|
HC IDR CORDIS VISTA BRITE TIPN
|
Facility
|
OP
|
$5,293.00
|
|
|
Service Code
|
CPT 0220T
|
| Hospital Charge Code |
909010220
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$542.56 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$13,086.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,499.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,911.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,911.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,175.80
|
| Rate for Payer: Blue Shield of California Commercial |
$833.61
|
| Rate for Payer: Blue Shield of California EPN |
$542.56
|
| Rate for Payer: Cash Price |
$2,381.85
|
| Rate for Payer: Cash Price |
$2,381.85
|
| Rate for Payer: Cigna of CA PPO |
$3,916.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,499.05
|
| Rate for Payer: Dignity Health Media |
$4,499.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,499.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,117.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,117.20
|
| Rate for Payer: Galaxy Health WC |
$4,499.05
|
| Rate for Payer: Global Benefits Group Commercial |
$3,175.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,969.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,530.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,016.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,270.32
|
| Rate for Payer: Multiplan Commercial |
$4,234.40
|
| Rate for Payer: Networks By Design Commercial |
$3,440.45
|
| Rate for Payer: Prime Health Services Commercial |
$4,499.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,175.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,499.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,499.05
|
| Rate for Payer: Vantage Medical Group Senior |
$4,499.05
|
|
|
HC I&D RECTAL ABSCESS
|
Facility
|
OP
|
$10,485.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
900501335
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$339.53 |
| Max. Negotiated Rate |
$9,590.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,291.00
|
| Rate for Payer: Cash Price |
$4,718.25
|
| Rate for Payer: Cash Price |
$4,718.25
|
| Rate for Payer: Cash Price |
$4,718.25
|
| Rate for Payer: Cigna of CA PPO |
$7,758.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Dignity Health Media |
$1,474.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,621.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Galaxy Health WC |
$8,912.25
|
| Rate for Payer: Global Benefits Group Commercial |
$6,291.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,863.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,418.05
|
| Rate for Payer: Heritage Provider Network Transplant |
$2,418.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,474.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,993.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$339.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,516.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,857.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Multiplan Commercial |
$8,388.00
|
| Rate for Payer: Networks By Design Commercial |
$6,815.25
|
| Rate for Payer: Prime Health Services Commercial |
$8,912.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,291.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,242.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,242.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,242.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,242.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC I&D RECTAL ABSCESS
|
Facility
|
IP
|
$10,485.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
900501335
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,516.40 |
| Max. Negotiated Rate |
$8,912.25 |
| Rate for Payer: Cash Price |
$4,718.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,194.00
|
| Rate for Payer: Galaxy Health WC |
$8,912.25
|
| Rate for Payer: Global Benefits Group Commercial |
$6,291.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,993.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,994.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,516.40
|
| Rate for Payer: Multiplan Commercial |
$8,388.00
|
| Rate for Payer: Networks By Design Commercial |
$6,815.25
|
| Rate for Payer: Prime Health Services Commercial |
$8,912.25
|
|
|
HC I & D THYROGLOSSAL DUCT CYST
|
Facility
|
OP
|
$3,545.00
|
|
|
Service Code
|
CPT 60000
|
| Hospital Charge Code |
900501674
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$128.74 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,858.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,095.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,905.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,127.00
|
| Rate for Payer: Cash Price |
$1,595.25
|
| Rate for Payer: Cash Price |
$1,595.25
|
| Rate for Payer: Cash Price |
$1,595.25
|
| Rate for Payer: Cigna of CA PPO |
$2,623.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,858.16
|
| Rate for Payer: Dignity Health Media |
$1,905.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,095.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,572.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,905.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,905.44
|
| Rate for Payer: Galaxy Health WC |
$3,013.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,127.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,658.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,124.92
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,124.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,905.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,364.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$128.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,905.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$850.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,400.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,553.29
|
| Rate for Payer: Multiplan Commercial |
$2,836.00
|
| Rate for Payer: Networks By Design Commercial |
$2,304.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,013.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,127.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,772.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,772.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,772.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,772.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,858.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,095.98
|
| Rate for Payer: Vantage Medical Group Senior |
$1,905.44
|
|
|
HC I & D THYROGLOSSAL DUCT CYST
|
Facility
|
IP
|
$3,545.00
|
|
|
Service Code
|
CPT 60000
|
| Hospital Charge Code |
900501674
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$850.80 |
| Max. Negotiated Rate |
$3,013.25 |
| Rate for Payer: Cash Price |
$1,595.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,418.00
|
