|
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 |
$146.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.65
|
| Rate for Payer: Blue Shield of California Commercial |
$284.18
|
| Rate for Payer: Blue Shield of California Commercial |
$430.65
|
| 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 |
$167.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$472.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.68
|
| Rate for Payer: EPIC Health Plan Senior |
$123.12
|
| Rate for Payer: Galaxy Health WC |
$573.75
|
| Rate for Payer: Global Benefits Group Commercial |
$405.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$183.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$31.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$428.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$36.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$156.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$141.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$149.99
|
| 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 |
$111.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Vantage Medical Group Senior |
$111.93
|
|
|
HC ANORECTAL MANOMETRY
|
Facility
|
IP
|
$2,224.00
|
|
|
Service Code
|
CPT 91125
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,556.80
|
| 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 Foundation Hospitals Commercial/Self Funded |
$1,412.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,312.16
|
| 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 ANORECTAL MANOMETRY
|
Facility
|
OP
|
$2,224.00
|
|
|
Service Code
|
CPT 91125
|
| Hospital Charge Code |
906791122
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$444.80 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$444.80
|
| Rate for Payer: Adventist Health Commercial |
$487.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$479.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$479.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,563.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,427.14
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$1,000.80
|
| Rate for Payer: Cash Price |
$1,000.80
|
| Rate for Payer: Cash Price |
$1,000.80
|
| 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 |
$1,423.36
|
| Rate for Payer: Cigna of CA HMO |
$1,559.04
|
| Rate for Payer: Cigna of CA PPO |
$1,802.64
|
| Rate for Payer: Cigna of CA PPO |
$1,645.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$719.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$719.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$527.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$527.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$479.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$479.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,556.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,705.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$791.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$791.90
|
| Rate for Payer: EPIC Health Plan Senior |
$527.93
|
| Rate for Payer: EPIC Health Plan Senior |
$527.93
|
| Rate for Payer: Galaxy Health WC |
$1,890.40
|
| Rate for Payer: Galaxy Health WC |
$2,070.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,461.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,334.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$787.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$787.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$479.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$479.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,412.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,546.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$671.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$671.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$584.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$533.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$604.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$604.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$643.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$643.12
|
| Rate for Payer: Multiplan Commercial |
$1,779.20
|
| Rate for Payer: Multiplan Commercial |
$1,948.80
|
| Rate for Payer: Networks By Design Commercial |
$1,583.40
|
| Rate for Payer: Networks By Design Commercial |
$1,445.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,890.40
|
| 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: Temecula Valley Physicians Medical Group Commercial |
$1,334.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$575.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$575.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,112.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,218.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,112.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,218.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,218.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,112.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,218.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,112.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$479.94
|
| Rate for Payer: Upland Medical Group Pediatric |
$479.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Vantage Medical Group Senior |
$479.94
|
| Rate for Payer: Vantage Medical Group Senior |
$479.94
|
|
|
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 |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$79.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| 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 |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$277.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$336.60
|
| Rate for Payer: Global Benefits Group Commercial |
$237.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$251.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$41.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$183.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$215.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$229.30
|
| 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 |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
|
HC ANOSCOPY DIAGNOSTIC W WO SPEC COLLECT
|
Facility
|
IP
|
$396.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
900501159
|
|
Hospital Revenue Code
|
456
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$277.20
|
| 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 Foundation Hospitals Commercial/Self Funded |
$251.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$233.64
|
| 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 DIAGNOSTIC W WO SPEC COLLECT
