|
HC PULM REHAB W/EXER/MONT PER HR
|
Facility
IP
|
$289.00
|
|
|
Service Code
|
CPT 94626
|
| Hospital Charge Code |
900201805
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$57.80 |
| Max. Negotiated Rate |
$260.10 |
| Rate for Payer: Cash Price |
$130.05
|
| Rate for Payer: Central Health Plan Commercial |
$231.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.60
|
| Rate for Payer: Galaxy Health WC |
$245.65
|
| Rate for Payer: Global Benefits Group Commercial |
$173.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$260.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$192.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.80
|
| Rate for Payer: Multiplan Commercial |
$216.75
|
| Rate for Payer: Networks By Design Commercial |
$187.85
|
| Rate for Payer: Prime Health Services Commercial |
$245.65
|
|
|
HC PULM STRESS TEST COMPLEX
|
Facility
OP
|
$3,286.00
|
|
|
Service Code
|
CPT 94621
|
| Hospital Charge Code |
900801021
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$281.00 |
| Max. Negotiated Rate |
$2,957.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$392.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$571.66
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$392.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$342.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,941.37
|
| Rate for Payer: BCBS Transplant Transplant |
$1,971.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,030.75
|
| Rate for Payer: Blue Shield of California EPN |
$1,597.00
|
| Rate for Payer: Caremore Medicare Advantage |
$392.17
|
| Rate for Payer: Cash Price |
$1,478.70
|
| Rate for Payer: Cash Price |
$1,478.70
|
| Rate for Payer: Cash Price |
$1,478.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,628.80
|
| Rate for Payer: Cigna of CA HMO |
$2,103.04
|
| Rate for Payer: Cigna of CA PPO |
$2,431.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$529.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$392.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$392.17
|
| Rate for Payer: Galaxy Health WC |
$2,793.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,971.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,957.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,464.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$643.16
|
| Rate for Payer: IEHP medi-cal |
$647.08
|
| Rate for Payer: IEHP Medicare Advantage |
$392.17
|
| Rate for Payer: Innovage PACE Commercial |
$588.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,191.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$657.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$525.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$525.51
|
| Rate for Payer: Multiplan Commercial |
$2,464.50
|
| Rate for Payer: Networks By Design Commercial |
$2,135.90
|
| Rate for Payer: Prime Health Services Commercial |
$2,793.10
|
| Rate for Payer: Prime Health Services Medicare |
$415.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,971.60
|
| Rate for Payer: Riverside University Health MISP |
$431.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,971.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,971.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$725.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$696.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$636.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Vantage Medical Group Senior |
$392.17
|
|
|
HC PULM STRESS TEST COMPLEX
|
Facility
IP
|
$3,286.00
|
|
|
Service Code
|
CPT 94621
|
| Hospital Charge Code |
900801021
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$657.20 |
| Max. Negotiated Rate |
$2,957.40 |
| Rate for Payer: Cash Price |
$1,478.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,628.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,314.40
|
| Rate for Payer: Galaxy Health WC |
$2,793.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,971.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,957.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,191.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$657.20
|
| Rate for Payer: Multiplan Commercial |
$2,464.50
|
| Rate for Payer: Networks By Design Commercial |
$2,135.90
|
| Rate for Payer: Prime Health Services Commercial |
$2,793.10
|
|
|
HC PULM STRESS TEST SIMPLE
|
Facility
OP
|
$1,997.00
|
|
|
Service Code
|
CPT 94618
|
| Hospital Charge Code |
900801020
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$67.15 |
| Max. Negotiated Rate |
$1,797.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$69.09
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$67.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,179.83
|
| Rate for Payer: BCBS Transplant Transplant |
$1,198.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,234.15
|
| Rate for Payer: Blue Shield of California EPN |
$970.54
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$898.65
|
| Rate for Payer: Cash Price |
$898.65
|
| Rate for Payer: Cash Price |
$898.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,597.60
|
| Rate for Payer: Cigna of CA HMO |
$1,278.08
|
| Rate for Payer: Cigna of CA PPO |
$1,477.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$1,697.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,198.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,797.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,497.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: IEHP medi-cal |
$263.34
|
| Rate for Payer: IEHP Medicare Advantage |
$159.60
|
