|
HC BRONCHIAL THERMOPLASTY 2+ LOBES
|
Facility
|
OP
|
$10,147.00
|
|
|
Service Code
|
CPT 31661
|
| Hospital Charge Code |
900831661
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$373.48 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,406.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,551.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,088.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4,128.35
|
| Rate for Payer: Blue Shield of California EPN |
$2,686.96
|
| Rate for Payer: Cash Price |
$4,566.15
|
| Rate for Payer: Cash Price |
$4,566.15
|
| Rate for Payer: Cigna of CA PPO |
$7,508.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Dignity Health Media |
$8,551.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,406.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,544.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,551.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,551.50
|
| Rate for Payer: Galaxy Health WC |
$8,624.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,088.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,610.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,024.46
|
| Rate for Payer: Heritage Provider Network Transplant |
$14,024.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13,853.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$13,853.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,551.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,768.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$373.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,551.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,435.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,774.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,459.01
|
| Rate for Payer: Multiplan Commercial |
$8,117.60
|
| Rate for Payer: Multiplan WC |
$11,691.12
|
| Rate for Payer: Networks By Design Commercial |
$6,595.55
|
| Rate for Payer: Prime Health Services Commercial |
$8,624.95
|
| Rate for Payer: Prime Health Services WC |
$11,571.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,088.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,406.65
|
| Rate for Payer: Vantage Medical Group Senior |
$8,551.50
|
|
|
HC BRONCHIAL THERMOPLASTY 2+ LOBES
|
Facility
|
IP
|
$10,147.00
|
|
|
Service Code
|
CPT 31661
|
| Hospital Charge Code |
900831661
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,435.28 |
| Max. Negotiated Rate |
$8,624.95 |
| Rate for Payer: Cash Price |
$4,566.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,058.80
|
| Rate for Payer: Galaxy Health WC |
$8,624.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,088.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,768.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,866.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,435.28
|
| Rate for Payer: Multiplan Commercial |
$8,117.60
|
| Rate for Payer: Networks By Design Commercial |
$6,595.55
|
| Rate for Payer: Prime Health Services Commercial |
$8,624.95
|
|
|
HC BRONCHOGRAM BILAT
|
Facility
|
IP
|
$800.00
|
|
|
Service Code
|
CPT 71060
|
| Hospital Charge Code |
909001451
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$192.00 |
| Max. Negotiated Rate |
$680.00 |
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$320.00
|
| Rate for Payer: Galaxy Health WC |
$680.00
|
| Rate for Payer: Global Benefits Group Commercial |
$480.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$533.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$304.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.00
|
| Rate for Payer: Multiplan Commercial |
$640.00
|
| Rate for Payer: Networks By Design Commercial |
$520.00
|
| Rate for Payer: Prime Health Services Commercial |
$680.00
|
|
|
HC BRONCHOGRAM BILAT
|
Facility
|
OP
|
$800.00
|
|
|
Service Code
|
CPT 71060
|
| Hospital Charge Code |
909001451
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$192.00 |
| Max. Negotiated Rate |
$680.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$524.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$680.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$440.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$440.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$476.64
|
| Rate for Payer: Blue Distinction Transplant |
$480.00
|
| Rate for Payer: Blue Shield of California Commercial |
$472.80
|
| Rate for Payer: Blue Shield of California EPN |
$375.20
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cigna of CA HMO |
$512.00
|
| Rate for Payer: Cigna of CA PPO |
$592.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$680.00
|
| Rate for Payer: Dignity Health Media |
$680.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$680.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$320.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$320.00
|
| Rate for Payer: Galaxy Health WC |
$680.00
|
| Rate for Payer: Global Benefits Group Commercial |
$480.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$600.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$533.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$304.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.00
|
| Rate for Payer: Multiplan Commercial |
$640.00
|
| Rate for Payer: Networks By Design Commercial |
$520.00
|
| Rate for Payer: Prime Health Services Commercial |
$680.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$480.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$480.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$400.00
|
| Rate for Payer: United Healthcare All Other HMO |
$400.00
|
| Rate for Payer: United Healthcare HMO Rider |
$400.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$400.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$680.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$680.00
