|
HC LHC, CORONARY ANGIO, W/WO LV
|
Facility
|
OP
|
$20,116.00
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
906811405
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,800.00 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$12,942.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,375.00
|
| Rate for Payer: Blue Distinction Transplant |
$12,069.60
|
| Rate for Payer: Blue Shield of California Commercial |
$8,058.23
|
| Rate for Payer: Blue Shield of California EPN |
$5,244.75
|
| Rate for Payer: Cash Price |
$9,052.20
|
| Rate for Payer: Cash Price |
$9,052.20
|
| Rate for Payer: Cash Price |
$9,052.20
|
| Rate for Payer: Cigna of CA PPO |
$14,885.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Dignity Health Media |
$4,071.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,478.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$17,098.60
|
| Rate for Payer: Global Benefits Group Commercial |
$12,069.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$15,087.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,677.03
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,677.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$6,595.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$6,595.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,071.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,417.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,805.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,827.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,129.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$16,092.80
|
| Rate for Payer: Networks By Design Commercial |
$13,075.40
|
| Rate for Payer: Prime Health Services Commercial |
$17,098.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,069.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC LHC, CORONARY ANGIO, W/WO LV
|
Facility
|
IP
|
$20,116.00
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
906811405
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,827.84 |
| Max. Negotiated Rate |
$17,098.60 |
| Rate for Payer: Cash Price |
$9,052.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,046.40
|
| Rate for Payer: Galaxy Health WC |
$17,098.60
|
| Rate for Payer: Global Benefits Group Commercial |
$12,069.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,417.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,664.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,827.84
|
| Rate for Payer: Multiplan Commercial |
$16,092.80
|
| Rate for Payer: Networks By Design Commercial |
$13,075.40
|
| Rate for Payer: Prime Health Services Commercial |
$17,098.60
|
|
|
HC LIFESTREAM LAB STEM CELL DONOR
|
Facility
|
OP
|
$151.00
|
|
|
Service Code
|
CPT 38204
|
| Hospital Charge Code |
907702206
|
|
Hospital Revenue Code
|
819
|
| Min. Negotiated Rate |
$36.24 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$621.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$128.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$83.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$90.60
|
| Rate for Payer: Blue Shield of California Commercial |
$111.29
|
| Rate for Payer: Blue Shield of California EPN |
$88.18
|
| Rate for Payer: Cash Price |
$67.95
|
| Rate for Payer: Cash Price |
$67.95
|
| Rate for Payer: Cigna of CA HMO |
$96.64
|
| Rate for Payer: Cigna of CA PPO |
$111.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$128.35
|
| Rate for Payer: Dignity Health Media |
$128.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$128.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$60.40
|
| Rate for Payer: Galaxy Health WC |
$128.35
|
| Rate for Payer: Global Benefits Group Commercial |
$90.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$113.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$100.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.24
|
| Rate for Payer: Multiplan Commercial |
$120.80
|
| Rate for Payer: Networks By Design Commercial |
$98.15
|
| Rate for Payer: Prime Health Services Commercial |
$128.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$90.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$90.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$75.50
|
| Rate for Payer: United Healthcare All Other HMO |
$75.50
|
| Rate for Payer: United Healthcare HMO Rider |
$75.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$75.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$128.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$128.35
|
| Rate for Payer: Vantage Medical Group Senior |
$128.35
|
|
|
HC LIFESTREAM LAB STEM CELL DONOR
|
Facility
|
IP
|
$151.00
|
|
|
Service Code
|
CPT 38204
|
| Hospital Charge Code |
907702206
|
|
Hospital Revenue Code
|
819
|
| Min. Negotiated Rate |
$36.24 |
| Max. Negotiated Rate |
$128.35 |
| Rate for Payer: Cash Price |
$67.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.40
|
| Rate for Payer: Galaxy Health WC |
$128.35
|
| Rate for Payer: Global Benefits Group Commercial |
$90.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$100.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.24
|
| Rate for Payer: Multiplan Commercial |
$120.80
|
| Rate for Payer: Networks By Design Commercial |
$98.15
|
| Rate for Payer: Prime Health Services Commercial |
$128.35
|
|
|
HC LIFESTREAM LAB STEM CELL RECIPIENT
|
Facility
|
OP
|
$151.00
|
|
|
Service Code
|
CPT 38204
|
| Hospital Charge Code |
907702207
|
|
Hospital Revenue Code
|
819
|
| Min. Negotiated Rate |
$36.24 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$621.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$128.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$83.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$90.60
|
| Rate for Payer: Blue Shield of California Commercial |
$111.29
|
| Rate for Payer: Blue Shield of California EPN |
$88.18
|
| Rate for Payer: Cash Price |
$67.95
|
| Rate for Payer: Cash Price |
$67.95
|
| Rate for Payer: Cigna of CA HMO |
$96.64
|
| Rate for Payer: Cigna of CA PPO |
$111.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$128.35
|
| Rate for Payer: Dignity Health Media |
$128.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$128.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$60.40
|
| Rate for Payer: Galaxy Health WC |
$128.35
|
| Rate for Payer: Global Benefits Group Commercial |
