|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,735.10
|
| 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 Foundation Hospitals Commercial/Self Funded |
$5,202.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,833.87
|
| 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 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,897.60
|
| 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 Foundation Hospitals Commercial/Self Funded |
$3,535.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,285.12
|
| 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 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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,113.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,289.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| 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 |
$3,433.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,518.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,289.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,897.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,777.26
|
| Rate for Payer: EPIC Health Plan Senior |
$2,518.18
|
| 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/Senior |
$3,754.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$358.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,289.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,535.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$405.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,204.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,336.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,884.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,067.59
|
| 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 |
$2,784.00
|
| 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 |
$2,289.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Vantage Medical Group Senior |
$2,289.25
|
|
|
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: Networks By Design Commercial |
$3,066.70
|
| Rate for Payer: Adventist Health Commercial |
$943.60
|
| Rate for Payer: Cash Price |
$2,123.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,302.60
|
| 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 Foundation Hospitals Commercial/Self Funded |
$2,995.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,783.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,132.32
|
| Rate for Payer: Multiplan Commercial |
$3,774.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,010.30
|
|
|
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 |
$6,716.00 |
| Rate for Payer: Adventist Health Commercial |
$943.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,289.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| 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 |
$3,433.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,518.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,289.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,302.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,777.26
|
| Rate for Payer: EPIC Health Plan Senior |
$2,518.18
|
| 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/Senior |
$3,754.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,289.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,995.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$396.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,460.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,132.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,884.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,067.59
|
| 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 |
$2,289.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Vantage Medical Group Senior |
$2,289.25
|
|
|
HC BRONCH-RADIOELEMENT PLACEMENT
|
Facility
|
OP
|
$3,351.00
|
|
|
Service Code
|
CPT 31643
|
| Hospital Charge Code |
900803506
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$302.10 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Vantage Medical Group Senior |
$2,289.25
|
| Rate for Payer: Adventist Health Commercial |
$670.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,086.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,289.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$1,507.95
|
| Rate for Payer: Cash Price |
$1,507.95
|
| Rate for Payer: Cash Price |
$1,507.95
|
| Rate for Payer: Cigna of CA HMO |
$2,144.64
|
| Rate for Payer: Cigna of CA PPO |
$2,479.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,518.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,289.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,345.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,777.26
|
| Rate for Payer: EPIC Health Plan Senior |
$2,518.18
|
| Rate for Payer: Galaxy Health WC |
$2,848.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,010.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,754.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$302.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,289.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,127.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$341.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,204.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$804.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,884.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,067.59
|
| 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
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,010.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,010.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,675.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,675.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,675.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,675.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,289.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,518.18
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,345.70
|
| 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 Foundation Hospitals Commercial/Self Funded |
$2,127.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,977.09
|
| 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
|
|
|
HC BRONCH W BLLN OCC ADD LOBES
|
Facility
|
IP
|
$3,654.00
|
|
|
Service Code
|
CPT 31651
|
| Hospital Charge Code |
900831651
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$730.80 |
| Max. Negotiated Rate |
$3,105.90 |
| Rate for Payer: Adventist Health Commercial |
$730.80
|
| Rate for Payer: Cash Price |
$1,644.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,557.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,461.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,461.60
|
| Rate for Payer: Galaxy Health WC |
