|
HC BRISK PROFILE
|
Facility
|
IP
|
$445.00
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
900912001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$89.00 |
| Max. Negotiated Rate |
$378.25 |
| Rate for Payer: Adventist Health Commercial |
$89.00
|
| Rate for Payer: Cash Price |
$200.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$178.00
|
| Rate for Payer: EPIC Health Plan Senior |
$178.00
|
| Rate for Payer: Galaxy Health WC |
$378.25
|
| Rate for Payer: Global Benefits Group Commercial |
$267.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$296.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$169.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$275.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$106.80
|
| Rate for Payer: Multiplan Commercial |
$356.00
|
| Rate for Payer: Networks By Design Commercial |
$289.25
|
| Rate for Payer: Prime Health Services Commercial |
$378.25
|
|
|
HC BRISK PROFILE
|
Facility
|
OP
|
$156.00
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
900912001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$19.99 |
| Max. Negotiated Rate |
$180.27 |
| Rate for Payer: Adventist Health Commercial |
$31.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$102.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$180.27
|
| Rate for Payer: Blue Shield of California Commercial |
$104.36
|
| Rate for Payer: Blue Shield of California EPN |
$68.95
|
| Rate for Payer: Cash Price |
$70.20
|
| Rate for Payer: Cash Price |
$70.20
|
| Rate for Payer: Cigna of CA HMO |
$99.84
|
| Rate for Payer: Cigna of CA PPO |
$115.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.63
|
| Rate for Payer: EPIC Health Plan Senior |
$24.91
|
| Rate for Payer: Galaxy Health WC |
$132.60
|
| Rate for Payer: Global Benefits Group Commercial |
$93.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$40.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$104.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.38
|
| Rate for Payer: Multiplan Commercial |
$124.80
|
| Rate for Payer: Networks By Design Commercial |
$101.40
|
| Rate for Payer: Prime Health Services Commercial |
$132.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$93.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$93.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.18
|
| Rate for Payer: United Healthcare All Other HMO |
$20.18
|
| Rate for Payer: United Healthcare HMO Rider |
$20.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.18
|
| Rate for Payer: Upland Medical Group Pediatric |
$24.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.40
|
| Rate for Payer: Vantage Medical Group Senior |
$24.91
|
|
|
HC BRONCH COMTR AIDED NAVIGATION
|
Facility
|
IP
|
$1,338.00
|
|
|
Service Code
|
CPT 31627
|
| Hospital Charge Code |
900531627
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$267.60 |
| Max. Negotiated Rate |
$1,137.30 |
| Rate for Payer: Adventist Health Commercial |
$267.60
|
| Rate for Payer: Cash Price |
$602.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$535.20
|
| Rate for Payer: EPIC Health Plan Senior |
$535.20
|
| Rate for Payer: Galaxy Health WC |
$1,137.30
|
| Rate for Payer: Global Benefits Group Commercial |
$802.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$892.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$509.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$828.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.12
|
| Rate for Payer: Multiplan Commercial |
$1,070.40
|
| Rate for Payer: Networks By Design Commercial |
$869.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,137.30
|
|
|
HC BRONCH COMTR AIDED NAVIGATION
|
Facility
|
OP
|
$1,338.00
|
|
|
Service Code
|
CPT 31627
|
| Hospital Charge Code |
900531627
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$267.60 |
| Max. Negotiated Rate |
$6,906.11 |
| Rate for Payer: Adventist Health Commercial |
$267.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,137.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$735.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,003.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$602.10
|
| Rate for Payer: Cash Price |
$602.10
|
| Rate for Payer: Cash Price |
$602.10
|
| Rate for Payer: Cigna of CA HMO |
$856.32
|
| Rate for Payer: Cigna of CA PPO |
$990.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,137.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,137.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,137.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$535.20
|
| Rate for Payer: EPIC Health Plan Senior |
$535.20
|
| Rate for Payer: Galaxy Health WC |
$1,137.30
|
| Rate for Payer: Global Benefits Group Commercial |
$802.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,816.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$892.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,054.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$828.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$936.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$936.60
|
| Rate for Payer: Multiplan Commercial |
$1,070.40
|
| Rate for Payer: Networks By Design Commercial |
$869.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,137.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$802.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,137.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,137.30
|
| Rate for Payer: Vantage Medical Group Senior |
$1,137.30
|
|
|
HC BRONCH EBUS PERIPHERAL LESION
|
Facility
|
OP
|
$3,281.00
|
|
|
Service Code
|
CPT 31654
|
| Hospital Charge Code |
900831654
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$216.42 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$656.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,788.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,804.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,460.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$1,476.45
|
| Rate for Payer: Cash Price |
$1,476.45
|
| Rate for Payer: Cash Price |
$1,476.45
|
| Rate for Payer: Cigna of CA HMO |
$2,099.84
|
| Rate for Payer: Cigna of CA PPO |
