|
HC BFLEX 5.8 BRONCHOSCOPE
|
Facility
|
IP
|
$1,564.00
|
|
| Hospital Charge Code |
900831702
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$312.80 |
| Max. Negotiated Rate |
$1,329.40 |
| Rate for Payer: Adventist Health Commercial |
$312.80
|
| Rate for Payer: Cash Price |
$703.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,094.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$625.60
|
| Rate for Payer: EPIC Health Plan Senior |
$625.60
|
| Rate for Payer: Galaxy Health WC |
$1,329.40
|
| Rate for Payer: Global Benefits Group Commercial |
$938.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$993.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$922.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$375.36
|
| Rate for Payer: Multiplan Commercial |
$1,251.20
|
| Rate for Payer: Networks By Design Commercial |
$1,016.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,329.40
|
|
|
HC BFLEX 5.8 BRONCHOSCOPE
|
Facility
|
OP
|
$1,564.00
|
|
| Hospital Charge Code |
900831702
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$312.80 |
| Max. Negotiated Rate |
$1,329.40 |
| Rate for Payer: Adventist Health Commercial |
$312.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,025.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,329.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$860.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,173.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,003.62
|
| Rate for Payer: Cash Price |
$703.80
|
| Rate for Payer: Cigna of CA HMO |
$1,000.96
|
| Rate for Payer: Cigna of CA PPO |
$1,157.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,329.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,329.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,329.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,094.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$625.60
|
| Rate for Payer: EPIC Health Plan Senior |
$625.60
|
| Rate for Payer: Galaxy Health WC |
$1,329.40
|
| Rate for Payer: Global Benefits Group Commercial |
$938.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$993.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$567.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$922.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$375.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,094.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,094.80
|
| Rate for Payer: Multiplan Commercial |
$1,251.20
|
| Rate for Payer: Networks By Design Commercial |
$1,016.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,329.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$938.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$938.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$782.00
|
| Rate for Payer: United Healthcare All Other HMO |
$782.00
|
| Rate for Payer: United Healthcare HMO Rider |
$782.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$782.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,329.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,329.40
|
| Rate for Payer: Vantage Medical Group Senior |
$1,329.40
|
|
|
HC BG ARTERIAL PUNCTURE
|
Facility
|
OP
|
$353.00
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
900801101
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$21.27 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$70.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$101.50
|
| 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 |
$158.85
|
| Rate for Payer: Cash Price |
$158.85
|
| Rate for Payer: Cash Price |
$158.85
|
| Rate for Payer: Cigna of CA HMO |
$225.92
|
| Rate for Payer: Cigna of CA PPO |
$261.22
|
| 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 |
$247.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$300.05
|
| Rate for Payer: Global Benefits Group Commercial |
$211.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$21.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$224.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$239.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.72
|
| 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 |
$282.40
|
| Rate for Payer: Networks By Design Commercial |
$229.45
|
| Rate for Payer: Prime Health Services Commercial |
$300.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$211.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$211.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$176.50
|
| Rate for Payer: United Healthcare All Other HMO |
$176.50
|
| Rate for Payer: United Healthcare HMO Rider |
$176.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$176.50
|
| 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 BG ARTERIAL PUNCTURE
|
Facility
|
IP
|
$353.00
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
900801101
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$70.60 |
| Max. Negotiated Rate |
$300.05 |
| Rate for Payer: Adventist Health Commercial |
$70.60
|
| Rate for Payer: Cash Price |
$158.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$247.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$141.20
|
| Rate for Payer: EPIC Health Plan Senior |
$141.20
|
| Rate for Payer: Galaxy Health WC |
$300.05
|
| Rate for Payer: Global Benefits Group Commercial |
$211.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$224.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$208.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.72
|
| Rate for Payer: Multiplan Commercial |
$282.40
|
| Rate for Payer: Networks By Design Commercial |
$229.45
|
| Rate for Payer: Prime Health Services Commercial |
$300.05
|
|
|
HC BG IONIZED CALCIUM
|
Facility
|
IP
|
$455.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
900801120
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$91.00 |