| Rate for Payer: Innovage PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,332.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$399.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$1,497.75
|
| Rate for Payer: Networks By Design Commercial |
$1,298.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,697.45
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,198.20
|
| Rate for Payer: Riverside University Health MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,198.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,198.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$725.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$696.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$636.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC PULM STRESS TEST SIMPLE
|
Facility
IP
|
$1,997.00
|
|
|
Service Code
|
CPT 94618
|
| Hospital Charge Code |
900801020
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$399.40 |
| Max. Negotiated Rate |
$1,797.30 |
| Rate for Payer: Cash Price |
$898.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,597.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$798.80
|
| Rate for Payer: Galaxy Health WC |
$1,697.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,198.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,797.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,332.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$399.40
|
| Rate for Payer: Multiplan Commercial |
$1,497.75
|
| Rate for Payer: Networks By Design Commercial |
$1,298.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,697.45
|
|
|
HC PULSE OXIMETRY MULT DETER
|
Facility
IP
|
$500.00
|
|
|
Service Code
|
CPT 94761
|
| Hospital Charge Code |
900800106
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$100.00 |
| Max. Negotiated Rate |
$450.00 |
| Rate for Payer: Cash Price |
$225.00
|
| Rate for Payer: Central Health Plan Commercial |
$400.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$200.00
|
| Rate for Payer: Galaxy Health WC |
$425.00
|
| Rate for Payer: Global Benefits Group Commercial |
$300.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$450.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$333.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$100.00
|
| Rate for Payer: Multiplan Commercial |
$375.00
|
| Rate for Payer: Networks By Design Commercial |
$325.00
|
| Rate for Payer: Prime Health Services Commercial |
$425.00
|
|
|
HC PULSE OXIMETRY MULT DETER
|
Facility
OP
|
$500.00
|
|
|
Service Code
|
CPT 94761
|
| Hospital Charge Code |
900800106
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$25.83 |
| Max. Negotiated Rate |
$725.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25.83
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$425.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$275.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$275.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$174.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$295.40
|
| Rate for Payer: BCBS Transplant Transplant |
$300.00
|
| Rate for Payer: Blue Shield of California Commercial |
$309.00
|
| Rate for Payer: Blue Shield of California EPN |
$243.00
|
| Rate for Payer: Cash Price |
$225.00
|
| Rate for Payer: Cash Price |
$225.00
|
| Rate for Payer: Cash Price |
$225.00
|
| Rate for Payer: Central Health Plan Commercial |
$400.00
|
| Rate for Payer: Cigna of CA HMO |
$320.00
|
| Rate for Payer: Cigna of CA PPO |
$370.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$425.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$200.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$200.00
|
| Rate for Payer: Galaxy Health WC |
$425.00
|
| Rate for Payer: Global Benefits Group Commercial |
$300.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$450.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$375.00
|
| Rate for Payer: IEHP medi-cal |
$175.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$333.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$100.00
|
| Rate for Payer: Multiplan Commercial |
$375.00
|
| Rate for Payer: Networks By Design Commercial |
$325.00
|
| Rate for Payer: Prime Health Services Commercial |
$425.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$300.00
|
| Rate for Payer: Riverside University Health MISP |
$200.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$300.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$300.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$725.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$696.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$636.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$425.00
|
| Rate for Payer: Vantage Medical Group Senior |
$425.00
|
|
|
HC PULSE OXIMETRY SNGL DETER
|
Facility
OP
|
$225.00
|
|
|
Service Code
|
CPT 94760
|
| Hospital Charge Code |
900800102
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$45.00 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$191.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$123.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$123.75
|
| 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 |
$135.00
|
| Rate for Payer: Cash Price |
$101.25
|
| Rate for Payer: Cash Price |
$101.25
|
| Rate for Payer: Cash Price |
$101.25
|
| Rate for Payer: Central Health Plan Commercial |
$180.00
|
| Rate for Payer: Cigna of CA PPO |
$166.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$191.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$90.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$90.00
