|
HC PREP/HARVEST W TUMOR CELL DEP
|
Facility
|
OP
|
$2,078.00
|
|
|
Service Code
|
CPT 38211
|
| Hospital Charge Code |
911800307
|
|
Hospital Revenue Code
|
362
|
| Min. Negotiated Rate |
$415.60 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$415.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$555.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,261.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$833.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$611.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$555.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$885.06
|
| Rate for Payer: Blue Shield of California Commercial |
$1,269.66
|
| Rate for Payer: Blue Shield of California EPN |
$829.12
|
| Rate for Payer: Cash Price |
$1,142.90
|
| Rate for Payer: Cash Price |
$1,142.90
|
| Rate for Payer: Cash Price |
$1,142.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,662.40
|
| Rate for Payer: Cigna of CA HMO |
$1,329.92
|
| Rate for Payer: Cigna of CA PPO |
$1,537.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$833.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$555.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$555.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$749.90
|
| Rate for Payer: EPIC Health Plan Senior |
$555.48
|
| Rate for Payer: Galaxy Health WC |
$1,766.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,246.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,870.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$910.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$555.48
|
| Rate for Payer: InnovAge PACE Commercial |
$833.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,386.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$555.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$415.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$744.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$744.34
|
| Rate for Payer: Multiplan Commercial |
$1,558.50
|
| Rate for Payer: Multiplan WC |
$885.06
|
| Rate for Payer: Networks By Design Commercial |
$1,350.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$555.48
|
| Rate for Payer: Preferred Health Network WC |
$903.12
|
| Rate for Payer: Prime Health Services Commercial |
$1,766.30
|
| Rate for Payer: Prime Health Services Medicare |
$588.81
|
| Rate for Payer: Prime Health Services WC |
$876.03
|
| Rate for Payer: Riverside University Health System MISP |
$611.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,246.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,246.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,039.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,039.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,039.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$555.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$833.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$555.48
|
| Rate for Payer: Vantage Medical Group Senior |
$555.48
|
|
|
HC PRE POST CHALLENGE SPIROMETRY
|
Facility
|
OP
|
$1,289.00
|
|
|
Service Code
|
CPT 94060
|
| Hospital Charge Code |
900801002
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$77.45 |
| Max. Negotiated Rate |
$1,160.10 |
| Rate for Payer: Adventist Health Commercial |
$257.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$395.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$782.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$241.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$757.03
|
| Rate for Payer: Blue Shield of California Commercial |
$782.42
|
| Rate for Payer: Blue Shield of California EPN |
$511.73
|
| Rate for Payer: Cash Price |
$708.95
|
| Rate for Payer: Cash Price |
$708.95
|
| Rate for Payer: Cash Price |
$708.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,031.20
|
| Rate for Payer: Cigna of CA HMO |
$824.96
|
| Rate for Payer: Cigna of CA PPO |
$953.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.14
|
| Rate for Payer: EPIC Health Plan Senior |
$395.66
|
| Rate for Payer: Galaxy Health WC |
$1,095.65
|
| Rate for Payer: Global Benefits Group Commercial |
$773.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,160.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$648.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$77.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: InnovAge PACE Commercial |
$593.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$859.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$85.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$530.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$530.18
|
| Rate for Payer: Multiplan Commercial |
$966.75
|
| Rate for Payer: Networks By Design Commercial |
$837.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$395.66
|
| Rate for Payer: Prime Health Services Commercial |
$1,095.65
|
| Rate for Payer: Prime Health Services Medicare |
$419.40
|
| Rate for Payer: Riverside University Health System MISP |
$435.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$773.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$773.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$764.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$731.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$669.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$395.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC PRE POST CHALLENGE SPIROMETRY
|
Facility
|
IP
|
$1,289.00
|
|
|
Service Code
|
CPT 94060
|
| Hospital Charge Code |
900801002
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$257.80 |
| Max. Negotiated Rate |
$1,160.10 |
| Rate for Payer: Adventist Health Commercial |
$257.80
|
| Rate for Payer: Cash Price |
$708.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,031.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$515.60
|
| Rate for Payer: EPIC Health Plan Senior |
$515.60
|
| Rate for Payer: Galaxy Health WC |
$1,095.65
|
| Rate for Payer: Global Benefits Group Commercial |
