|
HC ELECTROGSTROGRPHY DIAG TRANSCU
|
Facility
|
IP
|
$1,655.00
|
|
|
Service Code
|
CPT 91132
|
| Hospital Charge Code |
906791132
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$299.56 |
| Max. Negotiated Rate |
$1,241.25 |
| Rate for Payer: Adventist Health Commercial |
$331.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,136.98
|
| Rate for Payer: Cash Price |
$744.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,120.44
|
| Rate for Payer: Heritage Provider Network Senior |
$1,120.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$299.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$413.75
|
| Rate for Payer: Multiplan Commercial |
$1,241.25
|
|
|
HC ELECTROLYTE PANEL
|
Facility
|
OP
|
$17.00
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
900912165
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.08 |
| Max. Negotiated Rate |
$58.72 |
| Rate for Payer: Adventist Health Commercial |
$3.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$20.41
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$58.72
|
| Rate for Payer: Blue Shield of California Commercial |
$54.78
|
| Rate for Payer: Blue Shield of California EPN |
$42.83
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.71
|
| Rate for Payer: Dignity Health Senior |
$7.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$7.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.52
|
| Rate for Payer: Heritage Provider Network Senior |
$10.52
|
| Rate for Payer: Humana Medicare |
$7.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.83
|
| Rate for Payer: Multiplan Commercial |
$12.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$7.01
|
| Rate for Payer: TriValley Medical Group Senior |
$7.01
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7.57
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.71
|
| Rate for Payer: Vantage Medical Group Senior |
$7.01
|
|
|
HC ELECTROLYTE PANEL
|
Facility
|
IP
|
$246.00
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
900912165
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.53 |
| Max. Negotiated Rate |
$184.50 |
| Rate for Payer: Adventist Health Commercial |
$49.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$169.00
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$166.54
|
| Rate for Payer: Heritage Provider Network Senior |
$166.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.50
|
| Rate for Payer: Multiplan Commercial |
$184.50
|
|
|
HC ELECTRON MICROSCOPY COMPLEX
|
Facility
|
IP
|
$4,463.00
|
|
|
Service Code
|
CPT 88348
|
| Hospital Charge Code |
903800039
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$807.80 |
| Max. Negotiated Rate |
$3,347.25 |
| Rate for Payer: Adventist Health Commercial |
$892.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,066.08
|
| Rate for Payer: Cash Price |
$2,008.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,021.45
|
| Rate for Payer: Heritage Provider Network Senior |
$3,021.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$807.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,115.75
|
| Rate for Payer: Multiplan Commercial |
$3,347.25
|
|
|
HC ELECTRON MICROSCOPY COMPLEX
|
Facility
|
OP
|
$952.00
|
|
|
Service Code
|
CPT 88348
|
| Hospital Charge Code |
903800039
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$172.31 |
| Max. Negotiated Rate |
$2,041.30 |
| Rate for Payer: Adventist Health Commercial |
$190.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,351.70
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$654.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,611.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,181.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,074.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$278.15
|
| Rate for Payer: Blue Shield of California Commercial |
$591.19
|
| Rate for Payer: Blue Shield of California EPN |
$558.82
|
| Rate for Payer: Cash Price |
$428.40
|
| Rate for Payer: Cash Price |
$428.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$618.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,611.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,181.81
|
| Rate for Payer: Dignity Health Senior |
$1,074.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$618.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,074.37
|
| Rate for Payer: Heritage Provider Network Commercial |
$589.29
|
| Rate for Payer: Heritage Provider Network Senior |
$589.29
|
| Rate for Payer: Humana Medicare |
$1,074.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$370.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,074.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,041.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$172.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,267.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$238.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,353.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,353.71
|
| Rate for Payer: Multiplan Commercial |
$714.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,074.37
|
| Rate for Payer: TriValley Medical Group Senior |
$1,074.37
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$722.83
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$722.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,611.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,181.81
|
| Rate for Payer: Vantage Medical Group Senior |
$1,074.37
|
|
|
HC ELECTROPHYSIO EVAL
|
Facility
|
IP
|
$4,746.00
|
|
|
Service Code
|
CPT 93642
|
| Hospital Charge Code |
906820090
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$859.03 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$949.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,260.50
|
| Rate for Payer: Cash Price |
$2,135.70
|
| Rate for Payer: Cash Price |
$2,135.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$859.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,186.50
|
| Rate for Payer: Multiplan Commercial |
$3,559.50
|
|
|
HC ELECTROPHYSIO EVAL
|
Facility
|
IP
|
$4,746.00
|
|
|
Service Code
|
CPT 93642
|
| Hospital Charge Code |
906813411
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$859.03 |
| Max. Negotiated Rate |
$3,559.50 |
| Rate for Payer: Adventist Health Commercial |
$949.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,260.50
|
| Rate for Payer: Cash Price |
$2,135.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,213.04
|
