|
HC SWALLOW CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8996
|
| Hospital Charge Code |
900018418
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$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 HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cigna of CA HMO/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 |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| 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 |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| 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 SWALLOW D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8998
|
| Hospital Charge Code |
900018220
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
|
|
HC SWALLOW D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8998
|
| Hospital Charge Code |
900018220
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$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 HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cigna of CA HMO/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 |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| 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 |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| 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 SWALLOW D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8998
|
| Hospital Charge Code |
900018420
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
|
|
HC SWALLOW D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8998
|
| Hospital Charge Code |
900018120
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
|
|
HC SWALLOW D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8998
|
| Hospital Charge Code |
900018120
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$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 HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cigna of CA HMO/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 |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| 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 |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| 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 SWALLOW D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8998
|
| Hospital Charge Code |
900018420
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$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 HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cigna of CA HMO/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 |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| 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 |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| 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 SWALLOW GOAL STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8997
|
| Hospital Charge Code |
900018219
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
|
|
HC SWALLOW GOAL STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8997
|
| Hospital Charge Code |
900018419
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
|
|
HC SWALLOW GOAL STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8997
|
| Hospital Charge Code |
900018419
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$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 HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cigna of CA HMO/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 |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| 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 |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| 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 SWALLOW GOAL STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8997
|
| Hospital Charge Code |
900018119
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
|
|
HC SWALLOW GOAL STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8997
|
| Hospital Charge Code |
900018119
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$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 HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cigna of CA HMO/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 |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| 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 |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| 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 SWALLOW GOAL STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8997
|
| Hospital Charge Code |
900018219
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$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 HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cigna of CA HMO/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 |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| 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 |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| 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 SWALLOWING STUDY W VIDEO
|
Facility
|
OP
|
$1,319.00
|
|
|
Service Code
|
CPT 74230
|
| Hospital Charge Code |
909001803
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$137.33 |
| Max. Negotiated Rate |
$989.25 |
| Rate for Payer: Adventist Health Commercial |
$263.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$815.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$354.77
|
| Rate for Payer: Blue Shield of California Commercial |
$274.70
|
| Rate for Payer: Blue Shield of California EPN |
$220.91
|
| Rate for Payer: Cash Price |
$593.55
|
| Rate for Payer: Cash Price |
$593.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$857.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$778.21
|
| Rate for Payer: EPIC Health Plan Medicare |
$225.59
|
| Rate for Payer: Heritage Provider Network Commercial |
$816.46
|
| Rate for Payer: Heritage Provider Network Senior |
$816.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$629.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$238.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$259.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$329.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$302.29
|
| Rate for Payer: Multiplan Commercial |
$989.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$225.59
|
| Rate for Payer: TriValley Medical Group Senior |
$225.59
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$137.33
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$137.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
|
|
HC SWALLOWING STUDY W VIDEO
|
Facility
|
IP
|
$1,319.00
|
|
|
Service Code
|
CPT 74230
|
| Hospital Charge Code |
909001803
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$238.74 |
| Max. Negotiated Rate |
$989.25 |
| Rate for Payer: Adventist Health Commercial |
$263.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$849.44
|
| Rate for Payer: Cash Price |
$593.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$892.96
|
| Rate for Payer: Heritage Provider Network Senior |
$892.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$238.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$329.75
|
| Rate for Payer: Multiplan Commercial |
$989.25
|
|
|
HC SWEAT CHLORIDE, IONTOPHORESIS
|
Facility
|
OP
|
$314.00
|
|
|
Service Code
|
CPT 89230
|
| Hospital Charge Code |
900910257