|
| Rate for Payer: Galaxy Health WC |
$191.25
|
| Rate for Payer: Global Benefits Group Commercial |
$135.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$202.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$168.75
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$150.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.00
|
| Rate for Payer: Multiplan Commercial |
$168.75
|
| Rate for Payer: Networks By Design Commercial |
$146.25
|
| Rate for Payer: Prime Health Services Commercial |
$191.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$135.00
|
| Rate for Payer: Riverside University Health MISP |
$90.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$135.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$112.50
|
| Rate for Payer: United Healthcare All Other HMO |
$112.50
|
| Rate for Payer: United Healthcare HMO Rider |
$112.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$112.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$191.25
|
| Rate for Payer: Vantage Medical Group Senior |
$191.25
|
|
|
HC PULSE OXIMETRY SNGL DETER
|
Facility
OP
|
$225.00
|
|
|
Service Code
|
CPT 94760
|
| Hospital Charge Code |
900800102
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$15.52 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$15.52
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$191.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$123.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$123.75
|
| 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 |
$135.00
|
| Rate for Payer: Blue Shield of California Commercial |
$141.52
|
| Rate for Payer: Blue Shield of California EPN |
$110.02
|
| Rate for Payer: Cash Price |
$101.25
|
| Rate for Payer: Cash Price |
$101.25
|
| Rate for Payer: Cash Price |
$101.25
|
| Rate for Payer: Central Health Plan Commercial |
$180.00
|
| Rate for Payer: Cigna of CA HMO |
$144.00
|
| Rate for Payer: Cigna of CA PPO |
$166.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$191.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$90.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$90.00
|
| Rate for Payer: Galaxy Health WC |
$191.25
|
| Rate for Payer: Global Benefits Group Commercial |
$135.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$202.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$168.75
|
| Rate for Payer: IEHP medi-cal |
$78.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$150.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.00
|
| Rate for Payer: Multiplan Commercial |
$168.75
|
| Rate for Payer: Networks By Design Commercial |
$146.25
|
| Rate for Payer: Prime Health Services Commercial |
$191.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$135.00
|
| Rate for Payer: Riverside University Health MISP |
$90.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$135.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$135.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$112.50
|
| Rate for Payer: United Healthcare All Other HMO |
$112.50
|
| Rate for Payer: United Healthcare HMO Rider |
$112.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$112.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$191.25
|
| Rate for Payer: Vantage Medical Group Senior |
$191.25
|
|
|
HC PULSE OXIMETRY SNGL DETER
|
Facility
IP
|
$225.00
|
|
|
Service Code
|
CPT 94760
|
| Hospital Charge Code |
900800102
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$45.00 |
| Max. Negotiated Rate |
$202.50 |
| Rate for Payer: Cash Price |
$101.25
|
| Rate for Payer: Central Health Plan Commercial |
$180.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$90.00
|
| Rate for Payer: Galaxy Health WC |
$191.25
|
| Rate for Payer: Global Benefits Group Commercial |
$135.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$202.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$150.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.00
|
| Rate for Payer: Multiplan Commercial |
$168.75
|
| Rate for Payer: Networks By Design Commercial |
$146.25
|
| Rate for Payer: Prime Health Services Commercial |
$191.25
|
|
|
HC PULSE OXIMETRY SNGL DETER
|
Facility
IP
|
$225.00
|
|
|
Service Code
|
CPT 94760
|
| Hospital Charge Code |
900800102
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$45.00 |
| Max. Negotiated Rate |
$202.50 |
| Rate for Payer: Cash Price |
$101.25
|
| Rate for Payer: Central Health Plan Commercial |
$180.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$90.00
|
| Rate for Payer: Galaxy Health WC |
$191.25
|
| Rate for Payer: Global Benefits Group Commercial |
$135.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$202.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$150.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.00
|
| Rate for Payer: Multiplan Commercial |
$168.75
|
| Rate for Payer: Networks By Design Commercial |
$146.25
|
| Rate for Payer: Prime Health Services Commercial |
$191.25
|
|
|
HC PULSE OXIMETRY SNGL DETER
|
Facility
OP
|
$225.00
|
|
|
Service Code
|
CPT 94760
|
| Hospital Charge Code |
900800102
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$15.52 |
| Max. Negotiated Rate |
$725.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$15.52
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$191.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$123.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$123.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$67.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$132.93
|
