|
HC EPSTEIN ANTIBODY SCREEN IGM
|
Facility
OP
|
$39.00
|
|
|
Service Code
|
CPT 86308
|
| Hospital Charge Code |
900913657
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$47.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43.03
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.17
|
| Rate for Payer: BCBS Transplant Transplant |
$23.40
|
| Rate for Payer: Blue Shield of California Commercial |
$25.19
|
| Rate for Payer: Blue Shield of California EPN |
$19.97
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cigna of CA HMO |
$24.96
|
| Rate for Payer: Cigna of CA PPO |
$28.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Media |
$5.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.18
|
| Rate for Payer: Galaxy Health WC |
$33.15
|
| Rate for Payer: Global Benefits Group Commercial |
$23.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$29.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.50
|
| Rate for Payer: Heritage Provider Network Transplant |
$8.50
|
| Rate for Payer: IEHP Medi-Cal |
$8.39
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$8.39
|
| Rate for Payer: IEHP Medicare Advantage |
$5.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$31.20
|
| Rate for Payer: Networks By Design Commercial |
$25.35
|
| Rate for Payer: Prime Health Services Commercial |
$33.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC EPSTEIN BARR EARLY ANTIGEN IGG
|
Facility
OP
|
$39.00
|
|
|
Service Code
|
CPT 86663
|
| Hospital Charge Code |
900913653
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.36 |
| Max. Negotiated Rate |
$120.33 |
| Rate for Payer: Aetna of CA HMO/PPO |
$109.08
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.68
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.43
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$120.33
|
| Rate for Payer: BCBS Transplant Transplant |
$23.40
|
| Rate for Payer: Blue Shield of California Commercial |
$25.19
|
| Rate for Payer: Blue Shield of California EPN |
$19.97
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cigna of CA HMO |
$24.96
|
| Rate for Payer: Cigna of CA PPO |
$28.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.68
|
| Rate for Payer: Dignity Health Media |
$13.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.71
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.12
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.12
|
| Rate for Payer: Galaxy Health WC |
$33.15
|
| Rate for Payer: Global Benefits Group Commercial |
$23.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$29.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$21.52
|
| Rate for Payer: Heritage Provider Network Transplant |
$21.52
|
| Rate for Payer: IEHP Medi-Cal |
$21.25
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$21.25
|
| Rate for Payer: IEHP Medicare Advantage |
$13.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.58
|
| Rate for Payer: Multiplan Commercial |
$31.20
|
| Rate for Payer: Networks By Design Commercial |
$25.35
|
| Rate for Payer: Prime Health Services Commercial |
$33.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.63
|
| Rate for Payer: United Healthcare All Other HMO |
$10.63
|
| Rate for Payer: United Healthcare HMO Rider |
$10.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.43
|
| Rate for Payer: Vantage Medical Group Senior |
$13.12
|
|
|
HC EPSTEIN BARR NUCLEAR ANTIGEN IGG
|
Facility
OP
|
$39.00
|
|
|
Service Code
|
CPT 86664
|
| Hospital Charge Code |
900913654
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.36 |
| Max. Negotiated Rate |
$141.64 |
| Rate for Payer: Aetna of CA HMO/PPO |
$127.23
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$22.94
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$15.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$141.64
|
| Rate for Payer: BCBS Transplant Transplant |
$23.40
|
| Rate for Payer: Blue Shield of California Commercial |
$25.19
|
| Rate for Payer: Blue Shield of California EPN |
$19.97
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cigna of CA HMO |
$24.96
|
| Rate for Payer: Cigna of CA PPO |
$28.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.94
|
| Rate for Payer: Dignity Health Media |
$15.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.64
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15.29
|
| Rate for Payer: EPIC Health Plan Transplant |
$15.29
|
| Rate for Payer: Galaxy Health WC |
$33.15
|
| Rate for Payer: Global Benefits Group Commercial |
$23.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$29.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$25.08
|
| Rate for Payer: Heritage Provider Network Transplant |
$25.08
|
| Rate for Payer: IEHP Medi-Cal |
$24.77
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$24.77
|
| Rate for Payer: IEHP Medicare Advantage |
$15.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.49
|
| Rate for Payer: Multiplan Commercial |
$31.20
|
| Rate for Payer: Networks By Design Commercial |
$25.35
|
| Rate for Payer: Prime Health Services Commercial |
$33.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.38
|
| Rate for Payer: United Healthcare All Other HMO |
$12.38
|
| Rate for Payer: United Healthcare HMO Rider |
$12.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.82
|
| Rate for Payer: Vantage Medical Group Senior |
$15.29
|
|
|
HC EPSTEIN BARR VIRAL CAPSID IGG
|
Facility
OP
|
$39.00
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
900913655
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.36 |
| Max. Negotiated Rate |
$150.86 |