| Max. Negotiated Rate |
$386.75 |
| Rate for Payer: Galaxy Health WC |
$386.75
|
| Rate for Payer: Adventist Health Commercial |
$91.00
|
| Rate for Payer: Cash Price |
$204.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$318.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.00
|
| Rate for Payer: EPIC Health Plan Senior |
$182.00
|
| Rate for Payer: Global Benefits Group Commercial |
$273.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$288.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$268.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.20
|
| Rate for Payer: Multiplan Commercial |
$364.00
|
| Rate for Payer: Networks By Design Commercial |
$295.75
|
| Rate for Payer: Prime Health Services Commercial |
$386.75
|
|
|
HC BG IONIZED CALCIUM
|
Facility
|
OP
|
$455.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
900801120
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$386.75 |
| Rate for Payer: Adventist Health Commercial |
$91.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$113.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$141.06
|
| Rate for Payer: Blue Shield of California Commercial |
$209.75
|
| Rate for Payer: Blue Shield of California Commercial |
$317.13
|
| Rate for Payer: Cash Price |
$204.75
|
| Rate for Payer: Cash Price |
$204.75
|
| Rate for Payer: Cigna of CA HMO |
$291.20
|
| Rate for Payer: Cigna of CA PPO |
$336.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.68
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$318.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.57
|
| Rate for Payer: EPIC Health Plan Senior |
$15.05
|
| Rate for Payer: Galaxy Health WC |
$386.75
|
| Rate for Payer: Global Benefits Group Commercial |
$273.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$288.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.33
|
| Rate for Payer: Multiplan Commercial |
$364.00
|
| Rate for Payer: Networks By Design Commercial |
$295.75
|
| Rate for Payer: Prime Health Services Commercial |
$386.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$273.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$273.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.08
|
| Rate for Payer: United Healthcare All Other HMO |
$11.08
|
| Rate for Payer: United Healthcare HMO Rider |
$11.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.05
|
| Rate for Payer: Vantage Medical Group Senior |
$13.68
|
|
|
HC BILATERAL LSHO-CUSTOM FIT ABD
|
Facility
|
IP
|
$3,039.00
|
|
|
Service Code
|
CPT L1690
|
| Hospital Charge Code |
915351690
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$607.80 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$607.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Cigna of CA HMO |
$2,127.30
|
| Rate for Payer: Cigna of CA PPO |
$2,127.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,127.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,215.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,215.60
|
| Rate for Payer: Galaxy Health WC |
$2,583.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,823.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,929.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,793.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$729.36
|
| Rate for Payer: Multiplan Commercial |
$2,431.20
|
| Rate for Payer: Networks By Design Commercial |
$1,975.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,583.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,140.54
|
| Rate for Payer: United Healthcare All Other HMO |
$1,110.15
|
| Rate for Payer: United Healthcare HMO Rider |
$1,086.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$995.27
|
|
|
HC BILATERAL LSHO-CUSTOM FIT ABD
|
Facility
|
OP
|
$3,039.00
|
|
|
Service Code
|
CPT L1690
|
| Hospital Charge Code |
905351690
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$729.36 |
| Max. Negotiated Rate |
$2,583.15 |
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Adventist Health Commercial |
$1,245.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,583.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,671.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,279.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,839.51
|
| Rate for Payer: Blue Shield of California Commercial |
$2,336.99
|
| Rate for Payer: Blue Shield of California Commercial |
$1,540.77
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Cigna of CA HMO |
$2,127.30
|
| Rate for Payer: Cigna of CA PPO |
$2,127.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,583.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,583.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,583.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,127.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,215.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,215.60
|
| Rate for Payer: Galaxy Health WC |
$2,583.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,823.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,641.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,929.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,856.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,793.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$729.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,127.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,127.30
|
| Rate for Payer: Multiplan Commercial |
$2,431.20
|
| Rate for Payer: Networks By Design Commercial |
$1,519.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,583.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,823.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,823.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,140.54
|
| Rate for Payer: United Healthcare All Other HMO |