$2,427.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,788.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,788.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,788.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,312.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,312.40
|
| Rate for Payer: Galaxy Health WC |
$2,788.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,968.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$216.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,188.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$244.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,030.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$787.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,296.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,296.70
|
| Rate for Payer: Multiplan Commercial |
$2,624.80
|
| Rate for Payer: Networks By Design Commercial |
$2,132.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,788.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,968.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,788.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,788.85
|
| Rate for Payer: Vantage Medical Group Senior |
$2,788.85
|
|
|
HC BRONCH EBUS PERIPHERAL LESION
|
Facility
|
IP
|
$3,281.00
|
|
|
Service Code
|
CPT 31654
|
| Hospital Charge Code |
900831654
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$656.20 |
| Max. Negotiated Rate |
$2,788.85 |
| Rate for Payer: Adventist Health Commercial |
$656.20
|
| Rate for Payer: Cash Price |
$1,476.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,312.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,312.40
|
| Rate for Payer: Galaxy Health WC |
$2,788.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,968.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,188.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,250.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,030.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$787.44
|
| Rate for Payer: Multiplan Commercial |
$2,624.80
|
| Rate for Payer: Networks By Design Commercial |
$2,132.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,788.85
|
|
|
HC BRONCH EBUS SAMP 1-2 NODES
|
Facility
|
IP
|
$5,322.00
|
|
|
Service Code
|
CPT 31652
|
| Hospital Charge Code |
900831652
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,064.40 |
| Max. Negotiated Rate |
$4,523.70 |
| Rate for Payer: Adventist Health Commercial |
$1,064.40
|
| Rate for Payer: Cash Price |
$2,394.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,128.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,128.80
|
| Rate for Payer: Galaxy Health WC |
$4,523.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,193.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,549.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,027.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,294.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,277.28
|
| Rate for Payer: Multiplan Commercial |
$4,257.60
|
| Rate for Payer: Networks By Design Commercial |
$3,459.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,523.70
|
|
|
HC BRONCH EBUS SAMP 1-2 NODES
|
Facility
|
OP
|
$5,322.00
|
|
|
Service Code
|
CPT 31652
|
| Hospital Charge Code |
900831652
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,064.40 |
| Max. Negotiated Rate |
$16,122.00 |
| Rate for Payer: Adventist Health Commercial |
$1,064.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,153.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,684.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,470.08
|
| Rate for Payer: Cash Price |
$2,394.90
|
| Rate for Payer: Cash Price |
$2,394.90
|
| Rate for Payer: Cash Price |
$2,394.90
|
| Rate for Payer: Cigna of CA HMO |
$3,406.08
|
| Rate for Payer: Cigna of CA PPO |
$3,938.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,153.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,684.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,324.26
|
| Rate for Payer: EPIC Health Plan Senior |
$4,684.64
|
| Rate for Payer: Galaxy Health WC |
$4,523.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,193.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,682.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,389.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,684.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,549.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,571.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,684.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,277.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,902.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,277.42
|
| Rate for Payer: Multiplan Commercial |
$4,257.60
|
| Rate for Payer: Multiplan WC |
$7,464.14
|
| Rate for Payer: Networks By Design Commercial |
$3,459.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,523.70
|
| Rate for Payer: Prime Health Services WC |
$7,387.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,193.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,984.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,684.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,153.10
|
| Rate for Payer: Vantage Medical Group Senior |
$4,684.64
|
|
|
HC BRONCH EBUS SAMP 3 GT NODES
|
Facility
|
IP
|
$5,322.00
|
|
|
Service Code
|
CPT 31653
|
| Hospital Charge Code |
900831653
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,064.40 |
| Max. Negotiated Rate |
$4,523.70 |
| Rate for Payer: Adventist Health Commercial |
$1,064.40
|
| Rate for Payer: Cash Price |
$2,394.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,128.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,128.80
|
| Rate for Payer: Galaxy Health WC |
$4,523.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,193.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,549.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,027.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,294.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,277.28
|
| Rate for Payer: Multiplan Commercial |
$4,257.60
|
| Rate for Payer: Networks By Design Commercial |
$3,459.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,523.70
|
|
|
HC BRONCH EBUS SAMP 3 GT NODES
|
Facility
|
OP
|
$5,322.00
|
|
|
Service Code
|
CPT 31653
|
| Hospital Charge Code |
900831653
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,064.40 |