| Rate for Payer: Aetna of CA HMO/PPO |
$150.86
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$27.21
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$19.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$147.11
|
| Rate for Payer: BCBS Transplant Transplant |
$23.40
|
| Rate for Payer: Blue Shield of California Commercial |
$25.19
|
| Rate for Payer: Blue Shield of California EPN |
$19.97
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cigna of CA HMO |
$24.96
|
| Rate for Payer: Cigna of CA PPO |
$28.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.21
|
| Rate for Payer: Dignity Health Media |
$18.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.49
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.14
|
| Rate for Payer: Galaxy Health WC |
$33.15
|
| Rate for Payer: Global Benefits Group Commercial |
$23.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$29.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$29.75
|
| Rate for Payer: Heritage Provider Network Transplant |
$29.75
|
| Rate for Payer: IEHP Medi-Cal |
$29.39
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$29.39
|
| Rate for Payer: IEHP Medicare Advantage |
$18.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.31
|
| Rate for Payer: Multiplan Commercial |
$31.20
|
| Rate for Payer: Networks By Design Commercial |
$25.35
|
| Rate for Payer: Prime Health Services Commercial |
$33.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.70
|
| Rate for Payer: United Healthcare All Other HMO |
$14.70
|
| Rate for Payer: United Healthcare HMO Rider |
$14.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.95
|
| Rate for Payer: Vantage Medical Group Senior |
$18.14
|
|
|
HC EPSTEIN BARR VIRAL CAPSID IGM
|
Facility
OP
|
$39.00
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
900913656
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.36 |
| Max. Negotiated Rate |
$150.86 |
| Rate for Payer: Aetna of CA HMO/PPO |
$150.86
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$27.21
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$19.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$147.11
|
| Rate for Payer: BCBS Transplant Transplant |
$23.40
|
| Rate for Payer: Blue Shield of California Commercial |
$25.19
|
| Rate for Payer: Blue Shield of California EPN |
$19.97
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cigna of CA HMO |
$24.96
|
| Rate for Payer: Cigna of CA PPO |
$28.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.21
|
| Rate for Payer: Dignity Health Media |
$18.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.49
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.14
|
| Rate for Payer: Galaxy Health WC |
$33.15
|
| Rate for Payer: Global Benefits Group Commercial |
$23.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$29.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$29.75
|
| Rate for Payer: Heritage Provider Network Transplant |
$29.75
|
| Rate for Payer: IEHP Medi-Cal |
$29.39
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$29.39
|
| Rate for Payer: IEHP Medicare Advantage |
$18.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.31
|
| Rate for Payer: Multiplan Commercial |
$31.20
|
| Rate for Payer: Networks By Design Commercial |
$25.35
|
| Rate for Payer: Prime Health Services Commercial |
$33.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.70
|
| Rate for Payer: United Healthcare All Other HMO |
$14.70
|
| Rate for Payer: United Healthcare HMO Rider |
$14.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.95
|
| Rate for Payer: Vantage Medical Group Senior |
$18.14
|
|
|
HC EP STIMULATION BY MEDICATION
|
Facility
IP
|
$635.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906811482
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$152.40 |
| Max. Negotiated Rate |
$539.75 |
| Rate for Payer: Cash Price |
$285.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$254.00
|
| Rate for Payer: Galaxy Health WC |
$539.75
|
| Rate for Payer: Global Benefits Group Commercial |
$381.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$423.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$241.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$152.40
|
| Rate for Payer: Multiplan Commercial |
$508.00
|
| Rate for Payer: Networks By Design Commercial |
$412.75
|
| Rate for Payer: Prime Health Services Commercial |
$539.75
|
|
|
HC EP STIMULATION BY MEDICATION
|
Facility
OP
|
$635.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906811482
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$152.40 |
| Max. Negotiated Rate |
$6,668.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$416.50
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$195.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$378.33
|
| Rate for Payer: BCBS Transplant Transplant |
$381.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$285.75
|
| Rate for Payer: Cash Price |
$285.75
|
| Rate for Payer: Cash Price |
$285.75
|
| Rate for Payer: Cigna of CA HMO |
$406.40
|
| Rate for Payer: Cigna of CA PPO |
$469.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| Rate for Payer: Dignity Health Media |
$195.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$263.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$195.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$195.17
|
| Rate for Payer: Galaxy Health WC |
$539.75
|
| Rate for Payer: Global Benefits Group Commercial |
$381.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$476.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$320.08
