|
HC ENDOLUMINAL BRUSHING
|
Facility
IP
|
$1,128.00
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
909081376
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$270.72 |
| Max. Negotiated Rate |
$958.80 |
| Rate for Payer: Cash Price |
$507.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$451.20
|
| Rate for Payer: Galaxy Health WC |
$958.80
|
| Rate for Payer: Global Benefits Group Commercial |
$676.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$752.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$429.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$270.72
|
| Rate for Payer: Multiplan Commercial |
$902.40
|
| Rate for Payer: Networks By Design Commercial |
$733.20
|
| Rate for Payer: Prime Health Services Commercial |
$958.80
|
|
|
HC ENDOLUMINAL BRUSHING
|
Facility
IP
|
$1,128.00
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
909081376
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$270.72 |
| Max. Negotiated Rate |
$958.80 |
| Rate for Payer: Cash Price |
$507.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$451.20
|
| Rate for Payer: Galaxy Health WC |
$958.80
|
| Rate for Payer: Global Benefits Group Commercial |
$676.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$752.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$429.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$270.72
|
| Rate for Payer: Multiplan Commercial |
$902.40
|
| Rate for Payer: Networks By Design Commercial |
$733.20
|
| Rate for Payer: Prime Health Services Commercial |
$958.80
|
|
|
HC ENDOLUMINAL BX BILIARY TREE
|
Facility
IP
|
$1,098.00
|
|
|
Service Code
|
CPT 47543
|
| Hospital Charge Code |
909047543
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$263.52 |
| Max. Negotiated Rate |
$933.30 |
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$439.20
|
| Rate for Payer: Galaxy Health WC |
$933.30
|
| Rate for Payer: Global Benefits Group Commercial |
$658.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$732.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$418.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$263.52
|
| Rate for Payer: Multiplan Commercial |
$878.40
|
| Rate for Payer: Networks By Design Commercial |
$713.70
|
| Rate for Payer: Prime Health Services Commercial |
$933.30
|
|
|
HC ENDOLUMINAL BX BILIARY TREE
|
Facility
OP
|
$1,098.00
|
|
|
Service Code
|
CPT 47543
|
| Hospital Charge Code |
909047543
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$263.52 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$933.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$603.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$603.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: BCBS Transplant Transplant |
$658.80
|
| Rate for Payer: Blue Shield of California Commercial |
$4,128.35
|
| Rate for Payer: Blue Shield of California EPN |
$2,686.96
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Cigna of CA PPO |
$812.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$933.30
|
| Rate for Payer: Dignity Health Media |
$933.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$933.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$439.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$439.20
|
| Rate for Payer: Galaxy Health WC |
$933.30
|
| Rate for Payer: Global Benefits Group Commercial |
$658.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$823.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$732.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,325.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$263.52
|
| Rate for Payer: Multiplan Commercial |
$878.40
|
| Rate for Payer: Networks By Design Commercial |
$713.70
|
| Rate for Payer: Prime Health Services Commercial |
$933.30
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$658.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$658.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$933.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$933.30
|
| Rate for Payer: Vantage Medical Group Senior |
$933.30
|
|
|
HC ENDOMETRIAL BIOPSY
|
Facility
OP
|
$684.00
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
900501615
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$77.98 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$373.46
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$273.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$248.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: BCBS Transplant Transplant |
$410.40
|
| Rate for Payer: Cash Price |
$307.80
|
| Rate for Payer: Cash Price |
$307.80
|
| Rate for Payer: Cash Price |
$307.80
|
| Rate for Payer: Cigna of CA PPO |
$506.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$373.46
|
| Rate for Payer: Dignity Health Media |
$248.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$273.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$336.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$248.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$248.97
|
| Rate for Payer: Galaxy Health WC |
$581.40
|
| Rate for Payer: Global Benefits Group Commercial |
$410.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$513.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$408.31
|
| Rate for Payer: Heritage Provider Network Transplant |
$408.31
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$248.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$456.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$248.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$164.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$313.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$333.62
|
| Rate for Payer: Multiplan Commercial |
$547.20
|
| Rate for Payer: Networks By Design Commercial |
$444.60
|
| Rate for Payer: Prime Health Services Commercial |