|
| Rate for Payer: Vantage Medical Group Senior |
$680.00
|
|
|
HC BRONCHOGRAM UNILAT
|
Facility
|
IP
|
$800.00
|
|
|
Service Code
|
CPT 71040
|
| Hospital Charge Code |
909001477
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$192.00 |
| Max. Negotiated Rate |
$680.00 |
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$320.00
|
| Rate for Payer: Galaxy Health WC |
$680.00
|
| Rate for Payer: Global Benefits Group Commercial |
$480.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$533.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$304.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.00
|
| Rate for Payer: Multiplan Commercial |
$640.00
|
| Rate for Payer: Networks By Design Commercial |
$520.00
|
| Rate for Payer: Prime Health Services Commercial |
$680.00
|
|
|
HC BRONCHOGRAM UNILAT
|
Facility
|
OP
|
$800.00
|
|
|
Service Code
|
CPT 71040
|
| Hospital Charge Code |
909001477
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$192.00 |
| Max. Negotiated Rate |
$680.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$524.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$680.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$440.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$440.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$476.64
|
| Rate for Payer: Blue Distinction Transplant |
$480.00
|
| Rate for Payer: Blue Shield of California Commercial |
$472.80
|
| Rate for Payer: Blue Shield of California EPN |
$375.20
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cigna of CA HMO |
$512.00
|
| Rate for Payer: Cigna of CA PPO |
$592.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$680.00
|
| Rate for Payer: Dignity Health Media |
$680.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$680.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$320.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$320.00
|
| Rate for Payer: Galaxy Health WC |
$680.00
|
| Rate for Payer: Global Benefits Group Commercial |
$480.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$600.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$533.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$304.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.00
|
| Rate for Payer: Multiplan Commercial |
$640.00
|
| Rate for Payer: Networks By Design Commercial |
$520.00
|
| Rate for Payer: Prime Health Services Commercial |
$680.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$480.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$480.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$400.00
|
| Rate for Payer: United Healthcare All Other HMO |
$400.00
|
| Rate for Payer: United Healthcare HMO Rider |
$400.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$400.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$680.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$680.00
|
| Rate for Payer: Vantage Medical Group Senior |
$680.00
|
|
|
HC BRONCHOSCOPY W BRONCH ALVEOLAR
|
Facility
|
OP
|
$6,895.00
|
|
|
Service Code
|
CPT 31624
|
| Hospital Charge Code |
900803502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$405.33 |
| 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 |
$3,180.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,137.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,612.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,351.09
|
| Rate for Payer: Cash Price |
$3,102.75
|
| Rate for Payer: Cash Price |
$3,102.75
|
| Rate for Payer: Cigna of CA PPO |
$5,102.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Dignity Health Media |
$2,120.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,332.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,862.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,120.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,120.62
|
| Rate for Payer: Galaxy Health WC |
$5,860.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,137.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,171.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,477.82
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,477.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3,435.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$3,435.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,120.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,598.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$405.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,120.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,654.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,671.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,841.63
|
| Rate for Payer: Multiplan Commercial |
$5,516.00
|
| Rate for Payer: Networks By Design Commercial |
$4,481.75
|
| Rate for Payer: Prime Health Services Commercial |
$5,860.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,137.00
|
| 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 |
$3,180.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,120.62
|
|
|
HC BRONCHOSCOPY W BRONCH ALVEOLAR
|
Facility
|
IP
|
$6,895.00
|
|
|
Service Code
|
CPT 31624
|
| Hospital Charge Code |
900803502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,654.80 |
| Max. Negotiated Rate |
$5,860.75 |
| Rate for Payer: Cash Price |
$3,102.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,758.00
|
| Rate for Payer: Galaxy Health WC |
$5,860.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,137.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,598.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,627.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,654.80
|
| Rate for Payer: Multiplan Commercial |
$5,516.00
|
| Rate for Payer: Networks By Design Commercial |
$4,481.75
|
| Rate for Payer: Prime Health Services Commercial |
$5,860.75
|
|
|
HC BRONCHOSCOPY W/RMVL OF F.B.