| Rate for Payer: BCBS Transplant Transplant |
$135.00
|
| Rate for Payer: Blue Shield of California Commercial |
$139.05
|
| Rate for Payer: Blue Shield of California EPN |
$109.35
|
| Rate for Payer: Cash Price |
$101.25
|
| Rate for Payer: Cash Price |
$101.25
|
| Rate for Payer: Cash Price |
$101.25
|
| Rate for Payer: Central Health Plan Commercial |
$180.00
|
| Rate for Payer: Cigna of CA HMO |
$144.00
|
| Rate for Payer: Cigna of CA PPO |
$166.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$191.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$90.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$90.00
|
| Rate for Payer: Galaxy Health WC |
$191.25
|
| Rate for Payer: Global Benefits Group Commercial |
$135.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$202.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$168.75
|
| Rate for Payer: IEHP medi-cal |
$78.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$150.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.00
|
| Rate for Payer: Multiplan Commercial |
$168.75
|
| Rate for Payer: Networks By Design Commercial |
$146.25
|
| Rate for Payer: Prime Health Services Commercial |
$191.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$135.00
|
| Rate for Payer: Riverside University Health MISP |
$90.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$135.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$135.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$725.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$696.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$636.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$191.25
|
| Rate for Payer: Vantage Medical Group Senior |
$191.25
|
|
|
HC PULSE OXIMETRY SNGL DETER
|
Facility
IP
|
$225.00
|
|
|
Service Code
|
CPT 94760
|
| Hospital Charge Code |
900800102
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$45.00 |
| Max. Negotiated Rate |
$202.50 |
| Rate for Payer: Cash Price |
$101.25
|
| Rate for Payer: Central Health Plan Commercial |
$180.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$90.00
|
| Rate for Payer: Galaxy Health WC |
$191.25
|
| Rate for Payer: Global Benefits Group Commercial |
$135.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$202.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$150.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.00
|
| Rate for Payer: Multiplan Commercial |
$168.75
|
| Rate for Payer: Networks By Design Commercial |
$146.25
|
| Rate for Payer: Prime Health Services Commercial |
$191.25
|
|
|
HC PUNCH BX SKIN EA SEP/ADD LSN
|
Facility
OP
|
$284.00
|
|
|
Service Code
|
CPT 11105
|
| Hospital Charge Code |
900511105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$56.80 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$241.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$156.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$156.20
|
| 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 |
$170.40
|
| 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 |
$127.80
|
| Rate for Payer: Cash Price |
$127.80
|
| Rate for Payer: Cash Price |
$127.80
|
| Rate for Payer: Central Health Plan Commercial |
$227.20
|
| Rate for Payer: Cigna of CA PPO |
$210.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$241.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$113.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$113.60
|
| Rate for Payer: Galaxy Health WC |
$241.40
|
| Rate for Payer: Global Benefits Group Commercial |
$170.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$255.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$213.00
|
| Rate for Payer: IEHP medi-cal |
$99.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$189.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.80
|
| Rate for Payer: Multiplan Commercial |
$213.00
|
| Rate for Payer: Networks By Design Commercial |
$184.60
|
| Rate for Payer: Prime Health Services Commercial |
$241.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$170.40
|
| Rate for Payer: Riverside University Health MISP |
$113.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$170.40
|
| 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 |
$241.40
|
| Rate for Payer: Vantage Medical Group Senior |
$241.40
|
|
|
HC PUNCH BX SKIN EA SEP/ADD LSN
|
Facility
IP
|
$284.00
|
|
|
Service Code
|
CPT 11105
|
| Hospital Charge Code |
900511105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$56.80 |
| Max. Negotiated Rate |
$255.60 |
| Rate for Payer: Cash Price |
$127.80
|
| Rate for Payer: Central Health Plan Commercial |
$227.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$113.60
|
| Rate for Payer: Galaxy Health WC |
$241.40
|
| Rate for Payer: Global Benefits Group Commercial |
$170.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$255.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$189.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.80
|
| Rate for Payer: Multiplan Commercial |
$213.00
|
| Rate for Payer: Networks By Design Commercial |
$184.60
|
| Rate for Payer: Prime Health Services Commercial |
$241.40
|
|
|
HC PUNCH BX SKIN SINGLE LESION
|
Facility
OP
|
$653.00
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
900511104
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$130.60 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$498.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$498.20
|
| 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 |
$391.80
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$498.20
|