$3,105.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,192.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,320.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,155.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$876.96
|
| Rate for Payer: Multiplan Commercial |
$2,923.20
|
| Rate for Payer: Networks By Design Commercial |
$2,375.10
|
| Rate for Payer: Prime Health Services Commercial |
$3,105.90
|
|
|
HC BRONCH W BLLN OCC ADD LOBES
|
Facility
|
OP
|
$3,654.00
|
|
|
Service Code
|
CPT 31651
|
| Hospital Charge Code |
900831651
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$110.07 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$730.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,105.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,009.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,740.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$1,644.30
|
| Rate for Payer: Cash Price |
$1,644.30
|
| Rate for Payer: Cash Price |
$1,644.30
|
| Rate for Payer: Cigna of CA HMO |
$2,338.56
|
| Rate for Payer: Cigna of CA PPO |
$2,703.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,105.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,105.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,105.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,557.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,461.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,461.60
|
| Rate for Payer: Galaxy Health WC |
$3,105.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,192.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$110.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,320.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$124.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,155.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$876.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,557.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,557.80
|
| Rate for Payer: Multiplan Commercial |
$2,923.20
|
| Rate for Payer: Networks By Design Commercial |
$2,375.10
|
| Rate for Payer: Prime Health Services Commercial |
$3,105.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,192.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,827.00
|
| 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 |
$3,105.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,105.90
|
| Rate for Payer: Vantage Medical Group Senior |
$3,105.90
|
|
|
HC BRONCH W/BLLN OCCLUSION
|
Facility
|
IP
|
$3,585.00
|
|
|
Service Code
|
CPT 31634
|
| Hospital Charge Code |
900803513
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$717.00 |
| Max. Negotiated Rate |
$3,047.25 |
| Rate for Payer: Adventist Health Commercial |
$717.00
|
| Rate for Payer: Cash Price |
$1,613.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,509.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,434.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,434.00
|
| Rate for Payer: Galaxy Health WC |
$3,047.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,151.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,276.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,115.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$860.40
|
| Rate for Payer: Multiplan Commercial |
$2,868.00
|
| Rate for Payer: Networks By Design Commercial |
$2,330.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,047.25
|
|
|
HC BRONCH W/BLLN OCCLUSION
|
Facility
|
OP
|
$3,585.00
|
|
|
Service Code
|
CPT 31634
|
| Hospital Charge Code |
900803513
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$292.08 |
| Max. Negotiated Rate |
$14,977.17 |
| Rate for Payer: Adventist Health Commercial |
$717.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,280.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,615.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,984.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,077.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$1,613.25
|
| Rate for Payer: Cash Price |
$1,613.25
|
| Rate for Payer: Cash Price |
$1,613.25
|
| Rate for Payer: Cigna of CA HMO |
$2,294.40
|
| Rate for Payer: Cigna of CA PPO |
$2,652.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,615.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,984.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,077.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,509.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,977.17
|
| Rate for Payer: EPIC Health Plan Senior |
$9,984.78
|
| Rate for Payer: Galaxy Health WC |
$3,047.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,151.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14,886.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$292.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,077.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,276.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$330.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,707.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$860.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,437.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,163.27
|
| Rate for Payer: Multiplan Commercial |
$2,868.00
|
| Rate for Payer: Networks By Design Commercial |
$2,330.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,047.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,151.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,151.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,792.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,792.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,792.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,792.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$9,077.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,615.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,984.78
|
| Rate for Payer: Vantage Medical Group Senior |
$9,077.07
|
|
|
HC BRONCH W PLCMNT FIDUCIAL MRK
|
Facility
|
OP
|
$9,755.00
|
|
|
Service Code
|
CPT 31626
|
| Hospital Charge Code |
900531626
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$630.47 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,951.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,615.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,984.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,077.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| 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 |
$4,389.75
|
| Rate for Payer: Cash Price |
$4,389.75
|
| Rate for Payer: Cash Price |
$4,389.75
|
| Rate for Payer: Cigna of CA HMO |
$6,243.20
|
| Rate for Payer: Cigna of CA PPO |
$7,218.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,615.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,984.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,077.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,828.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,977.17
