|
HC SELF CARE CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8987
|
| Hospital Charge Code |
900018309
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC SELF CARE CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8987
|
| Hospital Charge Code |
900018309
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC SELF CARE D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8989
|
| Hospital Charge Code |
900018311
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC SELF CARE D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8989
|
| Hospital Charge Code |
900018411
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC SELF CARE D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8989
|
| Hospital Charge Code |
900018411
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC SELF CARE D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8989
|
| Hospital Charge Code |
900018311
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC SELF CARE GOAL STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8988
|
| Hospital Charge Code |
900018310
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC SELF CARE GOAL STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8988
|
| Hospital Charge Code |
900018410
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC SELF CARE GOAL STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8988
|
| Hospital Charge Code |
900018410
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC SELF CARE GOAL STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8988
|
| Hospital Charge Code |
900018310
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC SELF CARE/HOME MGT TRNG 15 MIN MCAL
|
Facility
|
OP
|
$211.00
|
|
|
Service Code
|
CPT 97535
|
| Hospital Charge Code |
901300066
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$9.13 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$86.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$128.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$179.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$116.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$158.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$116.05
|
| Rate for Payer: Cash Price |
$116.05
|
| Rate for Payer: Cash Price |
$116.05
|
| Rate for Payer: Cash Price |
$116.05
|
| Rate for Payer: Central Health Plan Commercial |
$168.80
|
| Rate for Payer: Cigna of CA HMO |
$135.04
|
| Rate for Payer: Cigna of CA PPO |
$156.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$179.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$179.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$179.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.40
|
| Rate for Payer: EPIC Health Plan Senior |
$84.40
|
| Rate for Payer: Galaxy Health WC |
$179.35
|
| Rate for Payer: Global Benefits Group Commercial |
$126.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.13
|
| Rate for Payer: InnovAge PACE Commercial |
$105.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$140.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$130.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$147.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$147.70
|
| Rate for Payer: Multiplan Commercial |
$158.25
|
| Rate for Payer: Networks By Design Commercial |
$137.15
|
| Rate for Payer: Prime Health Services Commercial |
$179.35
|
| Rate for Payer: Riverside University Health System MISP |
$84.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$126.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$126.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$179.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$179.35
|
| Rate for Payer: Vantage Medical Group Senior |
$179.35
|
|
|
HC SELF CARE/HOME MGT TRNG 15 MIN MCAL
|
Facility
|
IP
|
$211.00
|
|
|
Service Code
|
CPT 97535
|
| Hospital Charge Code |
901300066
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$42.20 |
| Max. Negotiated Rate |
$189.90 |
| Rate for Payer: Adventist Health Commercial |
$42.20
|
| Rate for Payer: Cash Price |
$116.05
|
| Rate for Payer: Central Health Plan Commercial |
$168.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.40
|
| Rate for Payer: EPIC Health Plan Senior |
$84.40
|
| Rate for Payer: Galaxy Health WC |
$179.35
|
| Rate for Payer: Global Benefits Group Commercial |
$126.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$140.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$80.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$130.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.20
|
| Rate for Payer: Multiplan Commercial |
$158.25
|
| Rate for Payer: Networks By Design Commercial |
$137.15
|
| Rate for Payer: Prime Health Services Commercial |
$179.35
|
|
|
HC SELF CARE/HOME MGT TRNG 15 MIN OT
|
Facility
|
IP
|
$211.00
|
|
|
Service Code
|
CPT 97535
|
| Hospital Charge Code |
905104363
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$42.20 |
| Max. Negotiated Rate |
$189.90 |
| Rate for Payer: Adventist Health Commercial |
$42.20
|
| Rate for Payer: Cash Price |
$116.05
|
| Rate for Payer: Central Health Plan Commercial |
$168.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.40
|
| Rate for Payer: EPIC Health Plan Senior |
$84.40
|
| Rate for Payer: Galaxy Health WC |
$179.35
|
| Rate for Payer: Global Benefits Group Commercial |
$126.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$140.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$80.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$130.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.20
|
| Rate for Payer: Multiplan Commercial |
$158.25
|
| Rate for Payer: Networks By Design Commercial |
$137.15
|
| Rate for Payer: Prime Health Services Commercial |
$179.35
|
|
|
HC SELF CARE/HOME MGT TRNG 15 MIN OT
|
Facility
|
OP
|
$211.00
|
|
|
Service Code
|
