|
HC ANGIOPLASTY/ENDEAVOR
|
Facility
|
OP
|
$1,530.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081807
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$306.00 |
| Max. Negotiated Rate |
$1,300.50 |
| Rate for Payer: Adventist Health Commercial |
$306.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,300.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$841.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,147.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$886.18
|
| Rate for Payer: Blue Shield of California Commercial |
$1,129.14
|
| Rate for Payer: Blue Shield of California EPN |
$743.58
|
| Rate for Payer: Cash Price |
$688.50
|
| Rate for Payer: Cigna of CA HMO |
$1,071.00
|
| Rate for Payer: Cigna of CA PPO |
$1,071.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,300.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,300.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,300.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$612.00
|
| Rate for Payer: EPIC Health Plan Senior |
$612.00
|
| Rate for Payer: Galaxy Health WC |
$1,300.50
|
| Rate for Payer: Global Benefits Group Commercial |
$918.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,020.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$582.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$947.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$367.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,071.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,071.00
|
| Rate for Payer: Multiplan Commercial |
$1,224.00
|
| Rate for Payer: Networks By Design Commercial |
$765.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,300.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$918.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$918.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$574.21
|
| Rate for Payer: United Healthcare All Other HMO |
$558.91
|
| Rate for Payer: United Healthcare HMO Rider |
$546.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$501.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,300.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,300.50
|
| Rate for Payer: Vantage Medical Group Senior |
$1,300.50
|
|
|
HC ANGIOPLASTY/ENDEAVOR
|
Facility
|
IP
|
$1,530.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081807
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$306.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$306.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$688.50
|
| Rate for Payer: Cash Price |
$688.50
|
| Rate for Payer: Cigna of CA HMO |
$1,071.00
|
| Rate for Payer: Cigna of CA PPO |
$1,071.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$612.00
|
| Rate for Payer: EPIC Health Plan Senior |
$612.00
|
| Rate for Payer: Galaxy Health WC |
$1,300.50
|
| Rate for Payer: Global Benefits Group Commercial |
$918.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,020.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$582.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$947.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$367.20
|
| Rate for Payer: Multiplan Commercial |
$1,224.00
|
| Rate for Payer: Networks By Design Commercial |
$765.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,300.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$574.21
|
| Rate for Payer: United Healthcare All Other HMO |
$558.91
|
| Rate for Payer: United Healthcare HMO Rider |
$546.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$501.07
|
|
|
HC ANGIOPLASTY INTRACRANIAL
|
Facility
|
IP
|
$5,246.00
|
|
|
Service Code
|
CPT 61630
|
| Hospital Charge Code |
909081013
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,049.20 |
| Max. Negotiated Rate |
$4,459.10 |
| Rate for Payer: Adventist Health Commercial |
$1,049.20
|
| Rate for Payer: Cash Price |
$2,360.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,098.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,098.40
|
| Rate for Payer: Galaxy Health WC |
$4,459.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,147.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,499.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,998.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,247.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,259.04
|
| Rate for Payer: Multiplan Commercial |
$4,196.80
|
| Rate for Payer: Networks By Design Commercial |
$3,409.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,459.10
|
|
|
HC ANGIOPLASTY INTRACRANIAL
|
Facility
|
OP
|
$5,246.00
|
|
|
Service Code
|
CPT 61630
|
| Hospital Charge Code |
909081013
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,049.20 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,049.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,459.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,885.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,934.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,712.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$2,360.70
|
| Rate for Payer: Cash Price |
$2,360.70
|
| Rate for Payer: Cigna of CA HMO |
$3,357.44
|
| Rate for Payer: Cigna of CA PPO |
$3,882.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,459.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,459.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,459.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,098.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,098.40
|
| Rate for Payer: Galaxy Health WC |
$4,459.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,147.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,499.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,247.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,259.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,672.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,672.20
|
| Rate for Payer: Multiplan Commercial |
$4,196.80
|
| Rate for Payer: Networks By Design Commercial |
