|
HC ABDOMEN KUB SUPINE
|
Facility
|
IP
|
$631.00
|
|
|
Service Code
|
CPT 74018
|
| Hospital Charge Code |
909001702
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$151.44 |
| Max. Negotiated Rate |
$536.35 |
| Rate for Payer: Cash Price |
$283.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$252.40
|
| Rate for Payer: Galaxy Health WC |
$536.35
|
| Rate for Payer: Global Benefits Group Commercial |
$378.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$420.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$240.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.44
|
| Rate for Payer: Multiplan Commercial |
$504.80
|
| Rate for Payer: Networks By Design Commercial |
$410.15
|
| Rate for Payer: Prime Health Services Commercial |
$536.35
|
|
|
HC ABDOMEN/RETROPERIT PERC BIO
|
Facility
|
OP
|
$4,233.00
|
|
|
Service Code
|
CPT 49180
|
| Hospital Charge Code |
909000161
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$474.64 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,539.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$1,904.85
|
| Rate for Payer: Cash Price |
$1,904.85
|
| Rate for Payer: Cigna of CA PPO |
$3,132.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Dignity Health Media |
$2,025.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
| Rate for Payer: Galaxy Health WC |
$3,598.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,539.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,174.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,322.13
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,322.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3,281.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$3,281.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,823.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$474.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,015.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,552.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
| Rate for Payer: Multiplan Commercial |
$3,386.40
|
| Rate for Payer: Networks By Design Commercial |
$2,751.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,598.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,539.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC ABDOMEN/RETROPERIT PERC BIO
|
Facility
|
IP
|
$4,233.00
|
|
|
Service Code
|
CPT 49180
|
| Hospital Charge Code |
909000161
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,015.92 |
| Max. Negotiated Rate |
$3,598.05 |
| Rate for Payer: Cash Price |
$1,904.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,693.20
|
| Rate for Payer: Galaxy Health WC |
$3,598.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,539.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,823.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,612.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,015.92
|
| Rate for Payer: Multiplan Commercial |
$3,386.40
|
| Rate for Payer: Networks By Design Commercial |
$2,751.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,598.05
|
|
|
HC ABDOMEN SINGLE AP VIEW
|
Facility
|
IP
|
$631.00
|
|
|
Service Code
|
CPT 74018
|
| Hospital Charge Code |
909001175
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$151.44 |
| Max. Negotiated Rate |
$536.35 |
| Rate for Payer: Cash Price |
$283.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$252.40
|
| Rate for Payer: Galaxy Health WC |
$536.35
|
| Rate for Payer: Global Benefits Group Commercial |
$378.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$420.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$240.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.44
|
| Rate for Payer: Multiplan Commercial |
$504.80
|
| Rate for Payer: Networks By Design Commercial |
$410.15
|
| Rate for Payer: Prime Health Services Commercial |
$536.35
|
|
|
HC ABDOMEN SINGLE AP VIEW
|
Facility
|
OP
|
$631.00
|
|
|
Service Code
|
CPT 74018
|
| Hospital Charge Code |
909001175
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.80 |
| Max. Negotiated Rate |
$536.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$115.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$113.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$179.67
|
| Rate for Payer: Blue Distinction Transplant |
$378.60
|
| Rate for Payer: Blue Shield of California Commercial |
$372.92
|
| Rate for Payer: Blue Shield of California EPN |
$295.94
|
| Rate for Payer: Cash Price |
$283.95
|
| Rate for Payer: Cash Price |
$283.95
|
| Rate for Payer: Cigna of CA HMO |
$403.84
|
| Rate for Payer: Cigna of CA PPO |
$466.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$170.31
|
| Rate for Payer: Dignity Health Media |
$113.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$124.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$153.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$113.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$113.54
|
| Rate for Payer: Galaxy Health WC |
$536.35
|
| Rate for Payer: Global Benefits Group Commercial |
$378.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$473.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$186.21
|
| Rate for Payer: Heritage Provider Network Transplant |
$186.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$183.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$183.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$113.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$420.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$46.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$113.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$143.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$152.14
|
| Rate for Payer: Multiplan Commercial |
$504.80
|
| Rate for Payer: Networks By Design Commercial |
$410.15
|
| Rate for Payer: Prime Health Services Commercial |
$536.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$378.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$378.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$159.01
|
| Rate for Payer: United Healthcare All Other HMO |
$159.01
|
| Rate for Payer: United Healthcare HMO Rider |
$159.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$159.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Vantage Medical Group Senior |
$113.54
|
|
|
HC ABDOMEN THREE OR MORE VIEWS
|
Facility
|
OP
|
$986.00
|
|
|
Service Code
|
CPT 74021
|
| Hospital Charge Code |
909074021
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$66.73 |
| Max. Negotiated Rate |
$838.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$161.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$251.22
|
| Rate for Payer: Blue Distinction Transplant |
$591.60
|
| Rate for Payer: Blue Shield of California Commercial |
$582.73
|
| Rate for Payer: Blue Shield of California EPN |
$462.43
|
| Rate for Payer: Cash Price |
$443.70
|
| Rate for Payer: Cash Price |
$443.70
|
| Rate for Payer: Cigna of CA HMO |
$631.04
|
| Rate for Payer: Cigna of CA PPO |
$729.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Media |
$137.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
| Rate for Payer: Galaxy Health WC |
$838.10
|