$773.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,160.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$859.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$491.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$797.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.80
|
| Rate for Payer: Multiplan Commercial |
$966.75
|
| Rate for Payer: Networks By Design Commercial |
$837.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,095.65
|
|
|
HC PREP SPLIT UNIT
|
Facility
|
OP
|
$537.00
|
|
|
Service Code
|
CPT 86985
|
| Hospital Charge Code |
900904439
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$107.40 |
| Max. Negotiated Rate |
$676.00 |
| Rate for Payer: Adventist Health Commercial |
$107.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$217.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$326.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$217.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$260.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$315.38
|
| Rate for Payer: Blue Shield of California Commercial |
$328.11
|
| Rate for Payer: Blue Shield of California EPN |
$214.26
|
| Rate for Payer: Cash Price |
$295.35
|
| Rate for Payer: Cash Price |
$295.35
|
| Rate for Payer: Cash Price |
$295.35
|
| Rate for Payer: Central Health Plan Commercial |
$429.60
|
| Rate for Payer: Cigna of CA HMO |
$343.68
|
| Rate for Payer: Cigna of CA PPO |
$397.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$326.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$239.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$217.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$293.94
|
| Rate for Payer: EPIC Health Plan Senior |
$217.73
|
| Rate for Payer: Galaxy Health WC |
$456.45
|
| Rate for Payer: Global Benefits Group Commercial |
$322.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$483.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$357.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$217.73
|
| Rate for Payer: InnovAge PACE Commercial |
$326.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$358.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$204.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$217.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$107.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$291.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$291.76
|
| Rate for Payer: Multiplan Commercial |
$402.75
|
| Rate for Payer: Networks By Design Commercial |
$349.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$217.73
|
| Rate for Payer: Prime Health Services Commercial |
$456.45
|
| Rate for Payer: Prime Health Services Medicare |
$230.79
|
| Rate for Payer: Riverside University Health System MISP |
$239.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$322.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$322.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$676.00
|
| Rate for Payer: United Healthcare All Other HMO |
$663.00
|
| Rate for Payer: United Healthcare HMO Rider |
$662.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$605.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$217.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Vantage Medical Group Senior |
$217.73
|
|
|
HC PREP SPLIT UNIT
|
Facility
|
IP
|
$537.00
|
|
|
Service Code
|
CPT 86985
|
| Hospital Charge Code |
900904439
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$107.40 |
| Max. Negotiated Rate |
$483.30 |
| Rate for Payer: Adventist Health Commercial |
$107.40
|
| Rate for Payer: Cash Price |
$295.35
|
| Rate for Payer: Central Health Plan Commercial |
$429.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$214.80
|
| Rate for Payer: EPIC Health Plan Senior |
$214.80
|
| Rate for Payer: Galaxy Health WC |
$456.45
|
| Rate for Payer: Global Benefits Group Commercial |
$322.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$483.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$358.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$204.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$332.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$107.40
|
| Rate for Payer: Multiplan Commercial |
$402.75
|
| Rate for Payer: Networks By Design Commercial |
$349.05
|
| Rate for Payer: Prime Health Services Commercial |
$456.45
|
|
|
HC PRE-TIBIAL SHELL MOLDED ADDITON LE
|
Facility
|
IP
|
$1,065.00
|
|
|
Service Code
|
CPT L2340
|
| Hospital Charge Code |
905352340
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$213.00 |
| Max. Negotiated Rate |
$958.50 |
| Rate for Payer: Adventist Health Commercial |
$213.00
|
| Rate for Payer: Blue Shield of California Commercial |
$823.25
|
| Rate for Payer: Blue Shield of California EPN |
$536.76
|
| Rate for Payer: Cash Price |
$585.75
|
| Rate for Payer: Central Health Plan Commercial |
$852.00
|
| Rate for Payer: Cigna of CA HMO |
$745.50
|
| Rate for Payer: Cigna of CA PPO |
$745.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$426.00
|
| Rate for Payer: EPIC Health Plan Senior |
$426.00
|
| Rate for Payer: Galaxy Health WC |
$905.25
|
| Rate for Payer: Global Benefits Group Commercial |
$639.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$958.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$710.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$405.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$659.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$213.00
|
| Rate for Payer: Multiplan Commercial |
$798.75
|
| Rate for Payer: Networks By Design Commercial |
$692.25
|
| Rate for Payer: Prime Health Services Commercial |
$905.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$399.69
|
| Rate for Payer: United Healthcare All Other HMO |
$389.04
|
| Rate for Payer: United Healthcare HMO Rider |
$380.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$348.79
|
|
|
HC PRE-TIBIAL SHELL MOLDED ADDITON LE
|
Facility
|
OP
|
$1,065.00
|
|
|
Service Code
|
CPT L2340
|
| Hospital Charge Code |
905352340
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$348.79 |
| Max. Negotiated Rate |
$958.50 |
| Rate for Payer: Adventist Health Commercial |