| Rate for Payer: Cash Price |
$293.85
|
| Rate for Payer: Cash Price |
$293.85
|
| Rate for Payer: Cash Price |
$293.85
|
| Rate for Payer: Central Health Plan Commercial |
$522.40
|
| Rate for Payer: Cigna of CA PPO |
$483.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$672.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$498.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$498.20
|
| Rate for Payer: Galaxy Health WC |
$555.05
|
| Rate for Payer: Global Benefits Group Commercial |
$391.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$587.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$489.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$817.05
|
| Rate for Payer: IEHP medi-cal |
$822.03
|
| Rate for Payer: IEHP Medicare Advantage |
$498.20
|
| Rate for Payer: Innovage PACE Commercial |
$747.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$435.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$498.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$130.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$667.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$667.59
|
| Rate for Payer: Multiplan Commercial |
$489.75
|
| Rate for Payer: Networks By Design Commercial |
$424.45
|
| Rate for Payer: Prime Health Services Commercial |
$555.05
|
| Rate for Payer: Prime Health Services Medicare |
$528.09
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$391.80
|
| Rate for Payer: Riverside University Health MISP |
$548.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$391.80
|
| 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 Commercial/Exchange |
$747.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Vantage Medical Group Senior |
$498.20
|
|
|
HC PUNCH BX SKIN SINGLE LESION
|
Facility
IP
|
$653.00
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
900511104
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$130.60 |
| Max. Negotiated Rate |
$587.70 |
| Rate for Payer: Cash Price |
$293.85
|
| Rate for Payer: Central Health Plan Commercial |
$522.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$261.20
|
| Rate for Payer: Galaxy Health WC |
$555.05
|
| Rate for Payer: Global Benefits Group Commercial |
$391.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$587.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$435.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$130.60
|
| Rate for Payer: Multiplan Commercial |
$489.75
|
| Rate for Payer: Networks By Design Commercial |
$424.45
|
| Rate for Payer: Prime Health Services Commercial |
$555.05
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
OP
|
$1,094.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$218.80 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$498.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$498.20
|
| 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 |
$656.40
|
| Rate for Payer: Blue Shield of California Commercial |
$688.13
|
| Rate for Payer: Blue Shield of California EPN |
$534.97
|
| Rate for Payer: Caremore Medicare Advantage |
$498.20
|
| Rate for Payer: Cash Price |
$492.30
|
| Rate for Payer: Cash Price |
$492.30
|
| Rate for Payer: Cash Price |
$492.30
|
| Rate for Payer: Central Health Plan Commercial |
$875.20
|
| Rate for Payer: Cigna of CA HMO |
$700.16
|
| Rate for Payer: Cigna of CA PPO |
$809.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$672.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$498.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$498.20
|
| Rate for Payer: Galaxy Health WC |
$929.90
|
| Rate for Payer: Global Benefits Group Commercial |
$656.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$984.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$820.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$817.05
|
| Rate for Payer: IEHP medi-cal |
$822.03
|
| Rate for Payer: IEHP Medicare Advantage |
$498.20
|
| Rate for Payer: Innovage PACE Commercial |
$747.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$729.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$498.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$218.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$667.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$667.59
|
| Rate for Payer: Multiplan Commercial |
$820.50
|
| Rate for Payer: Networks By Design Commercial |
$711.10
|
| Rate for Payer: Prime Health Services Commercial |
$929.90
|
| Rate for Payer: Prime Health Services Medicare |
$528.09
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$656.40
|
| Rate for Payer: Riverside University Health MISP |
$548.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$656.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$656.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$547.00
|
| Rate for Payer: United Healthcare All Other HMO |
$547.00
|
| Rate for Payer: United Healthcare HMO Rider |
$547.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$547.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Vantage Medical Group Senior |
$498.20
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
OP
|
$1,094.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$218.80 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$498.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$498.20
|
| 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 |
$656.40
|
| Rate for Payer: Blue Shield of California Commercial |
$688.13
|
| Rate for Payer: Blue Shield of California EPN |
$534.97
|
| Rate for Payer: Caremore Medicare Advantage |
$498.20
|