$3,409.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,459.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,147.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,459.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,459.10
|
| Rate for Payer: Vantage Medical Group Senior |
$4,459.10
|
|
|
HC ANGIO RV/OR RA
|
Facility
|
IP
|
$1,858.00
|
|
|
Service Code
|
CPT 93566
|
| Hospital Charge Code |
906820072
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$371.60 |
| Max. Negotiated Rate |
$1,579.30 |
| Rate for Payer: Adventist Health Commercial |
$371.60
|
| Rate for Payer: Cash Price |
$836.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$743.20
|
| Rate for Payer: EPIC Health Plan Senior |
$743.20
|
| Rate for Payer: Galaxy Health WC |
$1,579.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,114.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,239.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$707.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,150.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$445.92
|
| Rate for Payer: Multiplan Commercial |
$1,486.40
|
| Rate for Payer: Networks By Design Commercial |
$1,207.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,579.30
|
|
|
HC ANGIO RV/OR RA
|
Facility
|
IP
|
$1,912.00
|
|
|
Service Code
|
CPT 93566
|
| Hospital Charge Code |
906811415
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$382.40 |
| Max. Negotiated Rate |
$1,625.20 |
| Rate for Payer: Adventist Health Commercial |
$382.40
|
| Rate for Payer: Cash Price |
$860.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$764.80
|
| Rate for Payer: EPIC Health Plan Senior |
$764.80
|
| Rate for Payer: Galaxy Health WC |
$1,625.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,147.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,275.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$728.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,183.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$458.88
|
| Rate for Payer: Multiplan Commercial |
$1,529.60
|
| Rate for Payer: Networks By Design Commercial |
$1,242.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,625.20
|
|
|
HC ANGIO RV/OR RA
|
Facility
|
OP
|
$1,912.00
|
|
|
Service Code
|
CPT 93566
|
| Hospital Charge Code |
906811415
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$259.88 |
| Max. Negotiated Rate |
$6,906.11 |
| Rate for Payer: Adventist Health Commercial |
$382.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,625.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,051.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,434.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$860.40
|
| Rate for Payer: Cash Price |
$860.40
|
| Rate for Payer: Cash Price |
$860.40
|
| Rate for Payer: Cigna of CA HMO |
$1,242.80
|
| Rate for Payer: Cigna of CA PPO |
$1,414.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,625.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,625.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,625.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$764.80
|
| Rate for Payer: EPIC Health Plan Senior |
$764.80
|
| Rate for Payer: Galaxy Health WC |
$1,625.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,147.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$259.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,275.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$293.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,183.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$458.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,338.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,338.40
|
| Rate for Payer: Multiplan Commercial |
$1,529.60
|
| Rate for Payer: Networks By Design Commercial |
$1,242.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,625.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,147.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,147.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,625.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,625.20
|
| Rate for Payer: Vantage Medical Group Senior |
$1,625.20
|
|
|
HC ANGIO RV/OR RA
|
Facility
|
OP
|
$1,858.00
|
|
|
Service Code
|
CPT 93566
|
| Hospital Charge Code |
906820072
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$259.88 |
| Max. Negotiated Rate |
$6,906.11 |
| Rate for Payer: Adventist Health Commercial |
$371.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,579.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,021.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,393.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$836.10
|
| Rate for Payer: Cash Price |
$836.10
|
| Rate for Payer: Cash Price |
$836.10
|
| Rate for Payer: Cigna of CA HMO |
$1,207.70
|
| Rate for Payer: Cigna of CA PPO |
$1,374.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,579.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,579.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,579.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$743.20
|
| Rate for Payer: EPIC Health Plan Senior |
$743.20
|
| Rate for Payer: Galaxy Health WC |
$1,579.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,114.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$259.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,239.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$293.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,150.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$445.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,300.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,300.60
|
| Rate for Payer: Multiplan Commercial |
$1,486.40
|
| Rate for Payer: Networks By Design Commercial |
$1,207.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,579.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,114.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,114.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,579.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,579.30
|
| Rate for Payer: Vantage Medical Group Senior |
$1,579.30
