|
HC OCCLUSIVE DEVICE IN VEIN ART
|
Facility
OP
|
$1,074.00
|
|
|
Service Code
|
CPT G0269
|
| Hospital Charge Code |
906820128
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$214.80 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16,537.55
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$912.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$590.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$590.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$644.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$483.30
|
| Rate for Payer: Cash Price |
$483.30
|
| Rate for Payer: Cash Price |
$483.30
|
| Rate for Payer: Central Health Plan Commercial |
$859.20
|
| Rate for Payer: Cigna of CA PPO |
$794.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$912.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$429.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$429.60
|
| Rate for Payer: Galaxy Health WC |
$912.90
|
| Rate for Payer: Global Benefits Group Commercial |
$644.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$966.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$805.50
|
| Rate for Payer: IEHP medi-cal |
$375.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$716.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$214.80
|
| Rate for Payer: Multiplan Commercial |
$805.50
|
| Rate for Payer: Networks By Design Commercial |
$698.10
|
| Rate for Payer: Prime Health Services Commercial |
$912.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$644.40
|
| Rate for Payer: Riverside University Health MISP |
$429.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$644.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$912.90
|
| Rate for Payer: Vantage Medical Group Senior |
$912.90
|
|
|
HC OCCLUSIVE DEVICE IN VEIN ART
|
Facility
IP
|
$1,074.00
|
|
|
Service Code
|
CPT G0269
|
| Hospital Charge Code |
906811384
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$214.80 |
| Max. Negotiated Rate |
$966.60 |
| Rate for Payer: Cash Price |
$483.30
|
| Rate for Payer: Central Health Plan Commercial |
$859.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$429.60
|
| Rate for Payer: Galaxy Health WC |
$912.90
|
| Rate for Payer: Global Benefits Group Commercial |
$644.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$966.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$716.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$214.80
|
| Rate for Payer: Multiplan Commercial |
$805.50
|
| Rate for Payer: Networks By Design Commercial |
$698.10
|
| Rate for Payer: Prime Health Services Commercial |
$912.90
|
|
|
HC OCC THER ELECT STIM UNATTEND WOUND CARE
|
Facility
OP
|
$125.00
|
|
|
Service Code
|
CPT G0282
|
| Hospital Charge Code |
905104525
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$43.75 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$58.53
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$106.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$68.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$68.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$75.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$56.25
|
| Rate for Payer: Cash Price |
$56.25
|
| Rate for Payer: Cash Price |
$56.25
|
| Rate for Payer: Cash Price |
$56.25
|
| Rate for Payer: Central Health Plan Commercial |
$100.00
|
| Rate for Payer: Cigna of CA HMO |
$80.00
|
| Rate for Payer: Cigna of CA PPO |
$92.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$106.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$50.00
|
| Rate for Payer: Galaxy Health WC |
$106.25
|
| Rate for Payer: Global Benefits Group Commercial |
$75.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$112.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$93.75
|
| Rate for Payer: IEHP medi-cal |
$43.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.25
|
| Rate for Payer: Multiplan Commercial |
$93.75
|
| Rate for Payer: Networks By Design Commercial |
$81.25
|
| Rate for Payer: Prime Health Services Commercial |
$106.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$75.00
|
| Rate for Payer: Riverside University Health MISP |
$50.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$75.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$75.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$106.25
|
| Rate for Payer: Vantage Medical Group Senior |
$106.25
|
|
|
HC OCC THER ELECT STIM UNATTEND WOUND CARE
|
Facility
IP
|
$125.00
|
|
|
Service Code
|
CPT G0282
|
| Hospital Charge Code |
905104525
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$25.00 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Cash Price |
$56.25
|
| Rate for Payer: Central Health Plan Commercial |
$100.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.00
|
| Rate for Payer: Galaxy Health WC |
