|
HC NEEDLE ELEC CRANI NERVE UNI
|
Facility
OP
|
$441.00
|
|
|
Service Code
|
CPT 95867
|
| Hospital Charge Code |
900600252
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$88.20 |
| Max. Negotiated Rate |
$1,231.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$392.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$238.80
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$392.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$152.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$260.54
|
| Rate for Payer: BCBS Transplant Transplant |
$264.60
|
| Rate for Payer: Blue Shield of California Commercial |
$272.54
|
| Rate for Payer: Blue Shield of California EPN |
$214.33
|
| Rate for Payer: Caremore Medicare Advantage |
$392.17
|
| Rate for Payer: Cash Price |
$198.45
|
| Rate for Payer: Cash Price |
$198.45
|
| Rate for Payer: Cash Price |
$198.45
|
| Rate for Payer: Central Health Plan Commercial |
$352.80
|
| Rate for Payer: Cigna of CA HMO |
$282.24
|
| Rate for Payer: Cigna of CA PPO |
$326.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.26
|
| 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 |
$374.85
|
| Rate for Payer: Global Benefits Group Commercial |
$264.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$396.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$330.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$643.16
|
| Rate for Payer: IEHP medi-cal |
$647.08
|
| Rate for Payer: IEHP Medicare Advantage |
$392.17
|
| Rate for Payer: Innovage PACE Commercial |
$588.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$294.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.20
|
| 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 |
$330.75
|
| Rate for Payer: Networks By Design Commercial |
$286.65
|
| Rate for Payer: Prime Health Services Commercial |
$374.85
|
| Rate for Payer: Prime Health Services Medicare |
$415.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$264.60
|
| Rate for Payer: Riverside University Health MISP |
$431.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$264.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$264.60
|
| 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 |
$588.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Vantage Medical Group Senior |
$392.17
|
|
|
HC NEEDLE ELEC CRANI NERVE UNI
|
Facility
IP
|
$441.00
|
|
|
Service Code
|
CPT 95867
|
| Hospital Charge Code |
900600252
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$88.20 |
| Max. Negotiated Rate |
$396.90 |
| Rate for Payer: Cash Price |
$198.45
|
| Rate for Payer: Central Health Plan Commercial |
$352.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$176.40
|
| Rate for Payer: Galaxy Health WC |
$374.85
|
| Rate for Payer: Global Benefits Group Commercial |
$264.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$396.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$294.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.20
|
| Rate for Payer: Multiplan Commercial |
$330.75
|
| Rate for Payer: Networks By Design Commercial |
$286.65
|
| Rate for Payer: Prime Health Services Commercial |
$374.85
|
|
|
HC NEEDLE ELEC LIMIT STUDY 1 SITE
|
Facility
IP
|
$256.00
|
|
|
Service Code
|
CPT 95870
|
| Hospital Charge Code |
900600255
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$51.20 |
| Max. Negotiated Rate |
$230.40 |
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Central Health Plan Commercial |
$204.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$102.40
|
| Rate for Payer: Galaxy Health WC |
$217.60
|
| Rate for Payer: Global Benefits Group Commercial |
$153.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$230.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$170.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.20
|
| Rate for Payer: Multiplan Commercial |
$192.00
|
| Rate for Payer: Networks By Design Commercial |
$166.40
|
| Rate for Payer: Prime Health Services Commercial |
$217.60
|
|
|
HC NEEDLE ELEC LIMIT STUDY 1 SITE
|
Facility
OP
|
$256.00
|
|
|
Service Code
|
CPT 95870
|
| Hospital Charge Code |
900600255
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$48.59 |
| Max. Negotiated Rate |
$1,231.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$232.60
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$48.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$151.24
|
| Rate for Payer: BCBS Transplant Transplant |
$153.60
|
| Rate for Payer: Blue Shield of California Commercial |
$158.21
|
| Rate for Payer: Blue Shield of California EPN |
$124.42
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Central Health Plan Commercial |
$204.80
|
| Rate for Payer: Cigna of CA HMO |
$163.84
|
| Rate for Payer: Cigna of CA PPO |
$189.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$217.60
|
| Rate for Payer: Global Benefits Group Commercial |
$153.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$230.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$192.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: IEHP medi-cal |
$263.34
|
| Rate for Payer: IEHP Medicare Advantage |
$159.60
|
| Rate for Payer: Innovage PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$170.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$192.00
|
| Rate for Payer: Networks By Design Commercial |
$166.40
|
| Rate for Payer: Prime Health Services Commercial |
$217.60
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$153.60
|
| Rate for Payer: Riverside University Health MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$153.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$153.60
|
| 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 |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC NEEDLE ELEC LIMIT STUDY 1 SITE
|
Facility
OP
|
$256.00
|
|
|
Service Code
|
CPT 95870
|
| Hospital Charge Code |
900600255
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$48.59 |
| Max. Negotiated Rate |
$1,935.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$232.60
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$48.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$151.24
|
| Rate for Payer: BCBS Transplant Transplant |
$153.60
|
| Rate for Payer: Blue Shield of California Commercial |