CPT 97535
|
| Hospital Charge Code |
905104363
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$9.13 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$86.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$128.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$179.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$116.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$158.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$116.05
|
| Rate for Payer: Cash Price |
$116.05
|
| Rate for Payer: Cash Price |
$116.05
|
| Rate for Payer: Cash Price |
$116.05
|
| Rate for Payer: Central Health Plan Commercial |
$168.80
|
| Rate for Payer: Cigna of CA HMO |
$135.04
|
| Rate for Payer: Cigna of CA PPO |
$156.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$179.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$179.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$179.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.40
|
| Rate for Payer: EPIC Health Plan Senior |
$84.40
|
| Rate for Payer: Galaxy Health WC |
$179.35
|
| Rate for Payer: Global Benefits Group Commercial |
$126.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.13
|
| Rate for Payer: InnovAge PACE Commercial |
$105.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$140.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$130.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$147.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$147.70
|
| Rate for Payer: Multiplan Commercial |
$158.25
|
| Rate for Payer: Networks By Design Commercial |
$137.15
|
| Rate for Payer: Prime Health Services Commercial |
$179.35
|
| Rate for Payer: Riverside University Health System MISP |
$84.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$126.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$126.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$179.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$179.35
|
| Rate for Payer: Vantage Medical Group Senior |
$179.35
|
|
|
HC SELF CARE/HOME MGT TRNG 15 MIN PT
|
Facility
|
OP
|
$211.00
|
|
|
Service Code
|
CPT 97535
|
| Hospital Charge Code |
900419056
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$9.13 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$86.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$128.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$179.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$116.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$158.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$116.05
|
| Rate for Payer: Cash Price |
$116.05
|
| Rate for Payer: Cash Price |
$116.05
|
| Rate for Payer: Cash Price |
$116.05
|
| Rate for Payer: Central Health Plan Commercial |
$168.80
|
| Rate for Payer: Cigna of CA HMO |
$135.04
|
| Rate for Payer: Cigna of CA PPO |
$156.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$179.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$179.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$179.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.40
|
| Rate for Payer: EPIC Health Plan Senior |
$84.40
|
| Rate for Payer: Galaxy Health WC |
$179.35
|
| Rate for Payer: Global Benefits Group Commercial |
$126.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.13
|
| Rate for Payer: InnovAge PACE Commercial |
$105.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$140.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$130.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$147.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$147.70
|
| Rate for Payer: Multiplan Commercial |
$158.25
|
| Rate for Payer: Networks By Design Commercial |
$137.15
|
| Rate for Payer: Prime Health Services Commercial |
$179.35
|
| Rate for Payer: Riverside University Health System MISP |
$84.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$126.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$126.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$179.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$179.35
|
| Rate for Payer: Vantage Medical Group Senior |
$179.35
|
|
|
HC SELF CARE/HOME MGT TRNG 15 MIN PT
|
Facility
|
IP
|
$211.00
|
|
|
Service Code
|
CPT 97535
|
| Hospital Charge Code |
900419056
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$42.20 |
| Max. Negotiated Rate |
$189.90 |
| Rate for Payer: Adventist Health Commercial |
$42.20
|
| Rate for Payer: Cash Price |
$116.05
|
| Rate for Payer: Central Health Plan Commercial |
$168.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.40
|
| Rate for Payer: EPIC Health Plan Senior |
$84.40
|
| Rate for Payer: Galaxy Health WC |
$179.35
|
| Rate for Payer: Global Benefits Group Commercial |
$126.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$140.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$80.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$130.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.20
|
| Rate for Payer: Multiplan Commercial |
$158.25
|
| Rate for Payer: Networks By Design Commercial |
$137.15
|
| Rate for Payer: Prime Health Services Commercial |
$179.35
|
|
|
HC SELLA TURCICA
|
Facility
|
IP
|
$736.00
|
|
|
Service Code
|
CPT 70240
|
| Hospital Charge Code |
909001114
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$147.20 |
| Max. Negotiated Rate |
$662.40 |
| Rate for Payer: Adventist Health Commercial |
$147.20
|
| Rate for Payer: Cash Price |
$404.80
|
| Rate for Payer: Central Health Plan Commercial |
$588.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$294.40
|
| Rate for Payer: EPIC Health Plan Senior |
$294.40
|
| Rate for Payer: Galaxy Health WC |
$625.60
|
| Rate for Payer: Global Benefits Group Commercial |