| Max. Negotiated Rate |
$16,122.00 |
| Rate for Payer: Adventist Health Commercial |
$1,064.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,153.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,684.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,470.08
|
| Rate for Payer: Cash Price |
$2,394.90
|
| Rate for Payer: Cash Price |
$2,394.90
|
| Rate for Payer: Cash Price |
$2,394.90
|
| Rate for Payer: Cigna of CA HMO |
$3,406.08
|
| Rate for Payer: Cigna of CA PPO |
$3,938.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,153.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,684.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,324.26
|
| Rate for Payer: EPIC Health Plan Senior |
$4,684.64
|
| Rate for Payer: Galaxy Health WC |
$4,523.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,193.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,682.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,475.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,684.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,549.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,668.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,684.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,277.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,902.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,277.42
|
| Rate for Payer: Multiplan Commercial |
$4,257.60
|
| Rate for Payer: Multiplan WC |
$7,464.14
|
| Rate for Payer: Networks By Design Commercial |
$3,459.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,523.70
|
| Rate for Payer: Prime Health Services WC |
$7,387.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,193.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,984.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,684.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,153.10
|
| Rate for Payer: Vantage Medical Group Senior |
$4,684.64
|
|
|
HC BRONCH FOREIGN BODY REMOVAL
|
Facility
|
OP
|
$4,482.00
|
|
|
Service Code
|
CPT 31635
|
| Hospital Charge Code |
900803505
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$350.26 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Adventist Health Commercial |
$896.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,410.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,191.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Cash Price |
$2,016.90
|
| Rate for Payer: Cash Price |
$2,016.90
|
| Rate for Payer: Cash Price |
$2,016.90
|
| Rate for Payer: Cigna of CA HMO |
$2,868.48
|
| Rate for Payer: Cigna of CA PPO |
$3,316.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,410.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,191.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,958.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,191.11
|
| Rate for Payer: Galaxy Health WC |
$3,809.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,689.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,593.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$350.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,191.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,989.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$396.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,191.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,075.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,760.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,936.09
|
| Rate for Payer: Multiplan Commercial |
$3,585.60
|
| Rate for Payer: Networks By Design Commercial |
$2,913.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,809.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,689.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,689.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,241.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,241.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,241.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,241.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,191.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,410.22
|
| Rate for Payer: Vantage Medical Group Senior |
$2,191.11
|
|
|
HC BRONCH FOREIGN BODY REMOVAL
|
Facility
|
IP
|
$4,482.00
|
|
|
Service Code
|
CPT 31635
|
| Hospital Charge Code |
900803505
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$896.40 |
| Max. Negotiated Rate |
$3,809.70 |
| Rate for Payer: Adventist Health Commercial |
$896.40
|
| Rate for Payer: Cash Price |
$2,016.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,792.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,792.80
|
| Rate for Payer: Galaxy Health WC |
$3,809.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,689.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,989.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,707.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,774.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,075.68
|
| Rate for Payer: Multiplan Commercial |
$3,585.60
|
| Rate for Payer: Networks By Design Commercial |
$2,913.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,809.70
|
|
|
HC BRONCHIAL THERMOPLASTY 1 LOBE
|
Facility
|
IP
|
$8,193.00
|
|
|
Service Code
|
CPT 31660
|
| Hospital Charge Code |
900831660
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,638.60 |
| Max. Negotiated Rate |
$6,964.05 |
| Rate for Payer: Adventist Health Commercial |
$1,638.60
|
| Rate for Payer: Cash Price |
$3,686.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,277.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,277.20
|
| Rate for Payer: Galaxy Health WC |
$6,964.05
|
| Rate for Payer: Global Benefits Group Commercial |
$4,915.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,464.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,121.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,071.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,966.32
|
| Rate for Payer: Multiplan Commercial |
$6,554.40
|
| Rate for Payer: Networks By Design Commercial |
$5,325.45
|
| Rate for Payer: Prime Health Services Commercial |
$6,964.05
|
|
|
HC BRONCHIAL THERMOPLASTY 1 LOBE
|
Facility
|
OP
|
$8,193.00
|
|
|
Service Code
|
CPT 31660
|
| Hospital Charge Code |
900831660