$158.21
|
| Rate for Payer: Blue Shield of California EPN |
$124.42
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Central Health Plan Commercial |
$204.80
|
| Rate for Payer: Cigna of CA HMO |
$163.84
|
| Rate for Payer: Cigna of CA PPO |
$189.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$217.60
|
| Rate for Payer: Global Benefits Group Commercial |
$153.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$230.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$192.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: IEHP medi-cal |
$263.34
|
| Rate for Payer: IEHP Medicare Advantage |
$159.60
|
| Rate for Payer: Innovage PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$170.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$192.00
|
| Rate for Payer: Networks By Design Commercial |
$166.40
|
| Rate for Payer: Prime Health Services Commercial |
$217.60
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$153.60
|
| Rate for Payer: Riverside University Health MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$153.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$153.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,935.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,806.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,323.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC NEEDLE ELEC LIMIT STUDY 1 SITE
|
Facility
IP
|
$256.00
|
|
|
Service Code
|
CPT 95870
|
| Hospital Charge Code |
900600255
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$51.20 |
| Max. Negotiated Rate |
$230.40 |
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Central Health Plan Commercial |
$204.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$102.40
|
| Rate for Payer: Galaxy Health WC |
$217.60
|
| Rate for Payer: Global Benefits Group Commercial |
$153.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$230.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$170.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.20
|
| Rate for Payer: Multiplan Commercial |
$192.00
|
| Rate for Payer: Networks By Design Commercial |
$166.40
|
| Rate for Payer: Prime Health Services Commercial |
$217.60
|
|
|
HC NEEDLE ELECT CRANI NERVE BI
|
Facility
IP
|
$761.00
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
900600253
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$152.20 |
| Max. Negotiated Rate |
$684.90 |
| Rate for Payer: Cash Price |
$342.45
|
| Rate for Payer: Central Health Plan Commercial |
$608.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$304.40
|
| Rate for Payer: Galaxy Health WC |
$646.85
|
| Rate for Payer: Global Benefits Group Commercial |
$456.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$684.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$507.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$152.20
|
| Rate for Payer: Multiplan Commercial |
$570.75
|
| Rate for Payer: Networks By Design Commercial |
$494.65
|
| Rate for Payer: Prime Health Services Commercial |
$646.85
|
|
|
HC NEEDLE ELECT CRANI NERVE BI
|
Facility
OP
|
$761.00
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
900600253
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$152.20 |
| Max. Negotiated Rate |
$1,935.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$392.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$294.64
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$392.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$184.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$449.60
|
| Rate for Payer: BCBS Transplant Transplant |
$456.60
|
| Rate for Payer: Blue Shield of California Commercial |
$470.30
|
| Rate for Payer: Blue Shield of California EPN |
$369.85
|
| Rate for Payer: Caremore Medicare Advantage |
$392.17
|
| Rate for Payer: Cash Price |
$342.45
|
| Rate for Payer: Cash Price |
$342.45
|
| Rate for Payer: Cash Price |
$342.45
|
| Rate for Payer: Central Health Plan Commercial |
$608.80
|
| Rate for Payer: Cigna of CA HMO |
$487.04
|
| Rate for Payer: Cigna of CA PPO |
$563.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.26
|
| 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 |
$646.85
|
| Rate for Payer: Global Benefits Group Commercial |
$456.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$684.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$570.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$643.16
|
| Rate for Payer: IEHP medi-cal |
$647.08
|
| Rate for Payer: IEHP Medicare Advantage |
$392.17
|
| Rate for Payer: Innovage PACE Commercial |
$588.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$507.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$152.20
|
| 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 |
$570.75
|
| Rate for Payer: Networks By Design Commercial |
$494.65
|
| Rate for Payer: Prime Health Services Commercial |
$646.85
|
| Rate for Payer: Prime Health Services Medicare |
$415.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$456.60
|
| Rate for Payer: Riverside University Health MISP |
$431.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$456.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$456.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,935.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,806.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,323.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,209.00
|
| 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 NEEDLE ELECT CRANI NERVE BI
|
Facility
IP
|
$761.00
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
900600253
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$152.20 |
| Max. Negotiated Rate |
$684.90 |
| Rate for Payer: Cash Price |
$342.45
|
| Rate for Payer: Central Health Plan Commercial |
$608.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$304.40
|
| Rate for Payer: Galaxy Health WC |
$646.85
|
| Rate for Payer: Global Benefits Group Commercial |
$456.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$684.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$507.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$152.20
|
| Rate for Payer: Multiplan Commercial |
$570.75
|
| Rate for Payer: Networks By Design Commercial |
$494.65
|