$1,110.15
|
| Rate for Payer: United Healthcare HMO Rider |
$1,086.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$995.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,583.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,583.15
|
| Rate for Payer: Vantage Medical Group Senior |
$2,583.15
|
|
|
HC BILATERAL LSHO-CUSTOM FIT ABD
|
Facility
|
IP
|
$3,039.00
|
|
|
Service Code
|
CPT L1690
|
| Hospital Charge Code |
905351690
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$607.80 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$607.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Cigna of CA HMO |
$2,127.30
|
| Rate for Payer: Cigna of CA PPO |
$2,127.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,127.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,215.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,215.60
|
| Rate for Payer: Galaxy Health WC |
$2,583.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,823.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,929.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,793.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$729.36
|
| Rate for Payer: Multiplan Commercial |
$2,431.20
|
| Rate for Payer: Networks By Design Commercial |
$1,975.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,583.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,140.54
|
| Rate for Payer: United Healthcare All Other HMO |
$1,110.15
|
| Rate for Payer: United Healthcare HMO Rider |
$1,086.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$995.27
|
|
|
HC BILATERAL LSHO-CUSTOM FIT ABD
|
Facility
|
OP
|
$3,039.00
|
|
|
Service Code
|
CPT L1690
|
| Hospital Charge Code |
915351690
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$729.36 |
| Max. Negotiated Rate |
$2,583.15 |
| Rate for Payer: Adventist Health Commercial |
$1,245.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,583.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,671.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,279.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,839.51
|
| Rate for Payer: Blue Shield of California Commercial |
$2,336.99
|
| Rate for Payer: Blue Shield of California Commercial |
$1,540.77
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Cigna of CA HMO |
$2,127.30
|
| Rate for Payer: Cigna of CA PPO |
$2,127.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,583.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,583.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,583.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,127.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,215.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,215.60
|
| Rate for Payer: Galaxy Health WC |
$2,583.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,823.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,641.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,929.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,856.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,793.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$729.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,127.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,127.30
|
| Rate for Payer: Multiplan Commercial |
$2,431.20
|
| Rate for Payer: Networks By Design Commercial |
$1,519.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,583.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,823.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,823.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,140.54
|
| Rate for Payer: United Healthcare All Other HMO |
$1,110.15
|
| Rate for Payer: United Healthcare HMO Rider |
$1,086.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$995.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,583.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,583.15
|
| Rate for Payer: Vantage Medical Group Senior |
$2,583.15
|
|
|
HC BIL CATH CONV EXT TO INT/EXT
|
Facility
|
IP
|
$7,427.00
|
|
|
Service Code
|
CPT 47535
|
| Hospital Charge Code |
909047535
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,485.40 |
| Max. Negotiated Rate |
$6,312.95 |
| Rate for Payer: Adventist Health Commercial |
$1,485.40
|
| Rate for Payer: Cash Price |
$3,342.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,198.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,970.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,970.80
|
| Rate for Payer: Galaxy Health WC |
$6,312.95
|
| Rate for Payer: Global Benefits Group Commercial |
$4,456.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,716.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,381.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,782.48
|
| Rate for Payer: Multiplan Commercial |
$5,941.60
|
| Rate for Payer: Networks By Design Commercial |
$4,827.55
|
| Rate for Payer: Prime Health Services Commercial |
$6,312.95
|
|
|
HC BIL CATH CONV EXT TO INT/EXT
|
Facility
|
OP
|
$7,427.00
|
|
|
Service Code
|
CPT 47535
|
| Hospital Charge Code |
909047535
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,485.40 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,485.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,065.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,604.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,942.61
|
| Rate for Payer: Blue Shield of California Commercial |
$4,454.70
|
| Rate for Payer: Cash Price |
$3,342.15
|
| Rate for Payer: Cash Price |
$3,342.15
|
| Rate for Payer: Cash Price |
$3,342.15
|
| Rate for Payer: Cigna of CA HMO |
$4,753.28
|
| Rate for Payer: Cigna of CA PPO |
$5,495.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,065.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,604.99