|
| Rate for Payer: EPIC Health Plan Senior |
$9,984.78
|
| Rate for Payer: Galaxy Health WC |
$8,291.75
|
| Rate for Payer: Global Benefits Group Commercial |
$5,853.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14,886.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$630.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,077.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,194.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$713.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,707.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,341.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,437.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,163.27
|
| Rate for Payer: Multiplan Commercial |
$7,804.00
|
| Rate for Payer: Multiplan WC |
$14,014.35
|
| Rate for Payer: Networks By Design Commercial |
$6,340.75
|
| Rate for Payer: Prime Health Services Commercial |
$8,291.75
|
| Rate for Payer: Prime Health Services WC |
$13,871.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,853.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,877.50
|
| 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 |
$9,077.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,615.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,984.78
|
| Rate for Payer: Vantage Medical Group Senior |
$9,077.07
|
|
|
HC BRONCH W PLCMNT FIDUCIAL MRK
|
Facility
|
IP
|
$9,755.00
|
|
|
Service Code
|
CPT 31626
|
| Hospital Charge Code |
900531626
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,951.00 |
| Max. Negotiated Rate |
$8,291.75 |
| Rate for Payer: Adventist Health Commercial |
$1,951.00
|
| Rate for Payer: Cash Price |
$4,389.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,828.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,902.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,902.00
|
| Rate for Payer: Galaxy Health WC |
$8,291.75
|
| Rate for Payer: Global Benefits Group Commercial |
$5,853.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,194.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,755.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,341.20
|
| Rate for Payer: Multiplan Commercial |
$7,804.00
|
| Rate for Payer: Networks By Design Commercial |
$6,340.75
|
| Rate for Payer: Prime Health Services Commercial |
$8,291.75
|
|
|
HC BRONCH W/TUMOR EXCISION
|
Facility
|
OP
|
$7,511.00
|
|
|
Service Code
|
CPT 31640
|
| Hospital Charge Code |
900803516
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$354.01 |
| Max. Negotiated Rate |
$7,912.21 |
| Rate for Payer: Adventist Health Commercial |
$1,502.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,606.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,192.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,274.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,795.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$3,379.95
|
| Rate for Payer: Cash Price |
$3,379.95
|
| Rate for Payer: Cash Price |
$3,379.95
|
| Rate for Payer: Cigna of CA HMO |
$4,807.04
|
| Rate for Payer: Cigna of CA PPO |
$5,558.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,192.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,274.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,795.28
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,257.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,912.21
|
| Rate for Payer: EPIC Health Plan Senior |
$5,274.81
|
| Rate for Payer: Galaxy Health WC |
$6,384.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,506.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,864.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$354.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,795.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,769.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$400.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,713.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,802.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,042.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,425.68
|
| Rate for Payer: Multiplan Commercial |
$6,008.80
|
| Rate for Payer: Networks By Design Commercial |
$4,882.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,384.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,506.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,506.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,755.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,755.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,755.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,755.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,795.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,192.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,274.81
|
| Rate for Payer: Vantage Medical Group Senior |
$4,795.28
|
|
|
HC BRONCH W/TUMOR EXCISION
|
Facility
|
IP
|
$7,511.00
|
|
|
Service Code
|
CPT 31640
|
| Hospital Charge Code |
900803516
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,502.20 |
| Max. Negotiated Rate |
$6,384.35 |
| Rate for Payer: Adventist Health Commercial |
$1,502.20
|
| Rate for Payer: Cash Price |
$3,379.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,257.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,004.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,004.40
|
| Rate for Payer: Galaxy Health WC |
$6,384.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,506.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,769.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,431.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,802.64
|
| Rate for Payer: Multiplan Commercial |
$6,008.80
|
| Rate for Payer: Networks By Design Commercial |
$4,882.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,384.35
|
|
|
HC BRUKER AER ID
|
Facility
|
OP
|
$45.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900913001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.54 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: EPIC Health Plan Senior |
$8.89
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Galaxy Health WC |
$38.25
|
| Rate for Payer: Adventist Health Commercial |
$9.00
|
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$67.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$67.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$83.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$83.32
|
| Rate for Payer: Blue Shield of California Commercial |
$20.75
|
| Rate for Payer: Blue Shield of California Commercial |
$31.36
|
| Rate for Payer: Blue Shield of California Commercial |
$23.05
|
| Rate for Payer: Blue Shield of California Commercial |