$581.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$410.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$410.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$342.00
|
| Rate for Payer: United Healthcare All Other HMO |
$342.00
|
| Rate for Payer: United Healthcare HMO Rider |
$342.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$342.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$373.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$273.87
|
| Rate for Payer: Vantage Medical Group Senior |
$248.97
|
|
|
HC ENDOMETRIAL BIOPSY
|
Facility
IP
|
$684.00
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
900501615
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$164.16 |
| Max. Negotiated Rate |
$581.40 |
| Rate for Payer: Cash Price |
$307.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.60
|
| Rate for Payer: Galaxy Health WC |
$581.40
|
| Rate for Payer: Global Benefits Group Commercial |
$410.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$456.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$260.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$164.16
|
| Rate for Payer: Multiplan Commercial |
$547.20
|
| Rate for Payer: Networks By Design Commercial |
$444.60
|
| Rate for Payer: Prime Health Services Commercial |
$581.40
|
|
|
HC ENDOMYCARDIAL BIOPSY
|
Facility
IP
|
$5,866.00
|
|
|
Service Code
|
CPT 93505
|
| Hospital Charge Code |
906811308
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,407.84 |
| Max. Negotiated Rate |
$4,986.10 |
| Rate for Payer: Cash Price |
$2,639.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,346.40
|
| Rate for Payer: Galaxy Health WC |
$4,986.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,519.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,912.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,234.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,407.84
|
| Rate for Payer: Multiplan Commercial |
$4,692.80
|
| Rate for Payer: Networks By Design Commercial |
$3,812.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,986.10
|
|
|
HC ENDOMYCARDIAL BIOPSY
|
Facility
OP
|
$5,866.00
|
|
|
Service Code
|
CPT 93505
|
| Hospital Charge Code |
906811308
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$451.74 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,774.18
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare 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: BCBS Transplant Transplant |
$3,519.60
|
| 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 |
$2,639.70
|
| Rate for Payer: Cash Price |
$2,639.70
|
| Rate for Payer: Cash Price |
$2,639.70
|
| Rate for Payer: Cigna of CA PPO |
$4,340.84
|
| 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 |
$4,986.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,519.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,399.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,531.38
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,531.38
|
| Rate for Payer: IEHP Medi-Cal |
$6,451.73
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$6,451.73
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,912.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$451.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,407.84
|
| 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 |
$4,692.80
|
| Rate for Payer: Networks By Design Commercial |
$3,812.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,986.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,000.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,519.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,000.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| 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 ENDOSCOPIC PANCREATOSCOPY
|
Facility
IP
|
$8,545.00
|
|
|
Service Code
|
CPT 43273
|
| Hospital Charge Code |
906743273
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,050.80 |
| Max. Negotiated Rate |
$7,263.25 |
| Rate for Payer: Cash Price |
$3,845.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,418.00
|
| Rate for Payer: Galaxy Health WC |
$7,263.25
|
| Rate for Payer: Global Benefits Group Commercial |
$5,127.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,699.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,255.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,050.80
|
| Rate for Payer: Multiplan Commercial |
$6,836.00
|
| Rate for Payer: Networks By Design Commercial |
$5,554.25
|
| Rate for Payer: Prime Health Services Commercial |
$7,263.25
|
|
|
HC ENDOSCOPIC PANCREATOSCOPY
|
Facility
OP
|
$5,425.00
|
|
|
Service Code
|
CPT 43273
|
| Hospital Charge Code |
906743273
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$177.56 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,611.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,983.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,983.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,255.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,612.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,351.09
|
| Rate for Payer: Cash Price |
$2,441.25
|
| Rate for Payer: Cash Price |
$2,441.25
|
| Rate for Payer: Cigna of CA PPO |
$4,014.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,611.25
|
| Rate for Payer: Dignity Health Media |
$4,611.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,611.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,170.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,170.00
|
| Rate for Payer: Galaxy Health WC |
$4,611.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,255.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,068.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,618.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$177.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,302.00
|
| Rate for Payer: Multiplan Commercial |