| Rate for Payer: Galaxy Health WC |
$3,013.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,127.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,364.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,350.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$850.80
|
| Rate for Payer: Multiplan Commercial |
$2,836.00
|
| Rate for Payer: Networks By Design Commercial |
$2,304.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,013.25
|
|
|
HC I & D VAGINAL HEMATOMA
|
Facility
|
IP
|
$5,166.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
902400747
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,239.84 |
| Max. Negotiated Rate |
$4,391.10 |
| Rate for Payer: Cash Price |
$2,324.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,066.40
|
| Rate for Payer: Galaxy Health WC |
$4,391.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,099.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,445.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,968.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,239.84
|
| Rate for Payer: Multiplan Commercial |
$4,132.80
|
| Rate for Payer: Networks By Design Commercial |
$3,357.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,391.10
|
|
|
HC I & D VAGINAL HEMATOMA
|
Facility
|
OP
|
$5,166.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
902400747
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$552.00 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,325.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,905.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,550.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,099.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,807.34
|
| Rate for Payer: Blue Shield of California EPN |
$3,016.94
|
| Rate for Payer: Cash Price |
$2,324.70
|
| Rate for Payer: Cash Price |
$2,324.70
|
| Rate for Payer: Cash Price |
$2,324.70
|
| Rate for Payer: Cigna of CA HMO |
$3,306.24
|
| Rate for Payer: Cigna of CA PPO |
$3,822.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,325.39
|
| Rate for Payer: Dignity Health Media |
$3,550.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,905.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,792.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,550.26
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,550.26
|
| Rate for Payer: Galaxy Health WC |
$4,391.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,099.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,874.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,822.43
|
| Rate for Payer: Heritage Provider Network Transplant |
$5,822.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5,751.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$5,751.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,550.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,445.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,968.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,550.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,239.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,473.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,757.35
|
| Rate for Payer: Multiplan Commercial |
$4,132.80
|
| Rate for Payer: Networks By Design Commercial |
$3,357.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,391.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,099.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,099.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,036.00
|
| Rate for Payer: United Healthcare All Other HMO |
$799.00
|
| Rate for Payer: United Healthcare HMO Rider |
$605.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$552.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,325.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,905.29
|
| Rate for Payer: Vantage Medical Group Senior |
$3,550.26
|
|
|
HC I & D VAGINAL HEMATOMA
|
Facility
|
OP
|
$5,166.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
902400747
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$936.00 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,325.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,905.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,550.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,099.60
|
| Rate for Payer: Cash Price |
$2,324.70
|
| Rate for Payer: Cash Price |
$2,324.70
|
| Rate for Payer: Cash Price |
$2,324.70
|
| Rate for Payer: Cigna of CA PPO |
$3,822.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,325.39
|
| Rate for Payer: Dignity Health Media |
$3,550.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,905.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,792.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,550.26
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,550.26
|
| Rate for Payer: Galaxy Health WC |
$4,391.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,099.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,874.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,822.43
|
| Rate for Payer: Heritage Provider Network Transplant |
$5,822.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,550.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,445.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,968.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,550.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,239.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,473.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,757.35
|
| Rate for Payer: Multiplan Commercial |
$4,132.80
|
| Rate for Payer: Networks By Design Commercial |
$3,357.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,391.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,099.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,583.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,583.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,583.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,583.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,325.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,905.29
|
| Rate for Payer: Vantage Medical Group Senior |
$3,550.26
|
|
|
HC I & D VAGINAL HEMATOMA
|
Facility
|
IP
|
$5,166.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
902400747
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,239.84 |
| Max. Negotiated Rate |
$4,391.10 |
| Rate for Payer: Cash Price |
$2,324.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,066.40
|
| Rate for Payer: Galaxy Health WC |
$4,391.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,099.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,445.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,968.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,239.84
|
| Rate for Payer: Multiplan Commercial |
$4,132.80
|
| Rate for Payer: Networks By Design Commercial |
$3,357.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,391.10
|
|
|
HC IHC EACH ADDL SINGLE MULTI PER SPEC MEDI
|
Facility
|
IP
|