|
Facility
|
OP
|
$5,551.00
|
|
|
Service Code
|
CPT 31635
|
| Hospital Charge Code |
900501509
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$396.13 |
| 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 |
$3,180.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,330.60
|
| Rate for Payer: Cash Price |
$2,497.95
|
| Rate for Payer: Cash Price |
$2,497.95
|
| Rate for Payer: Cash Price |
$2,497.95
|
| Rate for Payer: Cigna of CA PPO |
$4,107.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Dignity Health Media |
$2,120.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,332.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,862.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,120.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,120.62
|
| Rate for Payer: Galaxy Health WC |
$4,718.35
|
| Rate for Payer: Global Benefits Group Commercial |
$3,330.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,163.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,477.82
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,477.82
|
| 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 |
$2,120.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,702.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$396.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,120.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,332.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,671.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,841.63
|
| Rate for Payer: Multiplan Commercial |
$4,440.80
|
| Rate for Payer: Networks By Design Commercial |
$3,608.15
|
| Rate for Payer: Prime Health Services Commercial |
$4,718.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,330.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,775.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,775.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,775.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,775.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,120.62
|
|
|
HC BRONCHOSCOPY W/RMVL OF F.B.
|
Facility
|
IP
|
$5,551.00
|
|
|
Service Code
|
CPT 31635
|
| Hospital Charge Code |
900501509
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,332.24 |
| Max. Negotiated Rate |
$4,718.35 |
| Rate for Payer: Cash Price |
$2,497.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,220.40
|
| Rate for Payer: Galaxy Health WC |
$4,718.35
|
| Rate for Payer: Global Benefits Group Commercial |
$3,330.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,702.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,114.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,332.24
|
| Rate for Payer: Multiplan Commercial |
$4,440.80
|
| Rate for Payer: Networks By Design Commercial |
$3,608.15
|
| Rate for Payer: Prime Health Services Commercial |
$4,718.35
|
|
|
HC BRONCH-RADIOELEMENT PLACEMENT
|
Facility
|
OP
|
$4,150.00
|
|
|
Service Code
|
CPT 31643
|
| Hospital Charge Code |
900803506
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$341.66 |
| 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 |
$3,180.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,490.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,058.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,423.60
|
| Rate for Payer: Cash Price |
$1,867.50
|
| Rate for Payer: Cash Price |
$1,867.50
|
| Rate for Payer: Cigna of CA HMO |
$2,656.00
|
| Rate for Payer: Cigna of CA PPO |
$3,071.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Dignity Health Media |
$2,120.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,332.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,862.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,120.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,120.62
|
| Rate for Payer: Galaxy Health WC |
$3,527.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,490.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,112.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,477.82
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,477.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3,435.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$3,435.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,120.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,768.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$341.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,120.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$996.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,671.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,841.63
|
| Rate for Payer: Multiplan Commercial |
$3,320.00
|
| Rate for Payer: Networks By Design Commercial |
$2,697.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,527.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,490.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,490.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,075.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,075.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,075.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,120.62
|
|
|
HC BRONCH-RADIOELEMENT PLACEMENT
|
Facility
|
IP
|
$4,150.00
|
|
|
Service Code
|
CPT 31643
|
| Hospital Charge Code |
900803506
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$996.00 |
| Max. Negotiated Rate |
$3,527.50 |
| Rate for Payer: Cash Price |
$1,867.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,660.00
|
| Rate for Payer: Galaxy Health WC |
$3,527.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,490.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,768.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,581.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$996.00
|
| Rate for Payer: Multiplan Commercial |
$3,320.00
|
| Rate for Payer: Networks By Design Commercial |
$2,697.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,527.50
|
|
|
HC BRONCH W BLLN OCC ADD LOBES
|
Facility
|
IP
|
$4,526.00
|
|
|
Service Code
|
CPT 31651
|
| Hospital Charge Code |
900831651
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,086.24 |
| Max. Negotiated Rate |
$3,847.10 |