$90.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$113.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$100.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.24
|
| Rate for Payer: Multiplan Commercial |
$120.80
|
| Rate for Payer: Networks By Design Commercial |
$98.15
|
| Rate for Payer: Prime Health Services Commercial |
$128.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$90.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$90.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$75.50
|
| Rate for Payer: United Healthcare All Other HMO |
$75.50
|
| Rate for Payer: United Healthcare HMO Rider |
$75.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$75.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$128.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$128.35
|
| Rate for Payer: Vantage Medical Group Senior |
$128.35
|
|
|
HC LIFESTREAM LAB STEM CELL RECIPIENT
|
Facility
|
IP
|
$151.00
|
|
|
Service Code
|
CPT 38204
|
| Hospital Charge Code |
907702207
|
|
Hospital Revenue Code
|
819
|
| Min. Negotiated Rate |
$36.24 |
| Max. Negotiated Rate |
$128.35 |
| Rate for Payer: Cash Price |
$67.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.40
|
| Rate for Payer: Galaxy Health WC |
$128.35
|
| Rate for Payer: Global Benefits Group Commercial |
$90.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$100.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.24
|
| Rate for Payer: Multiplan Commercial |
$120.80
|
| Rate for Payer: Networks By Design Commercial |
$98.15
|
| Rate for Payer: Prime Health Services Commercial |
$128.35
|
|
|
HC LIGATION/BIOPSY,TEMP ARTERY
|
Facility
|
IP
|
$7,123.00
|
|
|
Service Code
|
CPT 37609
|
| Hospital Charge Code |
900501523
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,709.52 |
| Max. Negotiated Rate |
$6,054.55 |
| Rate for Payer: Cash Price |
$3,205.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,849.20
|
| Rate for Payer: Galaxy Health WC |
$6,054.55
|
| Rate for Payer: Global Benefits Group Commercial |
$4,273.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,751.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,713.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,709.52
|
| Rate for Payer: Multiplan Commercial |
$5,698.40
|
| Rate for Payer: Networks By Design Commercial |
$4,629.95
|
| Rate for Payer: Prime Health Services Commercial |
$6,054.55
|
|
|
HC LIGATION/BIOPSY,TEMP ARTERY
|
Facility
|
OP
|
$7,123.00
|
|
|
Service Code
|
CPT 37609
|
| Hospital Charge Code |
900501523
|
|
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 |
$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 |
$4,273.80
|
| Rate for Payer: Cash Price |
$3,205.35
|
| Rate for Payer: Cash Price |
$3,205.35
|
| Rate for Payer: Cash Price |
$3,205.35
|
| Rate for Payer: Cigna of CA PPO |
$5,271.02
|
| 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 |
$6,054.55
|
| Rate for Payer: Global Benefits Group Commercial |
$4,273.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,342.25
|
| 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 |
$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 |
$2,025.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,751.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,709.52
|
| 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 |
$5,698.40
|
| Rate for Payer: Networks By Design Commercial |
$4,629.95
|
| Rate for Payer: Prime Health Services Commercial |
$6,054.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,273.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,561.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,561.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,561.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,561.50
|
| 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
|
|
|
HC LIGATION DIV/EXC VARICOSEVEIN
|
Facility
|
OP
|
$13,116.00
|
|
|
Service Code
|
CPT 37785
|
| Hospital Charge Code |
900501325
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$357.92 |
| Max. Negotiated Rate |
$11,148.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
| Rate for Payer: Blue Distinction Transplant |
$7,869.60
|
| Rate for Payer: Cash Price |
$5,902.20
|
| Rate for Payer: Cash Price |
$5,902.20
|
| Rate for Payer: Cash Price |
$5,902.20
|
| Rate for Payer: Cigna of CA PPO |
$9,705.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$11,148.60
|
| Rate for Payer: Global Benefits Group Commercial |
$7,869.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9,837.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,531.38
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,531.38
|
| 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 |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,748.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$357.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,147.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$10,492.80
|
| Rate for Payer: Networks By Design Commercial |
$8,525.40
|
| Rate for Payer: Prime Health Services Commercial |
$11,148.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,869.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,558.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6,558.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6,558.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,558.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC LIGATION DIV/EXC VARICOSEVEIN
|
Facility
|
IP
|
$13,116.00
|
|
|
Service Code
|
CPT 37785
|
| Hospital Charge Code |
900501325
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,147.84 |
| Max. Negotiated Rate |
$11,148.60 |
| Rate for Payer: Cash Price |
$5,902.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,246.40
|
| Rate for Payer: Galaxy Health WC |
$11,148.60
|
| Rate for Payer: Global Benefits Group Commercial |
$7,869.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,748.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,997.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,147.84
|
| Rate for Payer: Multiplan Commercial |
$10,492.80
|
| Rate for Payer: Networks By Design Commercial |
$8,525.40
|
| Rate for Payer: Prime Health Services Commercial |
$11,148.60
|
|
|
HC LIGATION HEMORRHOID(S)
|
Facility
|
OP
|
$2,244.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
906746221
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$146.43 |