|
|
|
HC ANGIOVAC ANGIODYN CANNULA SYS
|
Facility
|
IP
|
$25,000.00
|
|
| Hospital Charge Code |
906812646
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5,000.00 |
| Max. Negotiated Rate |
$21,250.00 |
| Rate for Payer: Adventist Health Commercial |
$5,000.00
|
| Rate for Payer: Cash Price |
$11,250.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,000.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,000.00
|
| Rate for Payer: Galaxy Health WC |
$21,250.00
|
| Rate for Payer: Global Benefits Group Commercial |
$15,000.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,675.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,525.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,475.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,000.00
|
| Rate for Payer: Multiplan Commercial |
$20,000.00
|
| Rate for Payer: Networks By Design Commercial |
$16,250.00
|
| Rate for Payer: Prime Health Services Commercial |
$21,250.00
|
|
|
HC ANGIOVAC ANGIODYN CANNULA SYS
|
Facility
|
OP
|
$25,000.00
|
|
| Hospital Charge Code |
906812646
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5,000.00 |
| Max. Negotiated Rate |
$21,250.00 |
| Rate for Payer: Adventist Health Commercial |
$5,000.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16,397.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13,750.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18,750.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,352.50
|
| Rate for Payer: Cash Price |
$11,250.00
|
| Rate for Payer: Cigna of CA HMO |
$16,000.00
|
| Rate for Payer: Cigna of CA PPO |
$18,500.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$21,250.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21,250.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,000.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,000.00
|
| Rate for Payer: Galaxy Health WC |
$21,250.00
|
| Rate for Payer: Global Benefits Group Commercial |
$15,000.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,675.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,525.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,475.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,000.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,500.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,500.00
|
| Rate for Payer: Multiplan Commercial |
$20,000.00
|
| Rate for Payer: Networks By Design Commercial |
$16,250.00
|
| Rate for Payer: Prime Health Services Commercial |
$21,250.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,000.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15,000.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,500.00
|
| Rate for Payer: United Healthcare All Other HMO |
$12,500.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,500.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12,500.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,250.00
|
| Rate for Payer: Vantage Medical Group Senior |
$21,250.00
|
|
|
HC ANKLE ARTHROGRAPHY INJECTION
|
Facility
|
OP
|
$387.00
|
|
|
Service Code
|
CPT 27648
|
| Hospital Charge Code |
909000118
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$77.40 |
| Max. Negotiated Rate |
$6,906.11 |
| Rate for Payer: Adventist Health Commercial |
$77.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$212.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$290.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$174.15
|
| Rate for Payer: Cash Price |
$174.15
|
| Rate for Payer: Cash Price |
$174.15
|
| Rate for Payer: Cigna of CA HMO |
$247.68
|
| Rate for Payer: Cigna of CA PPO |
$286.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$328.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$328.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$154.80
|
| Rate for Payer: EPIC Health Plan Senior |
$154.80
|
| Rate for Payer: Galaxy Health WC |
$328.95
|
| Rate for Payer: Global Benefits Group Commercial |
$232.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$268.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$258.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$304.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$239.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$270.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$270.90
|
| Rate for Payer: Multiplan Commercial |
$309.60
|
| Rate for Payer: Networks By Design Commercial |
$251.55
|
| Rate for Payer: Prime Health Services Commercial |
$328.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$232.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$328.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$328.95
|
| Rate for Payer: Vantage Medical Group Senior |
$328.95
|
|
|
HC ANKLE ARTHROGRAPHY INJECTION
|
Facility
|
IP
|
$387.00
|
|
|
Service Code
|
CPT 27648
|
| Hospital Charge Code |
909000118
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$77.40 |
| Max. Negotiated Rate |
$328.95 |
| Rate for Payer: Adventist Health Commercial |
$77.40
|
| Rate for Payer: Blue Shield of California Commercial |
$285.61
|
| Rate for Payer: Blue Shield of California EPN |
$188.08
|
| Rate for Payer: Cash Price |
$174.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$154.80
|
| Rate for Payer: EPIC Health Plan Senior |
$154.80
|
| Rate for Payer: Galaxy Health WC |
$328.95
|
| Rate for Payer: Global Benefits Group Commercial |
$232.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$258.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$147.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$239.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.88
|
| Rate for Payer: Multiplan Commercial |
$309.60
|
| Rate for Payer: Networks By Design Commercial |
$251.55
|
| Rate for Payer: Prime Health Services Commercial |
$328.95
|
|
|
HC ANKLE COMPLETE
|
Facility
|
IP
|
$790.00
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
909001648
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$158.00 |
| Max. Negotiated Rate |
$671.50 |
| Rate for Payer: Adventist Health Commercial |