$34.85
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cigna of CA HMO |
$32.00
|
| Rate for Payer: Cigna of CA HMO |
$28.80
|
| Rate for Payer: Cigna of CA PPO |
$33.30
|
| Rate for Payer: Cigna of CA PPO |
$37.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$31.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.33
|
| Rate for Payer: EPIC Health Plan Senior |
$8.89
|
| Rate for Payer: Global Benefits Group Commercial |
$27.00
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$28.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.83
|
| Rate for Payer: Multiplan Commercial |
$40.00
|
| Rate for Payer: Multiplan Commercial |
$36.00
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Networks By Design Commercial |
$29.25
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
| Rate for Payer: Prime Health Services Commercial |
$38.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.54
|
| Rate for Payer: United Healthcare All Other HMO |
$6.54
|
| Rate for Payer: United Healthcare All Other HMO |
$6.54
|
| Rate for Payer: United Healthcare HMO Rider |
$6.54
|
| Rate for Payer: United Healthcare HMO Rider |
$6.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.54
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Vantage Medical Group Senior |
$8.08
|
| Rate for Payer: Vantage Medical Group Senior |
$8.08
|
|
|
HC BRUKER AER ID
|
Facility
|
IP
|
$50.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900913001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$42.50 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.00
|
| Rate for Payer: EPIC Health Plan Senior |
$20.00
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Multiplan Commercial |
$40.00
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
|
|
HC BRUKER ANA ID
|
Facility
|
OP
|
$35.00
|
|
|
Service Code
|
CPT 87076
|
| Hospital Charge Code |
900913002
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.54 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$15.75
|
| Rate for Payer: Cash Price |
$15.75
|
| Rate for Payer: Cash Price |
$15.75
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cigna of CA HMO |
$38.40
|
| Rate for Payer: Cigna of CA HMO |
$22.40
|
| Rate for Payer: Cigna of CA PPO |
$25.90
|
| Rate for Payer: Cigna of CA PPO |
$44.40
|
| Rate for Payer: Adventist Health Commercial |
$7.00
|
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$67.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$67.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$130.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$130.01
|
| Rate for Payer: Blue Shield of California Commercial |
$16.14
|
| Rate for Payer: Blue Shield of California Commercial |
$24.39
|
| Rate for Payer: Blue Shield of California Commercial |
$27.66
|
| Rate for Payer: Blue Shield of California Commercial |
$41.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$24.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.33
|
| Rate for Payer: EPIC Health Plan Senior |
$8.89
|
| Rate for Payer: EPIC Health Plan Senior |
$8.89
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Galaxy Health WC |
$29.75
|
| Rate for Payer: Global Benefits Group Commercial |
$21.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.83
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Multiplan Commercial |
$28.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Networks By Design Commercial |
$22.75
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
| Rate for Payer: Prime Health Services Commercial |
$29.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.54
|
| Rate for Payer: United Healthcare All Other HMO |
$6.54
|
| Rate for Payer: United Healthcare All Other HMO |
$6.54
|
| Rate for Payer: United Healthcare HMO Rider |
$6.54
|
| Rate for Payer: United Healthcare HMO Rider |
$6.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.54
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Vantage Medical Group Senior |
$8.08
|
| Rate for Payer: Vantage Medical Group Senior |
$8.08
|
|
|
HC BRUKER ANA ID
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
CPT 87076
|
| Hospital Charge Code |
900913002
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.00
|
| Rate for Payer: EPIC Health Plan Senior |
$24.00
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.40
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
|
|
HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
|
Facility
|
OP
|
$792.00
|
|
|
Service Code
|
CPT Z7610
|
| Hospital Charge Code |
900831826
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$673.20 |
| Rate for Payer: Adventist Health Commercial |
$158.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$519.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$594.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$508.23
|
| Rate for Payer: Cash Price |
$356.40
|
| Rate for Payer: Cash Price |
$356.40
|
| Rate for Payer: Cigna of CA HMO |
$506.88
|
| Rate for Payer: Cigna of CA PPO |
$586.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$673.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$673.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$554.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$316.80
|
| Rate for Payer: EPIC Health Plan Senior |
$316.80
|
| Rate for Payer: Galaxy Health WC |
$673.20
|
| Rate for Payer: Global Benefits Group Commercial |
$475.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$502.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$467.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$190.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$554.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$554.40
|
| Rate for Payer: Multiplan Commercial |
$633.60
|
| Rate for Payer: Networks By Design Commercial |
$514.80
|
| Rate for Payer: Prime Health Services Commercial |
$673.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$475.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$475.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$396.00
|
| Rate for Payer: United Healthcare HMO Rider |
$396.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$396.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$673.20
|
| Rate for Payer: Vantage Medical Group Senior |
$673.20
|
|
|
HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
|
Facility
|
IP
|
$792.00
|
|
|
Service Code
|
CPT Z7610
|
| Hospital Charge Code |
900831826
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$158.40 |
| Max. Negotiated Rate |
$673.20 |
| Rate for Payer: Adventist Health Commercial |
$158.40
|
| Rate for Payer: Cash Price |
$356.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$554.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$316.80
|
| Rate for Payer: EPIC Health Plan Senior |