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,198.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,598.23
|
| Rate for Payer: EPIC Health Plan Senior |
$5,065.49
|
| Rate for Payer: Galaxy Health WC |
$6,312.95
|
| Rate for Payer: Global Benefits Group Commercial |
$4,456.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,552.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,704.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,604.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,716.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,927.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,446.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,782.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,802.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,170.69
|
| Rate for Payer: Multiplan Commercial |
$5,941.60
|
| Rate for Payer: Multiplan WC |
$7,144.49
|
| Rate for Payer: Networks By Design Commercial |
$4,827.55
|
| Rate for Payer: Prime Health Services Commercial |
$6,312.95
|
| Rate for Payer: Prime Health Services WC |
$7,071.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,456.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,713.50
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,604.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,065.49
|
| Rate for Payer: Vantage Medical Group Senior |
$4,604.99
|
|
|
HC BILIARY BRUSH/BIOPSY
|
Facility
|
IP
|
$6,773.00
|
|
|
Service Code
|
CPT 47553
|
| Hospital Charge Code |
909000148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,354.60 |
| Max. Negotiated Rate |
$5,757.05 |
| Rate for Payer: Adventist Health Commercial |
$1,354.60
|
| Rate for Payer: Cash Price |
$3,047.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,741.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,709.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,709.20
|
| Rate for Payer: Galaxy Health WC |
$5,757.05
|
| Rate for Payer: Global Benefits Group Commercial |
$4,063.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,300.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,996.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,625.52
|
| Rate for Payer: Multiplan Commercial |
$5,418.40
|
| Rate for Payer: Networks By Design Commercial |
$4,402.45
|
| Rate for Payer: Prime Health Services Commercial |
$5,757.05
|
|
|
HC BILIARY BRUSH/BIOPSY
|
Facility
|
OP
|
$6,773.00
|
|
|
Service Code
|
CPT 47553
|
| Hospital Charge Code |
909000148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$406.56 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,354.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,489.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,159.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,326.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,942.61
|
| Rate for Payer: Blue Shield of California Commercial |
$4,454.70
|
| Rate for Payer: Cash Price |
$3,047.85
|
| Rate for Payer: Cash Price |
$3,047.85
|
| Rate for Payer: Cash Price |
$3,047.85
|
| Rate for Payer: Cigna of CA HMO |
$4,334.72
|
| Rate for Payer: Cigna of CA PPO |
$5,012.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,489.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,159.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,326.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,741.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,738.58
|
| Rate for Payer: EPIC Health Plan Senior |
$9,159.05
|
| Rate for Payer: Galaxy Health WC |
$5,757.05
|
| Rate for Payer: Global Benefits Group Commercial |
$4,063.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13,655.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$406.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,326.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,300.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$459.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11,656.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,625.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,491.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,157.39
|
| Rate for Payer: Multiplan Commercial |
$5,418.40
|
| Rate for Payer: Multiplan WC |
$12,632.22
|
| Rate for Payer: Networks By Design Commercial |
$4,402.45
|
| Rate for Payer: Prime Health Services Commercial |
$5,757.05
|
| Rate for Payer: Prime Health Services WC |
$12,503.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,063.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,386.50
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$8,326.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,489.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,159.05
|
| Rate for Payer: Vantage Medical Group Senior |
$8,326.41
|
|
|
HC BILIARY CATH RMVL W FLUORO
|
Facility
|
OP
|
$1,647.00
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
909047537
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$329.40 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$329.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| 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 |
$741.15
|
| Rate for Payer: Cash Price |
$741.15
|
| Rate for Payer: Cash Price |
$741.15
|
| Rate for Payer: Cigna of CA HMO |
$1,054.08
|
| Rate for Payer: Cigna of CA PPO |
$1,218.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,152.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.77
|
| Rate for Payer: EPIC Health Plan Senior |
$1,283.18
|
| Rate for Payer: Galaxy Health WC |
$1,399.95
|
| Rate for Payer: Global Benefits Group Commercial |
