|
HC COLLAR SEMI-RIGID WIRE FRAME
|
Facility
|
OP
|
$485.00
|
|
|
Service Code
|
CPT L0160
|
| Hospital Charge Code |
915350160
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$116.40 |
| Max. Negotiated Rate |
$412.25 |
| Rate for Payer: Multiplan Commercial |
$388.00
|
| Rate for Payer: Adventist Health Commercial |
$198.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$412.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$266.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$363.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$280.91
|
| Rate for Payer: Blue Shield of California Commercial |
$357.93
|
| Rate for Payer: Blue Shield of California EPN |
$235.71
|
| Rate for Payer: Cash Price |
$218.25
|
| Rate for Payer: Cash Price |
$218.25
|
| Rate for Payer: Cigna of CA HMO |
$339.50
|
| Rate for Payer: Cigna of CA PPO |
$339.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$412.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$412.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$412.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$194.00
|
| Rate for Payer: EPIC Health Plan Senior |
$194.00
|
| Rate for Payer: Galaxy Health WC |
$412.25
|
| Rate for Payer: Global Benefits Group Commercial |
$291.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$128.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$323.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$145.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$300.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$339.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$339.50
|
| Rate for Payer: Networks By Design Commercial |
$242.50
|
| Rate for Payer: Prime Health Services Commercial |
$412.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$291.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$291.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$182.02
|
| Rate for Payer: United Healthcare All Other HMO |
$177.17
|
| Rate for Payer: United Healthcare HMO Rider |
$173.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$158.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$412.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$412.25
|
| Rate for Payer: Vantage Medical Group Senior |
$412.25
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
IP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
901200035
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$388.45 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.80
|
| Rate for Payer: EPIC Health Plan Senior |
$182.80
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$282.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.68
|
| Rate for Payer: Multiplan Commercial |
$365.60
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
IP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
946100108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$388.45 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.80
|
| Rate for Payer: EPIC Health Plan Senior |
$182.80
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$282.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.68
|
| Rate for Payer: Multiplan Commercial |
$365.60
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
OP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
946100108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$388.45 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$299.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$243.18
|
| Rate for Payer: Blue Shield of California Commercial |
$305.73
|
| Rate for Payer: Blue Shield of California EPN |
$201.99
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: Cigna of CA HMO |
$292.48
|
| Rate for Payer: Cigna of CA PPO |
$338.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$206.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$365.60
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$274.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$274.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.50
|
| Rate for Payer: United Healthcare All Other HMO |
$228.50
|
| Rate for Payer: United Healthcare HMO Rider |
$228.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$228.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
OP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
947200108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$388.45 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$299.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$243.18
|
| Rate for Payer: Blue Shield of California Commercial |
$305.73
|
| Rate for Payer: Blue Shield of California EPN |
$201.99
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: Cigna of CA HMO |
$292.48
|
| Rate for Payer: Cigna of CA PPO |
$338.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$206.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$365.60
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$274.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$274.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.50
|
| Rate for Payer: United Healthcare All Other HMO |
$228.50
|
| Rate for Payer: United Healthcare HMO Rider |
$228.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$228.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
IP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
946000108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$388.45 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.80
|
| Rate for Payer: EPIC Health Plan Senior |
$182.80
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$282.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.68
|
| Rate for Payer: Multiplan Commercial |
$365.60
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
OP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
946000108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$388.45 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$299.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$243.18
|
| Rate for Payer: Blue Shield of California Commercial |
$305.73
|
| Rate for Payer: Blue Shield of California EPN |
$201.99
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: Cigna of CA HMO |
$292.48
|
| Rate for Payer: Cigna of CA PPO |
$338.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$206.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$365.60
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$274.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$274.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.50
|
| Rate for Payer: United Healthcare All Other HMO |
$228.50
|
| Rate for Payer: United Healthcare HMO Rider |
$228.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$228.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
OP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
901200035
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$388.45 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$299.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$243.18
|
| Rate for Payer: Blue Shield of California Commercial |
$305.73
|
| Rate for Payer: Blue Shield of California EPN |
$201.99
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: Cigna of CA HMO |
$292.48
|
| Rate for Payer: Cigna of CA PPO |
$338.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$206.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$365.60
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$274.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$274.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.50
|
| Rate for Payer: United Healthcare All Other HMO |
$228.50
|
| Rate for Payer: United Healthcare HMO Rider |
$228.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$228.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
OP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
948100108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$388.45 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$299.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$243.18
|
| Rate for Payer: Blue Shield of California Commercial |
$305.73
|
| Rate for Payer: Blue Shield of California EPN |
$201.99
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: Cigna of CA HMO |