| Rate for Payer: Prime Health Services Commercial |
$646.85
|
|
|
HC NEEDLE ELECT CRANI NERVE BI
|
Facility
OP
|
$761.00
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
900600253
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$152.20 |
| Max. Negotiated Rate |
$1,231.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$392.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$294.64
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$392.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$184.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$449.60
|
| Rate for Payer: BCBS Transplant Transplant |
$456.60
|
| Rate for Payer: Blue Shield of California Commercial |
$470.30
|
| Rate for Payer: Blue Shield of California EPN |
$369.85
|
| Rate for Payer: Caremore Medicare Advantage |
$392.17
|
| Rate for Payer: Cash Price |
$342.45
|
| Rate for Payer: Cash Price |
$342.45
|
| Rate for Payer: Cash Price |
$342.45
|
| Rate for Payer: Central Health Plan Commercial |
$608.80
|
| Rate for Payer: Cigna of CA HMO |
$487.04
|
| Rate for Payer: Cigna of CA PPO |
$563.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.26
|
| 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 |
$646.85
|
| Rate for Payer: Global Benefits Group Commercial |
$456.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$684.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$570.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$643.16
|
| Rate for Payer: IEHP medi-cal |
$647.08
|
| Rate for Payer: IEHP Medicare Advantage |
$392.17
|
| Rate for Payer: Innovage PACE Commercial |
$588.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$507.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$152.20
|
| 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 |
$570.75
|
| Rate for Payer: Networks By Design Commercial |
$494.65
|
| Rate for Payer: Prime Health Services Commercial |
$646.85
|
| Rate for Payer: Prime Health Services Medicare |
$415.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$456.60
|
| Rate for Payer: Riverside University Health MISP |
$431.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$456.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$456.60
|
| 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 |
$588.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Vantage Medical Group Senior |
$392.17
|
|
|
HC NEEDLE ELEC THOR/SPINAL MUSC
|
Facility
OP
|
$320.00
|
|
|
Service Code
|
CPT 95869
|
| Hospital Charge Code |
900600254
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$57.01 |
| Max. Negotiated Rate |
$1,935.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$392.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$238.80
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$392.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$57.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$189.06
|
| Rate for Payer: BCBS Transplant Transplant |
$192.00
|
| Rate for Payer: Blue Shield of California Commercial |
$197.76
|
| Rate for Payer: Blue Shield of California EPN |
$155.52
|
| Rate for Payer: Caremore Medicare Advantage |
$392.17
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Central Health Plan Commercial |
$256.00
|
| Rate for Payer: Cigna of CA HMO |
$204.80
|
| Rate for Payer: Cigna of CA PPO |
$236.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.26
|
| 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 |
$272.00
|
| Rate for Payer: Global Benefits Group Commercial |
$192.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$288.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$240.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$643.16
|
| Rate for Payer: IEHP medi-cal |
$647.08
|
| Rate for Payer: IEHP Medicare Advantage |
$392.17
|
| Rate for Payer: Innovage PACE Commercial |
$588.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$213.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.00
|
| 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 |
$240.00
|
| Rate for Payer: Networks By Design Commercial |
$208.00
|
| Rate for Payer: Prime Health Services Commercial |
$272.00
|
| Rate for Payer: Prime Health Services Medicare |
$415.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$192.00
|
| Rate for Payer: Riverside University Health MISP |
$431.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$192.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$192.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,935.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,806.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,323.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,209.00
|
| 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 NEEDLE ELEC THOR/SPINAL MUSC
|
Facility
IP
|
$320.00
|
|
|
Service Code
|
CPT 95869
|
| Hospital Charge Code |
900600254
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$64.00 |
| Max. Negotiated Rate |
$288.00 |
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Central Health Plan Commercial |
$256.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$128.00
|
| Rate for Payer: Galaxy Health WC |
$272.00
|
| Rate for Payer: Global Benefits Group Commercial |
$192.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$288.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$213.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.00
|
| Rate for Payer: Multiplan Commercial |
$240.00
|
| Rate for Payer: Networks By Design Commercial |
$208.00
|
| Rate for Payer: Prime Health Services Commercial |
$272.00
|
|
|
HC NEEDLE EMG 1 EXT W/ WO PARASP
|
Facility
OP
|
$2,437.00
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
900600233
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$101.43 |
| Max. Negotiated Rate |
$2,193.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$247.08
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$101.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,439.78
|
| Rate for Payer: BCBS Transplant Transplant |
$1,462.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,506.07
|
| Rate for Payer: Blue Shield of California EPN |
$1,184.38
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$1,096.65
|
| Rate for Payer: Cash Price |
$1,096.65
|