| Rate for Payer: Cash Price |
$2,036.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,810.40
|
| Rate for Payer: Galaxy Health WC |
$3,847.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,715.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,018.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,724.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,086.24
|
| Rate for Payer: Multiplan Commercial |
$3,620.80
|
| Rate for Payer: Networks By Design Commercial |
$2,941.90
|
| Rate for Payer: Prime Health Services Commercial |
$3,847.10
|
|
|
HC BRONCH W BLLN OCC ADD LOBES
|
Facility
|
OP
|
$4,526.00
|
|
|
Service Code
|
CPT 31651
|
| Hospital Charge Code |
900831651
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$124.49 |
| Max. Negotiated Rate |
$6,668.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,847.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,489.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,489.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,715.60
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$2,036.70
|
| Rate for Payer: Cash Price |
$2,036.70
|
| Rate for Payer: Cash Price |
$2,036.70
|
| Rate for Payer: Cigna of CA PPO |
$3,349.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,847.10
|
| Rate for Payer: Dignity Health Media |
$3,847.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,847.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,810.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,810.40
|
| Rate for Payer: Galaxy Health WC |
$3,847.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,715.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,394.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,018.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$124.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,086.24
|
| Rate for Payer: Multiplan Commercial |
$3,620.80
|
| Rate for Payer: Networks By Design Commercial |
$2,941.90
|
| Rate for Payer: Prime Health Services Commercial |
$3,847.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,715.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,847.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,847.10
|
| Rate for Payer: Vantage Medical Group Senior |
$3,847.10
|
|
|
HC BRONCH W/BLLN OCCLUSION
|
Facility
|
OP
|
$4,440.00
|
|
|
Service Code
|
CPT 31634
|
| Hospital Charge Code |
900803513
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$330.12 |
| Max. Negotiated Rate |
$14,024.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,406.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,551.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,664.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,272.28
|
| Rate for Payer: Blue Shield of California EPN |
$2,592.96
|
| Rate for Payer: Cash Price |
$1,998.00
|
| Rate for Payer: Cash Price |
$1,998.00
|
| Rate for Payer: Cigna of CA HMO |
$2,841.60
|
| Rate for Payer: Cigna of CA PPO |
$3,285.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Dignity Health Media |
$8,551.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,406.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,544.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,551.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,551.50
|
| Rate for Payer: Galaxy Health WC |
$3,774.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,664.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,330.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,024.46
|
| Rate for Payer: Heritage Provider Network Transplant |
$14,024.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13,853.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$13,853.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,551.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,961.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$330.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,551.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,065.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,774.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,459.01
|
| Rate for Payer: Multiplan Commercial |
$3,552.00
|
| Rate for Payer: Networks By Design Commercial |
$2,886.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,774.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,664.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,664.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,220.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,220.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,220.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,406.65
|
| Rate for Payer: Vantage Medical Group Senior |
$8,551.50
|
|
|
HC BRONCH W/BLLN OCCLUSION
|
Facility
|
IP
|
$4,440.00
|
|
|
Service Code
|
CPT 31634
|
| Hospital Charge Code |
900803513
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,065.60 |
| Max. Negotiated Rate |
$3,774.00 |
| Rate for Payer: Cash Price |
$1,998.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,776.00
|
| Rate for Payer: Galaxy Health WC |
$3,774.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,664.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,961.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,691.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,065.60
|
| Rate for Payer: Multiplan Commercial |
$3,552.00
|
| Rate for Payer: Networks By Design Commercial |
$2,886.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,774.00
|
|
|
HC BRONCH W PLCMNT FIDUCIAL MRK
|
Facility
|
IP
|
$12,082.00
|
|
|
Service Code
|
CPT 31626
|
| Hospital Charge Code |
900531626
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,899.68 |
| Max. Negotiated Rate |
$10,269.70 |
| Rate for Payer: Cash Price |
$5,436.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,832.80
|
| Rate for Payer: Galaxy Health WC |
$10,269.70
|
| Rate for Payer: Global Benefits Group Commercial |
$7,249.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,058.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,603.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,899.68
|