|
| Rate for Payer: Heritage Provider Network Transplant |
$320.08
|
| Rate for Payer: IEHP Medi-Cal |
$316.18
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$316.18
|
| Rate for Payer: IEHP Medicare Advantage |
$195.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$423.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$195.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$152.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$261.53
|
| Rate for Payer: Multiplan Commercial |
$508.00
|
| Rate for Payer: Networks By Design Commercial |
$412.75
|
| Rate for Payer: Prime Health Services Commercial |
$539.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$381.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$381.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$381.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Vantage Medical Group Senior |
$195.17
|
|
|
HC EPS VENT &/OR ATRIAL MAPPING
|
Facility
IP
|
$7,720.00
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
906811323
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,852.80 |
| Max. Negotiated Rate |
$6,562.00 |
| Rate for Payer: Cash Price |
$3,474.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,088.00
|
| Rate for Payer: Galaxy Health WC |
$6,562.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,632.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,149.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,941.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,852.80
|
| Rate for Payer: Multiplan Commercial |
$6,176.00
|
| Rate for Payer: Networks By Design Commercial |
$5,018.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,562.00
|
|
|
HC EPS VENT &/OR ATRIAL MAPPING
|
Facility
OP
|
$7,720.00
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
906811323
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$558.52 |
| Max. Negotiated Rate |
$11,370.00 |
| Rate for Payer: Cash Price |
$3,474.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,562.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,246.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,246.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,241.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,632.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$3,474.00
|
| Rate for Payer: Cash Price |
$3,474.00
|
| Rate for Payer: Cigna of CA HMO |
$4,940.80
|
| Rate for Payer: Cigna of CA PPO |
$5,712.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,562.00
|
| Rate for Payer: Dignity Health Media |
$6,562.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,562.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,088.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,088.00
|
| Rate for Payer: Galaxy Health WC |
$6,562.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,632.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,790.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,149.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$558.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,852.80
|
| Rate for Payer: Multiplan Commercial |
$6,176.00
|
| Rate for Payer: Networks By Design Commercial |
$5,018.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,562.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,632.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,632.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,632.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,562.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,562.00
|
| Rate for Payer: Vantage Medical Group Senior |
$6,562.00
|
|
|
HC EPS VENTRICULAR PACING
|
Facility
IP
|
$7,412.00
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
906811325
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,778.88 |
| Max. Negotiated Rate |
$6,300.20 |
| Rate for Payer: Cash Price |
$3,335.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,964.80
|
| Rate for Payer: Galaxy Health WC |
$6,300.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,447.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,943.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,823.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,778.88
|
| Rate for Payer: Multiplan Commercial |
$5,929.60
|
| Rate for Payer: Networks By Design Commercial |
$4,817.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,300.20
|
|
|
HC EPS VENTRICULAR PACING
|
Facility
OP
|
$7,412.00
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
906811325
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$201.17 |
| Max. Negotiated Rate |
$15,302.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$452.31
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9,331.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,447.20
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$3,335.40
|
| Rate for Payer: Cash Price |
$3,335.40
|
| Rate for Payer: Cash Price |
$3,335.40
|
| Rate for Payer: Cigna of CA HMO |
$4,743.68
|
| Rate for Payer: Cigna of CA PPO |
$5,484.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Dignity Health Media |
$9,331.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,264.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,596.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9,331.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$9,331.00
|
| Rate for Payer: Galaxy Health WC |
$6,300.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,447.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,559.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,302.84
|