$4,340.00
|
| Rate for Payer: Networks By Design Commercial |
$3,526.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,611.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,255.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,255.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,255.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,611.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,611.25
|
| Rate for Payer: Vantage Medical Group Senior |
$4,611.25
|
|
|
HC ENDOSCOPIC STUDY SWALLOW FUNCT MCAL
|
Facility
IP
|
$1,208.00
|
|
|
Service Code
|
CPT 92612
|
| Hospital Charge Code |
907000015
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$289.92 |
| Max. Negotiated Rate |
$1,026.80 |
| Rate for Payer: Cash Price |
$543.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$483.20
|
| Rate for Payer: Galaxy Health WC |
$1,026.80
|
| Rate for Payer: Global Benefits Group Commercial |
$724.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$805.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$460.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.92
|
| Rate for Payer: Multiplan Commercial |
$966.40
|
| Rate for Payer: Networks By Design Commercial |
$785.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,026.80
|
|
|
HC ENDOSCOPIC STUDY SWALLOW FUNCT MCAL
|
Facility
OP
|
$1,208.00
|
|
|
Service Code
|
CPT 92612
|
| Hospital Charge Code |
907000015
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$196.00 |
| Max. Negotiated Rate |
$1,026.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$443.34
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,026.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$664.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$664.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$421.00
|
| Rate for Payer: BCBS Transplant Transplant |
$724.80
|
| Rate for Payer: Blue Shield of California Commercial |
$407.00
|
| Rate for Payer: Blue Shield of California EPN |
$293.00
|
| Rate for Payer: Cash Price |
$543.60
|
| Rate for Payer: Cash Price |
$543.60
|
| Rate for Payer: Cash Price |
$543.60
|
| Rate for Payer: Cash Price |
$543.60
|
| Rate for Payer: Cigna of CA HMO |
$773.12
|
| Rate for Payer: Cigna of CA PPO |
$893.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,026.80
|
| Rate for Payer: Dignity Health Media |
$1,026.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,026.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$483.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$483.20
|
| Rate for Payer: Galaxy Health WC |
$1,026.80
|
| Rate for Payer: Global Benefits Group Commercial |
$724.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$906.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$805.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.92
|
| Rate for Payer: Multiplan Commercial |
$966.40
|
| Rate for Payer: Networks By Design Commercial |
$785.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,026.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$724.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$724.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$724.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,026.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,026.80
|
| Rate for Payer: Vantage Medical Group Senior |
$1,026.80
|
|
|
HC ENDOSCOPIC US EXAM
|
Facility
OP
|
$1,873.00
|
|
|
Service Code
|
CPT 43237
|
| Hospital Charge Code |
906743237
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$237.73 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,377.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,123.80
|
| 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 |
$842.85
|
| Rate for Payer: Cash Price |
$842.85
|
| Rate for Payer: Cigna of CA PPO |
$1,386.02
|
| 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 |
$1,592.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,123.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,404.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,899.02
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,899.02
|
| Rate for Payer: IEHP Medi-Cal |
$3,851.47
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$3,851.47
|
| Rate for Payer: IEHP Medicare Advantage |
$2,377.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,249.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$237.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,377.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$449.52
|
| 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 |
$1,498.40
|
| Rate for Payer: Networks By Design Commercial |
$1,217.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,592.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,615.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,123.80
|
| 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 ENDOSCOPIC US EXAM
|
Facility
IP
|
$3,504.00
|
|
|
Service Code
|
CPT 43237
|
| Hospital Charge Code |
906743237
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$840.96 |
| Max. Negotiated Rate |
$2,978.40 |
| Rate for Payer: Cash Price |
$1,576.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,401.60
|
| Rate for Payer: Galaxy Health WC |
$2,978.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,102.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,337.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,335.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$840.96
|
| Rate for Payer: Multiplan Commercial |
$2,803.20
|
| Rate for Payer: Networks By Design Commercial |
$2,277.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,978.40
|
|
|
HC ENDO SM INT CNTRL BLEEDING
|
Facility
OP
|
$2,622.00
|
|
|
Service Code
|
CPT 44366
|
| Hospital Charge Code |
906744366