|
Facility
|
OP
|
$396.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
900501159
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$41.74 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$162.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$254.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| 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 |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$277.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$336.60
|
| Rate for Payer: Global Benefits Group Commercial |
$237.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$251.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$41.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$183.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$215.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$229.30
|
| 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: TriValley Medical Group Commercial/Senior |
$237.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$277.20
|
| 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 Foundation Hospitals Commercial/Self Funded |
$251.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$233.64
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,216.90
|
| 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 Foundation Hospitals Commercial/Self Funded |
$2,011.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,868.53
|
| 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
|
|
|
HC ANOSCOPY DIAG W/RMVL FB
|
Facility
|
OP
|
$3,167.00
|
|
|
Service Code
|
CPT 46608
|
| Hospital Charge Code |
900501160
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$205.14 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$633.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$1,425.15
|
| Rate for Payer: Cash Price |
$1,425.15
|
| Rate for Payer: Cash Price |
$1,425.15
|
| Rate for Payer: Cigna of CA HMO |
$2,026.88
|
| Rate for Payer: Cigna of CA PPO |
$2,343.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,216.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: Galaxy Health WC |
$2,691.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,900.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,011.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$205.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,285.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$760.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,507.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$2,533.60
|
| Rate for Payer: Multiplan WC |
$1,845.73
|
| Rate for Payer: Networks By Design Commercial |
$2,058.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,691.95
|
| Rate for Payer: Prime Health Services WC |
$1,826.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,900.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,583.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,583.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,583.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,583.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC ANOSCOPY DIAG W/RMVL FB
|
Facility
|
OP
|
$3,167.00
|
|
|
Service Code
|
CPT 46608
|
| Hospital Charge Code |
900501160
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$205.14 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$1,298.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$507.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$1,425.15
|
| Rate for Payer: Cash Price |
$1,425.15
|
| Rate for Payer: Cash Price |
$1,425.15
|
| Rate for Payer: Cigna of CA HMO |
$2,026.88
|
| Rate for Payer: Cigna of CA PPO |
$2,343.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,216.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: Galaxy Health WC |
$2,691.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,900.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,011.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$205.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,285.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$760.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,507.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$2,533.60
|
| Rate for Payer: Multiplan WC |
$1,845.73
|
| Rate for Payer: Networks By Design Commercial |
$2,058.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,691.95
|
| Rate for Payer: Prime Health Services WC |
$1,826.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,900.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,900.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC ANOSCOPY DIAG W/RMVL FB
|
Facility
|
IP
|
$3,167.00
|
|
|
Service Code
|
CPT 46608
|
| Hospital Charge Code |
900501160
|
|
Hospital Revenue Code
|
456
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,216.90
|
| 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 Foundation Hospitals Commercial/Self Funded |
$2,011.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,868.53
|
| 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
|
|
|
HC ANOSCOPY W CONTRL OF BLEEDNG
|
Facility
|
OP
|
$2,296.00
|
|
|
Service Code
|
CPT 46614
|
| Hospital Charge Code |
906746614
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$200.78 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$459.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$1,033.20
|
| Rate for Payer: Cash Price |
$1,033.20
|
| Rate for Payer: Cash Price |
$1,033.20
|
| Rate for Payer: Cigna of CA HMO |
$1,469.44
|
| Rate for Payer: Cigna of CA PPO |
$1,699.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,607.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$1,951.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,377.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$200.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,457.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$227.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$551.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,939.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$1,836.80
|
| Rate for Payer: Networks By Design Commercial |
$1,492.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,951.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,377.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,148.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC ANOSCOPY W CONTRL OF BLEEDNG
|
Facility
|
IP
|
$2,296.00
|
|
|
Service Code
|
CPT 46614
|
| Hospital Charge Code |
906746614
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$459.20 |
| Max. Negotiated Rate |
$1,951.60 |
| Rate for Payer: Adventist Health Commercial |
$459.20
|
| Rate for Payer: Cash Price |