| 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 |
$1,712.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,346.40
|
| Rate for Payer: Cash Price |
$1,009.80
|
| Rate for Payer: Cash Price |
$1,009.80
|
| Rate for Payer: Cash Price |
$1,009.80
|
| Rate for Payer: Cigna of CA PPO |
$1,660.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Dignity Health Media |
$1,141.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,256.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$1,907.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,346.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,683.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,872.77
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,872.77
|
| 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 |
$1,141.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,496.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$146.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$538.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,438.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$1,795.20
|
| Rate for Payer: Networks By Design Commercial |
$1,458.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,907.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,346.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,122.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,122.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC LIGATION HEMORRHOID(S)
|
Facility
|
OP
|
$2,244.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
906746221
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$146.43 |
| 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 |
$1,712.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,346.40
|
| 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 |
$1,009.80
|
| Rate for Payer: Cash Price |
$1,009.80
|
| Rate for Payer: Cigna of CA PPO |
$1,660.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Dignity Health Media |
$1,141.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,256.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$1,907.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,346.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,683.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,872.77
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,872.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,849.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$1,849.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,141.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,496.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$146.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$538.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,438.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$1,795.20
|
| Rate for Payer: Networks By Design Commercial |
$1,458.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,907.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,346.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,370.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC LIGATION HEMORRHOID(S)
|
Facility
|
IP
|
$5,078.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
906746221
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,218.72 |
| Max. Negotiated Rate |
$4,316.30 |
| Rate for Payer: Cash Price |
$2,285.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,031.20
|
| Rate for Payer: Galaxy Health WC |
$4,316.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,046.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,387.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,934.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,218.72
|
| Rate for Payer: Multiplan Commercial |
$4,062.40
|
| Rate for Payer: Networks By Design Commercial |
$3,300.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,316.30
|
|
|
HC LIGATION HEMORRHOID(S)
|
Facility
|
IP
|
$5,078.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
906746221
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,218.72 |
| Max. Negotiated Rate |
$4,316.30 |
| Rate for Payer: Cash Price |
$2,285.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,031.20
|
| Rate for Payer: Galaxy Health WC |
$4,316.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,046.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,387.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,934.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,218.72
|
| Rate for Payer: Multiplan Commercial |
$4,062.40
|
| Rate for Payer: Networks By Design Commercial |
$3,300.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,316.30
|
|
|
HC LIGATION OF NECK ARTERY
|
Facility
|
IP
|
$5,001.00
|
|
|
Service Code
|
CPT 37615
|
| Hospital Charge Code |
900501435
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,200.24 |
| Max. Negotiated Rate |
$4,250.85 |
| Rate for Payer: Cash Price |
$2,250.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,000.40
|
| Rate for Payer: Galaxy Health WC |
$4,250.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,000.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,335.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,905.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,200.24
|
| Rate for Payer: Multiplan Commercial |
$4,000.80
|
| Rate for Payer: Networks By Design Commercial |
$3,250.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,250.85
|
|
|
HC LIGATION OF NECK ARTERY
|
Facility
|
OP
|
$5,001.00
|
|
|
Service Code
|
CPT 37615
|
| Hospital Charge Code |
900501435
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$936.00 |
| Max. Negotiated Rate |
$7,282.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,000.60
|
| Rate for Payer: Cash Price |
$2,250.45
|
| Rate for Payer: Cash Price |
$2,250.45
|
| Rate for Payer: Cash Price |
$2,250.45
|
| Rate for Payer: Cigna of CA PPO |
$3,700.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$4,250.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,000.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,750.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,531.38
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,531.38
|
| 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 |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,335.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,200.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$4,000.80