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$446.35 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,377.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,573.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,612.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,351.09
|
| Rate for Payer: Cash Price |
$1,179.90
|
| Rate for Payer: Cash Price |
$1,179.90
|
| Rate for Payer: Cigna of CA PPO |
$1,940.28
|
| 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 |
$2,228.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,573.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,966.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,899.02
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,899.02
|
| Rate for Payer: IEHP Medi-Cal |
$3,851.47
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$3,851.47
|
| Rate for Payer: IEHP Medicare Advantage |
$2,377.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,748.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$446.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,377.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$629.28
|
| 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 |
$2,097.60
|
| Rate for Payer: Networks By Design Commercial |
$1,704.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,228.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,615.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,573.20
|
| 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 ENDO SM INT CNTRL BLEEDING
|
Facility
IP
|
$5,162.00
|
|
|
Service Code
|
CPT 44366
|
| Hospital Charge Code |
906744366
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,238.88 |
| Max. Negotiated Rate |
$4,387.70 |
| Rate for Payer: Cash Price |
$2,322.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,064.80
|
| Rate for Payer: Galaxy Health WC |
$4,387.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,097.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,443.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,966.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,238.88
|
| Rate for Payer: Multiplan Commercial |
$4,129.60
|
| Rate for Payer: Networks By Design Commercial |
$3,355.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,387.70
|
|
|
HC ENDO SM INTEST ENDO W/BX SNGL OR MUL
|
Facility
OP
|
$4,558.00
|
|
|
Service Code
|
CPT 44361
|
| Hospital Charge Code |
906744361
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$339.53 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,377.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,734.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,612.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,351.09
|
| 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 |
$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 |
$3,874.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,734.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,418.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,899.02
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,899.02
|
| Rate for Payer: IEHP Medi-Cal |
$3,851.47
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$3,851.47
|
| Rate for Payer: IEHP Medicare Advantage |
$2,377.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,040.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$339.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,377.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,093.92
|
| 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 |
$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: Redlands Yucaipa Medical Group Commercial/Senior |
$2,615.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,734.80
|
| 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 ENDO SM INTEST ENDO W/BX SNGL OR MUL
|
Facility
IP
|
$7,228.00
|
|
|
Service Code
|
CPT 44361
|
| Hospital Charge Code |
906744361
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,734.72 |
| Max. Negotiated Rate |
$6,143.80 |
| Rate for Payer: Cash Price |
$3,252.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,891.20
|
| Rate for Payer: Galaxy Health WC |
$6,143.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,336.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,821.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,753.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,734.72
|
| Rate for Payer: Multiplan Commercial |
$5,782.40
|
| Rate for Payer: Networks By Design Commercial |
$4,698.20
|
| Rate for Payer: Prime Health Services Commercial |
$6,143.80
|
|
|
HC ENDO SM INTEST W WO CO
|
Facility
IP
|
$7,178.00
|
|
|
Service Code
|
CPT 44360
|
| Hospital Charge Code |
906744360
|
|
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 ENDO SM INTEST W WO CO
|
Facility
OP
|
$4,558.00
|
|
|
Service Code
|
CPT 44360
|
| Hospital Charge Code |
906744360
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$289.31 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,377.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,734.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,612.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,351.09
|
| 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 |
$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 |
$3,874.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,734.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,418.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,899.02
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,899.02
|
| Rate for Payer: IEHP Medi-Cal |
$3,851.47
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$3,851.47
|
| Rate for Payer: IEHP Medicare Advantage |
$2,377.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,040.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$289.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,377.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,093.92
|
| 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 |