$436.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$905.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$585.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$798.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$625.47
|
| Rate for Payer: Blue Shield of California Commercial |
$823.25
|
| Rate for Payer: Blue Shield of California EPN |
$536.76
|
| Rate for Payer: Cash Price |
$585.75
|
| Rate for Payer: Cash Price |
$585.75
|
| Rate for Payer: Central Health Plan Commercial |
$852.00
|
| Rate for Payer: Cigna of CA HMO |
$745.50
|
| Rate for Payer: Cigna of CA PPO |
$745.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$905.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$905.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$905.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$426.00
|
| Rate for Payer: EPIC Health Plan Senior |
$426.00
|
| Rate for Payer: Galaxy Health WC |
$905.25
|
| Rate for Payer: Global Benefits Group Commercial |
$639.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$958.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$450.97
|
| Rate for Payer: InnovAge PACE Commercial |
$532.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$710.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$498.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$659.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$436.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$745.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$745.50
|
| Rate for Payer: Multiplan Commercial |
$798.75
|
| Rate for Payer: Networks By Design Commercial |
$532.50
|
| Rate for Payer: Prime Health Services Commercial |
$905.25
|
| Rate for Payer: Riverside University Health System MISP |
$426.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$639.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$639.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$399.69
|
| Rate for Payer: United Healthcare All Other HMO |
$389.04
|
| Rate for Payer: United Healthcare HMO Rider |
$380.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$348.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$905.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$905.25
|
| Rate for Payer: Vantage Medical Group Senior |
$905.25
|
|
|
HC PRE-TIBIAL SHELL MOLDED ADDITON LE
|
Facility
|
OP
|
$1,065.00
|
|
|
Service Code
|
CPT L2340
|
| Hospital Charge Code |
915352340
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$348.79 |
| Max. Negotiated Rate |
$958.50 |
| Rate for Payer: Adventist Health Commercial |
$436.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$905.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$585.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$798.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$625.47
|
| Rate for Payer: Blue Shield of California Commercial |
$823.25
|
| Rate for Payer: Blue Shield of California EPN |
$536.76
|
| Rate for Payer: Cash Price |
$585.75
|
| Rate for Payer: Cash Price |
$585.75
|
| Rate for Payer: Central Health Plan Commercial |
$852.00
|
| Rate for Payer: Cigna of CA HMO |
$745.50
|
| Rate for Payer: Cigna of CA PPO |
$745.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$905.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$905.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$905.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$426.00
|
| Rate for Payer: EPIC Health Plan Senior |
$426.00
|
| Rate for Payer: Galaxy Health WC |
$905.25
|
| Rate for Payer: Global Benefits Group Commercial |
$639.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$958.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$450.97
|
| Rate for Payer: InnovAge PACE Commercial |
$532.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$710.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$498.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$659.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$436.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$745.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$745.50
|
| Rate for Payer: Multiplan Commercial |
$798.75
|
| Rate for Payer: Networks By Design Commercial |
$532.50
|
| Rate for Payer: Prime Health Services Commercial |
$905.25
|
| Rate for Payer: Riverside University Health System MISP |
$426.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$639.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$639.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$399.69
|
| Rate for Payer: United Healthcare All Other HMO |
$389.04
|
| Rate for Payer: United Healthcare HMO Rider |
$380.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$348.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$905.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$905.25
|
| Rate for Payer: Vantage Medical Group Senior |
$905.25
|
|
|
HC PRE-TIBIAL SHELL MOLDED ADDITON LE
|
Facility
|
IP
|
$1,065.00
|
|
|
Service Code
|
CPT L2340
|
| Hospital Charge Code |
915352340
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$213.00 |
| Max. Negotiated Rate |
$958.50 |
| Rate for Payer: Adventist Health Commercial |
$213.00
|
| Rate for Payer: Blue Shield of California Commercial |
$823.25
|
| Rate for Payer: Blue Shield of California EPN |
$536.76
|
| Rate for Payer: Cash Price |
$585.75
|
| Rate for Payer: Central Health Plan Commercial |
$852.00
|
| Rate for Payer: Cigna of CA HMO |
$745.50
|
| Rate for Payer: Cigna of CA PPO |
$745.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$426.00
|
| Rate for Payer: EPIC Health Plan Senior |
$426.00
|
| Rate for Payer: Galaxy Health WC |
$905.25
|
| Rate for Payer: Global Benefits Group Commercial |
$639.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$958.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$710.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$405.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$659.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$213.00
|
| Rate for Payer: Multiplan Commercial |
$798.75
|
| Rate for Payer: Networks By Design Commercial |
$692.25
|
| Rate for Payer: Prime Health Services Commercial |