$441.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$662.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$490.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$280.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$455.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.20
|
| Rate for Payer: Multiplan Commercial |
$552.00
|
| Rate for Payer: Networks By Design Commercial |
$478.40
|
| Rate for Payer: Prime Health Services Commercial |
$625.60
|
|
|
HC SELLA TURCICA
|
Facility
|
OP
|
$736.00
|
|
|
Service Code
|
CPT 70240
|
| Hospital Charge Code |
909001114
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$17.95 |
| Max. Negotiated Rate |
$662.40 |
| Rate for Payer: Adventist Health Commercial |
$147.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$111.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$446.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$88.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.95
|
| Rate for Payer: Blue Shield of California Commercial |
$446.75
|
| Rate for Payer: Blue Shield of California EPN |
$292.19
|
| Rate for Payer: Cash Price |
$404.80
|
| Rate for Payer: Cash Price |
$404.80
|
| Rate for Payer: Central Health Plan Commercial |
$588.80
|
| Rate for Payer: Cigna of CA HMO |
$471.04
|
| Rate for Payer: Cigna of CA PPO |
$544.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$151.04
|
| Rate for Payer: EPIC Health Plan Senior |
$111.88
|
| Rate for Payer: Galaxy Health WC |
$625.60
|
| Rate for Payer: Global Benefits Group Commercial |
$441.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$662.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$183.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$37.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.88
|
| Rate for Payer: InnovAge PACE Commercial |
$167.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$490.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$111.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$149.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$149.92
|
| Rate for Payer: Multiplan Commercial |
$552.00
|
| Rate for Payer: Networks By Design Commercial |
$478.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$111.88
|
| Rate for Payer: Prime Health Services Commercial |
$625.60
|
| Rate for Payer: Prime Health Services Medicare |
$118.59
|
| Rate for Payer: Riverside University Health System MISP |
$123.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$441.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$441.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$111.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Vantage Medical Group Senior |
$111.88
|
|
|
HC SEMEN ANALYSIS
|
Facility
|
OP
|
$112.00
|
|
|
Service Code
|
CPT 89320
|
| Hospital Charge Code |
900910151
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.97 |
| Max. Negotiated Rate |
$108.97 |
| Rate for Payer: Adventist Health Commercial |
$22.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$12.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$108.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.12
|
| Rate for Payer: Blue Shield of California Commercial |
$67.98
|
| Rate for Payer: Blue Shield of California EPN |
$44.46
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Central Health Plan Commercial |
$89.60
|
| Rate for Payer: Cigna of CA HMO |
$71.68
|
| Rate for Payer: Cigna of CA PPO |
$82.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.62
|
| Rate for Payer: EPIC Health Plan Senior |
$12.31
|
| Rate for Payer: Galaxy Health WC |
$95.20
|
| Rate for Payer: Global Benefits Group Commercial |
$67.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$100.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$20.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.31
|
| Rate for Payer: InnovAge PACE Commercial |
$18.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$74.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.50
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: Networks By Design Commercial |
$72.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12.31
|
| Rate for Payer: Prime Health Services Commercial |
$95.20
|
| Rate for Payer: Prime Health Services Medicare |
$13.05
|
| Rate for Payer: Riverside University Health System MISP |
$13.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$67.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$67.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.97
|
| Rate for Payer: United Healthcare All Other HMO |
$9.97
|
| Rate for Payer: United Healthcare HMO Rider |
$9.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.97
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.54
|
| Rate for Payer: Vantage Medical Group Senior |
$12.31
|
|
|
HC SEMEN ANALYSIS
|
Facility
|
IP
|
$112.00
|
|
|
Service Code
|
CPT 89320
|
| Hospital Charge Code |
900910151
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$100.80 |
| Rate for Payer: Adventist Health Commercial |
$22.40
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Central Health Plan Commercial |
$89.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.80
|
| Rate for Payer: EPIC Health Plan Senior |
$44.80
|
| Rate for Payer: Galaxy Health WC |
$95.20
|
| Rate for Payer: Global Benefits Group Commercial |
$67.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$100.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$74.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$69.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.40
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: Networks By Design Commercial |
$72.80
|
| Rate for Payer: Prime Health Services Commercial |
$95.20
|
|
|
HC SENSITIVITY DISK DIFFUSION
|
Facility
|
IP
|
$46.00
|
|
|
Service Code
|
CPT 87184
|
| Hospital Charge Code |
900912403
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$41.40 |
| Rate for Payer: Adventist Health Commercial |
$9.20