$158.00
|
| Rate for Payer: Cash Price |
$355.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$316.00
|
| Rate for Payer: EPIC Health Plan Senior |
$316.00
|
| Rate for Payer: Galaxy Health WC |
$671.50
|
| Rate for Payer: Global Benefits Group Commercial |
$474.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$526.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$300.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$489.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$189.60
|
| Rate for Payer: Multiplan Commercial |
$632.00
|
| Rate for Payer: Networks By Design Commercial |
$513.50
|
| Rate for Payer: Prime Health Services Commercial |
$671.50
|
|
|
HC ANKLE COMPLETE
|
Facility
|
OP
|
$790.00
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
909001648
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$42.24 |
| Max. Negotiated Rate |
$671.50 |
| Rate for Payer: Adventist Health Commercial |
$158.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$518.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$149.88
|
| Rate for Payer: Blue Shield of California Commercial |
$483.48
|
| Rate for Payer: Blue Shield of California EPN |
$319.16
|
| Rate for Payer: Cash Price |
$355.50
|
| Rate for Payer: Cash Price |
$355.50
|
| Rate for Payer: Cigna of CA HMO |
$505.60
|
| Rate for Payer: Cigna of CA PPO |
$584.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$151.04
|
| Rate for Payer: EPIC Health Plan Senior |
$111.88
|
| Rate for Payer: Galaxy Health WC |
$671.50
|
| Rate for Payer: Global Benefits Group Commercial |
$474.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$183.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$42.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$526.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$111.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$189.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$140.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$149.92
|
| Rate for Payer: Multiplan Commercial |
$632.00
|
| Rate for Payer: Networks By Design Commercial |
$513.50
|
| Rate for Payer: Prime Health Services Commercial |
$671.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$474.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$474.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$111.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Vantage Medical Group Senior |
$111.88
|
|
|
HC ANKLE-FOOT SYS DORS-PLANT FLEX
|
Facility
|
IP
|
$48,612.58
|
|
|
Service Code
|
CPT L5973
|
| Hospital Charge Code |
905355973
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$9,722.52 |
| Max. Negotiated Rate |
$41,320.69 |
| Rate for Payer: Adventist Health Commercial |
$9,722.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$21,875.66
|
| Rate for Payer: Cash Price |
$21,875.66
|
| Rate for Payer: Cigna of CA HMO |
$34,028.81
|
| Rate for Payer: Cigna of CA PPO |
$34,028.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,445.03
|
| Rate for Payer: EPIC Health Plan Senior |
$19,445.03
|
| Rate for Payer: Galaxy Health WC |
$41,320.69
|
| Rate for Payer: Global Benefits Group Commercial |
$29,167.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32,424.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18,521.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,091.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,667.02
|
| Rate for Payer: Multiplan Commercial |
$38,890.06
|
| Rate for Payer: Networks By Design Commercial |
$24,306.29
|
| Rate for Payer: Prime Health Services Commercial |
$41,320.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$18,244.30
|
| Rate for Payer: United Healthcare All Other HMO |
$17,758.18
|
| Rate for Payer: United Healthcare HMO Rider |
$17,374.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,920.62
|
|
|
HC ANKLE-FOOT SYS DORS-PLANT FLEX
|
Facility
|
IP
|
$48,612.58
|
|
|
Service Code
|
CPT L5973
|
| Hospital Charge Code |
915355973
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$9,722.52 |
| Max. Negotiated Rate |
$41,320.69 |
| Rate for Payer: Adventist Health Commercial |
$9,722.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$21,875.66
|
| Rate for Payer: Cash Price |
$21,875.66
|
| Rate for Payer: Cigna of CA HMO |
$34,028.81
|
| Rate for Payer: Cigna of CA PPO |
$34,028.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,445.03
|
| Rate for Payer: EPIC Health Plan Senior |
$19,445.03
|
| Rate for Payer: Galaxy Health WC |
$41,320.69
|
| Rate for Payer: Global Benefits Group Commercial |
$29,167.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32,424.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18,521.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,091.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,667.02
|
| Rate for Payer: Multiplan Commercial |
$38,890.06
|
| Rate for Payer: Networks By Design Commercial |
$24,306.29
|
| Rate for Payer: Prime Health Services Commercial |
$41,320.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$18,244.30
|
| Rate for Payer: United Healthcare All Other HMO |
$17,758.18
|
| Rate for Payer: United Healthcare HMO Rider |
$17,374.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,920.62
|
|
|
HC ANKLE-FOOT SYS DORS-PLANT FLEX
|
Facility
|
OP
|
$48,612.58
|
|
|
Service Code
|
CPT L5973
|
| Hospital Charge Code |
915355973
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$11,667.02 |
| Max. Negotiated Rate |
$41,320.69 |
| Rate for Payer: Adventist Health Commercial |
$19,931.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$41,320.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26,736.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$36,459.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28,156.41
|
| Rate for Payer: Blue Shield of California Commercial |
$35,876.08
|
| Rate for Payer: Blue Shield of California EPN |
$23,625.71
|
| Rate for Payer: Cash Price |
$21,875.66
|
| Rate for Payer: Cigna of CA HMO |
$34,028.81
|