$1,033.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,607.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$918.40
|
| Rate for Payer: EPIC Health Plan Senior |
$918.40
|
| Rate for Payer: Galaxy Health WC |
$1,951.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,377.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,457.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,354.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$551.04
|
| Rate for Payer: Multiplan Commercial |
$1,836.80
|
| Rate for Payer: Networks By Design Commercial |
$1,492.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,951.60
|
|
|
HC ANS PARASYMP & SYMP W TILT
|
Facility
|
OP
|
$639.00
|
|
|
Service Code
|
CPT 95924
|
| Hospital Charge Code |
900600331
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$127.80 |
| Max. Negotiated Rate |
$1,021.00 |
| Rate for Payer: Cash Price |
$287.55
|
| Rate for Payer: Cigna of CA HMO |
$408.96
|
| Rate for Payer: Cigna of CA PPO |
$472.86
|
| Rate for Payer: Adventist Health Commercial |
$127.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$424.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$277.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$410.05
|
| Rate for Payer: Blue Shield of California Commercial |
$269.02
|
| Rate for Payer: Blue Shield of California Commercial |
$407.68
|
| Rate for Payer: Cash Price |
$287.55
|
| Rate for Payer: Cash Price |
$287.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$416.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$305.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$277.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$447.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$458.22
|
| Rate for Payer: EPIC Health Plan Senior |
$305.48
|
| Rate for Payer: Galaxy Health WC |
$543.15
|
| Rate for Payer: Global Benefits Group Commercial |
$383.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$455.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$216.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$277.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$405.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$244.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$388.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$153.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$349.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$372.13
|
| Rate for Payer: Multiplan Commercial |
$511.20
|
| Rate for Payer: Networks By Design Commercial |
$415.35
|
| Rate for Payer: Prime Health Services Commercial |
$543.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$383.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$383.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,021.00
|
| Rate for Payer: United Healthcare All Other HMO |
$803.00
|
| Rate for Payer: United Healthcare HMO Rider |
$608.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$558.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$277.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Vantage Medical Group Senior |
$277.71
|
|
|
HC ANS PARASYMP & SYMP W TILT
|
Facility
|
IP
|
$639.00
|
|
|
Service Code
|
CPT 95924
|
| Hospital Charge Code |
900600331
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$127.80 |
| Max. Negotiated Rate |
$543.15 |
| Rate for Payer: Adventist Health Commercial |
$127.80
|
| Rate for Payer: Cash Price |
$287.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$447.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$255.60
|
| Rate for Payer: EPIC Health Plan Senior |
$255.60
|
| Rate for Payer: Galaxy Health WC |
$543.15
|
| Rate for Payer: Global Benefits Group Commercial |
$383.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$405.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$377.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$153.36
|
| Rate for Payer: Multiplan Commercial |
$511.20
|
| Rate for Payer: Networks By Design Commercial |
$415.35
|
| Rate for Payer: Prime Health Services Commercial |
$543.15
|
|
|
HC ANTERIOR SWING BAND ADDITION LE
|
Facility
|
IP
|
$415.00
|
|
|
Service Code
|
CPT L2335
|
| Hospital Charge Code |
905352335
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$83.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$83.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$186.75
|
| Rate for Payer: Cash Price |
$186.75
|
| Rate for Payer: Cigna of CA HMO |
$290.50
|
| Rate for Payer: Cigna of CA PPO |
$290.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$290.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$166.00
|
| Rate for Payer: EPIC Health Plan Senior |
$166.00
|
| Rate for Payer: Galaxy Health WC |
$352.75
|
| Rate for Payer: Global Benefits Group Commercial |
$249.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$263.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$244.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.60
|
| Rate for Payer: Multiplan Commercial |
$332.00
|
| Rate for Payer: Networks By Design Commercial |
$269.75
|
| Rate for Payer: Prime Health Services Commercial |
$352.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$155.75
|
| Rate for Payer: United Healthcare All Other HMO |
$151.60
|
| Rate for Payer: United Healthcare HMO Rider |
$148.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$135.91
|
|
|
HC ANTERIOR SWING BAND ADDITION LE
|
Facility
|
OP
|
$415.00
|
|
|
Service Code
|
CPT L2335
|
| Hospital Charge Code |
905352335
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$99.60 |
| Max. Negotiated Rate |
$352.75 |
| Rate for Payer: Adventist Health Commercial |
$170.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$352.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$228.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$311.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$251.20
|
| Rate for Payer: Blue Shield of California Commercial |
$319.13
|
| Rate for Payer: Blue Shield of California Commercial |
$210.41
|
| Rate for Payer: Cash Price |
$186.75
|
| Rate for Payer: Cash Price |
$186.75
|
| Rate for Payer: Cigna of CA HMO |
$290.50
|
| Rate for Payer: Cigna of CA PPO |
$290.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$352.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$352.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$352.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$290.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$166.00
|
| Rate for Payer: EPIC Health Plan Senior |
$166.00
|
| Rate for Payer: Galaxy Health WC |
$352.75
|
| Rate for Payer: Global Benefits Group Commercial |