$988.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,913.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$569.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,045.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$644.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,633.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$395.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,469.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,563.15
|
| Rate for Payer: Multiplan Commercial |
$1,317.60
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: Networks By Design Commercial |
$1,070.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,399.95
|
| Rate for Payer: Prime Health Services WC |
$1,878.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$988.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$823.50
|
| 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 |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
|
|
HC BILIARY CATH RMVL W FLUORO
|
Facility
|
IP
|
$1,647.00
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
909047537
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$329.40 |
| Max. Negotiated Rate |
$1,399.95 |
| Rate for Payer: Adventist Health Commercial |
$329.40
|
| Rate for Payer: Cash Price |
$741.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,152.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$658.80
|
| Rate for Payer: EPIC Health Plan Senior |
$658.80
|
| Rate for Payer: Galaxy Health WC |
$1,399.95
|
| Rate for Payer: Global Benefits Group Commercial |
$988.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,045.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$971.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$395.28
|
| Rate for Payer: Multiplan Commercial |
$1,317.60
|
| Rate for Payer: Networks By Design Commercial |
$1,070.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,399.95
|
|
|
HC BILIARY COPE LOOP CATH
|
Facility
|
OP
|
$418.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909001069
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$83.60 |
| Max. Negotiated Rate |
$355.30 |
| Rate for Payer: Adventist Health Commercial |
$83.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$355.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$229.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$313.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$253.02
|
| Rate for Payer: Blue Shield of California Commercial |
$211.93
|
| Rate for Payer: Blue Shield of California Commercial |
$321.44
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cigna of CA HMO |
$292.60
|
| Rate for Payer: Cigna of CA PPO |
$292.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$355.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$355.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$355.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$292.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$167.20
|
| Rate for Payer: EPIC Health Plan Senior |
$167.20
|
| Rate for Payer: Galaxy Health WC |
$355.30
|
| Rate for Payer: Global Benefits Group Commercial |
$250.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$265.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$151.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$246.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$100.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$292.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$292.60
|
| Rate for Payer: Multiplan Commercial |
$334.40
|
| Rate for Payer: Networks By Design Commercial |
$209.00
|
| Rate for Payer: Prime Health Services Commercial |
$355.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$250.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$250.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$156.88
|
| Rate for Payer: United Healthcare All Other HMO |
$152.70
|
| Rate for Payer: United Healthcare HMO Rider |
$149.39
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$136.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$355.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$355.30
|
| Rate for Payer: Vantage Medical Group Senior |
$355.30
|
|
|
HC BILIARY COPE LOOP CATH
|
Facility
|
IP
|
$418.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909001069
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$83.60 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$83.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cigna of CA HMO |
$292.60
|
| Rate for Payer: Cigna of CA PPO |
$292.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$292.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$167.20
|
| Rate for Payer: EPIC Health Plan Senior |
$167.20
|
| Rate for Payer: Galaxy Health WC |
$355.30
|
| Rate for Payer: Global Benefits Group Commercial |
$250.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$265.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$246.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$100.32
|
| Rate for Payer: Multiplan Commercial |
$334.40
|
| Rate for Payer: Networks By Design Commercial |
$209.00
|
| Rate for Payer: Prime Health Services Commercial |
$355.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$156.88
|
| Rate for Payer: United Healthcare All Other HMO |
$152.70
|
| Rate for Payer: United Healthcare HMO Rider |
$149.39
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$136.90
|
|
|
HC BILIARY DILATION WITH STENT
|
Facility
|
IP
|
$13,073.00
|
|
|
Service Code
|
CPT 47556
|
| Hospital Charge Code |
909000150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,614.60 |
| Max. Negotiated Rate |
$11,112.05 |
| Rate for Payer: Adventist Health Commercial |
$2,614.60
|
| Rate for Payer: Cash Price |
$5,882.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,229.20
|
| Rate for Payer: EPIC Health Plan Senior |
$5,229.20
|
| Rate for Payer: Galaxy Health WC |
$11,112.05
|
| Rate for Payer: Global Benefits Group Commercial |