$905.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$399.69
|
| Rate for Payer: United Healthcare All Other HMO |
$389.04
|
| Rate for Payer: United Healthcare HMO Rider |
$380.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$348.79
|
|
|
HC PREVIEW TRT PLANNING
|
Facility
|
IP
|
$2,658.00
|
|
|
Service Code
|
CPT 76377
|
| Hospital Charge Code |
909201982
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$531.60 |
| Max. Negotiated Rate |
$2,392.20 |
| Rate for Payer: Adventist Health Commercial |
$531.60
|
| Rate for Payer: Cash Price |
$1,461.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,126.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,063.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,063.20
|
| Rate for Payer: Galaxy Health WC |
$2,259.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,594.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,392.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,772.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,012.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,645.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$531.60
|
| Rate for Payer: Multiplan Commercial |
$1,993.50
|
| Rate for Payer: Networks By Design Commercial |
$1,727.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,259.30
|
|
|
HC PREVIEW TRT PLANNING
|
Facility
|
OP
|
$2,658.00
|
|
|
Service Code
|
CPT 76377
|
| Hospital Charge Code |
909201982
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$531.60 |
| Max. Negotiated Rate |
$2,392.20 |
| Rate for Payer: Adventist Health Commercial |
$531.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,259.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,461.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,993.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$739.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,561.04
|
| Rate for Payer: Blue Shield of California Commercial |
$1,613.41
|
| Rate for Payer: Blue Shield of California EPN |
$1,055.23
|
| Rate for Payer: Cash Price |
$1,461.90
|
| Rate for Payer: Cash Price |
$1,461.90
|
| Rate for Payer: Cash Price |
$1,461.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,126.40
|
| Rate for Payer: Cigna of CA HMO |
$1,701.12
|
| Rate for Payer: Cigna of CA PPO |
$1,966.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,259.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,259.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,259.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,063.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,063.20
|
| Rate for Payer: Galaxy Health WC |
$2,259.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,594.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,392.20
|
| Rate for Payer: InnovAge PACE Commercial |
$1,329.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,772.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,012.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,645.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$531.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,860.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,860.60
|
| Rate for Payer: Multiplan Commercial |
$1,993.50
|
| Rate for Payer: Networks By Design Commercial |
$1,727.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,259.30
|
| Rate for Payer: Riverside University Health System MISP |
$1,063.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,594.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,594.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,329.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,329.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,329.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,329.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,259.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,259.30
|
| Rate for Payer: Vantage Medical Group Senior |
$2,259.30
|
|
|
HC PREVNAR ADMINISTRATION
|
Facility
|
IP
|
$24.00
|
|
| Hospital Charge Code |
902890224
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Adventist Health Commercial |
$4.80
|
| Rate for Payer: Cash Price |
$13.20
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
|
|
HC PREVNAR ADMINISTRATION
|
Facility
|
OP
|
$24.00
|
|
| Hospital Charge Code |
902890224
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$9.84
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.10
|
| Rate for Payer: Cash Price |
$13.20
|
| Rate for Payer: Cash Price |
$13.20
|
| Rate for Payer: Cash Price |
$13.20
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: Cigna of CA HMO |
$15.36
|
| Rate for Payer: Cigna of CA PPO |
$17.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: InnovAge PACE Commercial |
$12.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
| Rate for Payer: Riverside University Health System MISP |
$9.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.40
|
| Rate for Payer: Vantage Medical Group Senior |
$20.40
|
|
|
HC PRGRM DEV EVAL DUAL LEAD IMPL DFIB
|
Facility
|
IP
|
$136.00
|
|
|
Service Code
|
CPT 93283
|
| Hospital Charge Code |
900200304
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$122.40 |
| Rate for Payer: Adventist Health Commercial |
$27.20
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Central Health Plan Commercial |
$108.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.40
|
| Rate for Payer: EPIC Health Plan Senior |
$54.40
|
| Rate for Payer: Galaxy Health WC |
$115.60
|
| Rate for Payer: Global Benefits Group Commercial |
$81.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$122.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$90.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$51.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$84.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.20
|
| Rate for Payer: Multiplan Commercial |
$102.00
|
| Rate for Payer: Networks By Design Commercial |
$88.40
|
| Rate for Payer: Prime Health Services Commercial |
$115.60
|
|
|
HC PRGRM DEV EVAL DUAL LEAD IMPL DFIB
|
Facility
|
OP
|
$136.00
|
|
|
Service Code
|
CPT 93283
|
| Hospital Charge Code |