$249.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$247.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$263.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$280.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$244.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$290.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$290.50
|
| Rate for Payer: Multiplan Commercial |
$332.00
|
| Rate for Payer: Networks By Design Commercial |
$207.50
|
| Rate for Payer: Prime Health Services Commercial |
$352.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$249.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$249.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$155.75
|
| Rate for Payer: United Healthcare All Other HMO |
$151.60
|
| Rate for Payer: United Healthcare HMO Rider |
$148.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$135.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$352.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$352.75
|
| Rate for Payer: Vantage Medical Group Senior |
$352.75
|
|
|
HC ANTERIOR SWING BAND ADDITION LE
|
Facility
|
OP
|
$415.00
|
|
|
Service Code
|
CPT L2335
|
| Hospital Charge Code |
915352335
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$99.60 |
| Max. Negotiated Rate |
$352.75 |
| Rate for Payer: Adventist Health Commercial |
$170.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$352.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$228.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$311.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$251.20
|
| Rate for Payer: Blue Shield of California Commercial |
$319.13
|
| Rate for Payer: Blue Shield of California Commercial |
$210.41
|
| Rate for Payer: Cash Price |
$186.75
|
| Rate for Payer: Cash Price |
$186.75
|
| Rate for Payer: Cigna of CA HMO |
$290.50
|
| Rate for Payer: Cigna of CA PPO |
$290.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$352.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$352.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$352.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$290.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$166.00
|
| Rate for Payer: EPIC Health Plan Senior |
$166.00
|
| Rate for Payer: Galaxy Health WC |
$352.75
|
| Rate for Payer: Global Benefits Group Commercial |
$249.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$247.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$263.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$280.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$244.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$290.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$290.50
|
| Rate for Payer: Multiplan Commercial |
$332.00
|
| Rate for Payer: Networks By Design Commercial |
$207.50
|
| Rate for Payer: Prime Health Services Commercial |
$352.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$249.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$249.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$155.75
|
| Rate for Payer: United Healthcare All Other HMO |
$151.60
|
| Rate for Payer: United Healthcare HMO Rider |
$148.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$135.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$352.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$352.75
|
| Rate for Payer: Vantage Medical Group Senior |
$352.75
|
|
|
HC ANTERIOR SWING BAND ADDITION LE
|
Facility
|
IP
|
$415.00
|
|
|
Service Code
|
CPT L2335
|
| Hospital Charge Code |
915352335
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$83.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$83.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$186.75
|
| Rate for Payer: Cash Price |
$186.75
|
| Rate for Payer: Cigna of CA HMO |
$290.50
|
| Rate for Payer: Cigna of CA PPO |
$290.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$290.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$166.00
|
| Rate for Payer: EPIC Health Plan Senior |
$166.00
|
| Rate for Payer: Galaxy Health WC |
$352.75
|
| Rate for Payer: Global Benefits Group Commercial |
$249.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$263.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$244.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.60
|
| Rate for Payer: Multiplan Commercial |
$332.00
|
| Rate for Payer: Networks By Design Commercial |
$269.75
|
| Rate for Payer: Prime Health Services Commercial |
$352.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$155.75
|
| Rate for Payer: United Healthcare All Other HMO |
$151.60
|
| Rate for Payer: United Healthcare HMO Rider |
$148.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$135.91
|
|
|
HC ANTIBODY IDENTIFICATION
|
Facility
|
IP
|
$761.00
|
|
|
Service Code
|
CPT 86870
|
| Hospital Charge Code |
900904444
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$152.20 |
| Max. Negotiated Rate |
$646.85 |
| Rate for Payer: Adventist Health Commercial |
$152.20
|
| Rate for Payer: Cash Price |
$342.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$532.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$304.40
|
| Rate for Payer: EPIC Health Plan Senior |
$304.40
|
| Rate for Payer: Galaxy Health WC |
$646.85
|
| Rate for Payer: Global Benefits Group Commercial |
$456.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$483.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$448.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$182.64
|
| Rate for Payer: Multiplan Commercial |
$608.80
|
| Rate for Payer: Networks By Design Commercial |
$494.65
|
| Rate for Payer: Prime Health Services Commercial |
$646.85
|
|
|
HC ANTIBODY IDENTIFICATION
|
Facility
|
OP
|
$761.00
|
|
|
Service Code
|
CPT 86870
|
| Hospital Charge Code |
900904444
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.75 |
| Max. Negotiated Rate |
$760.68 |
| Rate for Payer: Adventist Health Commercial |
$152.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$208.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$691.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$507.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$461.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$232.23
|
| Rate for Payer: Blue Shield of California Commercial |
$350.82
|
| Rate for Payer: Blue Shield of California Commercial |
$530.42
|
| Rate for Payer: Cash Price |
$342.45
|
| Rate for Payer: Cash Price |
$342.45
|
| Rate for Payer: Cigna of CA HMO |
$487.04
|
| Rate for Payer: Cigna of CA PPO |
$563.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$691.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$507.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$461.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$532.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$760.68