|
| Rate for Payer: Networks By Design Commercial |
$3,250.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,250.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,000.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,500.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,500.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,500.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,500.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC LIPASE
|
Facility
|
OP
|
$26.00
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
900910334
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.58 |
| Max. Negotiated Rate |
$62.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$57.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.78
|
| Rate for Payer: Blue Distinction Transplant |
$15.60
|
| Rate for Payer: Blue Shield of California Commercial |
$16.80
|
| Rate for Payer: Blue Shield of California EPN |
$13.31
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cigna of CA HMO |
$16.64
|
| Rate for Payer: Cigna of CA PPO |
$19.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.34
|
| Rate for Payer: Dignity Health Media |
$6.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.30
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6.89
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.89
|
| Rate for Payer: Galaxy Health WC |
$22.10
|
| Rate for Payer: Global Benefits Group Commercial |
$15.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$19.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.30
|
| Rate for Payer: Heritage Provider Network Transplant |
$11.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$11.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.23
|
| Rate for Payer: Multiplan Commercial |
$20.80
|
| Rate for Payer: Networks By Design Commercial |
$16.90
|
| Rate for Payer: Prime Health Services Commercial |
$22.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.58
|
| Rate for Payer: United Healthcare All Other HMO |
$5.58
|
| Rate for Payer: United Healthcare HMO Rider |
$5.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Vantage Medical Group Senior |
$6.89
|
|
|
HC LIPASE BODY FLUID
|
Facility
|
OP
|
$17.00
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
900912244
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.08 |
| Max. Negotiated Rate |
$62.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$57.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.78
|
| Rate for Payer: Blue Distinction Transplant |
$10.20
|
| Rate for Payer: Blue Shield of California Commercial |
$10.98
|
| Rate for Payer: Blue Shield of California EPN |
$8.70
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cigna of CA HMO |
$10.88
|
| Rate for Payer: Cigna of CA PPO |
$12.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.34
|
| Rate for Payer: Dignity Health Media |
$6.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.30
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6.89
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.89
|
| Rate for Payer: Galaxy Health WC |
$14.45
|
| Rate for Payer: Global Benefits Group Commercial |
$10.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$12.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.30
|
| Rate for Payer: Heritage Provider Network Transplant |
$11.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$11.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.23
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
| Rate for Payer: Networks By Design Commercial |
$11.05
|
| Rate for Payer: Prime Health Services Commercial |
$14.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.58
|
| Rate for Payer: United Healthcare All Other HMO |
$5.58
|
| Rate for Payer: United Healthcare HMO Rider |
$5.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Vantage Medical Group Senior |
$6.89
|
|
|
HC LIPID PANEL MC
|
Facility
|
OP
|
$28.00
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
900912170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.72 |
| Max. Negotiated Rate |
$122.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$111.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.08
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$122.17
|
| Rate for Payer: Blue Distinction Transplant |
$16.80
|
| Rate for Payer: Blue Shield of California Commercial |
$18.09
|
| Rate for Payer: Blue Shield of California EPN |
$14.34
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Cigna of CA HMO |
$17.92
|
| Rate for Payer: Cigna of CA PPO |
$20.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.08
|
| Rate for Payer: Dignity Health Media |
$13.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.08
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.39
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.39
|
| Rate for Payer: Galaxy Health WC |
$23.80
|
| Rate for Payer: Global Benefits Group Commercial |
$16.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$21.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$21.96
|
| Rate for Payer: Heritage Provider Network Transplant |
$21.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$21.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$21.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.94
|
| Rate for Payer: Multiplan Commercial |
$22.40
|
| Rate for Payer: Networks By Design Commercial |
$18.20
|
| Rate for Payer: Prime Health Services Commercial |
$23.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.84
|
| Rate for Payer: United Healthcare All Other HMO |
$10.84
|
| Rate for Payer: United Healthcare HMO Rider |
$10.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.73
|
| Rate for Payer: Vantage Medical Group Senior |
$13.39
|
|
|
HC LITHIUM
|
Facility
|
OP
|
$26.00
|
|
|
Service Code
|
CPT 80178
|
| Hospital Charge Code |
900910332
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.36 |
| Max. Negotiated Rate |
$60.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$54.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$60.26
|
| Rate for Payer: Blue Distinction Transplant |
$15.60
|
| Rate for Payer: Blue Shield of California Commercial |
$16.80
|
| Rate for Payer: Blue Shield of California EPN |
$13.31
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cigna of CA HMO |