$106.25
|
| Rate for Payer: Global Benefits Group Commercial |
$75.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$112.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.00
|
| Rate for Payer: Multiplan Commercial |
$93.75
|
| Rate for Payer: Networks By Design Commercial |
$81.25
|
| Rate for Payer: Prime Health Services Commercial |
$106.25
|
|
|
HC OCC THER EVALUATION INITIAL 15MIN
|
Facility
OP
|
$202.00
|
|
| Hospital Charge Code |
901309051
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$70.70 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$122.67
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$171.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$111.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$111.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$121.20
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$90.90
|
| Rate for Payer: Cash Price |
$90.90
|
| Rate for Payer: Cash Price |
$90.90
|
| Rate for Payer: Central Health Plan Commercial |
$161.60
|
| Rate for Payer: Cigna of CA HMO |
$129.28
|
| Rate for Payer: Cigna of CA PPO |
$149.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$171.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$80.80
|
| Rate for Payer: Galaxy Health WC |
$171.70
|
| Rate for Payer: Global Benefits Group Commercial |
$121.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$181.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$151.50
|
| Rate for Payer: IEHP medi-cal |
$70.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$134.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.82
|
| Rate for Payer: Multiplan Commercial |
$151.50
|
| Rate for Payer: Networks By Design Commercial |
$131.30
|
| Rate for Payer: Prime Health Services Commercial |
$171.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$121.20
|
| Rate for Payer: Riverside University Health MISP |
$80.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$121.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$121.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$171.70
|
| Rate for Payer: Vantage Medical Group Senior |
$171.70
|
|
|
HC OCC THER EVALUATION INITIAL 15MIN
|
Facility
IP
|
$202.00
|
|
| Hospital Charge Code |
901309051
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$40.40 |
| Max. Negotiated Rate |
$181.80 |
| Rate for Payer: Cash Price |
$90.90
|
| Rate for Payer: Central Health Plan Commercial |
$161.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.80
|
| Rate for Payer: Galaxy Health WC |
$171.70
|
| Rate for Payer: Global Benefits Group Commercial |
$121.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$181.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$134.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.40
|
| Rate for Payer: Multiplan Commercial |
$151.50
|
| Rate for Payer: Networks By Design Commercial |
$131.30
|
| Rate for Payer: Prime Health Services Commercial |
$171.70
|
|
|
HC OCC THER EVALUATION INITIAL 30MIN
|
Facility
OP
|
$403.00
|
|
| Hospital Charge Code |
901309050
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$141.05 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$244.74
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$342.55
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$221.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$221.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$241.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$181.35
|
| Rate for Payer: Cash Price |
$181.35
|
| Rate for Payer: Cash Price |
$181.35
|
| Rate for Payer: Central Health Plan Commercial |
$322.40
|
| Rate for Payer: Cigna of CA HMO |
$257.92
|
| Rate for Payer: Cigna of CA PPO |
$298.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$342.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$161.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$161.20
|
| Rate for Payer: Galaxy Health WC |
$342.55
|
| Rate for Payer: Global Benefits Group Commercial |
$241.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$362.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$302.25
|
| Rate for Payer: IEHP medi-cal |
$141.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$268.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$165.23
|
| Rate for Payer: Multiplan Commercial |
$302.25
|
| Rate for Payer: Networks By Design Commercial |
$261.95
|
| Rate for Payer: Prime Health Services Commercial |
$342.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$241.80
|
| Rate for Payer: Riverside University Health MISP |
$161.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$241.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$241.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$342.55
|
| Rate for Payer: Vantage Medical Group Senior |
$342.55
|
|
|