$676.00
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
903800243
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$162.24 |
| Max. Negotiated Rate |
$574.60 |
| Rate for Payer: Cash Price |
$304.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$270.40
|
| Rate for Payer: Galaxy Health WC |
$574.60
|
| Rate for Payer: Global Benefits Group Commercial |
$405.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$450.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$257.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.24
|
| Rate for Payer: Multiplan Commercial |
$540.80
|
| Rate for Payer: Networks By Design Commercial |
$439.40
|
| Rate for Payer: Prime Health Services Commercial |
$574.60
|
|
|
HC IHC EACH ADDL SINGLE MULTI PER SPEC MEDI
|
Facility
|
OP
|
$676.00
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
903800243
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$162.24 |
| Max. Negotiated Rate |
$736.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$491.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$494.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$449.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$681.74
|
| Rate for Payer: Blue Distinction Transplant |
$405.60
|
| Rate for Payer: Blue Shield of California Commercial |
$436.70
|
| Rate for Payer: Blue Shield of California EPN |
$346.11
|
| Rate for Payer: Cash Price |
$304.20
|
| Rate for Payer: Cash Price |
$304.20
|
| Rate for Payer: Cigna of CA HMO |
$432.64
|
| Rate for Payer: Cigna of CA PPO |
$500.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.66
|
| Rate for Payer: Dignity Health Media |
$449.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$494.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$606.30
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$449.11
|
| Rate for Payer: EPIC Health Plan Transplant |
$449.11
|
| Rate for Payer: Galaxy Health WC |
$574.60
|
| Rate for Payer: Global Benefits Group Commercial |
$405.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$507.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$736.54
|
| Rate for Payer: Heritage Provider Network Transplant |
$736.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$727.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$727.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$449.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$450.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$199.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$449.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$565.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$601.81
|
| Rate for Payer: Multiplan Commercial |
$540.80
|
| Rate for Payer: Networks By Design Commercial |
$439.40
|
| Rate for Payer: Prime Health Services Commercial |
$574.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$405.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$405.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.94
|
| Rate for Payer: United Healthcare All Other HMO |
$240.94
|
| Rate for Payer: United Healthcare HMO Rider |
$240.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$494.02
|
| Rate for Payer: Vantage Medical Group Senior |
$449.11
|
|
|
HC IHC FIRST SINGLE MULTI PER SPEC MEDI
|
Facility
|
OP
|
$546.00
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
903800242
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$86.98 |
| Max. Negotiated Rate |
$464.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$399.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$320.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$234.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$213.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$86.98
|
| Rate for Payer: Blue Distinction Transplant |
$327.60
|
| Rate for Payer: Blue Shield of California Commercial |
$352.72
|
| Rate for Payer: Blue Shield of California EPN |
$279.55
|
| Rate for Payer: Cash Price |
$245.70
|
| Rate for Payer: Cash Price |
$245.70
|
| Rate for Payer: Cigna of CA HMO |
$349.44
|
| Rate for Payer: Cigna of CA PPO |
$404.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$320.12
|
| Rate for Payer: Dignity Health Media |
$213.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$234.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$288.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$213.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$213.41
|
| Rate for Payer: Galaxy Health WC |
$464.10
|
| Rate for Payer: Global Benefits Group Commercial |
$327.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$409.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$349.99
|
| Rate for Payer: Heritage Provider Network Transplant |
$349.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$345.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$345.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$213.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$364.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$213.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$131.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$268.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$285.97
|
| Rate for Payer: Multiplan Commercial |
$436.80
|
| Rate for Payer: Networks By Design Commercial |
$354.90
|
| Rate for Payer: Prime Health Services Commercial |
$464.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$327.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$327.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$320.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$234.75
|
| Rate for Payer: Vantage Medical Group Senior |
$213.41
|
|
|
HC IHC FIRST SINGLE MULTI PER SPEC MEDI
|
Facility
|
IP
|
$546.00
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
903800242
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$131.04 |
| Max. Negotiated Rate |
$464.10 |
| Rate for Payer: Cash Price |
$245.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$218.40
|
| Rate for Payer: Galaxy Health WC |
$464.10
|
| Rate for Payer: Global Benefits Group Commercial |
$327.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$364.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$208.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$131.04
|
| Rate for Payer: Multiplan Commercial |
$436.80
|
| Rate for Payer: Networks By Design Commercial |
$354.90
|
| Rate for Payer: Prime Health Services Commercial |
$464.10
|
|
|
HC ILAC ART ANGIO CARDIAC CATH
|
Facility
|
IP
|
$2,852.00
|
|
|
Service Code
|
CPT G0278
|
| Hospital Charge Code |
906811387
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$684.48 |
| Max. Negotiated Rate |
$2,424.20 |
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,140.80
|
| Rate for Payer: Galaxy Health WC |
$2,424.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,711.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,902.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,086.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$684.48