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Central Health Plan Commercial |
$36.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.40
|
| Rate for Payer: EPIC Health Plan Senior |
$18.40
|
| Rate for Payer: Galaxy Health WC |
$39.10
|
| Rate for Payer: Global Benefits Group Commercial |
$27.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$41.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.20
|
| Rate for Payer: Multiplan Commercial |
$34.50
|
| Rate for Payer: Networks By Design Commercial |
$29.90
|
| Rate for Payer: Prime Health Services Commercial |
$39.10
|
|
|
HC SENSITIVITY DISK DIFFUSION
|
Facility
|
OP
|
$46.00
|
|
|
Service Code
|
CPT 87184
|
| Hospital Charge Code |
900912403
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.06 |
| Max. Negotiated Rate |
$50.10 |
| Rate for Payer: Adventist Health Commercial |
$9.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$7.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$50.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.17
|
| Rate for Payer: Blue Shield of California Commercial |
$27.92
|
| Rate for Payer: Blue Shield of California EPN |
$18.26
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Central Health Plan Commercial |
$36.80
|
| Rate for Payer: Cigna of CA HMO |
$29.44
|
| Rate for Payer: Cigna of CA PPO |
$34.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.10
|
| Rate for Payer: EPIC Health Plan Senior |
$7.48
|
| Rate for Payer: Galaxy Health WC |
$39.10
|
| Rate for Payer: Global Benefits Group Commercial |
$27.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$41.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.48
|
| Rate for Payer: InnovAge PACE Commercial |
$11.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.02
|
| Rate for Payer: Multiplan Commercial |
$34.50
|
| Rate for Payer: Networks By Design Commercial |
$29.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7.48
|
| Rate for Payer: Prime Health Services Commercial |
$39.10
|
| Rate for Payer: Prime Health Services Medicare |
$7.93
|
| Rate for Payer: Riverside University Health System MISP |
$8.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.06
|
| Rate for Payer: United Healthcare All Other HMO |
$6.06
|
| Rate for Payer: United Healthcare HMO Rider |
$6.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.06
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.23
|
| Rate for Payer: Vantage Medical Group Senior |
$7.48
|
|
|
HC SENSITIVITY E TESTS
|
Facility
|
IP
|
$20.00
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
900912404
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Adventist Health Commercial |
$4.00
|
| Rate for Payer: Cash Price |
$11.00
|
| Rate for Payer: Central Health Plan Commercial |
$16.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.00
|
| Rate for Payer: EPIC Health Plan Senior |
$8.00
|
| Rate for Payer: Galaxy Health WC |
$17.00
|
| Rate for Payer: Global Benefits Group Commercial |
$12.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.00
|
| Rate for Payer: Multiplan Commercial |
$15.00
|
| Rate for Payer: Networks By Design Commercial |
$13.00
|
| Rate for Payer: Prime Health Services Commercial |
$17.00
|
|
|
HC SENSITIVITY E TESTS
|
Facility
|
OP
|
$20.00
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
900912404
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Adventist Health Commercial |
$4.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.33
|
| Rate for Payer: Blue Shield of California Commercial |
$12.14
|
| Rate for Payer: Blue Shield of California EPN |
$7.94
|
| Rate for Payer: Cash Price |
$11.00
|
| Rate for Payer: Cash Price |
$11.00
|
| Rate for Payer: Central Health Plan Commercial |
$16.00
|
| Rate for Payer: Cigna of CA HMO |
$12.80
|
| Rate for Payer: Cigna of CA PPO |
$14.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.41
|
| Rate for Payer: EPIC Health Plan Senior |
$4.75
|
| Rate for Payer: Galaxy Health WC |
$17.00
|
| Rate for Payer: Global Benefits Group Commercial |
$12.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.75
|
| Rate for Payer: InnovAge PACE Commercial |
$7.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.37
|
| Rate for Payer: Multiplan Commercial |
$15.00
|
| Rate for Payer: Networks By Design Commercial |
$13.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4.75
|
| Rate for Payer: Prime Health Services Commercial |
$17.00
|
| Rate for Payer: Prime Health Services Medicare |
$5.04
|
| Rate for Payer: Riverside University Health System MISP |
$5.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.85
|
| Rate for Payer: United Healthcare All Other HMO |
$3.85
|
| Rate for Payer: United Healthcare HMO Rider |
$3.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.85
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Vantage Medical Group Senior |
$4.75
|
|
|
HC SENSITIVITY GRAM NEGATIVE MIC
|
Facility
|
IP
|
$88.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
900912414
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$17.60 |
| Max. Negotiated Rate |
$79.20 |
| Rate for Payer: Adventist Health Commercial |
$17.60
|
| Rate for Payer: Cash Price |
$48.40
|
| Rate for Payer: Central Health Plan Commercial |
$70.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.20
|
| Rate for Payer: EPIC Health Plan Senior |
$35.20
|
| Rate for Payer: Galaxy Health WC |
$74.80
|
| Rate for Payer: Global Benefits Group Commercial |
$52.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$79.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$58.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$54.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.60
|
| Rate for Payer: Multiplan Commercial |
$66.00
|
| Rate for Payer: Networks By Design Commercial |
$57.20
|
| Rate for Payer: Prime Health Services Commercial |
$74.80
|
|