| Rate for Payer: Global Benefits Group Commercial |
$591.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$739.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$225.27
|
| Rate for Payer: Heritage Provider Network Transplant |
$225.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$222.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$222.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$137.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$657.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$66.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$236.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$173.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
| Rate for Payer: Multiplan Commercial |
$788.80
|
| Rate for Payer: Networks By Design Commercial |
$640.90
|
| Rate for Payer: Prime Health Services Commercial |
$838.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$591.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$591.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$303.97
|
| Rate for Payer: United Healthcare All Other HMO |
$303.97
|
| Rate for Payer: United Healthcare HMO Rider |
$303.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$303.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC ABDOMEN THREE OR MORE VIEWS
|
Facility
|
IP
|
$986.00
|
|
|
Service Code
|
CPT 74021
|
| Hospital Charge Code |
909074021
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$236.64 |
| Max. Negotiated Rate |
$838.10 |
| Rate for Payer: Cash Price |
$443.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$394.40
|
| Rate for Payer: Galaxy Health WC |
$838.10
|
| Rate for Payer: Global Benefits Group Commercial |
$591.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$657.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$375.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$236.64
|
| Rate for Payer: Multiplan Commercial |
$788.80
|
| Rate for Payer: Networks By Design Commercial |
$640.90
|
| Rate for Payer: Prime Health Services Commercial |
$838.10
|
|
|
HC ABDOMEN TWO VIEWS
|
Facility
|
IP
|
$789.00
|
|
|
Service Code
|
CPT 74019
|
| Hospital Charge Code |
909074019
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$189.36 |
| Max. Negotiated Rate |
$670.65 |
| Rate for Payer: Cash Price |
$355.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$315.60
|
| Rate for Payer: Galaxy Health WC |
$670.65
|
| Rate for Payer: Global Benefits Group Commercial |
$473.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$526.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$300.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$189.36
|
| Rate for Payer: Multiplan Commercial |
$631.20
|
| Rate for Payer: Networks By Design Commercial |
$512.85
|
| Rate for Payer: Prime Health Services Commercial |
$670.65
|
|
|
HC ABDOMEN TWO VIEWS
|
Facility
|
OP
|
$789.00
|
|
|
Service Code
|
CPT 74019
|
| Hospital Charge Code |
909074019
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$57.19 |
| Max. Negotiated Rate |
$670.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$138.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$215.41
|
| Rate for Payer: Blue Distinction Transplant |
$473.40
|
| Rate for Payer: Blue Shield of California Commercial |
$466.30
|
| Rate for Payer: Blue Shield of California EPN |
$370.04
|
| Rate for Payer: Cash Price |
$355.05
|
| Rate for Payer: Cash Price |
$355.05
|
| Rate for Payer: Cigna of CA HMO |
$504.96
|
| Rate for Payer: Cigna of CA PPO |
$583.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Media |
$137.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
| Rate for Payer: Galaxy Health WC |
$670.65
|
| Rate for Payer: Global Benefits Group Commercial |
$473.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$591.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$225.27
|
| Rate for Payer: Heritage Provider Network Transplant |
$225.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$222.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$222.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$137.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$526.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$189.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$173.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
| Rate for Payer: Multiplan Commercial |
$631.20
|
| Rate for Payer: Networks By Design Commercial |
$512.85
|
| Rate for Payer: Prime Health Services Commercial |
$670.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$473.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$473.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$303.97
|
| Rate for Payer: United Healthcare All Other HMO |
$303.97
|
| Rate for Payer: United Healthcare HMO Rider |
$303.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$303.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
IP
|
$1,743.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
906749080
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$418.32 |
| Max. Negotiated Rate |
$1,481.55 |
| Rate for Payer: Cash Price |
$784.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$697.20
|
| Rate for Payer: Galaxy Health WC |
$1,481.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,045.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,162.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$664.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$418.32
|
| Rate for Payer: Multiplan Commercial |
$1,394.40
|
| Rate for Payer: Networks By Design Commercial |
$1,132.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,481.55
|
|
|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
IP
|
$1,743.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
901200097
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$418.32 |
| Max. Negotiated Rate |
$1,481.55 |
| Rate for Payer: Cash Price |
$784.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$697.20
|
| Rate for Payer: Galaxy Health WC |
$1,481.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,045.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,162.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$664.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$418.32
|
| Rate for Payer: Multiplan Commercial |
$1,394.40
|
| Rate for Payer: Networks By Design Commercial |
$1,132.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,481.55
|
|
|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
OP
|
$1,743.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
906749080
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$418.32 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,045.80
|
| Rate for Payer: Cash Price |
$784.35
|
| Rate for Payer: Cash Price |
$784.35
|
| Rate for Payer: Cash Price |
$784.35
|
| Rate for Payer: Cigna of CA PPO |
$1,289.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$1,481.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,045.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,307.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,857.45