$7,843.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,301.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,713.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,137.52
|
| Rate for Payer: Multiplan Commercial |
$10,458.40
|
| Rate for Payer: Networks By Design Commercial |
$8,497.45
|
| Rate for Payer: Prime Health Services Commercial |
$11,112.05
|
|
|
HC BILIARY DILATION WITH STENT
|
Facility
|
OP
|
$13,073.00
|
|
|
Service Code
|
CPT 47556
|
| Hospital Charge Code |
909000150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$577.94 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$2,614.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,507.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,038.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,671.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,702.17
|
| Rate for Payer: Blue Shield of California Commercial |
$7,730.00
|
| Rate for Payer: Cash Price |
$5,882.85
|
| Rate for Payer: Cash Price |
$5,882.85
|
| Rate for Payer: Cash Price |
$5,882.85
|
| Rate for Payer: Cigna of CA HMO |
$8,366.72
|
| Rate for Payer: Cigna of CA PPO |
$9,674.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,507.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,038.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,671.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,558.37
|
| Rate for Payer: EPIC Health Plan Senior |
$15,038.91
|
| Rate for Payer: Galaxy Health WC |
$11,112.05
|
| Rate for Payer: Global Benefits Group Commercial |
$7,843.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,421.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$577.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,671.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,301.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$653.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19,140.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,137.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,226.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,320.13
|
| Rate for Payer: Multiplan Commercial |
$10,458.40
|
| Rate for Payer: Multiplan WC |
$21,077.25
|
| Rate for Payer: Networks By Design Commercial |
$8,497.45
|
| Rate for Payer: Prime Health Services Commercial |
$11,112.05
|
| Rate for Payer: Prime Health Services WC |
$20,862.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,843.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,536.50
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$13,671.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,507.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,038.91
|
| Rate for Payer: Vantage Medical Group Senior |
$13,671.74
|
|
|
HC BILIARY DILATION W/O STENT
|
Facility
|
IP
|
$7,130.00
|
|
|
Service Code
|
CPT 47555
|
| Hospital Charge Code |
909000149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,426.00 |
| Max. Negotiated Rate |
$6,060.50 |
| Rate for Payer: Adventist Health Commercial |
$1,426.00
|
| Rate for Payer: Cash Price |
$3,208.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,991.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,852.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,852.00
|
| Rate for Payer: Galaxy Health WC |
$6,060.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,278.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,527.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,206.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,711.20
|
| Rate for Payer: Multiplan Commercial |
$5,704.00
|
| Rate for Payer: Networks By Design Commercial |
$4,634.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,060.50
|
|
|
HC BILIARY DILATION W/O STENT
|
Facility
|
OP
|
$7,130.00
|
|
|
Service Code
|
CPT 47555
|
| Hospital Charge Code |
909000149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$387.79 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,426.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,489.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,159.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,326.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,942.61
|
| Rate for Payer: Blue Shield of California Commercial |
$4,454.70
|
| Rate for Payer: Cash Price |
$3,208.50
|
| Rate for Payer: Cash Price |
$3,208.50
|
| Rate for Payer: Cash Price |
$3,208.50
|
| Rate for Payer: Cigna of CA HMO |
$4,563.20
|
| Rate for Payer: Cigna of CA PPO |
$5,276.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,489.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,159.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,326.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,991.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,738.58
|
| Rate for Payer: EPIC Health Plan Senior |
$9,159.05
|
| Rate for Payer: Galaxy Health WC |
$6,060.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,278.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13,655.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$387.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,326.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,527.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$438.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11,656.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,711.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,491.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,157.39
|
| Rate for Payer: Multiplan Commercial |
$5,704.00
|
| Rate for Payer: Multiplan WC |
$7,144.49
|
| Rate for Payer: Networks By Design Commercial |
$4,634.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,060.50
|
| Rate for Payer: Prime Health Services WC |