| Rate for Payer: Cash Price |
$492.30
|
| Rate for Payer: Cash Price |
$492.30
|
| Rate for Payer: Cash Price |
$492.30
|
| Rate for Payer: Central Health Plan Commercial |
$875.20
|
| Rate for Payer: Cigna of CA HMO |
$700.16
|
| Rate for Payer: Cigna of CA PPO |
$809.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$672.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$498.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$498.20
|
| Rate for Payer: Galaxy Health WC |
$929.90
|
| Rate for Payer: Global Benefits Group Commercial |
$656.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$984.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$820.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$817.05
|
| Rate for Payer: IEHP medi-cal |
$822.03
|
| Rate for Payer: IEHP Medicare Advantage |
$498.20
|
| Rate for Payer: Innovage PACE Commercial |
$747.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$729.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$498.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$218.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$667.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$667.59
|
| Rate for Payer: Multiplan Commercial |
$820.50
|
| Rate for Payer: Networks By Design Commercial |
$711.10
|
| Rate for Payer: Prime Health Services Commercial |
$929.90
|
| Rate for Payer: Prime Health Services Medicare |
$528.09
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$656.40
|
| Rate for Payer: Riverside University Health MISP |
$548.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$656.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$656.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,036.00
|
| Rate for Payer: United Healthcare All Other HMO |
$799.00
|
| Rate for Payer: United Healthcare HMO Rider |
$605.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$552.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Vantage Medical Group Senior |
$498.20
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
IP
|
$1,094.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$218.80 |
| Max. Negotiated Rate |
$984.60 |
| Rate for Payer: Cash Price |
$492.30
|
| Rate for Payer: Central Health Plan Commercial |
$875.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$437.60
|
| Rate for Payer: Galaxy Health WC |
$929.90
|
| Rate for Payer: Global Benefits Group Commercial |
$656.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$984.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$729.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$218.80
|
| Rate for Payer: Multiplan Commercial |
$820.50
|
| Rate for Payer: Networks By Design Commercial |
$711.10
|
| Rate for Payer: Prime Health Services Commercial |
$929.90
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
IP
|
$1,094.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$218.80 |
| Max. Negotiated Rate |
$984.60 |
| Rate for Payer: Cash Price |
$492.30
|
| Rate for Payer: Central Health Plan Commercial |
$875.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$437.60
|
| Rate for Payer: Galaxy Health WC |
$929.90
|
| Rate for Payer: Global Benefits Group Commercial |
$656.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$984.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$729.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$218.80
|
| Rate for Payer: Multiplan Commercial |
$820.50
|
| Rate for Payer: Networks By Design Commercial |
$711.10
|
| Rate for Payer: Prime Health Services Commercial |
$929.90
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
IP
|
$1,094.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$218.80 |
| Max. Negotiated Rate |
$984.60 |
| Rate for Payer: Cash Price |
$492.30
|
| Rate for Payer: Central Health Plan Commercial |
$875.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$437.60
|
| Rate for Payer: Galaxy Health WC |
$929.90
|
| Rate for Payer: Global Benefits Group Commercial |
$656.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$984.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$729.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$218.80
|
| Rate for Payer: Multiplan Commercial |
$820.50
|
| Rate for Payer: Networks By Design Commercial |
$711.10
|
| Rate for Payer: Prime Health Services Commercial |
$929.90
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
OP
|
$1,094.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$218.80 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$498.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$498.20
|
| 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 |
$656.40
|
| Rate for Payer: Blue Shield of California Commercial |
$688.13
|
| Rate for Payer: Blue Shield of California EPN |
$534.97
|
| Rate for Payer: Caremore Medicare Advantage |
$498.20
|
| Rate for Payer: Cash Price |
$492.30
|
| Rate for Payer: Cash Price |
$492.30
|
| Rate for Payer: Cash Price |
$492.30
|
| Rate for Payer: Central Health Plan Commercial |
$875.20
|
| Rate for Payer: Cigna of CA HMO |
$700.16
|
| Rate for Payer: Cigna of CA PPO |
$809.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$672.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$498.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$498.20
|
| Rate for Payer: Galaxy Health WC |
$929.90
|
| Rate for Payer: Global Benefits Group Commercial |
$656.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$984.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$820.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$817.05