|
| Rate for Payer: Multiplan Commercial |
$2,281.60
|
| Rate for Payer: Networks By Design Commercial |
$1,853.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,424.20
|
|
|
HC ILAC ART ANGIO CARDIAC CATH
|
Facility
|
OP
|
$2,852.00
|
|
|
Service Code
|
CPT G0278
|
| Hospital Charge Code |
906811387
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$77.38 |
| Max. Negotiated Rate |
$2,424.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$77.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,424.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,568.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,568.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$85.81
|
| Rate for Payer: Blue Distinction Transplant |
$1,711.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,685.53
|
| Rate for Payer: Blue Shield of California EPN |
$1,337.59
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cigna of CA HMO |
$1,825.28
|
| Rate for Payer: Cigna of CA PPO |
$2,110.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,424.20
|
| Rate for Payer: Dignity Health Media |
$2,424.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,424.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,140.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,140.80
|
| Rate for Payer: Galaxy Health WC |
$2,424.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,711.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,139.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,902.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,086.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$684.48
|
| Rate for Payer: Multiplan Commercial |
$2,281.60
|
| Rate for Payer: Networks By Design Commercial |
$1,853.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,424.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,711.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,711.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,426.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,426.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,426.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,426.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,424.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,424.20
|
| Rate for Payer: Vantage Medical Group Senior |
$2,424.20
|
|
|
HC ILEOSCOPY STOMA W BX
|
Facility
|
OP
|
$4,558.00
|
|
|
Service Code
|
CPT 44382
|
| Hospital Charge Code |
906744382
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$207.25 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,734.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$2,051.10
|
| Rate for Payer: Cash Price |
$2,051.10
|
| Rate for Payer: Cigna of CA PPO |
$3,372.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$3,874.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,734.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,418.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,857.45
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,834.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$1,834.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,040.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$207.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,093.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,427.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$3,646.40
|
| Rate for Payer: Networks By Design Commercial |
$2,962.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,874.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,734.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,359.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC ILEOSCOPY STOMA W BX
|
Facility
|
IP
|
$7,178.00
|
|
|
Service Code
|
CPT 44382
|
| Hospital Charge Code |
906744382
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,722.72 |
| Max. Negotiated Rate |
$6,101.30 |
| Rate for Payer: Cash Price |
$3,230.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,871.20
|
| Rate for Payer: Galaxy Health WC |
$6,101.30
|
| Rate for Payer: Global Benefits Group Commercial |
$4,306.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,787.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,734.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,722.72
|
| Rate for Payer: Multiplan Commercial |
$5,742.40
|
| Rate for Payer: Networks By Design Commercial |
$4,665.70
|
| Rate for Payer: Prime Health Services Commercial |
$6,101.30
|
|
|
HC ILEOSCOPY STOMA W WO COLLECT
|
Facility
|
OP
|
$4,558.00
|
|
|
Service Code
|
CPT 44380
|
| Hospital Charge Code |
906744380
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$159.87 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,734.80
|
| Rate for Payer: Cash Price |
$2,051.10
|
| Rate for Payer: Cash Price |
$2,051.10
|
| Rate for Payer: Cash Price |
$2,051.10
|
| Rate for Payer: Cigna of CA PPO |
$3,372.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$3,874.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,734.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,418.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,857.45
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,040.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$159.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,093.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,427.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$3,646.40
|
| Rate for Payer: Networks By Design Commercial |
$2,962.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,874.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,734.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,279.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,279.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,279.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,279.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC ILEOSCOPY STOMA W WO COLLECT
|
Facility
|
OP
|
$4,558.00
|
|
|
Service Code
|
CPT 44380
|
| Hospital Charge Code |
906744380
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$159.87 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,734.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$2,051.10
|
| Rate for Payer: Cash Price |
$2,051.10
|
| Rate for Payer: Cigna of CA PPO |
$3,372.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$3,874.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,734.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,418.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,857.45
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,834.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$1,834.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,040.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$159.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,093.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,427.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$3,646.40