| Rate for Payer: Heritage Provider Network Transplant |
$15,302.84
|
| Rate for Payer: IEHP Medi-Cal |
$15,116.22
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$15,116.22
|
| Rate for Payer: IEHP Medicare Advantage |
$9,331.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,943.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$201.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,331.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,778.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,757.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,503.54
|
| Rate for Payer: Multiplan Commercial |
$5,929.60
|
| Rate for Payer: Networks By Design Commercial |
$4,817.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,300.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,447.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,447.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,447.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: Vantage Medical Group Senior |
$9,331.00
|
|
|
HC ERCP BILIARY/SPHINCT
|
Facility
OP
|
$2,255.00
|
|
|
Service Code
|
CPT 74328
|
| Hospital Charge Code |
909001862
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$218.75 |
| Max. Negotiated Rate |
$1,916.75 |
| Rate for Payer: Cigna of CA PPO |
$1,668.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$521.76
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,916.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,240.25
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,240.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$817.68
|
| Rate for Payer: BCBS Transplant Transplant |
$1,353.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,332.70
|
| Rate for Payer: Blue Shield of California EPN |
$1,057.60
|
| Rate for Payer: Cash Price |
$1,014.75
|
| Rate for Payer: Cash Price |
$1,014.75
|
| Rate for Payer: Cigna of CA HMO |
$1,443.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,916.75
|
| Rate for Payer: Dignity Health Media |
$1,916.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,916.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$902.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$902.00
|
| Rate for Payer: Galaxy Health WC |
$1,916.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,353.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,691.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,504.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$541.20
|
| Rate for Payer: Multiplan Commercial |
$1,804.00
|
| Rate for Payer: Networks By Design Commercial |
$1,465.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,916.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,353.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,353.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,353.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,127.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,127.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,127.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,127.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,916.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,916.75
|
| Rate for Payer: Vantage Medical Group Senior |
$1,916.75
|
|
|
HC ERCP BILIARY/SPHINCT
|
Facility
IP
|
$2,255.00
|
|
|
Service Code
|
CPT 74328
|
| Hospital Charge Code |
909001862
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$541.20 |
| Max. Negotiated Rate |
$1,916.75 |
| Rate for Payer: Cash Price |
$1,014.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$902.00
|
| Rate for Payer: Galaxy Health WC |
$1,916.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,353.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,504.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$859.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$541.20
|
| Rate for Payer: Multiplan Commercial |
$1,804.00
|
| Rate for Payer: Networks By Design Commercial |
$1,465.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,916.75
|
|
|
HC ERCP COMBINED SPHINCT
|
Facility
OP
|
$2,685.00
|
|
|
Service Code
|
CPT 74330
|
| Hospital Charge Code |
909001863
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$218.75 |
| Max. Negotiated Rate |
$2,282.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$777.26
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,282.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,476.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,476.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$817.68
|
| Rate for Payer: BCBS Transplant Transplant |
$1,611.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,586.84
|
| Rate for Payer: Blue Shield of California EPN |
$1,259.26
|
| Rate for Payer: Cash Price |
$1,208.25
|
| Rate for Payer: Cash Price |
$1,208.25
|
| Rate for Payer: Cigna of CA HMO |
$1,718.40
|
| Rate for Payer: Cigna of CA PPO |
$1,986.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,282.25
|
| Rate for Payer: Dignity Health Media |
$2,282.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,282.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,074.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,074.00
|
| Rate for Payer: Galaxy Health WC |
$2,282.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,611.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,013.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,790.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$644.40
|
| Rate for Payer: Multiplan Commercial |
$2,148.00
|
| Rate for Payer: Networks By Design Commercial |