| Rate for Payer: Multiplan Commercial |
$9,665.60
|
| Rate for Payer: Networks By Design Commercial |
$7,853.30
|
| Rate for Payer: Prime Health Services Commercial |
$10,269.70
|
|
|
HC BRONCH W PLCMNT FIDUCIAL MRK
|
Facility
|
OP
|
$12,082.00
|
|
|
Service Code
|
CPT 31626
|
| Hospital Charge Code |
900531626
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$713.03 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,406.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,551.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$7,249.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4,128.35
|
| Rate for Payer: Blue Shield of California EPN |
$2,686.96
|
| Rate for Payer: Cash Price |
$5,436.90
|
| Rate for Payer: Cash Price |
$5,436.90
|
| Rate for Payer: Cigna of CA PPO |
$8,940.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Dignity Health Media |
$8,551.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,406.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,544.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,551.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,551.50
|
| Rate for Payer: Galaxy Health WC |
$10,269.70
|
| Rate for Payer: Global Benefits Group Commercial |
$7,249.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9,061.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,024.46
|
| Rate for Payer: Heritage Provider Network Transplant |
$14,024.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13,853.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$13,853.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,551.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,058.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$713.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,551.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,899.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,774.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,459.01
|
| Rate for Payer: Multiplan Commercial |
$9,665.60
|
| Rate for Payer: Multiplan WC |
$11,691.12
|
| Rate for Payer: Networks By Design Commercial |
$7,853.30
|
| Rate for Payer: Prime Health Services Commercial |
$10,269.70
|
| Rate for Payer: Prime Health Services WC |
$11,571.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,249.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,406.65
|
| Rate for Payer: Vantage Medical Group Senior |
$8,551.50
|
|
|
HC BRONCH W/TUMOR EXCISION
|
Facility
|
OP
|
$9,302.00
|
|
|
Service Code
|
CPT 31640
|
| Hospital Charge Code |
900803516
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$400.37 |
| Max. Negotiated Rate |
$7,906.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,678.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,581.20
|
| Rate for Payer: Blue Shield of California Commercial |
$6,855.57
|
| Rate for Payer: Blue Shield of California EPN |
$5,432.37
|
| Rate for Payer: Cash Price |
$4,185.90
|
| Rate for Payer: Cash Price |
$4,185.90
|
| Rate for Payer: Cigna of CA HMO |
$5,953.28
|
| Rate for Payer: Cigna of CA PPO |
$6,883.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,018.40
|
| Rate for Payer: Dignity Health Media |
$4,678.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,146.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,316.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,678.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,678.93
|
| Rate for Payer: Galaxy Health WC |
$7,906.70
|
| Rate for Payer: Global Benefits Group Commercial |
$5,581.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,976.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,673.45
|
| Rate for Payer: Heritage Provider Network Transplant |
$7,673.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7,579.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$7,579.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,678.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,204.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$400.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,678.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,232.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,895.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,269.77
|
| Rate for Payer: Multiplan Commercial |
$7,441.60
|
| Rate for Payer: Networks By Design Commercial |
$6,046.30
|
| Rate for Payer: Prime Health Services Commercial |
$7,906.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,581.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,581.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,651.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,651.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,651.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,651.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: Vantage Medical Group Senior |
$4,678.93
|
|
|
HC BRONCH W/TUMOR EXCISION
|
Facility
|
IP
|
$9,302.00
|
|
|
Service Code
|
CPT 31640
|
| Hospital Charge Code |
900803516
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,232.48 |
| Max. Negotiated Rate |
$7,906.70 |
| Rate for Payer: Cash Price |
$4,185.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,720.80
|
| Rate for Payer: Galaxy Health WC |
$7,906.70
|
| Rate for Payer: Global Benefits Group Commercial |
$5,581.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,204.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,544.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,232.48
|
| Rate for Payer: Multiplan Commercial |
$7,441.60
|
| Rate for Payer: Networks By Design Commercial |
$6,046.30
|
| Rate for Payer: Prime Health Services Commercial |
$7,906.70
|
|
|
HC BUFFY COAT EXAM
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 85009
|
| Hospital Charge Code |
900910196
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$33.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33.91
|
| Rate for Payer: Blue Distinction Transplant |
$9.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9.69
|
| Rate for Payer: Blue Shield of California EPN |
$7.68
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.60