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$54.82 |
| Max. Negotiated Rate |
$323.18 |
| Rate for Payer: Adventist Health Commercial |
$62.80
|
| Rate for Payer: Adventist Health Commercial |
$6.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$19.16
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$194.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$100.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$100.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$73.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$73.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$119.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$119.60
|
| Rate for Payer: Blue Shield of California Commercial |
$323.18
|
| Rate for Payer: Blue Shield of California Commercial |
$323.18
|
| Rate for Payer: Blue Shield of California EPN |
$259.89
|
| Rate for Payer: Blue Shield of California EPN |
$259.89
|
| Rate for Payer: Cash Price |
$141.30
|
| Rate for Payer: Cash Price |
$141.30
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$20.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$204.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$100.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$100.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$73.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$73.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$67.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$67.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$204.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.15
|
| Rate for Payer: EPIC Health Plan Medicare |
$67.02
|
| Rate for Payer: EPIC Health Plan Medicare |
$67.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$194.37
|
| Rate for Payer: Heritage Provider Network Senior |
$19.19
|
| Rate for Payer: Heritage Provider Network Senior |
$194.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$14.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$149.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$56.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$77.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$77.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$89.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$89.81
|
| Rate for Payer: Multiplan Commercial |
$23.25
|
| Rate for Payer: Multiplan Commercial |
$235.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$67.02
|
| Rate for Payer: TriValley Medical Group Commercial |
$67.02
|
| Rate for Payer: TriValley Medical Group Senior |
$67.02
|
| Rate for Payer: TriValley Medical Group Senior |
$67.02
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$54.82
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$54.82
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$54.82
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$54.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$100.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$100.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$73.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$73.72
|
| Rate for Payer: Vantage Medical Group Senior |
$67.02
|
| Rate for Payer: Vantage Medical Group Senior |
$67.02
|
|
|
HC SWEAT CHLORIDE, IONTOPHORESIS
|
Facility
|
IP
|
$314.00
|
|
|
Service Code
|
CPT 89230
|
| Hospital Charge Code |
900910257
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$56.83 |
| Max. Negotiated Rate |
$235.50 |
| Rate for Payer: Adventist Health Commercial |
$62.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$202.22
|
| Rate for Payer: Cash Price |
$141.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$212.58
|
| Rate for Payer: Heritage Provider Network Senior |
$212.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$56.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.50
|
| Rate for Payer: Multiplan Commercial |
$235.50
|
|
|
HC SWEAT CHLORIDE MEASUREMENT
|
Facility
|
IP
|
$206.00
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
900910680
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.29 |
| Max. Negotiated Rate |
$154.50 |
| Rate for Payer: Adventist Health Commercial |
$41.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$132.66
|
| Rate for Payer: Cash Price |
$92.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$139.46
|
| Rate for Payer: Heritage Provider Network Senior |
$139.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$37.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.50
|
| Rate for Payer: Multiplan Commercial |
$154.50
|
|
|
HC SWEAT CHLORIDE MEASUREMENT
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
900910680
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.80 |
| Max. Negotiated Rate |
$46.41 |
| Rate for Payer: Multiplan Commercial |
$154.50
|
| Rate for Payer: Adventist Health Commercial |
$4.20
|
| Rate for Payer: Adventist Health Commercial |
$41.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$127.31
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.41
|
| Rate for Payer: Blue Shield of California Commercial |
$39.34
|
| Rate for Payer: Blue Shield of California Commercial |
$39.34
|
| Rate for Payer: Blue Shield of California EPN |
$31.55
|
| Rate for Payer: Blue Shield of California EPN |
$31.55
|
| Rate for Payer: Cash Price |
$9.45
|
| Rate for Payer: Cash Price |
$9.45
|
| Rate for Payer: Cash Price |
$92.70
|
| Rate for Payer: Cash Price |
$92.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$133.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$121.54
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$127.51
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.00
|
| Rate for Payer: Heritage Provider Network Senior |
$127.51
|
| Rate for Payer: Heritage Provider Network Senior |
$13.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$98.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$10.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$37.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.70
|
| Rate for Payer: Multiplan Commercial |
$15.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.00
|
| Rate for Payer: TriValley Medical Group Senior |
$5.00
|
| Rate for Payer: TriValley Medical Group Senior |
$5.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.40
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.40
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.40
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.50
|
| Rate for Payer: Vantage Medical Group Senior |
$5.00
|
| Rate for Payer: Vantage Medical Group Senior |
$5.00
|
|
|
HC SYNERCID E TEST
|
Facility
|
IP
|
$85.00
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
900912447
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$15.38 |
| Max. Negotiated Rate |
$63.75 |
| Rate for Payer: Adventist Health Commercial |
$17.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$54.74
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$57.55
|
| Rate for Payer: Heritage Provider Network Senior |
$57.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.25
|
| Rate for Payer: Multiplan Commercial |
$63.75
|
|
|
HC SYNERCID E TEST
|
Facility
|
OP
|
$85.00
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
900912447
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.75 |