900200304
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$27.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$47.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$82.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$71.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$47.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$165.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.87
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Central Health Plan Commercial |
$108.80
|
| Rate for Payer: Cigna of CA HMO |
$87.04
|
| Rate for Payer: Cigna of CA PPO |
$100.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$71.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$63.96
|
| Rate for Payer: EPIC Health Plan Senior |
$47.38
|
| Rate for Payer: Galaxy Health WC |
$115.60
|
| Rate for Payer: Global Benefits Group Commercial |
$81.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$122.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$77.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$130.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$47.38
|
| Rate for Payer: InnovAge PACE Commercial |
$71.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$90.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$144.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$63.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63.49
|
| Rate for Payer: Multiplan Commercial |
$102.00
|
| Rate for Payer: Networks By Design Commercial |
$88.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$47.38
|
| Rate for Payer: Prime Health Services Commercial |
$115.60
|
| Rate for Payer: Prime Health Services Medicare |
$50.22
|
| Rate for Payer: Riverside University Health System MISP |
$52.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$81.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$81.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$47.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$71.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.12
|
| Rate for Payer: Vantage Medical Group Senior |
$47.38
|
|
|
HC PRGRM DEV EVAL DUAL LEAD PACEMAKER
|
Facility
|
IP
|
$136.00
|
|
|
Service Code
|
CPT 93280
|
| Hospital Charge Code |
900200301
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$122.40 |
| Rate for Payer: Adventist Health Commercial |
$27.20
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Central Health Plan Commercial |
$108.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.40
|
| Rate for Payer: EPIC Health Plan Senior |
$54.40
|
| Rate for Payer: Galaxy Health WC |
$115.60
|
| Rate for Payer: Global Benefits Group Commercial |
$81.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$122.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$90.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$51.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$84.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.20
|
| Rate for Payer: Multiplan Commercial |
$102.00
|
| Rate for Payer: Networks By Design Commercial |
$88.40
|
| Rate for Payer: Prime Health Services Commercial |
$115.60
|
|
|
HC PRGRM DEV EVAL DUAL LEAD PACEMAKER
|
Facility
|
OP
|
$136.00
|
|
|
Service Code
|
CPT 93280
|
| Hospital Charge Code |
900200301
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$27.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$47.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$82.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$71.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$47.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$137.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.87
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Central Health Plan Commercial |
$108.80
|
| Rate for Payer: Cigna of CA HMO |
$87.04
|
| Rate for Payer: Cigna of CA PPO |
$100.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$71.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$63.96
|
| Rate for Payer: EPIC Health Plan Senior |
$47.38
|
| Rate for Payer: Galaxy Health WC |
$115.60
|
| Rate for Payer: Global Benefits Group Commercial |
$81.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$122.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$77.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$99.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$47.38
|
| Rate for Payer: InnovAge PACE Commercial |
$71.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$90.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$110.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$63.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63.49
|
| Rate for Payer: Multiplan Commercial |
$102.00
|
| Rate for Payer: Networks By Design Commercial |
$88.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$47.38
|
| Rate for Payer: Prime Health Services Commercial |
$115.60
|
| Rate for Payer: Prime Health Services Medicare |
$50.22
|
| Rate for Payer: Riverside University Health System MISP |
$52.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$81.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$81.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$47.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$71.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.12
|
| Rate for Payer: Vantage Medical Group Senior |
$47.38
|
|
|
HC PRGRM DEV EVAL MULT LEAD IMPL DFIB
|
Facility
|
IP
|
$136.00
|
|
|
Service Code
|
CPT 93284
|
| Hospital Charge Code |
900200305
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$122.40 |
| Rate for Payer: Adventist Health Commercial |
$27.20
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Central Health Plan Commercial |
$108.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.40
|
| Rate for Payer: EPIC Health Plan Senior |
$54.40
|
| Rate for Payer: Galaxy Health WC |
$115.60
|
| Rate for Payer: Global Benefits Group Commercial |
$81.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$122.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$90.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$51.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$84.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.20