|
| Rate for Payer: Dignity Health Media |
$5.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.07
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.31
|
| Rate for Payer: Heritage Provider Network Transplant |
$8.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.79
|
| Rate for Payer: Multiplan Commercial |
$12.00
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.10
|
| Rate for Payer: United Healthcare All Other HMO |
$4.10
|
| Rate for Payer: United Healthcare HMO Rider |
$4.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.58
|
| Rate for Payer: Vantage Medical Group Senior |
$5.07
|
|
|
HC BUN
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 84520
|
| Hospital Charge Code |
900910253
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$35.99 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35.99
|
| Rate for Payer: Blue Distinction Transplant |
$9.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9.69
|
| Rate for Payer: Blue Shield of California EPN |
$7.68
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.92
|
| Rate for Payer: Dignity Health Media |
$3.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.33
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3.95
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.95
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.48
|
| Rate for Payer: Heritage Provider Network Transplant |
$6.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$6.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$6.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.29
|
| Rate for Payer: Multiplan Commercial |
$12.00
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.20
|
| Rate for Payer: United Healthcare All Other HMO |
$3.20
|
| Rate for Payer: United Healthcare HMO Rider |
$3.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.34
|
| Rate for Payer: Vantage Medical Group Senior |
$3.95
|
|
|
HC BUN BODY FLUID
|
Facility
|
OP
|
$17.00
|
|
|
Service Code
|
CPT 84520
|
| Hospital Charge Code |
900912241
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$35.99 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35.99
|
| Rate for Payer: Blue Distinction Transplant |
$10.20
|
| Rate for Payer: Blue Shield of California Commercial |
$10.98
|
| Rate for Payer: Blue Shield of California EPN |
$8.70
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cigna of CA HMO |
$10.88
|
| Rate for Payer: Cigna of CA PPO |
$12.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.92
|
| Rate for Payer: Dignity Health Media |
$3.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.33
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3.95
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.95
|
| Rate for Payer: Galaxy Health WC |
$14.45
|
| Rate for Payer: Global Benefits Group Commercial |
$10.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$12.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.48
|
| Rate for Payer: Heritage Provider Network Transplant |
$6.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$6.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$6.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.29
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
| Rate for Payer: Networks By Design Commercial |
$11.05
|
| Rate for Payer: Prime Health Services Commercial |
$14.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.20
|
| Rate for Payer: United Healthcare All Other HMO |
$3.20
|
| Rate for Payer: United Healthcare HMO Rider |
$3.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.34
|
| Rate for Payer: Vantage Medical Group Senior |
$3.95
|
|
|
HC BURR HOLES/ICP
|
Facility
|
OP
|
$870.00
|
|
|
Service Code
|
CPT 61105
|
| Hospital Charge Code |
988161105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$208.80 |
| Max. Negotiated Rate |
$5,938.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,625.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$739.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$478.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$478.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$522.00
|
| 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 |
$391.50
|
| Rate for Payer: Cash Price |
$391.50
|
| Rate for Payer: Cigna of CA PPO |
$643.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$739.50
|
| Rate for Payer: Dignity Health Media |
$739.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$739.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$348.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$348.00
|
| Rate for Payer: Galaxy Health WC |
$739.50
|
| Rate for Payer: Global Benefits Group Commercial |
$522.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$652.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$580.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$560.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$208.80
|
| Rate for Payer: Multiplan Commercial |
$696.00
|
| Rate for Payer: Networks By Design Commercial |
$565.50
|
| Rate for Payer: Prime Health Services Commercial |
$739.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$522.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$739.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$739.50
|
| Rate for Payer: Vantage Medical Group Senior |
$739.50
|
|
|
HC BURR HOLES/ICP
|
Facility
|
IP
|
$870.00
|
|
|
Service Code
|
CPT 61105
|
| Hospital Charge Code |
988161105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$208.80 |
| Max. Negotiated Rate |
$739.50 |
| Rate for Payer: Cash Price |
$391.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$348.00
|
| Rate for Payer: Galaxy Health WC |
$739.50
|
| Rate for Payer: Global Benefits Group Commercial |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$580.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$331.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$208.80
|
| Rate for Payer: Multiplan Commercial |
$696.00
|
| Rate for Payer: Networks By Design Commercial |
$565.50
|
| Rate for Payer: Prime Health Services Commercial |
$739.50
|
|