$316.80
|
| Rate for Payer: Galaxy Health WC |
$673.20
|
| Rate for Payer: Global Benefits Group Commercial |
$475.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$502.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$467.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$190.08
|
| Rate for Payer: Multiplan Commercial |
$633.60
|
| Rate for Payer: Networks By Design Commercial |
$514.80
|
| Rate for Payer: Prime Health Services Commercial |
$673.20
|
|
|
HC BTTN MINI 1 12FRX0.8CM BLLN LP
|
Facility
|
OP
|
$941.39
|
|
|
Service Code
|
CPT B4088
|
| Hospital Charge Code |
901696291
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$120.13 |
| Max. Negotiated Rate |
$800.18 |
| Rate for Payer: Adventist Health Commercial |
$188.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$120.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$800.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$517.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$706.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$604.09
|
| Rate for Payer: Cash Price |
$423.63
|
| Rate for Payer: Cash Price |
$423.63
|
| Rate for Payer: Cigna of CA HMO |
$602.49
|
| Rate for Payer: Cigna of CA PPO |
$696.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$800.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$800.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$800.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$658.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.56
|
| Rate for Payer: EPIC Health Plan Senior |
$376.56
|
| Rate for Payer: Galaxy Health WC |
$800.18
|
| Rate for Payer: Global Benefits Group Commercial |
$564.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$597.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$341.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$555.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$658.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$658.97
|
| Rate for Payer: Multiplan Commercial |
$753.11
|
| Rate for Payer: Networks By Design Commercial |
$611.90
|
| Rate for Payer: Prime Health Services Commercial |
$800.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$564.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$564.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$470.69
|
| Rate for Payer: United Healthcare All Other HMO |
$470.69
|
| Rate for Payer: United Healthcare HMO Rider |
$470.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$470.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$800.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$800.18
|
| Rate for Payer: Vantage Medical Group Senior |
$800.18
|
|
|
HC BTTN MINI 1 12FRX0.8CM BLLN LP
|
Facility
|
IP
|
$941.39
|
|
|
Service Code
|
CPT B4088
|
| Hospital Charge Code |
901696291
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$188.28 |
| Max. Negotiated Rate |
$800.18 |
| Rate for Payer: Adventist Health Commercial |
$188.28
|
| Rate for Payer: Cash Price |
$423.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$658.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.56
|
| Rate for Payer: EPIC Health Plan Senior |
$376.56
|
| Rate for Payer: Galaxy Health WC |
$800.18
|
| Rate for Payer: Global Benefits Group Commercial |
$564.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$597.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$555.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.93
|
| Rate for Payer: Multiplan Commercial |
$753.11
|
| Rate for Payer: Networks By Design Commercial |
$611.90
|
| Rate for Payer: Prime Health Services Commercial |
$800.18
|
|
|
HC BTTN MINI 1 12FRX1.0CM BLLN LP
|
Facility
|
OP
|
$941.39
|
|
|
Service Code
|
CPT B4088
|
| Hospital Charge Code |
901696292
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$120.13 |
| Max. Negotiated Rate |
$800.18 |
| Rate for Payer: Adventist Health Commercial |
$188.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$120.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$800.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$517.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$706.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$604.09
|
| Rate for Payer: Cash Price |
$423.63
|
| Rate for Payer: Cash Price |
$423.63
|
| Rate for Payer: Cigna of CA HMO |
$602.49
|
| Rate for Payer: Cigna of CA PPO |
$696.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$800.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$800.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$800.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$658.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.56
|
| Rate for Payer: EPIC Health Plan Senior |
$376.56
|
| Rate for Payer: Galaxy Health WC |
$800.18
|
| Rate for Payer: Global Benefits Group Commercial |
$564.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$597.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$341.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$555.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$658.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$658.97
|
| Rate for Payer: Multiplan Commercial |
$753.11
|
| Rate for Payer: Networks By Design Commercial |
$611.90
|
| Rate for Payer: Prime Health Services Commercial |
$800.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$564.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$564.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$470.69
|
| Rate for Payer: United Healthcare All Other HMO |
$470.69
|
| Rate for Payer: United Healthcare HMO Rider |
$470.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$470.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$800.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$800.18
|
| Rate for Payer: Vantage Medical Group Senior |
$800.18
|
|
|
HC BTTN MINI 1 12FRX1.0CM BLLN LP
|
Facility
|
IP
|
$941.39
|
|
|
Service Code
|
CPT B4088
|
| Hospital Charge Code |
901696292
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$188.28 |
| Max. Negotiated Rate |
$800.18 |
| Rate for Payer: Adventist Health Commercial |
$188.28
|
| Rate for Payer: Cash Price |
$423.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$658.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.56
|
| Rate for Payer: EPIC Health Plan Senior |
$376.56
|
| Rate for Payer: Galaxy Health WC |
$800.18
|
| Rate for Payer: Global Benefits Group Commercial |
$564.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$597.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$555.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.93
|
| Rate for Payer: Multiplan Commercial |
$753.11
|
| Rate for Payer: Networks By Design Commercial |
$611.90
|
| Rate for Payer: Prime Health Services Commercial |
$800.18
|
|