|
| Rate for Payer: Multiplan Commercial |
$102.00
|
| Rate for Payer: Networks By Design Commercial |
$88.40
|
| Rate for Payer: Prime Health Services Commercial |
$115.60
|
|
|
HC PRGRM DEV EVAL MULT LEAD IMPL DFIB
|
Facility
|
OP
|
$136.00
|
|
|
Service Code
|
CPT 93284
|
| Hospital Charge Code |
900200305
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$27.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$47.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$82.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$71.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$47.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$187.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.87
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Central Health Plan Commercial |
$108.80
|
| Rate for Payer: Cigna of CA HMO |
$87.04
|
| Rate for Payer: Cigna of CA PPO |
$100.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$71.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$63.96
|
| Rate for Payer: EPIC Health Plan Senior |
$47.38
|
| Rate for Payer: Galaxy Health WC |
$115.60
|
| Rate for Payer: Global Benefits Group Commercial |
$81.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$122.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$77.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$152.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$47.38
|
| Rate for Payer: InnovAge PACE Commercial |
$71.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$90.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$168.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$63.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63.49
|
| Rate for Payer: Multiplan Commercial |
$102.00
|
| Rate for Payer: Networks By Design Commercial |
$88.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$47.38
|
| Rate for Payer: Prime Health Services Commercial |
$115.60
|
| Rate for Payer: Prime Health Services Medicare |
$50.22
|
| Rate for Payer: Riverside University Health System MISP |
$52.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$81.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$81.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$47.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$71.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.12
|
| Rate for Payer: Vantage Medical Group Senior |
$47.38
|
|
|
HC PRGRM DEV EVAL MULT LEAD PACEMAKER
|
Facility
|
IP
|
$136.00
|
|
|
Service Code
|
CPT 93281
|
| Hospital Charge Code |
900200302
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$122.40 |
| Rate for Payer: Adventist Health Commercial |
$27.20
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Central Health Plan Commercial |
$108.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.40
|
| Rate for Payer: EPIC Health Plan Senior |
$54.40
|
| Rate for Payer: Galaxy Health WC |
$115.60
|
| Rate for Payer: Global Benefits Group Commercial |
$81.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$122.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$90.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$51.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$84.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.20
|
| Rate for Payer: Multiplan Commercial |
$102.00
|
| Rate for Payer: Networks By Design Commercial |
$88.40
|
| Rate for Payer: Prime Health Services Commercial |
$115.60
|
|
|
HC PRGRM DEV EVAL MULT LEAD PACEMAKER
|
Facility
|
OP
|
$136.00
|
|
|
Service Code
|
CPT 93281
|
| Hospital Charge Code |
900200302
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$27.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$47.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$82.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$71.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$47.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$160.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.87
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Central Health Plan Commercial |
$108.80
|
| Rate for Payer: Cigna of CA HMO |
$87.04
|
| Rate for Payer: Cigna of CA PPO |
$100.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$71.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$63.96
|
| Rate for Payer: EPIC Health Plan Senior |
$47.38
|
| Rate for Payer: Galaxy Health WC |
$115.60
|
| Rate for Payer: Global Benefits Group Commercial |
$81.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$122.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$77.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$116.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$47.38
|
| Rate for Payer: InnovAge PACE Commercial |
$71.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$90.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$128.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$63.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63.49
|
| Rate for Payer: Multiplan Commercial |
$102.00
|
| Rate for Payer: Networks By Design Commercial |
$88.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$47.38
|
| Rate for Payer: Prime Health Services Commercial |
$115.60
|
| Rate for Payer: Prime Health Services Medicare |
$50.22
|
| Rate for Payer: Riverside University Health System MISP |
$52.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$81.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$81.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$47.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$71.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.12
|
| Rate for Payer: Vantage Medical Group Senior |
$47.38
|
|
|
HC PRGRM DEV EVAL SNGL LEAD IMPL DFIB
|
Facility
|
IP
|
$136.00
|
|
|
Service Code
|
CPT 93282
|
| Hospital Charge Code |
900200303
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$122.40 |
| Rate for Payer: Adventist Health Commercial |
$27.20
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Central Health Plan Commercial |
$108.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.40
|
