiplan Commercial |
$9,810.00
|
| Rate for Payer: Networks By Design Commercial |
$8,502.00
|
| Rate for Payer: Prime Health Services Commercial |
$11,118.00
|
|
|
HC MR ANGIO ABDOMEN W CONTRAST
|
Facility
|
OP
|
$6,019.00
|
|
|
Service Code
|
CPT 74185
|
| Hospital Charge Code |
908801037
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$630.86 |
| Max. Negotiated Rate |
$5,417.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,116.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,310.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,310.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,308.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,556.03
|
| Rate for Payer: Blue Distinction Transplant |
$3,611.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,719.74
|
| Rate for Payer: Blue Shield of California EPN |
$2,925.23
|
| Rate for Payer: Cash Price |
$2,708.55
|
| Rate for Payer: Cash Price |
$2,708.55
|
| Rate for Payer: Central Health Plan Commercial |
$4,815.20
|
| Rate for Payer: Cigna of CA HMO |
$3,852.16
|
| Rate for Payer: Cigna of CA PPO |
$4,454.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,116.15
|
| Rate for Payer: Dignity Health Media |
$5,116.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,116.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,407.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,407.60
|
| Rate for Payer: Galaxy Health WC |
$5,116.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,611.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,417.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,514.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,106.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,014.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$630.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,203.80
|
| Rate for Payer: Multiplan Commercial |
$4,514.25
|
| Rate for Payer: Networks By Design Commercial |
$3,912.35
|
| Rate for Payer: Prime Health Services Commercial |
$5,116.15
|
| Rate for Payer: Riverside University Health System MISP |
$2,407.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,611.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,611.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,111.86
|
| Rate for Payer: United Healthcare All Other HMO |
$1,111.86
|
| Rate for Payer: United Healthcare HMO Rider |
$1,111.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,111.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,116.15
|
| Rate for Payer: Vantage Medical Group Senior |
$5,116.15
|
|
|
HC MR ANGIO ABD W/O CONTRAST
|
Facility
|
OP
|
$5,640.00
|
|
|
Service Code
|
CPT 74185
|
| Hospital Charge Code |
908801089
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$630.86 |
| Max. Negotiated Rate |
$5,076.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,794.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,102.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,102.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,308.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,332.11
|
| Rate for Payer: Blue Distinction Transplant |
$3,384.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,485.52
|
| Rate for Payer: Blue Shield of California EPN |
$2,741.04
|
| Rate for Payer: Cash Price |
$2,538.00
|
| Rate for Payer: Cash Price |
$2,538.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,512.00
|
| Rate for Payer: Cigna of CA HMO |
$3,609.60
|
| Rate for Payer: Cigna of CA PPO |
$4,173.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,794.00
|
| Rate for Payer: Dignity Health Media |
$4,794.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,794.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,256.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,256.00
|
| Rate for Payer: Galaxy Health WC |
$4,794.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,384.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,076.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,230.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,974.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,761.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$630.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,128.00
|
| Rate for Payer: Multiplan Commercial |
$4,230.00
|
| Rate for Payer: Networks By Design Commercial |
$3,666.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,794.00
|
| Rate for Payer: Riverside University Health System MISP |
$2,256.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,384.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,384.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,111.86
|
| Rate for Payer: United Healthcare All Other HMO |
$1,111.86
|
| Rate for Payer: United Healthcare HMO Rider |
$1,111.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,111.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,794.00
|
| Rate for Payer: Vantage Medical Group Senior |
$4,794.00
|
|
|
HC MR ANGIO ABD W/O CONTRAST
|
Facility
|
IP
|
$12,457.00
|
|
|
Service Code
|
CPT 74185
|
| Hospital Charge Code |
908801089
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$2,491.40 |
| Max. Negotiated Rate |
$11,211.30 |
| Rate for Payer: Cash Price |
$5,605.65
|
| Rate for Payer: Central Health Plan Commercial |
$9,965.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,982.80
|
| Rate for Payer: Galaxy Health WC |
$10,588.45
|
| Rate for Payer: Global Benefits Group Commercial |
$7,474.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,211.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,308.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,746.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,491.40
|
| Rate for Payer: Multiplan Commercial |
$9,342.75
|
| Rate for Payer: Networks By Design Commercial |
$8,097.05
|