| Rate for Payer: Cash Price |
$1,096.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,949.60
|
| Rate for Payer: Cigna of CA HMO |
$1,559.68
|
| Rate for Payer: Cigna of CA PPO |
$1,803.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$2,071.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,462.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,193.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,827.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: IEHP medi-cal |
$263.34
|
| Rate for Payer: IEHP Medicare Advantage |
$159.60
|
| Rate for Payer: Innovage PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,625.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$487.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$1,827.75
|
| Rate for Payer: Networks By Design Commercial |
$1,584.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,071.45
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,462.20
|
| Rate for Payer: Riverside University Health MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,462.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,462.20
|
| 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 |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC NEEDLE EMG 1 EXT W/ WO PARASP
|
Facility
IP
|
$2,437.00
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
900600233
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$487.40 |
| Max. Negotiated Rate |
$2,193.30 |
| Rate for Payer: Cash Price |
$1,096.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,949.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$974.80
|
| Rate for Payer: Galaxy Health WC |
$2,071.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,462.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,193.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,625.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$487.40
|
| Rate for Payer: Multiplan Commercial |
$1,827.75
|
| Rate for Payer: Networks By Design Commercial |
$1,584.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,071.45
|
|
|
HC NEEDLE EMG 2 EXT W/WO PARASP
|
Facility
OP
|
$3,046.00
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
900600232
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$159.60 |
| Max. Negotiated Rate |
$2,741.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$315.31
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$197.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,799.58
|
| Rate for Payer: BCBS Transplant Transplant |
$1,827.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1,882.43
|
| Rate for Payer: Blue Shield of California EPN |
$1,480.36
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$1,370.70
|
| Rate for Payer: Cash Price |
$1,370.70
|
| Rate for Payer: Cash Price |
$1,370.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,436.80
|
| Rate for Payer: Cigna of CA HMO |
$1,949.44
|
| Rate for Payer: Cigna of CA PPO |
$2,254.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$2,589.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,827.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,741.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,284.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: IEHP medi-cal |
$263.34
|
| Rate for Payer: IEHP Medicare Advantage |
$159.60
|
| Rate for Payer: Innovage PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,031.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$609.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$2,284.50
|
| Rate for Payer: Networks By Design Commercial |
$1,979.90
|
| Rate for Payer: Prime Health Services Commercial |
$2,589.10
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,827.60
|
| Rate for Payer: Riverside University Health MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,827.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,827.60
|
| 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 |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC NEEDLE EMG 2 EXT W/WO PARASP
|
Facility
IP
|
$3,046.00
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
900600232
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$609.20 |
| Max. Negotiated Rate |
$2,741.40 |
| Rate for Payer: Cash Price |
$1,370.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,436.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,218.40
|
| Rate for Payer: Galaxy Health WC |
$2,589.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,827.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,741.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,031.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$609.20
|
| Rate for Payer: Multiplan Commercial |
$2,284.50
|
| Rate for Payer: Networks By Design Commercial |
$1,979.90
|
| Rate for Payer: Prime Health Services Commercial |
$2,589.10
|
|
|
HC NEEDLE EMG 3 EXT W WO PARASP
|
Facility
IP
|
$2,949.00
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
900600250
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$589.80 |
| Max. Negotiated Rate |
$2,654.10 |
| Rate for Payer: Cash Price |
$1,327.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,359.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,179.60
|
| Rate for Payer: Galaxy Health WC |
$2,506.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,769.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,654.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,966.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$589.80
|
| Rate for Payer: Multiplan Commercial |
$2,211.75
|
| Rate for Payer: Networks By Design Commercial |
$1,916.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,506.65
|
|
|
HC NEEDLE EMG 3 EXT W WO PARASP
|
Facility
OP
|
$2,949.00
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
900600250
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$195.17 |
| Max. Negotiated Rate |
$2,654.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$195.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$383.54
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$195.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$249.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,742.27
|
| Rate for Payer: BCBS Transplant Transplant |