|
| Rate for Payer: Networks By Design Commercial |
$2,962.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,874.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,734.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,359.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC ILEOSCOPY STOMA W WO COLLECT
|
Facility
|
IP
|
$7,178.00
|
|
|
Service Code
|
CPT 44380
|
| Hospital Charge Code |
906744380
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,722.72 |
| Max. Negotiated Rate |
$6,101.30 |
| Rate for Payer: Cash Price |
$3,230.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,871.20
|
| Rate for Payer: Galaxy Health WC |
$6,101.30
|
| Rate for Payer: Global Benefits Group Commercial |
$4,306.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,787.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,734.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,722.72
|
| Rate for Payer: Multiplan Commercial |
$5,742.40
|
| Rate for Payer: Networks By Design Commercial |
$4,665.70
|
| Rate for Payer: Prime Health Services Commercial |
$6,101.30
|
|
|
HC ILEOSCOPY STOMA W WO COLLECT
|
Facility
|
IP
|
$7,178.00
|
|
|
Service Code
|
CPT 44380
|
| Hospital Charge Code |
906744380
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,722.72 |
| Max. Negotiated Rate |
$6,101.30 |
| Rate for Payer: Cash Price |
$3,230.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,871.20
|
| Rate for Payer: Galaxy Health WC |
$6,101.30
|
| Rate for Payer: Global Benefits Group Commercial |
$4,306.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,787.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,734.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,722.72
|
| Rate for Payer: Multiplan Commercial |
$5,742.40
|
| Rate for Payer: Networks By Design Commercial |
$4,665.70
|
| Rate for Payer: Prime Health Services Commercial |
$6,101.30
|
|
|
HC ILEOSCOPY W/STNT PLCMNT
|
Facility
|
OP
|
$7,192.00
|
|
|
Service Code
|
CPT 44384
|
| Hospital Charge Code |
906744384
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,726.08 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,377.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,315.20
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$3,236.40
|
| Rate for Payer: Cash Price |
$3,236.40
|
| Rate for Payer: Cigna of CA PPO |
$5,322.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Dignity Health Media |
$2,377.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,615.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,209.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,377.45
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,377.45
|
| Rate for Payer: Galaxy Health WC |
$6,113.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,315.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,394.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,899.02
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,899.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3,851.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$3,851.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,377.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,797.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,377.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,726.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,995.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,185.78
|
| Rate for Payer: Multiplan Commercial |
$5,753.60
|
| Rate for Payer: Networks By Design Commercial |
$4,674.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,113.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,315.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,852.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: Vantage Medical Group Senior |
$2,377.45
|
|
|
HC ILEOSCOPY W/STNT PLCMNT
|
Facility
|
IP
|
$11,328.00
|
|
|
Service Code
|
CPT 44384
|
| Hospital Charge Code |
906744384
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,718.72 |
| Max. Negotiated Rate |
$9,628.80 |
| Rate for Payer: Cash Price |
$5,097.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,531.20
|
| Rate for Payer: Galaxy Health WC |
$9,628.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,796.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,555.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,315.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,718.72
|
| Rate for Payer: Multiplan Commercial |
$9,062.40
|
| Rate for Payer: Networks By Design Commercial |
$7,363.20
|
| Rate for Payer: Prime Health Services Commercial |
$9,628.80
|
|
|
HC IMAGE GUIDED FLUID COLL DRAIN CATH RETRO/PERITONEAL, PERC
|
Facility
|
IP
|
$3,831.00
|
|
|
Service Code
|
CPT 49406
|
| Hospital Charge Code |
900100011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$919.44 |
| Max. Negotiated Rate |
$3,256.35 |
| Rate for Payer: Cash Price |
$1,723.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,532.40
|
| Rate for Payer: Galaxy Health WC |
$3,256.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,298.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,555.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,459.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$919.44
|
| Rate for Payer: Multiplan Commercial |
$3,064.80
|
| Rate for Payer: Networks By Design Commercial |
$2,490.15
|
| Rate for Payer: Prime Health Services Commercial |
$3,256.35
|
|
|
HC IMAGE GUIDED FLUID COLL DRAIN CATH RETRO/PERITONEAL, PERC
|
Facility
|
OP
|
$3,831.00
|
|
|
Service Code
|
CPT 49406
|
| Hospital Charge Code |
900100011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$350.15 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,298.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$1,723.95
|
| Rate for Payer: Cash Price |
$1,723.95
|
| Rate for Payer: Cigna of CA PPO |
$2,834.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Dignity Health Media |
$2,025.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
| Rate for Payer: Galaxy Health WC |
$3,256.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,298.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,873.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,322.13
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,322.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3,281.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$3,281.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,555.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$350.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$919.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,552.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
| Rate for Payer: Multiplan Commercial |
$3,064.80
|
| Rate for Payer: Networks By Design Commercial |
$2,490.15
|
| Rate for Payer: Prime Health Services Commercial |
$3,256.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,298.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