| Rate for Payer: Heritage Provider Network Senior |
$3,213.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$859.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,186.50
|
| Rate for Payer: Multiplan Commercial |
$3,559.50
|
|
|
HC ELECTROPHYSIO EVAL
|
Facility
|
OP
|
$4,746.00
|
|
|
Service Code
|
CPT 93642
|
| Hospital Charge Code |
906813411
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$859.03 |
| Max. Negotiated Rate |
$4,547.00 |
| Rate for Payer: Adventist Health Commercial |
$949.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,260.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,486.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Cash Price |
$2,135.70
|
| Rate for Payer: Cash Price |
$2,135.70
|
| Rate for Payer: Cash Price |
$2,135.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,084.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,635.69
|
| Rate for Payer: Dignity Health Senior |
$1,486.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,084.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,486.99
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,213.04
|
| Rate for Payer: Heritage Provider Network Senior |
$3,213.04
|
| Rate for Payer: Humana Medicare |
$1,486.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,486.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,287.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$859.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,754.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,186.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,873.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,873.61
|
| Rate for Payer: Multiplan Commercial |
$3,559.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,723.27
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,585.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,486.99
|
|
|
HC ELECTROPHYSIO EVAL
|
Facility
|
OP
|
$4,746.00
|
|
|
Service Code
|
CPT 93642
|
| Hospital Charge Code |
906820090
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$8,689.75 |
| Rate for Payer: Adventist Health Commercial |
$949.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,420.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,260.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,486.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$2,135.70
|
| Rate for Payer: Cash Price |
$2,135.70
|
| Rate for Payer: Cash Price |
$2,135.70
|
| Rate for Payer: Cash Price |
$2,135.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,084.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,635.69
|
| Rate for Payer: Dignity Health Senior |
$1,486.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,084.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,486.99
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,937.77
|
| Rate for Payer: Heritage Provider Network Senior |
$1,829.00
|
| Rate for Payer: Humana Medicare |
$1,486.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$818.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,486.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,825.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$859.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,754.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,186.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,873.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,873.61
|
| Rate for Payer: Multiplan Commercial |
$3,559.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,635.69
|
| Rate for Payer: TriValley Medical Group Senior |
$1,486.99
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$547.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$460.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,230.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,635.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,486.99
|
|
|
HC ELECT STIM MANUAL 15 MIN MC
|
Facility
|
IP
|
$242.00
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
901300049
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$43.80 |
| Max. Negotiated Rate |
$181.50 |
| Rate for Payer: Adventist Health Commercial |
$48.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$166.25
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$163.83
|
| Rate for Payer: Heritage Provider Network Senior |
$163.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.50
|
| Rate for Payer: Multiplan Commercial |
$181.50
|
|
|
HC ELECT STIM MANUAL 15 MIN MC
|
Facility
|
OP
|
$242.00
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
901300049
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$13.51 |
| Max. Negotiated Rate |
$343.00 |
| Rate for Payer: Adventist Health Commercial |
$48.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$28.99
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$166.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$205.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$133.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$181.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.00
|
| Rate for Payer: Blue Shield of California Commercial |
$343.00
|
| Rate for Payer: Blue Shield of California EPN |
$295.00
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$157.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$205.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$205.70
|
| Rate for Payer: Dignity Health Senior |
$205.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$149.80
|
| Rate for Payer: Heritage Provider Network Senior |
$149.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$116.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.50
|
| Rate for Payer: Multiplan Commercial |
$181.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$205.70
|
| Rate for Payer: Vantage Medical Group Senior |
$205.70
|
|
|
HC ELECT STIM MANUAL 15 MIN MCAL
|
Facility
|
IP
|
$242.00
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
900400026
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$43.80 |
| Max. Negotiated Rate |
$181.50 |
| Rate for Payer: Adventist Health Commercial |
$48.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$166.25
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$163.83
|
| Rate for Payer: Heritage Provider Network Senior |
$163.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.50
|
| Rate for Payer: Multiplan Commercial |
$181.50
|
|
|
HC ELECT STIM MANUAL 15 MIN MCAL
|
Facility