$292.48
|
| Rate for Payer: Cigna of CA PPO |
$338.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$206.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$365.60
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$274.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$274.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.50
|
| Rate for Payer: United Healthcare All Other HMO |
$228.50
|
| Rate for Payer: United Healthcare HMO Rider |
$228.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$228.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
IP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
944000108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$388.45 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.80
|
| Rate for Payer: EPIC Health Plan Senior |
$182.80
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$282.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.68
|
| Rate for Payer: Multiplan Commercial |
$365.60
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
IP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
948100108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$388.45 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.80
|
| Rate for Payer: EPIC Health Plan Senior |
$182.80
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$282.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.68
|
| Rate for Payer: Multiplan Commercial |
$365.60
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
OP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
947300108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$388.45 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$299.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$243.18
|
| Rate for Payer: Blue Shield of California Commercial |
$305.73
|
| Rate for Payer: Blue Shield of California EPN |
$201.99
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: Cigna of CA HMO |
$292.48
|
| Rate for Payer: Cigna of CA PPO |
$338.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$206.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$365.60
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$274.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$274.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.50
|
| Rate for Payer: United Healthcare All Other HMO |
$228.50
|
| Rate for Payer: United Healthcare HMO Rider |
$228.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$228.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
IP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
947200108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$388.45 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.80
|
| Rate for Payer: EPIC Health Plan Senior |
$182.80
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$282.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.68
|
| Rate for Payer: Multiplan Commercial |
$365.60
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
IP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
947300108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$388.45 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.80
|
| Rate for Payer: EPIC Health Plan Senior |
$182.80
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$282.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.68
|
| Rate for Payer: Multiplan Commercial |
$365.60
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
IP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
940100108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$388.45 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.80
|
| Rate for Payer: EPIC Health Plan Senior |
$182.80
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$282.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.68
|
| Rate for Payer: Multiplan Commercial |
$365.60
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
OP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
944000108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$388.45 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$299.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$243.18
|
| Rate for Payer: Blue Shield of California Commercial |
$305.73
|
| Rate for Payer: Blue Shield of California EPN |
$201.99
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: Cigna of CA HMO |
$292.48
|
| Rate for Payer: Cigna of CA PPO |
$338.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$206.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$365.60
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$274.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$274.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.50
|
| Rate for Payer: United Healthcare All Other HMO |
$228.50
|
| Rate for Payer: United Healthcare HMO Rider |
$228.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$228.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
OP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
940100108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$388.45 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$299.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$243.18
|
| Rate for Payer: Blue Shield of California Commercial |
$305.73
|
| Rate for Payer: Blue Shield of California EPN |
$201.99
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: Cigna of CA HMO |
$292.48
|
| Rate for Payer: Cigna of CA PPO |
$338.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$206.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$365.60
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$274.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$274.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.50
|
| Rate for Payer: United Healthcare All Other HMO |
$228.50
|
| Rate for Payer: United Healthcare HMO Rider |
$228.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$228.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC COLONOSCOPY DILATE STRICTURE
|
Facility
|
IP
|
$5,506.00
|
|
|
Service Code
|
CPT 45386
|
| Hospital Charge Code |
906745386
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,101.20 |
| Max. Negotiated Rate |
$4,680.10 |
| Rate for Payer: Adventist Health Commercial |
$1,101.20
|
| Rate for Payer: Cash Price |
$2,477.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,202.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,202.40
|
| Rate for Payer: Galaxy Health WC |
$4,680.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,303.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,672.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,097.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,408.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,321.44
|
| Rate for Payer: Multiplan Commercial |
$4,404.80
|
| Rate for Payer: Networks By Design Commercial |
$3,578.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,680.10
|
|
|
HC COLONOSCOPY DILATE STRICTURE
|
Facility
|
OP
|
$3,533.00
|
|
|
Service Code
|
CPT 45386
|
| Hospital Charge Code |
906745386
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$706.60 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$706.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,498.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,470.08
|
| Rate for Payer: Cash Price |
$1,589.85
|
| Rate for Payer: Cash Price |
$1,589.85
|
| Rate for Payer: Cash Price |
$1,589.85
|
| Rate for Payer: Cigna of CA HMO |
$2,261.12
|
| Rate for Payer: Cigna of CA PPO |
$2,614.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,647.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,498.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,022.49
|
| Rate for Payer: EPIC Health Plan Senior |
$1,498.14
|
| Rate for Payer: Galaxy Health WC |
$3,003.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,119.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,456.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,339.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,356.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,515.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$847.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,887.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,007.51
|