$16.64
|
| Rate for Payer: Cigna of CA PPO |
$19.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.92
|
| Rate for Payer: Dignity Health Media |
$6.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6.61
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.61
|
| Rate for Payer: Galaxy Health WC |
$22.10
|
| Rate for Payer: Global Benefits Group Commercial |
$15.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$19.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.84
|
| Rate for Payer: Heritage Provider Network Transplant |
$10.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$10.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.86
|
| Rate for Payer: Multiplan Commercial |
$20.80
|
| Rate for Payer: Networks By Design Commercial |
$16.90
|
| Rate for Payer: Prime Health Services Commercial |
$22.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.36
|
| Rate for Payer: United Healthcare All Other HMO |
$5.36
|
| Rate for Payer: United Healthcare HMO Rider |
$5.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.27
|
| Rate for Payer: Vantage Medical Group Senior |
$6.61
|
|
|
HC LIVER BIOPSY PERCUTANEOUS
|
Facility
|
OP
|
$5,008.00
|
|
|
Service Code
|
CPT 47000
|
| Hospital Charge Code |
909000140
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$319.73 |
| 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 |
$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 |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,004.80
|
| 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 |
$2,253.60
|
| Rate for Payer: Cash Price |
$2,253.60
|
| Rate for Payer: Cigna of CA PPO |
$3,705.92
|
| 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 |
$4,256.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,004.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,756.00
|
| 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 |
$3,340.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$319.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,201.92
|
| 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 |
$4,006.40
|
| Rate for Payer: Networks By Design Commercial |
$3,255.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,256.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,004.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,430.83
|
| 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
|
|
|
HC LIVER BIOPSY PERCUTANEOUS
|
Facility
|
IP
|
$5,008.00
|
|
|
Service Code
|
CPT 47000
|
| Hospital Charge Code |
909000140
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,201.92 |
| Max. Negotiated Rate |
$4,256.80 |
| Rate for Payer: Cash Price |
$2,253.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,003.20
|
| Rate for Payer: Galaxy Health WC |
$4,256.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,004.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,340.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,908.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,201.92
|
| Rate for Payer: Multiplan Commercial |
$4,006.40
|
| Rate for Payer: Networks By Design Commercial |
$3,255.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,256.80
|
|
|
HC LIVER BIOPSY PERCUTANEOUS
|
Facility
|
IP
|
$5,008.00
|
|
|
Service Code
|
CPT 47000
|
| Hospital Charge Code |
909000140
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,201.92 |
| Max. Negotiated Rate |
$4,256.80 |
| Rate for Payer: Cash Price |
$2,253.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,003.20
|
| Rate for Payer: Galaxy Health WC |
$4,256.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,004.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,340.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,908.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,201.92
|
| Rate for Payer: Multiplan Commercial |
$4,006.40
|
| Rate for Payer: Networks By Design Commercial |
$3,255.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,256.80
|
|
|
HC LIVER BIOPSY PERCUTANEOUS
|
Facility
|
OP
|
$5,008.00
|
|
|
Service Code
|
CPT 47000
|
| Hospital Charge Code |
909000140
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$319.73 |
| 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 |
$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 |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,004.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,959.73
|
| Rate for Payer: Blue Shield of California EPN |
$2,348.75
|
| Rate for Payer: Cash Price |
$2,253.60
|
| Rate for Payer: Cash Price |
$2,253.60
|
| Rate for Payer: Cigna of CA HMO |
$3,205.12
|
| Rate for Payer: Cigna of CA PPO |
$3,705.92
|
| 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 |
$4,256.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,004.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,756.00
|
| 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 |
$3,340.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$319.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,201.92
|
| 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 |
$4,006.40
|
| Rate for Payer: Networks By Design Commercial |
$3,255.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,256.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,004.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,004.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,504.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,504.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,504.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,504.00
|
| 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
|
|
|
HC LIVER BIOPSY W OTHER PROC
|
Facility
|
IP
|
$629.00
|
|
|
Service Code
|
CPT 47001
|
| Hospital Charge Code |
909000141
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$150.96 |
| Max. Negotiated Rate |
$534.65 |
| Rate for Payer: Cash Price |
$283.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$251.60
|
| Rate for Payer: Galaxy Health WC |
$534.65
|
| Rate for Payer: Global Benefits Group Commercial |
$377.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$419.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$239.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.96
|
| Rate for Payer: Multiplan Commercial |
$503.20
|
| Rate for Payer: Networks By Design Commercial |
$408.85
|
| Rate for Payer: Prime Health Services Commercial |
$534.65
|
|