| Rate for Payer: Prime Health Services Commercial |
$10,588.45
|
|
|
HC MR ANGIO CHEST W CONTRAST
|
Facility
|
OP
|
$5,295.00
|
|
|
Service Code
|
CPT 71555
|
| Hospital Charge Code |
908801090
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$626.51 |
| Max. Negotiated Rate |
$4,765.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,500.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,912.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,912.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,307.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,128.29
|
| Rate for Payer: Blue Distinction Transplant |
$3,177.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,272.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,573.37
|
| Rate for Payer: Cash Price |
$2,382.75
|
| Rate for Payer: Cash Price |
$2,382.75
|
| Rate for Payer: Central Health Plan Commercial |
$4,236.00
|
| Rate for Payer: Cigna of CA HMO |
$3,388.80
|
| Rate for Payer: Cigna of CA PPO |
$3,918.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,500.75
|
| Rate for Payer: Dignity Health Media |
$4,500.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,500.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,118.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,118.00
|
| Rate for Payer: Galaxy Health WC |
$4,500.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,177.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,765.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,971.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,853.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,531.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$626.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,059.00
|
| Rate for Payer: Multiplan Commercial |
$3,971.25
|
| Rate for Payer: Networks By Design Commercial |
$3,441.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,500.75
|
| Rate for Payer: Riverside University Health System MISP |
$2,118.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,177.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,177.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,110.11
|
| Rate for Payer: United Healthcare All Other HMO |
$1,110.11
|
| Rate for Payer: United Healthcare HMO Rider |
$1,110.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,110.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,500.75
|
| Rate for Payer: Vantage Medical Group Senior |
$4,500.75
|
|
|
HC MR ANGIO CHEST W CONTRAST
|
Facility
|
IP
|
$11,201.00
|
|
|
Service Code
|
CPT 71555
|
| Hospital Charge Code |
908801090
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$2,240.20 |
| Max. Negotiated Rate |
$10,080.90 |
| Rate for Payer: Cash Price |
$5,040.45
|
| Rate for Payer: Central Health Plan Commercial |
$8,960.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,480.40
|
| Rate for Payer: Galaxy Health WC |
$9,520.85
|
| Rate for Payer: Global Benefits Group Commercial |
$6,720.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,080.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,471.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,267.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,240.20
|
| Rate for Payer: Multiplan Commercial |
$8,400.75
|
| Rate for Payer: Networks By Design Commercial |
$7,280.65
|
| Rate for Payer: Prime Health Services Commercial |
$9,520.85
|
|
|
HC MR ANGIO CHEST W/O CONTRAST
|
Facility
|
OP
|
$4,919.00
|
|
|
Service Code
|
CPT 71555
|
| Hospital Charge Code |
908801091
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$626.51 |
| Max. Negotiated Rate |
$4,427.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,954.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,181.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,705.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,705.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,307.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,906.15
|
| Rate for Payer: Blue Distinction Transplant |
$2,951.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,039.94
|
| Rate for Payer: Blue Shield of California EPN |
$2,390.63
|
| Rate for Payer: Cash Price |
$2,213.55
|
| Rate for Payer: Cash Price |
$2,213.55
|
| Rate for Payer: Central Health Plan Commercial |
$3,935.20
|
| Rate for Payer: Cigna of CA HMO |
$3,148.16
|
| Rate for Payer: Cigna of CA PPO |
$3,640.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,181.15
|
| Rate for Payer: Dignity Health Media |
$4,181.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,181.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,967.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,967.60
|
| Rate for Payer: Galaxy Health WC |
$4,181.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,951.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,427.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,689.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,721.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,280.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$626.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$983.80
|
| Rate for Payer: Multiplan Commercial |
$3,689.25
|
| Rate for Payer: Networks By Design Commercial |
$3,197.35
|
| Rate for Payer: Prime Health Services Commercial |
$4,181.15
|
| Rate for Payer: Riverside University Health System MISP |
$1,967.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,951.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,951.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,110.11
|
| Rate for Payer: United Healthcare All Other HMO |
$1,110.11
|
| Rate for Payer: United Healthcare HMO Rider |
$1,110.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,110.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,181.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,181.15
|
|