| Rate for Payer: Cigna of CA PPO |
$34,028.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$41,320.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$41,320.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$41,320.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,445.03
|
| Rate for Payer: EPIC Health Plan Senior |
$19,445.03
|
| Rate for Payer: Galaxy Health WC |
$41,320.69
|
| Rate for Payer: Global Benefits Group Commercial |
$29,167.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32,424.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,091.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,667.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,028.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,028.81
|
| Rate for Payer: Multiplan Commercial |
$38,890.06
|
| Rate for Payer: Networks By Design Commercial |
$24,306.29
|
| Rate for Payer: Prime Health Services Commercial |
$41,320.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29,167.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29,167.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$18,244.30
|
| Rate for Payer: United Healthcare All Other HMO |
$17,758.18
|
| Rate for Payer: United Healthcare HMO Rider |
$17,374.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,920.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$41,320.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$41,320.69
|
| Rate for Payer: Vantage Medical Group Senior |
$41,320.69
|
|
|
HC ANKLE-FOOT SYS DORS-PLANT FLEX
|
Facility
|
OP
|
$48,612.58
|
|
|
Service Code
|
CPT L5973
|
| Hospital Charge Code |
905355973
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$11,667.02 |
| Max. Negotiated Rate |
$41,320.69 |
| Rate for Payer: Adventist Health Commercial |
$19,931.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$41,320.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26,736.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$36,459.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28,156.41
|
| Rate for Payer: Blue Shield of California Commercial |
$35,876.08
|
| Rate for Payer: Blue Shield of California EPN |
$23,625.71
|
| Rate for Payer: Cash Price |
$21,875.66
|
| Rate for Payer: Cigna of CA HMO |
$34,028.81
|
| Rate for Payer: Cigna of CA PPO |
$34,028.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$41,320.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$41,320.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$41,320.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,445.03
|
| Rate for Payer: EPIC Health Plan Senior |
$19,445.03
|
| Rate for Payer: Galaxy Health WC |
$41,320.69
|
| Rate for Payer: Global Benefits Group Commercial |
$29,167.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32,424.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,091.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,667.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,028.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,028.81
|
| Rate for Payer: Multiplan Commercial |
$38,890.06
|
| Rate for Payer: Networks By Design Commercial |
$24,306.29
|
| Rate for Payer: Prime Health Services Commercial |
$41,320.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29,167.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29,167.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$18,244.30
|
| Rate for Payer: United Healthcare All Other HMO |
$17,758.18
|
| Rate for Payer: United Healthcare HMO Rider |
$17,374.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,920.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$41,320.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$41,320.69
|
| Rate for Payer: Vantage Medical Group Senior |
$41,320.69
|
|
|
HC ANKLE LIMITED
|
Facility
|
OP
|
$675.00
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
909001642
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$31.95 |
| Max. Negotiated Rate |
$573.75 |
| Rate for Payer: Adventist Health Commercial |
$135.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$442.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$139.38
|
| Rate for Payer: Blue Shield of California Commercial |
$413.10
|
| Rate for Payer: Blue Shield of California EPN |
$272.70
|
| Rate for Payer: Cash Price |
$303.75
|
| Rate for Payer: Cash Price |
$303.75
|
| Rate for Payer: Cigna of CA HMO |
$432.00
|
| Rate for Payer: Cigna of CA PPO |
$499.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$151.04
|
| Rate for Payer: EPIC Health Plan Senior |
$111.88
|
| Rate for Payer: Galaxy Health WC |
$573.75
|
| Rate for Payer: Global Benefits Group Commercial |
$405.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$183.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$31.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$450.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$111.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$140.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$149.92
|
| Rate for Payer: Multiplan Commercial |
$540.00
|
| Rate for Payer: Networks By Design Commercial |
$438.75
|
| Rate for Payer: Prime Health Services Commercial |
$573.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$405.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$405.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$111.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Vantage Medical Group Senior |
$111.88
|
|
|
HC ANKLE LIMITED
|
Facility
|
IP
|
$675.00
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
909001642
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$573.75 |
| Rate for Payer: Adventist Health Commercial |
$135.00
|
| Rate for Payer: Cash Price |
$303.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$270.00
|
| Rate for Payer: EPIC Health Plan Senior |
$270.00
|
| Rate for Payer: Galaxy Health WC |
$573.75
|
| Rate for Payer: Global Benefits Group Commercial |