$1,769.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,822.48
|
| Rate for Payer: Blue Shield of California EPN |
$1,433.21
|
| Rate for Payer: Caremore Medicare Advantage |
$195.17
|
| Rate for Payer: Cash Price |
$1,327.05
|
| Rate for Payer: Cash Price |
$1,327.05
|
| Rate for Payer: Cash Price |
$1,327.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,359.20
|
| Rate for Payer: Cigna of CA HMO |
$1,887.36
|
| Rate for Payer: Cigna of CA PPO |
$2,182.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| 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 |
$2,506.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,769.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,654.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,211.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$320.08
|
| Rate for Payer: IEHP medi-cal |
$322.03
|
| Rate for Payer: IEHP Medicare Advantage |
$195.17
|
| Rate for Payer: Innovage PACE Commercial |
$292.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,966.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$195.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$589.80
|
| 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 |
$2,211.75
|
| Rate for Payer: Networks By Design Commercial |
$1,916.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,506.65
|
| Rate for Payer: Prime Health Services Medicare |
$206.88
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,769.40
|
| Rate for Payer: Riverside University Health MISP |
$214.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,769.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,769.40
|
| 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 |
$292.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Vantage Medical Group Senior |
$195.17
|
|
|
HC NEEDLE EMG 3 EXT W WO PARASP
|
Facility
IP
|
$2,949.00
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
900600250
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$589.80 |
| Max. Negotiated Rate |
$2,654.10 |
| Rate for Payer: Cash Price |
$1,327.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,359.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,179.60
|
| Rate for Payer: Galaxy Health WC |
$2,506.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,769.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,654.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,966.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$589.80
|
| Rate for Payer: Multiplan Commercial |
$2,211.75
|
| Rate for Payer: Networks By Design Commercial |
$1,916.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,506.65
|
|
|
HC NEEDLE EMG 3 EXT W WO PARASP
|
Facility
OP
|
$2,949.00
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
900600250
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$195.17 |
| Max. Negotiated Rate |
$2,654.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$195.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$383.54
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$195.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$249.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,742.27
|
| Rate for Payer: BCBS Transplant Transplant |
$1,769.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,822.48
|
| Rate for Payer: Blue Shield of California EPN |
$1,433.21
|
| Rate for Payer: Caremore Medicare Advantage |
$195.17
|
| Rate for Payer: Cash Price |
$1,327.05
|
| Rate for Payer: Cash Price |
$1,327.05
|
| Rate for Payer: Cash Price |
$1,327.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,359.20
|
| Rate for Payer: Cigna of CA HMO |
$1,887.36
|
| Rate for Payer: Cigna of CA PPO |
$2,182.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| 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 |
$2,506.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,769.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,654.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,211.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$320.08
|
| Rate for Payer: IEHP medi-cal |
$322.03
|
| Rate for Payer: IEHP Medicare Advantage |
$195.17
|
| Rate for Payer: Innovage PACE Commercial |
$292.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,966.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$195.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$589.80
|
| 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 |
$2,211.75
|
| Rate for Payer: Networks By Design Commercial |
$1,916.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,506.65
|
| Rate for Payer: Prime Health Services Medicare |
$206.88
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,769.40
|
| Rate for Payer: Riverside University Health MISP |
$214.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,769.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,769.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,935.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,806.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,323.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,209.00
|
| 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 NEEDLE EMG 4 EXT W WO PARASP
|
Facility
IP
|
$2,949.00
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
900600251
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$589.80 |
| Max. Negotiated Rate |
$2,654.10 |
| Rate for Payer: Cash Price |
$1,327.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,359.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,179.60
|
| Rate for Payer: Galaxy Health WC |
$2,506.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,769.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,654.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,966.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$589.80
|
| Rate for Payer: Multiplan Commercial |
$2,211.75
|
| Rate for Payer: Networks By Design Commercial |
$1,916.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,506.65
|
|
|
HC NEEDLE EMG 4 EXT W WO PARASP
|
Facility
OP
|
$2,949.00
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
900600251
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$195.17 |
| Max. Negotiated Rate |