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$313.35 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$1,638.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,193.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,675.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,795.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,470.08
|
| Rate for Payer: Cash Price |
$3,686.85
|
| Rate for Payer: Cash Price |
$3,686.85
|
| Rate for Payer: Cash Price |
$3,686.85
|
| Rate for Payer: Cigna of CA HMO |
$5,243.52
|
| Rate for Payer: Cigna of CA PPO |
$6,062.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,193.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,675.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,795.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,874.18
|
| Rate for Payer: EPIC Health Plan Senior |
$8,795.69
|
| Rate for Payer: Galaxy Health WC |
$6,964.05
|
| Rate for Payer: Global Benefits Group Commercial |
$4,915.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,424.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$313.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,795.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,464.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$354.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,795.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,966.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,082.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,786.22
|
| Rate for Payer: Multiplan Commercial |
$6,554.40
|
| Rate for Payer: Multiplan WC |
$14,014.35
|
| Rate for Payer: Networks By Design Commercial |
$5,325.45
|
| Rate for Payer: Prime Health Services Commercial |
$6,964.05
|
| Rate for Payer: Prime Health Services WC |
$13,871.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,915.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| 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 |
$8,795.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,193.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,675.26
|
| Rate for Payer: Vantage Medical Group Senior |
$8,795.69
|
|
|
HC BRONCHIAL THERMOPLASTY 2+ LOBES
|
Facility
|
OP
|
$8,193.00
|
|
|
Service Code
|
CPT 31661
|
| Hospital Charge Code |
900831661
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$330.24 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$1,638.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,193.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,675.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,795.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,822.94
|
| Rate for Payer: Cash Price |
$3,686.85
|
| Rate for Payer: Cash Price |
$3,686.85
|
| Rate for Payer: Cash Price |
$3,686.85
|
| Rate for Payer: Cigna of CA HMO |
$5,243.52
|
| Rate for Payer: Cigna of CA PPO |
$6,062.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,193.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,675.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,795.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,874.18
|
| Rate for Payer: EPIC Health Plan Senior |
$8,795.69
|
| Rate for Payer: Galaxy Health WC |
$6,964.05
|
| Rate for Payer: Global Benefits Group Commercial |
$4,915.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,424.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$330.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,795.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,464.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$373.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,795.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,966.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,082.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,786.22
|
| Rate for Payer: Multiplan Commercial |
$6,554.40
|
| Rate for Payer: Multiplan WC |
$14,014.35
|
| Rate for Payer: Networks By Design Commercial |
$5,325.45
|
| Rate for Payer: Prime Health Services Commercial |
$6,964.05
|
| Rate for Payer: Prime Health Services WC |
$13,871.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,915.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| 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 |
$8,795.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,193.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,675.26
|
| Rate for Payer: Vantage Medical Group Senior |
$8,795.69
|
|
|
HC BRONCHIAL THERMOPLASTY 2+ LOBES
|
Facility
|
IP
|
$8,193.00
|
|
|
Service Code
|
CPT 31661
|
| Hospital Charge Code |
900831661
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,638.60 |
| Max. Negotiated Rate |
$6,964.05 |
| Rate for Payer: Adventist Health Commercial |
$1,638.60
|
| Rate for Payer: Cash Price |
$3,686.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,277.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,277.20
|
| Rate for Payer: Galaxy Health WC |
$6,964.05
|
| Rate for Payer: Global Benefits Group Commercial |
$4,915.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,464.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,121.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,071.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,966.32
|
| Rate for Payer: Multiplan Commercial |
$6,554.40
|
| Rate for Payer: Networks By Design Commercial |
$5,325.45
|
| Rate for Payer: Prime Health Services Commercial |
$6,964.05
|
|
|
HC BRONCHOGRAM BILAT
|
Facility
|
IP
|
$1,058.00
|
|
|
Service Code
|
CPT 71060
|
| Hospital Charge Code |
909001451
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$211.60 |
| Max. Negotiated Rate |
$899.30 |
| Rate for Payer: Adventist Health Commercial |
$211.60
|
| Rate for Payer: Cash Price |
$476.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$423.20
|
| Rate for Payer: EPIC Health Plan Senior |
$423.20
|
| Rate for Payer: Galaxy Health WC |
$899.30
|
| Rate for Payer: Global Benefits Group Commercial |
$634.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$705.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$403.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$654.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.92
|
| Rate for Payer: Multiplan Commercial |
$846.40
|
| Rate for Payer: Networks By Design Commercial |
$687.70
|
| Rate for Payer: Prime Health Services Commercial |