HC OCC THER EVALUATION INITIAL 30MIN
|
Facility
IP
|
$403.00
|
|
| Hospital Charge Code |
901309050
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$80.60 |
| Max. Negotiated Rate |
$362.70 |
| Rate for Payer: Cash Price |
$181.35
|
| Rate for Payer: Central Health Plan Commercial |
$322.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$161.20
|
| Rate for Payer: Galaxy Health WC |
$342.55
|
| Rate for Payer: Global Benefits Group Commercial |
$241.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$362.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$268.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.60
|
| Rate for Payer: Multiplan Commercial |
$302.25
|
| Rate for Payer: Networks By Design Commercial |
$261.95
|
| Rate for Payer: Prime Health Services Commercial |
$342.55
|
|
|
HC OCCULT BLOOD, FECES 1-3 SIMUL
|
Facility
OP
|
$181.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
900501612
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.55 |
| Max. Negotiated Rate |
$162.90 |
| Rate for Payer: Adventist Health Medi-Cal |
$4.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.87
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6.57
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.28
|
| Rate for Payer: BCBS Transplant Transplant |
$108.60
|
| Rate for Payer: Blue Shield of California Commercial |
$111.86
|
| Rate for Payer: Blue Shield of California EPN |
$87.97
|
| Rate for Payer: Caremore Medicare Advantage |
$4.38
|
| Rate for Payer: Cash Price |
$81.45
|
| Rate for Payer: Cash Price |
$81.45
|
| Rate for Payer: Central Health Plan Commercial |
$144.80
|
| Rate for Payer: Cigna of CA HMO |
$115.84
|
| Rate for Payer: Cigna of CA PPO |
$133.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4.38
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.38
|
| Rate for Payer: Galaxy Health WC |
$153.85
|
| Rate for Payer: Global Benefits Group Commercial |
$108.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$162.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$135.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.18
|
| Rate for Payer: IEHP medi-cal |
$7.23
|
| Rate for Payer: IEHP Medicare Advantage |
$4.38
|
| Rate for Payer: Innovage PACE Commercial |
$6.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$120.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.87
|
| Rate for Payer: Multiplan Commercial |
$135.75
|
| Rate for Payer: Networks By Design Commercial |
$117.65
|
| Rate for Payer: Prime Health Services Commercial |
$153.85
|
| Rate for Payer: Prime Health Services Medicare |
$4.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$108.60
|
| Rate for Payer: Riverside University Health MISP |
$4.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$108.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$108.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.55
|
| Rate for Payer: United Healthcare All Other HMO |
$3.55
|
| Rate for Payer: United Healthcare HMO Rider |
$3.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.82
|
| Rate for Payer: Vantage Medical Group Senior |
$4.38
|
|
|
HC OCCULT BLOOD, FECES 1-3 SIMUL
|
Facility
IP
|
$181.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
900501612
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$36.20 |
| Max. Negotiated Rate |
$162.90 |
| Rate for Payer: Cash Price |
$81.45
|
| Rate for Payer: Central Health Plan Commercial |
$144.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.40
|
| Rate for Payer: Galaxy Health WC |
$153.85
|
| Rate for Payer: Global Benefits Group Commercial |
$108.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$162.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$120.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.20
|
| Rate for Payer: Multiplan Commercial |
$135.75
|
| Rate for Payer: Networks By Design Commercial |
$117.65
|
| Rate for Payer: Prime Health Services Commercial |
$153.85
|
|
|
HC OCCULT BLOOD, FECES 1-3 SIMUL
|
Facility
OP
|
$181.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
900501612
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$4.38 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.87
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6.57
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$108.60
|
| Rate for Payer: Blue Shield of California Commercial |
$113.85
|
| Rate for Payer: Blue Shield of California EPN |
$88.51
|
| Rate for Payer: Caremore Medicare Advantage |
$4.38
|
| Rate for Payer: Cash Price |
$81.45
|
| Rate for Payer: Cash Price |
$81.45
|
| Rate for Payer: Cash Price |
$81.45
|
| Rate for Payer: Central Health Plan Commercial |
$144.80
|
| Rate for Payer: Cigna of CA HMO |
$115.84
|
| Rate for Payer: Cigna of CA PPO |
$133.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4.38