| Rate for Payer: Multiplan Commercial |
$2,826.40
|
| Rate for Payer: Networks By Design Commercial |
$2,296.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,003.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,119.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,797.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,498.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,498.14
|
|
|
HC COLONOSCOPY DX W WO COLLECT
|
Facility
|
OP
|
$3,882.00
|
|
|
Service Code
|
CPT 45378
|
| Hospital Charge Code |
906745378
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$495.99 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$776.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,470.08
|
| Rate for Payer: Cash Price |
$1,746.90
|
| Rate for Payer: Cash Price |
$1,746.90
|
| Rate for Payer: Cash Price |
$1,746.90
|
| Rate for Payer: Cigna of CA HMO |
$2,484.48
|
| Rate for Payer: Cigna of CA PPO |
$2,872.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,563.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1,158.42
|
| Rate for Payer: Galaxy Health WC |
$3,299.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,329.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,899.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$495.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,589.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$560.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,158.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$931.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,459.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,552.28
|
| Rate for Payer: Multiplan Commercial |
$3,105.60
|
| Rate for Payer: Networks By Design Commercial |
$2,523.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,299.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,329.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,390.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,158.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC COLONOSCOPY DX W WO COLLECT
|
Facility
|
IP
|
$5,516.00
|
|
|
Service Code
|
CPT 45378
|
| Hospital Charge Code |
906745378
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,103.20 |
| Max. Negotiated Rate |
$4,688.60 |
| Rate for Payer: Adventist Health Commercial |
$1,103.20
|
| Rate for Payer: Cash Price |
$2,482.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,206.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,206.40
|
| Rate for Payer: Galaxy Health WC |
$4,688.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,309.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,679.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,101.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,414.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,323.84
|
| Rate for Payer: Multiplan Commercial |
$4,412.80
|
| Rate for Payer: Networks By Design Commercial |
$3,585.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,688.60
|
|
|
HC COLONOSCOPY, FLEXIBLE W DECOMPRESSION
|
Facility
|
IP
|
$3,183.00
|
|
|
Service Code
|
CPT 45393
|
| Hospital Charge Code |
906745393
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$636.60 |
| Max. Negotiated Rate |
$2,705.55 |
| Rate for Payer: Adventist Health Commercial |
$636.60
|
| Rate for Payer: Cash Price |
$1,432.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,273.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,273.20
|
| Rate for Payer: Galaxy Health WC |
$2,705.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,909.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,123.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,212.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,970.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$763.92
|
| Rate for Payer: Multiplan Commercial |
$2,546.40
|
| Rate for Payer: Networks By Design Commercial |
$2,068.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,705.55
|
|
|
HC COLONOSCOPY, FLEXIBLE W DECOMPRESSION
|
Facility
|
OP
|
$3,183.00
|
|
|
Service Code
|
CPT 45393
|
| Hospital Charge Code |
906745393
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$636.60 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$636.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,498.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$1,432.35
|
| Rate for Payer: Cash Price |
$1,432.35
|
| Rate for Payer: Cash Price |
$1,432.35
|
| Rate for Payer: Cigna of CA HMO |
$2,037.12
|
| Rate for Payer: Cigna of CA PPO |
$2,355.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,647.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,498.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,022.49
|
| Rate for Payer: EPIC Health Plan Senior |
$1,498.14
|
| Rate for Payer: Galaxy Health WC |
$2,705.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,909.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,456.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,123.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$763.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,887.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,007.51
|
| Rate for Payer: Multiplan Commercial |
$2,546.40
|
| Rate for Payer: Networks By Design Commercial |
$2,068.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,705.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,909.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,797.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,498.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,498.14
|
|
|
HC COLONOSCOPY STOMA W BX
|
Facility
|
OP
|
$3,224.00
|
|
|
Service Code
|
CPT 44389
|
| Hospital Charge Code |
906744389
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$303.98 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$644.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,498.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$1,450.80
|
| Rate for Payer: Cash Price |
$1,450.80
|
| Rate for Payer: Cash Price |
$1,450.80
|
| Rate for Payer: Cigna of CA HMO |
$2,063.36
|
| Rate for Payer: Cigna of CA PPO |
$2,385.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,647.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,498.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,022.49
|
| Rate for Payer: EPIC Health Plan Senior |
$1,498.14
|
| Rate for Payer: Galaxy Health WC |
$2,740.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,934.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,456.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$303.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,150.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$343.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$773.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,887.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,007.51
|
| Rate for Payer: Multiplan Commercial |
$2,579.20
|
| Rate for Payer: Networks By Design Commercial |
$2,095.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,740.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,934.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,797.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,498.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,498.14
|
|
|
HC COLONOSCOPY STOMA W BX
|
Facility
|
IP
|
$4,581.00
|
|
|
Service Code
|
CPT 44389
|
| Hospital Charge Code |
906744389
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$916.20 |
| Max. Negotiated Rate |
$3,893.85 |
| Rate for Payer: Adventist Health Commercial |
$916.20
|
| Rate for Payer: Cash Price |
$2,061.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,832.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,832.40
|
| Rate for Payer: Galaxy Health WC |
$3,893.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,748.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,055.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,745.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,835.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,099.44
|
| Rate for Payer: Multiplan Commercial |
$3,664.80
|
| Rate for Payer: Networks By Design Commercial |
$2,977.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,893.85
|
|