$899.30
|
|
|
HC BRONCHOGRAM BILAT
|
Facility
|
OP
|
$1,058.00
|
|
|
Service Code
|
CPT 71060
|
| Hospital Charge Code |
909001451
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$211.60 |
| Max. Negotiated Rate |
$899.30 |
| Rate for Payer: Adventist Health Commercial |
$211.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$693.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$899.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$581.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$793.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$649.72
|
| Rate for Payer: Blue Shield of California Commercial |
$647.50
|
| Rate for Payer: Blue Shield of California EPN |
$427.43
|
| Rate for Payer: Cash Price |
$476.10
|
| Rate for Payer: Cigna of CA HMO |
$677.12
|
| Rate for Payer: Cigna of CA PPO |
$782.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$899.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$899.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$899.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$423.20
|
| Rate for Payer: EPIC Health Plan Senior |
$423.20
|
| Rate for Payer: Galaxy Health WC |
$899.30
|
| Rate for Payer: Global Benefits Group Commercial |
$634.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$705.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$403.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$654.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$740.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$740.60
|
| Rate for Payer: Multiplan Commercial |
$846.40
|
| Rate for Payer: Networks By Design Commercial |
$687.70
|
| Rate for Payer: Prime Health Services Commercial |
$899.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$634.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$634.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$529.00
|
| Rate for Payer: United Healthcare All Other HMO |
$529.00
|
| Rate for Payer: United Healthcare HMO Rider |
$529.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$529.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$899.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$899.30
|
| Rate for Payer: Vantage Medical Group Senior |
$899.30
|
|
|
HC BRONCHOGRAM UNILAT
|
Facility
|
IP
|
$1,058.00
|
|
|
Service Code
|
CPT 71040
|
| Hospital Charge Code |
909001477
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$211.60 |
| Max. Negotiated Rate |
$899.30 |
| Rate for Payer: Adventist Health Commercial |
$211.60
|
| Rate for Payer: Cash Price |
$476.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$423.20
|
| Rate for Payer: EPIC Health Plan Senior |
$423.20
|
| Rate for Payer: Galaxy Health WC |
$899.30
|
| Rate for Payer: Global Benefits Group Commercial |
$634.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$705.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$403.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$654.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.92
|
| Rate for Payer: Multiplan Commercial |
$846.40
|
| Rate for Payer: Networks By Design Commercial |
$687.70
|
| Rate for Payer: Prime Health Services Commercial |
$899.30
|
|
|
HC BRONCHOGRAM UNILAT
|
Facility
|
OP
|
$1,058.00
|
|
|
Service Code
|
CPT 71040
|
| Hospital Charge Code |
909001477
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$211.60 |
| Max. Negotiated Rate |
$899.30 |
| Rate for Payer: Adventist Health Commercial |
$211.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$693.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$899.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$581.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$793.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$649.72
|
| Rate for Payer: Blue Shield of California Commercial |
$647.50
|
| Rate for Payer: Blue Shield of California EPN |
$427.43
|
| Rate for Payer: Cash Price |
$476.10
|
| Rate for Payer: Cigna of CA HMO |
$677.12
|
| Rate for Payer: Cigna of CA PPO |
$782.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$899.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$899.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$899.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$423.20
|
| Rate for Payer: EPIC Health Plan Senior |
$423.20
|
| Rate for Payer: Galaxy Health WC |
$899.30
|
| Rate for Payer: Global Benefits Group Commercial |
$634.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$705.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$403.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$654.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$740.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$740.60
|
| Rate for Payer: Multiplan Commercial |
$846.40
|
| Rate for Payer: Networks By Design Commercial |
$687.70
|
| Rate for Payer: Prime Health Services Commercial |
$899.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$634.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$634.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$529.00
|
| Rate for Payer: United Healthcare All Other HMO |
$529.00
|
| Rate for Payer: United Healthcare HMO Rider |
$529.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$529.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$899.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$899.30
|
| Rate for Payer: Vantage Medical Group Senior |
$899.30
|
|
|
HC BRONCHOSCOPY W BRONCH ALVEOLAR
|
Facility
|
OP
|
$5,568.00
|
|
|
Service Code
|
CPT 31624
|
| Hospital Charge Code |
900803502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$358.39 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$1,113.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,410.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,191.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,470.08
|
| Rate for Payer: Cash Price |
$2,505.60
|
| Rate for Payer: Cash Price |
$2,505.60
|
| Rate for Payer: Cash Price |
$2,505.60
|
| Rate for Payer: Cigna of CA HMO |
$3,563.52
|
| Rate for Payer: Cigna of CA PPO |
$4,120.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,410.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,191.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,958.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,191.11
|