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,162.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$526.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$418.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,427.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$1,394.40
|
| Rate for Payer: Networks By Design Commercial |
$1,132.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,481.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,045.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$871.50
|
| Rate for Payer: United Healthcare All Other HMO |
$871.50
|
| Rate for Payer: United Healthcare HMO Rider |
$871.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$871.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
IP
|
$1,743.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
906749080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$418.32 |
| Max. Negotiated Rate |
$1,481.55 |
| Rate for Payer: Cash Price |
$784.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$697.20
|
| Rate for Payer: Galaxy Health WC |
$1,481.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,045.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,162.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$664.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$418.32
|
| Rate for Payer: Multiplan Commercial |
$1,394.40
|
| Rate for Payer: Networks By Design Commercial |
$1,132.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,481.55
|
|
|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
IP
|
$1,743.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
901200037
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$418.32 |
| Max. Negotiated Rate |
$1,481.55 |
| Rate for Payer: Cash Price |
$784.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$697.20
|
| Rate for Payer: Galaxy Health WC |
$1,481.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,045.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,162.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$664.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$418.32
|
| Rate for Payer: Multiplan Commercial |
$1,394.40
|
| Rate for Payer: Networks By Design Commercial |
$1,132.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,481.55
|
|
|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
OP
|
$1,743.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
901200037
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$418.32 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,045.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$784.35
|
| Rate for Payer: Cash Price |
$784.35
|
| Rate for Payer: Cigna of CA PPO |
$1,289.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$1,481.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,045.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,307.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,857.45
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,834.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$1,834.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,162.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$526.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$418.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,427.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$1,394.40
|
| Rate for Payer: Networks By Design Commercial |
$1,132.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,481.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,045.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
OP
|
$1,743.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
906749080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$418.32 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,045.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$784.35
|
| Rate for Payer: Cash Price |
$784.35
|
| Rate for Payer: Cigna of CA PPO |
$1,289.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$1,481.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,045.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,307.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,857.45
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,834.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$1,834.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,162.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$526.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$418.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,427.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$1,394.40
|
| Rate for Payer: Networks By Design Commercial |
$1,132.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,481.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,045.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
OP
|
$1,743.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
901200097
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$418.32 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,045.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$784.35
|
| Rate for Payer: Cash Price |
$784.35
|
| Rate for Payer: Cigna of CA PPO |
$1,289.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$1,481.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,045.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,307.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,857.45
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,834.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$1,834.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,162.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$526.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$418.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,427.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$1,394.40
|
| Rate for Payer: Networks By Design Commercial |
$1,132.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,481.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,045.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC ABD PARACENTESIS WO IMAGE GUID
|
Facility
|
IP
|
$1,803.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
906749081
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$432.72 |
| Max. Negotiated Rate |
$1,532.55 |
| Rate for Payer: Cash Price |
$811.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$721.20
|
| Rate for Payer: Galaxy Health WC |
$1,532.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,081.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,202.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$686.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$432.72
|
| Rate for Payer: Multiplan Commercial |
$1,442.40
|
| Rate for Payer: Networks By Design Commercial |
$1,171.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,532.55
|
|
|
HC ABD PARACENTESIS WO IMAGE GUID
|
Facility
|
IP
|
$1,803.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
901200098
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$432.72 |
| Max. Negotiated Rate |
$1,532.55 |
| Rate for Payer: Cash Price |
$811.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$721.20
|
| Rate for Payer: Galaxy Health WC |
$1,532.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,081.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,202.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$686.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$432.72