$2,654.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$195.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$439.38
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$195.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$471.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,742.27
|
| Rate for Payer: BCBS Transplant Transplant |
$1,769.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,822.48
|
| Rate for Payer: Blue Shield of California EPN |
$1,433.21
|
| Rate for Payer: Caremore Medicare Advantage |
$195.17
|
| Rate for Payer: Cash Price |
$1,327.05
|
| Rate for Payer: Cash Price |
$1,327.05
|
| Rate for Payer: Cash Price |
$1,327.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,359.20
|
| Rate for Payer: Cigna of CA HMO |
$1,887.36
|
| Rate for Payer: Cigna of CA PPO |
$2,182.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| 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 |
$2,506.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,769.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,654.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,211.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$320.08
|
| Rate for Payer: IEHP medi-cal |
$322.03
|
| Rate for Payer: IEHP Medicare Advantage |
$195.17
|
| Rate for Payer: Innovage PACE Commercial |
$292.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,966.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$195.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$589.80
|
| 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 |
$2,211.75
|
| Rate for Payer: Networks By Design Commercial |
$1,916.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,506.65
|
| Rate for Payer: Prime Health Services Medicare |
$206.88
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,769.40
|
| Rate for Payer: Riverside University Health MISP |
$214.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,769.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,769.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,935.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,806.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,323.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,209.00
|
| 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 NEEDLE EMG 4 EXT W WO PARASP
|
Facility
OP
|
$2,949.00
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
900600251
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$195.17 |
| Max. Negotiated Rate |
$2,654.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$195.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$439.38
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$195.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$471.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,742.27
|
| Rate for Payer: BCBS Transplant Transplant |
$1,769.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,822.48
|
| Rate for Payer: Blue Shield of California EPN |
$1,433.21
|
| Rate for Payer: Caremore Medicare Advantage |
$195.17
|
| Rate for Payer: Cash Price |
$1,327.05
|
| Rate for Payer: Cash Price |
$1,327.05
|
| Rate for Payer: Cash Price |
$1,327.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,359.20
|
| Rate for Payer: Cigna of CA HMO |
$1,887.36
|
| Rate for Payer: Cigna of CA PPO |
$2,182.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| 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 |
$2,506.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,769.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,654.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,211.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$320.08
|
| Rate for Payer: IEHP medi-cal |
$322.03
|
| Rate for Payer: IEHP Medicare Advantage |
$195.17
|
| Rate for Payer: Innovage PACE Commercial |
$292.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,966.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$195.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$589.80
|
| 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 |
$2,211.75
|
| Rate for Payer: Networks By Design Commercial |
$1,916.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,506.65
|
| Rate for Payer: Prime Health Services Medicare |
$206.88
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,769.40
|
| Rate for Payer: Riverside University Health MISP |
$214.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,769.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,769.40
|
| 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 |
$292.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Vantage Medical Group Senior |
$195.17
|
|
|
HC NEEDLE EMG 4 EXT W WO PARASP
|
Facility
IP
|
$2,949.00
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
900600251
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$589.80 |
| Max. Negotiated Rate |
$2,654.10 |
| Rate for Payer: Cash Price |
$1,327.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,359.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,179.60
|
| Rate for Payer: Galaxy Health WC |
$2,506.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,769.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,654.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,966.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$589.80
|
| Rate for Payer: Multiplan Commercial |
$2,211.75
|
| Rate for Payer: Networks By Design Commercial |
$1,916.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,506.65
|
|
|
HC NEFF SET
|
Facility
IP
|
$452.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
909001087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$90.40 |
| Max. Negotiated Rate |
$406.80 |
| Rate for Payer: Cash Price |
$203.40
|
| Rate for Payer: Central Health Plan Commercial |
$361.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$180.80
|
| Rate for Payer: Galaxy Health WC |
$384.20
|
| Rate for Payer: Global Benefits Group Commercial |
$271.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$406.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$301.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.40
|
| Rate for Payer: Multiplan Commercial |
$339.00
|
| Rate for Payer: Networks By Design Commercial |
$293.80
|
| Rate for Payer: Prime Health Services Commercial |
$384.20
|
|