| Rate for Payer: Galaxy Health WC |
$4,732.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,340.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,593.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$358.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,191.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,713.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$405.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,191.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,336.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,760.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,936.09
|
| Rate for Payer: Multiplan Commercial |
$4,454.40
|
| Rate for Payer: Multiplan WC |
$3,491.15
|
| Rate for Payer: Networks By Design Commercial |
$3,619.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,732.80
|
| Rate for Payer: Prime Health Services WC |
$3,455.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,340.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| 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 |
$2,191.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,410.22
|
| Rate for Payer: Vantage Medical Group Senior |
$2,191.11
|
|
|
HC BRONCHOSCOPY W BRONCH ALVEOLAR
|
Facility
|
IP
|
$5,568.00
|
|
|
Service Code
|
CPT 31624
|
| Hospital Charge Code |
900803502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,113.60 |
| Max. Negotiated Rate |
$4,732.80 |
| Rate for Payer: Adventist Health Commercial |
$1,113.60
|
| Rate for Payer: Cash Price |
$2,505.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,227.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,227.20
|
| Rate for Payer: Galaxy Health WC |
$4,732.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,340.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,713.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,121.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,446.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,336.32
|
| Rate for Payer: Multiplan Commercial |
$4,454.40
|
| Rate for Payer: Networks By Design Commercial |
$3,619.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,732.80
|
|
|
HC BRONCHOSCOPY W/RMVL OF F.B.
|
Facility
|
OP
|
$4,718.00
|
|
|
Service Code
|
CPT 31635
|
| Hospital Charge Code |
900501509
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$396.13 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Adventist Health Commercial |
$943.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,410.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,191.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Cash Price |
$2,123.10
|
| Rate for Payer: Cash Price |
$2,123.10
|
| Rate for Payer: Cash Price |
$2,123.10
|
| Rate for Payer: Cigna of CA HMO |
$3,019.52
|
| Rate for Payer: Cigna of CA PPO |
$3,491.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,410.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,191.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,958.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,191.11
|
| Rate for Payer: Galaxy Health WC |
$4,010.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,830.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,593.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,191.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,146.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$396.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,191.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,132.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,760.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,936.09
|
| Rate for Payer: Multiplan Commercial |
$3,774.40
|
| Rate for Payer: Multiplan WC |
$3,491.15
|
| Rate for Payer: Networks By Design Commercial |
$3,066.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,010.30
|
| Rate for Payer: Prime Health Services WC |
$3,455.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,830.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,359.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,359.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,359.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,359.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,191.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,410.22
|
| Rate for Payer: Vantage Medical Group Senior |
$2,191.11
|
|
|
HC BRONCHOSCOPY W/RMVL OF F.B.
|
Facility
|
IP
|
$4,718.00
|
|
|
Service Code
|
CPT 31635
|
| Hospital Charge Code |
900501509
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$943.60 |
| Max. Negotiated Rate |
$4,010.30 |
| Rate for Payer: Adventist Health Commercial |
$943.60
|
| Rate for Payer: Cash Price |
$2,123.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,887.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,887.20
|
| Rate for Payer: Galaxy Health WC |
$4,010.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,830.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,146.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,797.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,920.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,132.32
|
| Rate for Payer: Multiplan Commercial |
$3,774.40
|
| Rate for Payer: Networks By Design Commercial |
$3,066.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,010.30
|
|
|
HC BRONCH-RADIOELEMENT PLACEMENT
|
Facility
|
IP
|
$3,351.00
|
|
|
Service Code
|
CPT 31643
|
| Hospital Charge Code |
900803506
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$670.20 |
| Max. Negotiated Rate |
$2,848.35 |
| Rate for Payer: Adventist Health Commercial |
$670.20
|
| Rate for Payer: Cash Price |
$1,507.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,340.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,340.40
|
| Rate for Payer: Galaxy Health WC |
$2,848.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,010.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,235.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,276.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,074.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$804.24
|
| Rate for Payer: Multiplan Commercial |
$2,680.80
|
| Rate for Payer: Networks By Design Commercial |
$2,178.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,848.35
|
|