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.38
|
| Rate for Payer: Galaxy Health WC |
$153.85
|
| Rate for Payer: Global Benefits Group Commercial |
$108.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$162.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$135.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.18
|
| Rate for Payer: IEHP medi-cal |
$7.23
|
| Rate for Payer: IEHP Medicare Advantage |
$4.38
|
| Rate for Payer: Innovage PACE Commercial |
$6.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$120.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.87
|
| Rate for Payer: Multiplan Commercial |
$135.75
|
| Rate for Payer: Networks By Design Commercial |
$117.65
|
| Rate for Payer: Prime Health Services Commercial |
$153.85
|
| Rate for Payer: Prime Health Services Medicare |
$4.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$108.60
|
| Rate for Payer: Riverside University Health MISP |
$4.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$108.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$108.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$90.50
|
| Rate for Payer: United Healthcare All Other HMO |
$90.50
|
| Rate for Payer: United Healthcare HMO Rider |
$90.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$90.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.82
|
| Rate for Payer: Vantage Medical Group Senior |
$4.38
|
|
|
HC OCCULT BLOOD, FECES 1-3 SIMUL
|
Facility
IP
|
$181.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
900501612
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.20 |
| Max. Negotiated Rate |
$162.90 |
| Rate for Payer: Cash Price |
$81.45
|
| Rate for Payer: Central Health Plan Commercial |
$144.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.40
|
| Rate for Payer: Galaxy Health WC |
$153.85
|
| Rate for Payer: Global Benefits Group Commercial |
$108.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$162.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$120.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.20
|
| Rate for Payer: Multiplan Commercial |
$135.75
|
| Rate for Payer: Networks By Design Commercial |
$117.65
|
| Rate for Payer: Prime Health Services Commercial |
$153.85
|
|
|
HC OCCULT BLOOD GASTRIC
|
Facility
OP
|
$7.00
|
|
|
Service Code
|
CPT 82271
|
| Hospital Charge Code |
900912329
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.40 |
| Max. Negotiated Rate |
$28.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.87
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.98
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.20
|
| Rate for Payer: BCBS Transplant Transplant |
$4.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4.33
|
| Rate for Payer: Blue Shield of California EPN |
$3.40
|
| Rate for Payer: Caremore Medicare Advantage |
$5.32
|
| Rate for Payer: Cash Price |
$3.15
|
| Rate for Payer: Cash Price |
$3.15
|
| Rate for Payer: Central Health Plan Commercial |
$5.60
|
| Rate for Payer: Cigna of CA HMO |
$4.48
|
| Rate for Payer: Cigna of CA PPO |
$5.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.18
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.32
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.32
|
| Rate for Payer: Galaxy Health WC |
$5.95
|
| Rate for Payer: Global Benefits Group Commercial |
$4.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.72
|
| Rate for Payer: IEHP medi-cal |
$8.78
|
| Rate for Payer: IEHP Medicare Advantage |
$5.32
|
| Rate for Payer: Innovage PACE Commercial |
$7.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.13
|
| Rate for Payer: Multiplan Commercial |
$5.25
|
| Rate for Payer: Networks By Design Commercial |
$4.55
|
| Rate for Payer: Prime Health Services Commercial |
$5.95
|
| Rate for Payer: Prime Health Services Medicare |
$5.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4.20
|
| Rate for Payer: Riverside University Health MISP |
$5.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.31
|
| Rate for Payer: United Healthcare All Other HMO |
$4.31
|
| Rate for Payer: United Healthcare HMO Rider |
$4.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.85
|
| Rate for Payer: Vantage Medical Group Senior |
$5.32
|
|
|
HC OCCULT BLOOD GASTRIC
|
Facility
IP
|
$122.00
|
|
|
Service Code
|
CPT 82271
|
| Hospital Charge Code |
900912329
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$109.80 |
| Rate for Payer: Cash Price |
$54.90
|
| Rate for Payer: Central Health Plan Commercial |
$97.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.80
|
| Rate for Payer: Galaxy Health WC |
$103.70
|
| Rate for Payer: Global Benefits Group Commercial |
$73.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$109.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$81.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.40