$1,745.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,282.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,611.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,611.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,611.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,342.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,342.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,342.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,342.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,282.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,282.25
|
| Rate for Payer: Vantage Medical Group Senior |
$2,282.25
|
|
|
HC ERCP COMBINED SPHINCT
|
Facility
IP
|
$2,685.00
|
|
|
Service Code
|
CPT 74330
|
| Hospital Charge Code |
909001863
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$644.40 |
| Max. Negotiated Rate |
$2,282.25 |
| Rate for Payer: Cash Price |
$1,208.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,074.00
|
| Rate for Payer: Galaxy Health WC |
$2,282.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,611.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,790.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,022.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$644.40
|
| Rate for Payer: Multiplan Commercial |
$2,148.00
|
| Rate for Payer: Networks By Design Commercial |
$1,745.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,282.25
|
|
|
HC ERCP DIAG W/ OR W/O COLLECT SP
|
Facility
OP
|
$4,620.00
|
|
|
Service Code
|
CPT 43260
|
| Hospital Charge Code |
906743260
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$587.12 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,177.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,263.53
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,785.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,772.00
|
| 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 |
$2,079.00
|
| Rate for Payer: Cash Price |
$2,079.00
|
| Rate for Payer: Cigna of CA PPO |
$3,418.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,177.54
|
| Rate for Payer: Dignity Health Media |
$4,785.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,263.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,459.79
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,785.03
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,785.03
|
| Rate for Payer: Galaxy Health WC |
$3,927.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,772.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,465.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,847.45
|
| Rate for Payer: Heritage Provider Network Transplant |
$7,847.45
|
| Rate for Payer: IEHP Medi-Cal |
$7,751.75
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$7,751.75
|
| Rate for Payer: IEHP Medicare Advantage |
$4,785.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,081.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$587.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,785.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,108.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,029.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,411.94
|
| Rate for Payer: Multiplan Commercial |
$3,696.00
|
| Rate for Payer: Networks By Design Commercial |
$3,003.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,927.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,263.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,772.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,742.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,177.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,263.53
|
| Rate for Payer: Vantage Medical Group Senior |
$4,785.03
|
|
|
HC ERCP DIAG W/ OR W/O COLLECT SP
|
Facility
IP
|
$8,641.00
|
|
|
Service Code
|
CPT 43260
|
| Hospital Charge Code |
906743260
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,073.84 |
| Max. Negotiated Rate |
$7,344.85 |
| Rate for Payer: Cash Price |
$3,888.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,456.40
|
| Rate for Payer: Galaxy Health WC |
$7,344.85
|
| Rate for Payer: Global Benefits Group Commercial |
$5,184.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,763.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,292.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,073.84
|
| Rate for Payer: Multiplan Commercial |
$6,912.80
|
| Rate for Payer: Networks By Design Commercial |
$5,616.65
|
| Rate for Payer: Prime Health Services Commercial |
$7,344.85
|
|
|
HC ERCP DUCT STENT PLACEMENT
|
Facility
IP
|
$10,349.00
|
|
|
Service Code
|
CPT 43274
|
| Hospital Charge Code |
900100019
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,483.76 |
| Max. Negotiated Rate |
$8,796.65 |
| Rate for Payer: Cash Price |
$4,657.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,139.60
|
| Rate for Payer: Galaxy Health WC |
$8,796.65
|
| Rate for Payer: Global Benefits Group Commercial |
$6,209.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,902.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,942.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,483.76
|
| Rate for Payer: Multiplan Commercial |
$8,279.20
|
| Rate for Payer: Networks By Design Commercial |
$6,726.85
|
| Rate for Payer: Prime Health Services Commercial |
$8,796.65
|
|
|
HC ERCP DUCT STENT PLACEMENT
|
Facility
OP
|
$6,916.00
|
|
|
Service Code
|
CPT 43274
|
| Hospital Charge Code |
900100019
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$788.01 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,681.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,832.91