$7,071.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,278.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,565.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$8,326.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,489.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,159.05
|
| Rate for Payer: Vantage Medical Group Senior |
$8,326.41
|
|
|
HC BILIARY DRAINAGE CATH CHANGE
|
Facility
|
OP
|
$6,620.00
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
909000147
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,263.44 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,324.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,065.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,604.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,942.61
|
| Rate for Payer: Blue Shield of California Commercial |
$4,454.70
|
| Rate for Payer: Cash Price |
$2,979.00
|
| Rate for Payer: Cash Price |
$2,979.00
|
| Rate for Payer: Cash Price |
$2,979.00
|
| Rate for Payer: Cigna of CA HMO |
$4,236.80
|
| Rate for Payer: Cigna of CA PPO |
$4,898.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,065.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,604.99
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,634.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,598.23
|
| Rate for Payer: EPIC Health Plan Senior |
$5,065.49
|
| Rate for Payer: Galaxy Health WC |
$5,627.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,972.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,552.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,263.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,604.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,203.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,428.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,446.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,588.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,802.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,170.69
|
| Rate for Payer: Multiplan Commercial |
$5,296.00
|
| Rate for Payer: Multiplan WC |
$7,144.49
|
| Rate for Payer: Networks By Design Commercial |
$4,303.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,627.00
|
| Rate for Payer: Prime Health Services WC |
$7,071.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,972.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,310.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,604.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,065.49
|
| Rate for Payer: Vantage Medical Group Senior |
$4,604.99
|
|
|
HC BILIARY DRAINAGE CATH CHANGE
|
Facility
|
OP
|
$6,620.00
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
909000147
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$973.00 |
| Max. Negotiated Rate |
$7,598.23 |
| Rate for Payer: Adventist Health Commercial |
$1,324.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,065.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,604.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$2,979.00
|
| Rate for Payer: Cash Price |
$2,979.00
|
| Rate for Payer: Cash Price |
$2,979.00
|
| Rate for Payer: Cigna of CA HMO |
$4,236.80
|
| Rate for Payer: Cigna of CA PPO |
$4,898.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,065.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,604.99
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,634.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,598.23
|
| Rate for Payer: EPIC Health Plan Senior |
$5,065.49
|
| Rate for Payer: Galaxy Health WC |
$5,627.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,972.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,552.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,604.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,203.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,428.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,950.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,588.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,802.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,170.69
|
| Rate for Payer: Multiplan Commercial |
$5,296.00
|
| Rate for Payer: Multiplan WC |
$7,144.49
|
| Rate for Payer: Networks By Design Commercial |
$4,303.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,627.00
|
| Rate for Payer: Prime Health Services WC |
$7,071.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,972.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,310.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,310.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,310.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,310.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,604.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,065.49
|
| Rate for Payer: Vantage Medical Group Senior |
$4,604.99
|
|
|
HC BILIARY DRAINAGE CATH CHANGE
|
Facility
|
IP
|
$6,620.00
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
909000147
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,324.00 |
| Max. Negotiated Rate |
$5,627.00 |
| Rate for Payer: Adventist Health Commercial |
$1,324.00
|
| Rate for Payer: Cash Price |
$2,979.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,634.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,648.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,648.00
|
| Rate for Payer: Galaxy Health WC |
$5,627.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,972.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,203.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,905.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,588.80
|
| Rate for Payer: Multiplan Commercial |
$5,296.00
|
| Rate for Payer: Networks By Design Commercial |
$4,303.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,627.00
|
|