|
| Rate for Payer: Multiplan Commercial |
$91.50
|
| Rate for Payer: Networks By Design Commercial |
$79.30
|
| Rate for Payer: Prime Health Services Commercial |
$103.70
|
|
|
HC OCCULT BLOOD OTHR SOURCE
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT 82271
|
| Hospital Charge Code |
900911536
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.80 |
| Max. Negotiated Rate |
$28.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.87
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.98
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.20
|
| Rate for Payer: BCBS Transplant Transplant |
$5.40
|
| Rate for Payer: Blue Shield of California Commercial |
$5.56
|
| Rate for Payer: Blue Shield of California EPN |
$4.37
|
| Rate for Payer: Caremore Medicare Advantage |
$5.32
|
| Rate for Payer: Cash Price |
$4.05
|
| Rate for Payer: Cash Price |
$4.05
|
| Rate for Payer: Central Health Plan Commercial |
$7.20
|
| Rate for Payer: Cigna of CA HMO |
$5.76
|
| Rate for Payer: Cigna of CA PPO |
$6.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.18
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.32
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.32
|
| Rate for Payer: Galaxy Health WC |
$7.65
|
| Rate for Payer: Global Benefits Group Commercial |
$5.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.72
|
| Rate for Payer: IEHP medi-cal |
$8.78
|
| Rate for Payer: IEHP Medicare Advantage |
$5.32
|
| Rate for Payer: Innovage PACE Commercial |
$7.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.13
|
| Rate for Payer: Multiplan Commercial |
$6.75
|
| Rate for Payer: Networks By Design Commercial |
$5.85
|
| Rate for Payer: Prime Health Services Commercial |
$7.65
|
| Rate for Payer: Prime Health Services Medicare |
$5.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5.40
|
| Rate for Payer: Riverside University Health MISP |
$5.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.31
|
| Rate for Payer: United Healthcare All Other HMO |
$4.31
|
| Rate for Payer: United Healthcare HMO Rider |
$4.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.85
|
| Rate for Payer: Vantage Medical Group Senior |
$5.32
|
|
|
HC OCCULT BLOOD OTHR SOURCE
|
Facility
IP
|
$122.00
|
|
|
Service Code
|
CPT 82271
|
| Hospital Charge Code |
900911536
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$109.80 |
| Rate for Payer: Cash Price |
$54.90
|
| Rate for Payer: Central Health Plan Commercial |
$97.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.80
|
| Rate for Payer: Galaxy Health WC |
$103.70
|
| Rate for Payer: Global Benefits Group Commercial |
$73.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$109.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$81.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.40
|
| Rate for Payer: Multiplan Commercial |
$91.50
|
| Rate for Payer: Networks By Design Commercial |
$79.30
|
| Rate for Payer: Prime Health Services Commercial |
$103.70
|
|
|
HC OCCUP THERAPY EVAL - 30 MIN
|
Facility
IP
|
$301.00
|
|
| Hospital Charge Code |
905104020
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$60.20 |
| Max. Negotiated Rate |
$270.90 |
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Central Health Plan Commercial |
$240.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.40
|
| Rate for Payer: Galaxy Health WC |
$255.85
|
| Rate for Payer: Global Benefits Group Commercial |
$180.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$270.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$200.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.20
|
| Rate for Payer: Multiplan Commercial |
$225.75
|
| Rate for Payer: Networks By Design Commercial |
$195.65
|
| Rate for Payer: Prime Health Services Commercial |
$255.85
|
|
|
HC OCCUP THERAPY EVAL - 30 MIN
|
Facility
OP
|
$301.00
|
|
| Hospital Charge Code |
905104020
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$105.35 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$182.80
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$255.85
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$165.55
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$165.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$180.60
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Central Health Plan Commercial |
$240.80
|
| Rate for Payer: Cigna of CA HMO |
$192.64
|
| Rate for Payer: Cigna of CA PPO |
$222.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$255.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$120.40
|
| Rate for Payer: Galaxy Health WC |
$255.85
|
| Rate for Payer: Global Benefits Group Commercial |
$180.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$270.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$225.75
|
| Rate for Payer: IEHP medi-cal |