| Max. Negotiated Rate |
$63.75 |
| Rate for Payer: Adventist Health Commercial |
$17.00
|
| Rate for Payer: Adventist Health Commercial |
$3.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10.51
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$52.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.12
|
| 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 Medi-Cal |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.41
|
| Rate for Payer: Blue Shield of California Commercial |
$23.16
|
| Rate for Payer: Blue Shield of California Commercial |
$23.16
|
| Rate for Payer: Blue Shield of California EPN |
$18.57
|
| Rate for Payer: Blue Shield of California EPN |
$18.57
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Cash Price |
$38.25
|
| 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: Cigna of CA HMO/PPO |
$55.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.03
|
| Rate for Payer: EPIC Health Plan Medicare |
$4.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$4.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.52
|
| Rate for Payer: Heritage Provider Network Commercial |
$52.62
|
| Rate for Payer: Heritage Provider Network Senior |
$10.52
|
| Rate for Payer: Heritage Provider Network Senior |
$52.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$8.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$40.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.37
|
| Rate for Payer: Multiplan Commercial |
$12.75
|
| Rate for Payer: Multiplan Commercial |
$63.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$4.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$4.75
|
| Rate for Payer: TriValley Medical Group Senior |
$4.75
|
| Rate for Payer: TriValley Medical Group Senior |
$4.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.12
|
| 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 Medi-Cal |
$5.22
|
| Rate for Payer: Vantage Medical Group Senior |
$4.75
|
| Rate for Payer: Vantage Medical Group Senior |
$4.75
|
|
|
HC SYPHILIS NON TREP QUAL RPR
|
Facility
|
IP
|
$77.00
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
900913673
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.94 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Adventist Health Commercial |
$15.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$49.59
|
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$52.13
|
| Rate for Payer: Heritage Provider Network Senior |
$52.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.25
|
| Rate for Payer: Multiplan Commercial |
$57.75
|
|
|
HC SYPHILIS NON TREP QUAL RPR
|
Facility
|
OP
|
$77.00
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
900913673
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.27 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Adventist Health Commercial |
$15.40
|
| Rate for Payer: Adventist Health Commercial |
$10.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$32.14
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$47.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40.53
|
| Rate for Payer: Blue Shield of California Commercial |
$34.33
|
| Rate for Payer: Blue Shield of California Commercial |
$34.33
|
| Rate for Payer: Blue Shield of California EPN |
$27.54
|
| Rate for Payer: Blue Shield of California EPN |
$27.54
|
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$33.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$50.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.68
|
| Rate for Payer: EPIC Health Plan Medicare |
$4.27
|
| Rate for Payer: EPIC Health Plan Medicare |
$4.27
|
| Rate for Payer: Heritage Provider Network Commercial |
$32.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$47.66
|
| Rate for Payer: Heritage Provider Network Senior |
$32.19
|
| Rate for Payer: Heritage Provider Network Senior |
$47.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.27
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$24.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$36.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5.72
|
| Rate for Payer: Multiplan Commercial |
$39.00
|
| Rate for Payer: Multiplan Commercial |
$57.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$4.27
|
| Rate for Payer: TriValley Medical Group Commercial |
$4.27
|
| Rate for Payer: TriValley Medical Group Senior |
$4.27
|
| Rate for Payer: TriValley Medical Group Senior |
$4.27
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.61
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.61
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.61
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4.27
|
| Rate for Payer: Vantage Medical Group Senior |
$4.27
|
|
|
HC SYPHILIS NON TREP QUANT
|
Facility
|
IP
|
$77.00
|
|
|
Service Code
|
CPT 86593
|
| Hospital Charge Code |
900913672
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.94 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Adventist Health Commercial |
$15.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$49.59
|
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$52.13
|
| Rate for Payer: Heritage Provider Network Senior |
$52.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.25
|
| Rate for Payer: Multiplan Commercial |
$57.75
|
|
|
HC SYPHILIS NON TREP QUANT
|
Facility
|
OP
|
$77.00
|
|
|
Service Code
|
CPT 86593
|
| Hospital Charge Code |
900913672
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Adventist Health Commercial |
$15.40
|
| Rate for Payer: Adventist Health Commercial |
$10.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$32.14
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$47.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41.80
|
| Rate for Payer: Blue Shield of California Commercial |
$35.48
|
| Rate for Payer: Blue Shield of California Commercial |
$35.48
|
| Rate for Payer: Blue Shield of California EPN |
$28.46
|
| Rate for Payer: Blue Shield of California EPN |
$28.46
|
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$33.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$50.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.68
|
| Rate for Payer: EPIC Health Plan Medicare |
$4.40
|
| Rate for Payer: EPIC Health Plan Medicare |
$4.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$32.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$47.66
|
| Rate for Payer: Heritage Provider Network Senior |
$32.19
|
| Rate for Payer: Heritage Provider Network Senior |
$47.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$24.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$36.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5.90
|
| Rate for Payer: Multiplan Commercial |
$39.00
|
| Rate for Payer: Multiplan Commercial |
$57.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$4.40
|
| Rate for Payer: TriValley Medical Group Commercial |
$4.40
|
| Rate for Payer: TriValley Medical Group Senior |
$4.40
|
| Rate for Payer: TriValley Medical Group Senior |
$4.40
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.75
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.75
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.84
|
| Rate for Payer: Vantage Medical Group Senior |
$4.40
|
| Rate for Payer: Vantage Medical Group Senior |
$4.40
|
|