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,120.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,149.60
|
| 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 |
$3,112.20
|
| Rate for Payer: Cash Price |
$3,112.20
|
| Rate for Payer: Cigna of CA PPO |
$5,117.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,681.24
|
| Rate for Payer: Dignity Health Media |
$7,120.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,832.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,613.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,120.83
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,120.83
|
| Rate for Payer: Galaxy Health WC |
$5,878.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,149.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,187.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,678.16
|
| Rate for Payer: Heritage Provider Network Transplant |
$11,678.16
|
| Rate for Payer: IEHP Medi-Cal |
$11,535.74
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$11,535.74
|
| Rate for Payer: IEHP Medicare Advantage |
$7,120.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,612.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$788.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,120.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,659.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,972.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,541.91
|
| Rate for Payer: Multiplan Commercial |
$5,532.80
|
| Rate for Payer: Networks By Design Commercial |
$4,495.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,878.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7,832.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,149.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,545.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,681.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,832.91
|
| Rate for Payer: Vantage Medical Group Senior |
$7,120.83
|
|
|
HC ERCP EA DUCT/AMPULLA DILATATION
|
Facility
IP
|
$12,715.00
|
|
|
Service Code
|
CPT 43277
|
| Hospital Charge Code |
900100020
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$3,051.60 |
| Max. Negotiated Rate |
$10,807.75 |
| Rate for Payer: Cash Price |
$5,721.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,086.00
|
| Rate for Payer: Galaxy Health WC |
$10,807.75
|
| Rate for Payer: Global Benefits Group Commercial |
$7,629.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,480.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,844.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,051.60
|
| Rate for Payer: Multiplan Commercial |
$10,172.00
|
| Rate for Payer: Networks By Design Commercial |
$8,264.75
|
| Rate for Payer: Prime Health Services Commercial |
$10,807.75
|
|
|
HC ERCP EA DUCT/AMPULLA DILATATION
|
Facility
OP
|
$8,498.00
|
|
|
Service Code
|
CPT 43277
|
| Hospital Charge Code |
900100020
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$653.62 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,177.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,263.53
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,785.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: BCBS Transplant Transplant |
$5,098.80
|
| 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 |
$3,824.10
|
| Rate for Payer: Cash Price |
$3,824.10
|
| Rate for Payer: Cigna of CA PPO |
$6,288.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,177.54
|
| Rate for Payer: Dignity Health Media |
$4,785.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,263.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,459.79
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,785.03
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,785.03
|
| Rate for Payer: Galaxy Health WC |
$7,223.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,098.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6,373.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,847.45
|
| Rate for Payer: Heritage Provider Network Transplant |
$7,847.45
|
| Rate for Payer: IEHP Medi-Cal |
$7,751.75
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$7,751.75
|
| Rate for Payer: IEHP Medicare Advantage |
$4,785.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,668.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$653.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,785.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,039.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,029.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,411.94
|
| Rate for Payer: Multiplan Commercial |
$6,798.40
|
| Rate for Payer: Networks By Design Commercial |
$5,523.70
|
| Rate for Payer: Prime Health Services Commercial |
$7,223.30
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,263.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,098.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,742.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,177.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,263.53
|
| Rate for Payer: Vantage Medical Group Senior |
$4,785.03
|
|
|
HC ERCP LESION ABLAT W DILATION
|
Facility
IP
|
$6,756.00
|
|
|
Service Code
|
CPT 43278
|
| Hospital Charge Code |
906743278
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,621.44 |
| Max. Negotiated Rate |
$5,742.60 |
| Rate for Payer: Cash Price |
$3,040.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,702.40
|
| Rate for Payer: Galaxy Health WC |