$105.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$200.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.41
|
| Rate for Payer: Multiplan Commercial |
$225.75
|
| Rate for Payer: Networks By Design Commercial |
$195.65
|
| Rate for Payer: Prime Health Services Commercial |
$255.85
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$180.60
|
| Rate for Payer: Riverside University Health MISP |
$120.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$180.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$180.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$255.85
|
| Rate for Payer: Vantage Medical Group Senior |
$255.85
|
|
|
HC OCCUP THERAPY EVAL - 45 MIN
|
Facility
OP
|
$406.00
|
|
| Hospital Charge Code |
905104001
|
|
Hospital Revenue Code
|
434
|
| Min. Negotiated Rate |
$142.10 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$246.56
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$345.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$223.30
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$223.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$243.60
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$182.70
|
| Rate for Payer: Cash Price |
$182.70
|
| Rate for Payer: Cash Price |
$182.70
|
| Rate for Payer: Central Health Plan Commercial |
$324.80
|
| Rate for Payer: Cigna of CA HMO |
$259.84
|
| Rate for Payer: Cigna of CA PPO |
$300.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$345.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$162.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$162.40
|
| Rate for Payer: Galaxy Health WC |
$345.10
|
| Rate for Payer: Global Benefits Group Commercial |
$243.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$365.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$304.50
|
| Rate for Payer: IEHP medi-cal |
$142.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$270.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$166.46
|
| Rate for Payer: Multiplan Commercial |
$304.50
|
| Rate for Payer: Networks By Design Commercial |
$263.90
|
| Rate for Payer: Prime Health Services Commercial |
$345.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$243.60
|
| Rate for Payer: Riverside University Health MISP |
$162.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$243.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$243.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$345.10
|
| Rate for Payer: Vantage Medical Group Senior |
$345.10
|
|
|
HC OCCUP THERAPY EVAL - 45 MIN
|
Facility
IP
|
$406.00
|
|
| Hospital Charge Code |
905104001
|
|
Hospital Revenue Code
|
434
|
| Min. Negotiated Rate |
$81.20 |
| Max. Negotiated Rate |
$365.40 |
| Rate for Payer: Cash Price |
$182.70
|
| Rate for Payer: Central Health Plan Commercial |
$324.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$162.40
|
| Rate for Payer: Galaxy Health WC |
$345.10
|
| Rate for Payer: Global Benefits Group Commercial |
$243.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$365.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$270.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.20
|
| Rate for Payer: Multiplan Commercial |
$304.50
|
| Rate for Payer: Networks By Design Commercial |
$263.90
|
| Rate for Payer: Prime Health Services Commercial |
$345.10
|
|
|
HC OCCUP THERAPY EVAL - 60 MIN
|
Facility
IP
|
$509.00
|
|
| Hospital Charge Code |
905104002
|
|
Hospital Revenue Code
|
434
|
| Min. Negotiated Rate |
$101.80 |
| Max. Negotiated Rate |
$458.10 |
| Rate for Payer: Cash Price |
$229.05
|
| Rate for Payer: Central Health Plan Commercial |
$407.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$203.60
|
| Rate for Payer: Galaxy Health WC |
$432.65
|
| Rate for Payer: Global Benefits Group Commercial |
$305.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$458.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$339.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$101.80
|
| Rate for Payer: Multiplan Commercial |
$381.75
|
| Rate for Payer: Networks By Design Commercial |
$330.85
|
| Rate for Payer: Prime Health Services Commercial |
$432.65
|
|
|
HC OCCUP THERAPY EVAL - 60 MIN
|
Facility
OP
|
$509.00
|
|
| Hospital Charge Code |
905104002
|
|
Hospital Revenue Code
|
434
|
| Min. Negotiated Rate |
$178.15 |
| Max. Negotiated Rate |
$458.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$309.12
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$432.65
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$279.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$279.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$305.40
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$229.05
|
| Rate for Payer: Cash Price |
$229.05
|
| Rate for Payer: Cash Price |
$229.05
|
| Rate for Payer: Central Health Plan Commercial |