|
OP
|
$242.00
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
900400026
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$13.51 |
| Max. Negotiated Rate |
$343.00 |
| Rate for Payer: Adventist Health Commercial |
$48.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$28.99
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$166.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$205.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$133.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$181.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.00
|
| Rate for Payer: Blue Shield of California Commercial |
$343.00
|
| Rate for Payer: Blue Shield of California EPN |
$295.00
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$157.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$205.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$205.70
|
| Rate for Payer: Dignity Health Senior |
$205.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$149.80
|
| Rate for Payer: Heritage Provider Network Senior |
$149.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$116.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.50
|
| Rate for Payer: Multiplan Commercial |
$181.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$205.70
|
| Rate for Payer: Vantage Medical Group Senior |
$205.70
|
|
|
HC ELECT STIM MANUAL 15 MIN MCARE COMM
|
Facility
|
OP
|
$242.00
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
900407032
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$13.51 |
| Max. Negotiated Rate |
$343.00 |
| Rate for Payer: Adventist Health Commercial |
$48.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$28.99
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$166.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$205.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$133.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$181.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.00
|
| Rate for Payer: Blue Shield of California Commercial |
$343.00
|
| Rate for Payer: Blue Shield of California EPN |
$295.00
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$157.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$205.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$205.70
|
| Rate for Payer: Dignity Health Senior |
$205.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$149.80
|
| Rate for Payer: Heritage Provider Network Senior |
$149.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$116.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.50
|
| Rate for Payer: Multiplan Commercial |
$181.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$205.70
|
| Rate for Payer: Vantage Medical Group Senior |
$205.70
|
|
|
HC ELECT STIM MANUAL 15 MIN MCARE COMM
|
Facility
|
IP
|
$242.00
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
900407032
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$43.80 |
| Max. Negotiated Rate |
$181.50 |
| Rate for Payer: Adventist Health Commercial |
$48.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$166.25
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$163.83
|
| Rate for Payer: Heritage Provider Network Senior |
$163.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.50
|
| Rate for Payer: Multiplan Commercial |
$181.50
|
|
|
HC ELECT STIM MANUAL 15MIN OT
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
905104122
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$13.51 |
| Max. Negotiated Rate |
$343.00 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$28.99
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$67.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$83.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$53.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$73.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.00
|
| Rate for Payer: Blue Shield of California Commercial |
$343.00
|
| Rate for Payer: Blue Shield of California EPN |
$295.00
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$63.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$83.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.30
|
| Rate for Payer: Dignity Health Senior |
$83.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$63.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$60.66
|
| Rate for Payer: Heritage Provider Network Senior |
$60.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$47.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.50
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.30
|
| Rate for Payer: Vantage Medical Group Senior |
$83.30
|
|
|
HC ELECT STIM MANUAL 15MIN OT
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
905104122
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$17.74 |
| Max. Negotiated Rate |
$73.50 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$67.33
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$66.35
|
| Rate for Payer: Heritage Provider Network Senior |
$66.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.50
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
|
|
HC ELECT STIM MANUAL 15 MIN PT
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
900417032
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$13.51 |
| Max. Negotiated Rate |
$343.00 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$28.99
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$67.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$83.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$53.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$73.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.00
|
| Rate for Payer: Blue Shield of California Commercial |
$343.00
|
| Rate for Payer: Blue Shield of California EPN |
$295.00
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$63.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$83.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.30
|
| Rate for Payer: Dignity Health Senior |
$83.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$63.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$60.66
|
| Rate for Payer: Heritage Provider Network Senior |
$60.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$47.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.50
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.30
|
| Rate for Payer: Vantage Medical Group Senior |
$83.30
|
|
|
HC ELECT STIM MANUAL 15 MIN PT
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