$5,742.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,053.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,506.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,574.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,621.44
|
| Rate for Payer: Multiplan Commercial |
$5,404.80
|
| Rate for Payer: Networks By Design Commercial |
$4,391.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,742.60
|
|
|
HC ERCP LESION ABLAT W DILATION
|
Facility
OP
|
$5,328.00
|
|
|
Service Code
|
CPT 43278
|
| Hospital Charge Code |
906743278
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$743.45 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,177.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,263.53
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,785.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,196.80
|
| 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 |
$2,397.60
|
| Rate for Payer: Cash Price |
$2,397.60
|
| Rate for Payer: Cigna of CA PPO |
$3,942.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,177.54
|
| Rate for Payer: Dignity Health Media |
$4,785.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,263.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,459.79
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,785.03
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,785.03
|
| Rate for Payer: Galaxy Health WC |
$4,528.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,196.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,996.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,847.45
|
| Rate for Payer: Heritage Provider Network Transplant |
$7,847.45
|
| Rate for Payer: IEHP Medi-Cal |
$7,751.75
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$7,751.75
|
| Rate for Payer: IEHP Medicare Advantage |
$4,785.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,553.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$743.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,785.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,278.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,029.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,411.94
|
| Rate for Payer: Multiplan Commercial |
$4,262.40
|
| Rate for Payer: Networks By Design Commercial |
$3,463.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,528.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,263.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,196.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,742.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,177.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,263.53
|
| Rate for Payer: Vantage Medical Group Senior |
$4,785.03
|
|
|
HC ERCP PANCREATIC/SPHINCT
|
Facility
OP
|
$2,040.00
|
|
|
Service Code
|
CPT 74329
|
| Hospital Charge Code |
909001830
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$218.75 |
| Max. Negotiated Rate |
$1,734.00 |
| Rate for Payer: Vantage Medical Group Senior |
$1,734.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$415.67
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,734.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,122.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,122.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$817.68
|
| Rate for Payer: BCBS Transplant Transplant |
$1,224.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,205.64
|
| Rate for Payer: Blue Shield of California EPN |
$956.76
|
| Rate for Payer: Cash Price |
$918.00
|
| Rate for Payer: Cash Price |
$918.00
|
| Rate for Payer: Cigna of CA HMO |
$1,305.60
|
| Rate for Payer: Cigna of CA PPO |
$1,509.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,734.00
|
| Rate for Payer: Dignity Health Media |
$1,734.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,734.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$816.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$816.00
|
| Rate for Payer: Galaxy Health WC |
$1,734.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,224.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,530.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,360.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$489.60
|
| Rate for Payer: Multiplan Commercial |
$1,632.00
|
| Rate for Payer: Networks By Design Commercial |
$1,326.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,734.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,224.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,224.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,224.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,020.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,020.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,020.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,020.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,734.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,734.00
|
|
|
HC ERCP PANCREATIC/SPHINCT
|
Facility
IP
|
$2,040.00
|
|
|
Service Code
|
CPT 74329
|
| Hospital Charge Code |
909001830
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$489.60 |
| Max. Negotiated Rate |
$1,734.00 |
| Rate for Payer: Cash Price |
$918.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$816.00
|
| Rate for Payer: Galaxy Health WC |
$1,734.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,224.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,360.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$777.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$489.60
|
| Rate for Payer: Multiplan Commercial |
$1,632.00
|
| Rate for Payer: Networks By Design Commercial |
$1,326.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,734.00
|
|