$407.20
|
| Rate for Payer: Cigna of CA HMO |
$325.76
|
| Rate for Payer: Cigna of CA PPO |
$376.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$432.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$203.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$203.60
|
| Rate for Payer: Galaxy Health WC |
$432.65
|
| Rate for Payer: Global Benefits Group Commercial |
$305.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$458.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$381.75
|
| Rate for Payer: IEHP medi-cal |
$178.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$339.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$208.69
|
| Rate for Payer: Multiplan Commercial |
$381.75
|
| Rate for Payer: Networks By Design Commercial |
$330.85
|
| Rate for Payer: Prime Health Services Commercial |
$432.65
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$305.40
|
| Rate for Payer: Riverside University Health MISP |
$203.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$305.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$305.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$432.65
|
| Rate for Payer: Vantage Medical Group Senior |
$432.65
|
|
|
HC OCCUP THER EVAL ADDL 15 MIN
|
Facility
OP
|
$162.00
|
|
| Hospital Charge Code |
905104021
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$56.70 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$98.38
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$137.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$89.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$89.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$97.20
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$72.90
|
| Rate for Payer: Cash Price |
$72.90
|
| Rate for Payer: Cash Price |
$72.90
|
| Rate for Payer: Central Health Plan Commercial |
$129.60
|
| Rate for Payer: Cigna of CA HMO |
$103.68
|
| Rate for Payer: Cigna of CA PPO |
$119.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$137.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$64.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$64.80
|
| Rate for Payer: Galaxy Health WC |
$137.70
|
| Rate for Payer: Global Benefits Group Commercial |
$97.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$145.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$121.50
|
| Rate for Payer: IEHP medi-cal |
$56.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$108.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.42
|
| Rate for Payer: Multiplan Commercial |
$121.50
|
| Rate for Payer: Networks By Design Commercial |
$105.30
|
| Rate for Payer: Prime Health Services Commercial |
$137.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$97.20
|
| Rate for Payer: Riverside University Health MISP |
$64.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$97.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$97.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$137.70
|
| Rate for Payer: Vantage Medical Group Senior |
$137.70
|
|
|
HC OCCUP THER EVAL ADDL 15 MIN
|
Facility
IP
|
$162.00
|
|
| Hospital Charge Code |
905104021
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$32.40 |
| Max. Negotiated Rate |
$145.80 |
| Rate for Payer: Cash Price |
$72.90
|
| Rate for Payer: Central Health Plan Commercial |
$129.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$64.80
|
| Rate for Payer: Galaxy Health WC |
$137.70
|
| Rate for Payer: Global Benefits Group Commercial |
$97.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$145.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$108.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.40
|
| Rate for Payer: Multiplan Commercial |
$121.50
|
| Rate for Payer: Networks By Design Commercial |
$105.30
|
| Rate for Payer: Prime Health Services Commercial |
$137.70
|
|
|
HC OFFSET KNEE HEAVY DUTY EA ADDITION LE
|
Facility
IP
|
$327.00
|
|
|
Service Code
|
CPT L2395
|
| Hospital Charge Code |
905352395
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$65.40 |
| Max. Negotiated Rate |
$294.30 |
| Rate for Payer: Blue Shield of California EPN |
$174.62
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Central Health Plan Commercial |
$261.60
|
| Rate for Payer: Cigna of CA HMO |
$228.90
|
| Rate for Payer: Cigna of CA PPO |
$228.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$130.80
|
| Rate for Payer: Galaxy Health WC |
$277.95
|
| Rate for Payer: Global Benefits Group Commercial |
$196.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$294.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$218.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.40
|
| Rate for Payer: Multiplan Commercial |
$245.25
|
| Rate for Payer: Networks By Design Commercial |
$163.50
|
| Rate for Payer: Prime Health Services Commercial |
$277.95
|
|