905103122
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$13.51 |
| Max. Negotiated Rate |
$343.00 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$28.99
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$67.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$83.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$53.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$73.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.00
|
| Rate for Payer: Blue Shield of California Commercial |
$343.00
|
| Rate for Payer: Blue Shield of California EPN |
$295.00
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$63.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$83.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.30
|
| Rate for Payer: Dignity Health Senior |
$83.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$63.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$60.66
|
| Rate for Payer: Heritage Provider Network Senior |
$60.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$47.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.50
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.30
|
| Rate for Payer: Vantage Medical Group Senior |
$83.30
|
|
|
HC ELECT STIM MANUAL 15 MIN PT
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
900417032
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$17.74 |
| Max. Negotiated Rate |
$73.50 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$67.33
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$66.35
|
| Rate for Payer: Heritage Provider Network Senior |
$66.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.50
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
|
|
HC ELECT STIM MANUAL 15 MIN PT
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
905103122
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$17.74 |
| Max. Negotiated Rate |
$73.50 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$67.33
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$66.35
|
| Rate for Payer: Heritage Provider Network Senior |
$66.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.50
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
|
|
HC ELECT STIM MANUAL 15 MIN ST
|
Facility
|
IP
|
$242.00
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
905601303
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$43.80 |
| Max. Negotiated Rate |
$181.50 |
| Rate for Payer: Adventist Health Commercial |
$48.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$166.25
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$163.83
|
| Rate for Payer: Heritage Provider Network Senior |
$163.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.50
|
| Rate for Payer: Multiplan Commercial |
$181.50
|
|
|
HC ELECT STIM MANUAL 15 MIN ST
|
Facility
|
OP
|
$242.00
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
905601303
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$13.51 |
| Max. Negotiated Rate |
$343.00 |
| Rate for Payer: Adventist Health Commercial |
$48.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$28.99
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$166.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$205.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$133.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$181.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.00
|
| Rate for Payer: Blue Shield of California Commercial |
$343.00
|
| Rate for Payer: Blue Shield of California EPN |
$295.00
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$157.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$205.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$205.70
|
| Rate for Payer: Dignity Health Senior |
$205.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$149.80
|
| Rate for Payer: Heritage Provider Network Senior |
$149.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$116.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.50
|
| Rate for Payer: Multiplan Commercial |
$181.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$125.00
|
| Rate for Payer: TriValley Medical Group Senior |
$125.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$205.70
|
| Rate for Payer: Vantage Medical Group Senior |
$205.70
|
|
|
HC ELECT STIM MANUAL 15 MIN ST MCAL
|
Facility
|
IP
|
$242.00
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
907000013
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$43.80 |
| Max. Negotiated Rate |
$181.50 |
| Rate for Payer: Adventist Health Commercial |
$48.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$166.25
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$163.83
|
| Rate for Payer: Heritage Provider Network Senior |
$163.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.50
|
| Rate for Payer: Multiplan Commercial |
$181.50
|
|
|
HC ELECT STIM MANUAL 15 MIN ST MCAL
|
Facility
|
OP
|
$242.00
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
907000013
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$13.51 |
| Max. Negotiated Rate |
$343.00 |
| Rate for Payer: Adventist Health Commercial |
$48.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$28.99
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$166.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$205.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$133.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$181.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.00
|
| Rate for Payer: Blue Shield of California Commercial |
$343.00
|
| Rate for Payer: Blue Shield of California EPN |
$295.00
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$157.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$205.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$205.70
|
| Rate for Payer: Dignity Health Senior |
$205.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$149.80
|
| Rate for Payer: Heritage Provider Network Senior |
$149.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$116.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.50
|
| Rate for Payer: Multiplan Commercial |
$181.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$125.00
|
| Rate for Payer: TriValley Medical Group Senior |
$125.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$248.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$209.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$205.70
|
| Rate for Payer: Vantage Medical Group Senior |
$205.70
|
|