|
| Rate for Payer: EPIC Health Plan Senior |
$507.12
|
| Rate for Payer: Galaxy Health WC |
$646.85
|
| Rate for Payer: Global Benefits Group Commercial |
$456.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$756.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$27.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$461.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$483.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$645.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$182.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$580.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$617.77
|
| Rate for Payer: Multiplan Commercial |
$608.80
|
| Rate for Payer: Networks By Design Commercial |
$494.65
|
| Rate for Payer: Prime Health Services Commercial |
$646.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$456.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$456.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.94
|
| Rate for Payer: United Healthcare All Other HMO |
$240.94
|
| Rate for Payer: United Healthcare HMO Rider |
$240.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.94
|
| Rate for Payer: Upland Medical Group Pediatric |
$461.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$691.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$507.12
|
| Rate for Payer: Vantage Medical Group Senior |
$461.02
|
|
|
HC ANTIBODY SCREEN
|
Facility
|
OP
|
$401.00
|
|
|
Service Code
|
CPT 86850
|
| Hospital Charge Code |
900904542
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.37 |
| Max. Negotiated Rate |
$340.85 |
| Rate for Payer: Cigna of CA PPO |
$296.74
|
| Rate for Payer: Adventist Health Commercial |
$80.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$117.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$111.46
|
| Rate for Payer: Blue Shield of California Commercial |
$184.86
|
| Rate for Payer: Blue Shield of California Commercial |
$279.50
|
| Rate for Payer: Cash Price |
$180.45
|
| Rate for Payer: Cash Price |
$180.45
|
| Rate for Payer: Cigna of CA HMO |
$256.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.77
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$280.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.12
|
| Rate for Payer: EPIC Health Plan Senior |
$10.75
|
| Rate for Payer: Galaxy Health WC |
$340.85
|
| Rate for Payer: Global Benefits Group Commercial |
$240.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$16.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$4.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.77
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$254.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.09
|
| Rate for Payer: Multiplan Commercial |
$320.80
|
| Rate for Payer: Networks By Design Commercial |
$260.65
|
| Rate for Payer: Prime Health Services Commercial |
$340.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$240.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$240.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.91
|
| Rate for Payer: United Healthcare All Other HMO |
$7.91
|
| Rate for Payer: United Healthcare HMO Rider |
$7.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.91
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.75
|
| Rate for Payer: Vantage Medical Group Senior |
$9.77
|
|
|
HC ANTIBODY SCREEN
|
Facility
|
IP
|
$401.00
|
|
|
Service Code
|
CPT 86850
|
| Hospital Charge Code |
900904542
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$80.20 |
| Max. Negotiated Rate |
$340.85 |
| Rate for Payer: Adventist Health Commercial |
$80.20
|
| Rate for Payer: Cash Price |
$180.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$280.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.40
|
| Rate for Payer: EPIC Health Plan Senior |
$160.40
|
| Rate for Payer: Galaxy Health WC |
$340.85
|
| Rate for Payer: Global Benefits Group Commercial |
$240.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$254.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$236.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.24
|
| Rate for Payer: Multiplan Commercial |
$320.80
|
| Rate for Payer: Networks By Design Commercial |
$260.65
|
| Rate for Payer: Prime Health Services Commercial |
$340.85
|
|
|
HC ANTIBODY TITRATION
|
Facility
|
IP
|
$571.00
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
900904500
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$114.20 |
| Max. Negotiated Rate |
$485.35 |
| Rate for Payer: Adventist Health Commercial |
$114.20
|
| Rate for Payer: Cash Price |
$256.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$399.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$228.40
|
| Rate for Payer: EPIC Health Plan Senior |
$228.40
|
| Rate for Payer: Galaxy Health WC |
$485.35
|
| Rate for Payer: Global Benefits Group Commercial |
$342.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$362.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$336.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$137.04
|
| Rate for Payer: Multiplan Commercial |
$456.80
|
| Rate for Payer: Networks By Design Commercial |
$371.15
|
| Rate for Payer: Prime Health Services Commercial |
$485.35
|
|
|
HC ANTIBODY TITRATION
|
Facility
|
OP
|
$571.00
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
900904500
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$485.35 |
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: Adventist Health Commercial |
$114.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$43.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$53.37
|
| Rate for Payer: Blue Shield of California Commercial |
$263.23
|
| Rate for Payer: Blue Shield of California Commercial |
$397.99
|
| Rate for Payer: Cash Price |
$256.95
|
| Rate for Payer: Cash Price |
$256.95
|
| Rate for Payer: Cigna of CA HMO |
$365.44
|
| Rate for Payer: Cigna of CA PPO |
$422.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$399.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.55
|
| Rate for Payer: EPIC Health Plan Senior |
$5.70
|
| Rate for Payer: Galaxy Health WC |
$485.35
|
| Rate for Payer: Global Benefits Group Commercial |
$342.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$362.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$137.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$456.80
|
| Rate for Payer: Networks By Design Commercial |
$371.15
|
| Rate for Payer: Prime Health Services Commercial |
$485.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$342.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$342.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