$405.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$450.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$257.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$417.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.00
|
| Rate for Payer: Multiplan Commercial |
$540.00
|
| Rate for Payer: Networks By Design Commercial |
$438.75
|
| Rate for Payer: Prime Health Services Commercial |
$573.75
|
|
|
HC ANORECTAL MANOMETRY
|
Facility
|
OP
|
$2,436.00
|
|
|
Service Code
|
CPT 91122
|
| Hospital Charge Code |
906791122
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$101.42 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$487.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,495.95
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$1,096.20
|
| Rate for Payer: Cash Price |
$1,096.20
|
| Rate for Payer: Cash Price |
$1,096.20
|
| Rate for Payer: Cigna of CA HMO |
$1,559.04
|
| Rate for Payer: Cigna of CA PPO |
$1,802.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.14
|
| Rate for Payer: EPIC Health Plan Senior |
$395.66
|
| Rate for Payer: Galaxy Health WC |
$2,070.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,461.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$648.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$101.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,624.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$114.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$584.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$498.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$530.18
|
| Rate for Payer: Multiplan Commercial |
$1,948.80
|
| Rate for Payer: Networks By Design Commercial |
$1,583.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,070.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,461.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$474.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$395.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC ANORECTAL MANOMETRY
|
Facility
|
IP
|
$2,224.00
|
|
|
Service Code
|
CPT 91122
|
| Hospital Charge Code |
906791122
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$444.80 |
| Max. Negotiated Rate |
$1,890.40 |
| Rate for Payer: Adventist Health Commercial |
$444.80
|
| Rate for Payer: Cash Price |
$1,000.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$889.60
|
| Rate for Payer: EPIC Health Plan Senior |
$889.60
|
| Rate for Payer: Galaxy Health WC |
$1,890.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,334.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,483.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$847.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,376.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$533.76
|
| Rate for Payer: Multiplan Commercial |
$1,779.20
|
| Rate for Payer: Networks By Design Commercial |
$1,445.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,890.40
|
|
|
HC ANOSCOPY DIAGNOSTIC W WO SPEC COLLECT
|
Facility
|
OP
|
$396.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
900501159
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$41.74 |
| Max. Negotiated Rate |
$5,398.00 |
| Rate for Payer: Adventist Health Commercial |
$79.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$178.20
|
| Rate for Payer: Cash Price |
$178.20
|
| Rate for Payer: Cash Price |
$178.20
|
| Rate for Payer: Cigna of CA HMO |
$253.44
|
| Rate for Payer: Cigna of CA PPO |
$293.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$336.60
|
| Rate for Payer: Global Benefits Group Commercial |
$237.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$264.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$206.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$316.80
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$257.40
|
| Rate for Payer: Prime Health Services Commercial |
$336.60
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$237.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$198.00
|
| Rate for Payer: United Healthcare All Other HMO |
$198.00
|
| Rate for Payer: United Healthcare HMO Rider |
$198.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$198.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC ANOSCOPY DIAGNOSTIC W WO SPEC COLLECT
|
Facility
|
IP
|
$396.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
900501159
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$79.20 |
| Max. Negotiated Rate |
$336.60 |
| Rate for Payer: Adventist Health Commercial |
$79.20
|
| Rate for Payer: Cash Price |
$178.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$158.40
|
| Rate for Payer: EPIC Health Plan Senior |
$158.40
|
| Rate for Payer: Galaxy Health WC |
$336.60
|
| Rate for Payer: Global Benefits Group Commercial |
$237.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$264.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$150.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$245.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.04
|
| Rate for Payer: Multiplan Commercial |
$316.80
|
| Rate for Payer: Networks By Design Commercial |
$257.40
|
| Rate for Payer: Prime Health Services Commercial |
$336.60
|
|
|
HC ANOSCOPY DIAG W/RMVL FB
|
Facility
|
IP
|
$3,167.00
|
|
|
Service Code
|
CPT 46608
|
| Hospital Charge Code |
900501160
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$633.40 |
| Max. Negotiated Rate |
$2,691.95 |
| Rate for Payer: Adventist Health Commercial |
$633.40
|
| Rate for Payer: Cash Price |
$1,425.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,266.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,266.80
|
| Rate for Payer: Galaxy Health WC |
$2,691.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,900.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,112.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,206.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,960.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$760.08
|
| Rate for Payer: Multiplan Commercial |
$2,533.60
|
| Rate for Payer: Networks By Design Commercial |
$2,058.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,691.95
|
|