$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: Redlands Yucaipa Medical Group Commercial/Senior |
$2,615.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,734.80
|
| 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 ENDO SM INT ILEUM DIAG
|
Facility
IP
|
$7,938.00
|
|
|
Service Code
|
CPT 44376
|
| Hospital Charge Code |
906744376
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,905.12 |
| Max. Negotiated Rate |
$6,747.30 |
| Rate for Payer: Cash Price |
$3,572.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,175.20
|
| Rate for Payer: Galaxy Health WC |
$6,747.30
|
| Rate for Payer: Global Benefits Group Commercial |
$4,762.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,294.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,024.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,905.12
|
| Rate for Payer: Multiplan Commercial |
$6,350.40
|
| Rate for Payer: Networks By Design Commercial |
$5,159.70
|
| Rate for Payer: Prime Health Services Commercial |
$6,747.30
|
|
|
HC ENDO SM INT ILEUM DIAG
|
Facility
OP
|
$4,745.00
|
|
|
Service Code
|
CPT 44376
|
| Hospital Charge Code |
906744376
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$479.60 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,377.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,847.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,612.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,351.09
|
| Rate for Payer: Cash Price |
$2,135.25
|
| Rate for Payer: Cash Price |
$2,135.25
|
| Rate for Payer: Cigna of CA PPO |
$3,511.30
|
| 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 |
$4,033.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,847.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,558.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,899.02
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,899.02
|
| Rate for Payer: IEHP Medi-Cal |
$3,851.47
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$3,851.47
|
| Rate for Payer: IEHP Medicare Advantage |
$2,377.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,164.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$479.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,377.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,138.80
|
| 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 |
$3,796.00
|
| Rate for Payer: Networks By Design Commercial |
$3,084.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,033.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,615.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,847.00
|
| 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 ENDO SM INT ILEUM W BX
|
Facility
IP
|
$5,162.00
|
|
|
Service Code
|
CPT 44377
|
| Hospital Charge Code |
906744377
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,238.88 |
| Max. Negotiated Rate |
$4,387.70 |
| Rate for Payer: Cash Price |
$2,322.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,064.80
|
| Rate for Payer: Galaxy Health WC |
$4,387.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,097.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,443.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,966.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,238.88
|
| Rate for Payer: Multiplan Commercial |
$4,129.60
|
| Rate for Payer: Networks By Design Commercial |
$3,355.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,387.70
|
|
|
HC ENDO SM INT ILEUM W BX
|
Facility
OP
|
$2,622.00
|
|
|
Service Code
|
CPT 44377
|
| Hospital Charge Code |
906744377
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$507.19 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,377.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,573.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,612.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,351.09
|
| Rate for Payer: Cash Price |
$1,179.90
|
| Rate for Payer: Cash Price |
$1,179.90
|
| Rate for Payer: Cigna of CA PPO |
$1,940.28
|
| 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 |
$2,228.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,573.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,966.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,899.02
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,899.02
|
| Rate for Payer: IEHP Medi-Cal |
$3,851.47
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$3,851.47
|
| Rate for Payer: IEHP Medicare Advantage |
$2,377.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,748.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$507.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,377.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$629.28
|
| 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 |
$2,097.60
|
| Rate for Payer: Networks By Design Commercial |
$1,704.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,228.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,615.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,573.20
|
| 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 ENDO SM INT ILEUM W CNTRL BLEEDING
|
Facility
IP
|
$5,162.00
|
|
|
Service Code
|
CPT 44378
|
| Hospital Charge Code |
906744378
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,238.88 |
| Max. Negotiated Rate |
$4,387.70 |
| Rate for Payer: Cash Price |
$2,322.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,064.80
|
| Rate for Payer: Galaxy Health WC |
$4,387.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,097.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,443.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,966.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,238.88
|
| Rate for Payer: Multiplan Commercial |
$4,129.60
|
| Rate for Payer: Networks By Design Commercial |
$3,355.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,387.70
|
|