|
| Rate for Payer: IEHP medi-cal |
$822.03
|
| Rate for Payer: IEHP Medicare Advantage |
$498.20
|
| Rate for Payer: Innovage PACE Commercial |
$747.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$729.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$498.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$218.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$667.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$667.59
|
| Rate for Payer: Multiplan Commercial |
$820.50
|
| Rate for Payer: Networks By Design Commercial |
$711.10
|
| Rate for Payer: Prime Health Services Commercial |
$929.90
|
| Rate for Payer: Prime Health Services Medicare |
$528.09
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$656.40
|
| Rate for Payer: Riverside University Health MISP |
$548.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$656.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$656.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$547.00
|
| Rate for Payer: United Healthcare All Other HMO |
$547.00
|
| Rate for Payer: United Healthcare HMO Rider |
$547.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$547.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Vantage Medical Group Senior |
$498.20
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
OP
|
$1,094.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$218.80 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$498.20
|
| 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 |
$656.40
|
| Rate for Payer: Caremore Medicare Advantage |
$498.20
|
| Rate for Payer: Cash Price |
$492.30
|
| Rate for Payer: Cash Price |
$492.30
|
| Rate for Payer: Cash Price |
$492.30
|
| Rate for Payer: Cash Price |
$492.30
|
| Rate for Payer: Central Health Plan Commercial |
$875.20
|
| Rate for Payer: Cigna of CA PPO |
$809.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$672.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$498.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$498.20
|
| Rate for Payer: Galaxy Health WC |
$929.90
|
| Rate for Payer: Global Benefits Group Commercial |
$656.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$984.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$820.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$817.05
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$498.20
|
| Rate for Payer: Innovage PACE Commercial |
$747.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$729.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$498.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$218.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$667.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$667.59
|
| Rate for Payer: Multiplan Commercial |
$820.50
|
| Rate for Payer: Networks By Design Commercial |
$711.10
|
| Rate for Payer: Prime Health Services Commercial |
$929.90
|
| Rate for Payer: Prime Health Services Medicare |
$528.09
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$656.40
|
| Rate for Payer: Riverside University Health MISP |
$548.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$656.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$547.00
|
| Rate for Payer: United Healthcare All Other HMO |
$547.00
|
| Rate for Payer: United Healthcare HMO Rider |
$547.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$547.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Vantage Medical Group Senior |
$498.20
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
OP
|
$1,094.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$218.80 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$498.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$498.20
|
| 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 |
$656.40
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$498.20
|
| Rate for Payer: Cash Price |
$492.30
|
| Rate for Payer: Cash Price |
$492.30
|
| Rate for Payer: Cash Price |
$492.30
|
| Rate for Payer: Central Health Plan Commercial |
$875.20
|
| Rate for Payer: Cigna of CA PPO |
$809.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$672.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$498.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$498.20
|
| Rate for Payer: Galaxy Health WC |
$929.90
|
| Rate for Payer: Global Benefits Group Commercial |
$656.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$984.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$820.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$817.05
|
| Rate for Payer: IEHP medi-cal |
$822.03
|
| Rate for Payer: IEHP Medicare Advantage |
$498.20
|
| Rate for Payer: Innovage PACE Commercial |
$747.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$729.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$498.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$218.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$667.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$667.59
|
| Rate for Payer: Multiplan Commercial |
$820.50
|
| Rate for Payer: Networks By Design Commercial |
$711.10
|
| Rate for Payer: Prime Health Services Commercial |
$929.90
|
| Rate for Payer: Prime Health Services Medicare |
$528.09
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$656.40
|
| Rate for Payer: Riverside University Health MISP |
$548.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$656.40
|
| 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 Commercial/Exchange |
$747.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Vantage Medical Group Senior |
$498.20
|
|