| Rate for Payer: EPIC Health Plan Senior |
$54.40
|
| Rate for Payer: Galaxy Health WC |
$115.60
|
| Rate for Payer: Global Benefits Group Commercial |
$81.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$122.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$90.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$51.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$84.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.20
|
| Rate for Payer: Multiplan Commercial |
$102.00
|
| Rate for Payer: Networks By Design Commercial |
$88.40
|
| Rate for Payer: Prime Health Services Commercial |
$115.60
|
|
|
HC PRGRM DEV EVAL SNGL LEAD IMPL DFIB
|
Facility
|
OP
|
$136.00
|
|
|
Service Code
|
CPT 93282
|
| Hospital Charge Code |
900200303
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$27.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$47.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$82.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$71.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$47.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$145.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.87
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Central Health Plan Commercial |
$108.80
|
| Rate for Payer: Cigna of CA HMO |
$87.04
|
| Rate for Payer: Cigna of CA PPO |
$100.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$71.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$63.96
|
| Rate for Payer: EPIC Health Plan Senior |
$47.38
|
| Rate for Payer: Galaxy Health WC |
$115.60
|
| Rate for Payer: Global Benefits Group Commercial |
$81.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$122.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$77.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$107.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$47.38
|
| Rate for Payer: InnovAge PACE Commercial |
$71.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$90.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$118.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$63.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63.49
|
| Rate for Payer: Multiplan Commercial |
$102.00
|
| Rate for Payer: Networks By Design Commercial |
$88.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$47.38
|
| Rate for Payer: Prime Health Services Commercial |
$115.60
|
| Rate for Payer: Prime Health Services Medicare |
$50.22
|
| Rate for Payer: Riverside University Health System MISP |
$52.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$81.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$81.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$47.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$71.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.12
|
| Rate for Payer: Vantage Medical Group Senior |
$47.38
|
|
|
HC PRGRM DEV EVAL SNGL LEAD PACEMAKER
|
Facility
|
IP
|
$136.00
|
|
|
Service Code
|
CPT 93279
|
| Hospital Charge Code |
900200300
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$122.40 |
| Rate for Payer: Adventist Health Commercial |
$27.20
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Central Health Plan Commercial |
$108.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.40
|
| Rate for Payer: EPIC Health Plan Senior |
$54.40
|
| Rate for Payer: Galaxy Health WC |
$115.60
|
| Rate for Payer: Global Benefits Group Commercial |
$81.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$122.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$90.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$51.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$84.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.20
|
| Rate for Payer: Multiplan Commercial |
$102.00
|
| Rate for Payer: Networks By Design Commercial |
$88.40
|
| Rate for Payer: Prime Health Services Commercial |
$115.60
|
|
|
HC PRGRM DEV EVAL SNGL LEAD PACEMAKER
|
Facility
|
OP
|
$136.00
|
|
|
Service Code
|
CPT 93279
|
| Hospital Charge Code |
900200300
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$27.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$47.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$82.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$71.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$47.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$137.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.87
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Cash Price |
$74.80
|
| Rate for Payer: Central Health Plan Commercial |
$108.80
|
| Rate for Payer: Cigna of CA HMO |
$87.04
|
| Rate for Payer: Cigna of CA PPO |
$100.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$71.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$63.96
|
| Rate for Payer: EPIC Health Plan Senior |
$47.38
|
| Rate for Payer: Galaxy Health WC |
$115.60
|
| Rate for Payer: Global Benefits Group Commercial |
$81.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$122.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$77.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$83.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$47.38
|
| Rate for Payer: InnovAge PACE Commercial |
$71.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$90.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$92.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$63.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63.49
|
| Rate for Payer: Multiplan Commercial |
$102.00
|
| Rate for Payer: Networks By Design Commercial |
$88.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$47.38
|
| Rate for Payer: Prime Health Services Commercial |
$115.60
|
| Rate for Payer: Prime Health Services Medicare |
$50.22
|
| Rate for Payer: Riverside University Health System MISP |
$52.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$81.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$81.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$47.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$71.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.12
|
| Rate for Payer: Vantage Medical Group Senior |
$47.38
|
|