|
| Rate for Payer: Multiplan Commercial |
$1,442.40
|
| Rate for Payer: Networks By Design Commercial |
$1,171.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,532.55
|
|
|
HC ABD PARACENTESIS WO IMAGE GUID
|
Facility
|
OP
|
$1,803.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
906749081
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$111.28 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,081.80
|
| Rate for Payer: Blue Shield of California Commercial |
$833.61
|
| Rate for Payer: Blue Shield of California EPN |
$542.56
|
| Rate for Payer: Cash Price |
$811.35
|
| Rate for Payer: Cash Price |
$811.35
|
| Rate for Payer: Cigna of CA PPO |
$1,334.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$1,532.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,081.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,352.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,857.45
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,834.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$1,834.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,202.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$432.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,427.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$1,442.40
|
| Rate for Payer: Networks By Design Commercial |
$1,171.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,532.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,081.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC ABD PARACENTESIS WO IMAGE GUID
|
Facility
|
OP
|
$1,803.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
901200098
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$111.28 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,081.80
|
| Rate for Payer: Blue Shield of California Commercial |
$833.61
|
| Rate for Payer: Blue Shield of California EPN |
$542.56
|
| Rate for Payer: Cash Price |
$811.35
|
| Rate for Payer: Cash Price |
$811.35
|
| Rate for Payer: Cigna of CA PPO |
$1,334.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$1,532.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,081.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,352.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,857.45
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,834.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$1,834.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,202.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$432.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,427.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$1,442.40
|
| Rate for Payer: Networks By Design Commercial |
$1,171.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,532.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,081.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC ABD PARACENTESIS WO IMAGE GUIDE
|
Facility
|
IP
|
$1,803.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
901249082
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$432.72 |
| Max. Negotiated Rate |
$1,532.55 |
| Rate for Payer: Cash Price |
$811.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$721.20
|
| Rate for Payer: Galaxy Health WC |
$1,532.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,081.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,202.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$686.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$432.72
|
| Rate for Payer: Multiplan Commercial |
$1,442.40
|
| Rate for Payer: Networks By Design Commercial |
$1,171.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,532.55
|
|
|
HC ABD PARACENTESIS WO IMAGE GUIDE
|
Facility
|
OP
|
$1,803.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
901249082
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$111.28 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,081.80
|
| Rate for Payer: Blue Shield of California Commercial |
$833.61
|
| Rate for Payer: Blue Shield of California EPN |
$542.56
|
| Rate for Payer: Cash Price |
$811.35
|
| Rate for Payer: Cash Price |
$811.35
|
| Rate for Payer: Cigna of CA PPO |
$1,334.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$1,532.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,081.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,352.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,857.45
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,834.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$1,834.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,202.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$432.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,427.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$1,442.40
|
| Rate for Payer: Networks By Design Commercial |
$1,171.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,532.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,081.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC ABD PARACENTESIS WO IMAGE GUIDE
|
Facility
|
OP
|
$1,803.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
901249082
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$111.28 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,081.80
|
| Rate for Payer: Blue Shield of California Commercial |
$833.61
|
| Rate for Payer: Blue Shield of California EPN |
$542.56
|
| Rate for Payer: Cash Price |
$811.35
|
| Rate for Payer: Cash Price |
$811.35
|
| Rate for Payer: Cigna of CA PPO |
$1,334.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$1,532.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,081.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,352.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,857.45
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,834.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$1,834.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,202.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$432.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,427.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$1,442.40
|
| Rate for Payer: Networks By Design Commercial |
$1,171.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,532.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,081.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,359.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC ABD PARACENTESIS WO IMAGE GUIDE
|
Facility
|
IP
|
$1,803.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
901249082
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$432.72 |
| Max. Negotiated Rate |
$1,532.55 |
| Rate for Payer: Cash Price |
$811.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$721.20
|
| Rate for Payer: Galaxy Health WC |
$1,532.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,081.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,202.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$686.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$432.72
|
| Rate for Payer: Multiplan Commercial |
$1,442.40
|
| Rate for Payer: Networks By Design Commercial |
$1,171.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,532.55
|
|
