|
HC COLONOSCOPY W ENDOS US EXAM
|
Facility
|
IP
|
$5,020.00
|
|
|
Service Code
|
CPT 45391
|
| Hospital Charge Code |
906745391
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,004.00 |
| Max. Negotiated Rate |
$4,267.00 |
| Rate for Payer: Adventist Health Commercial |
$1,004.00
|
| Rate for Payer: Cash Price |
$2,259.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,008.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,008.00
|
| Rate for Payer: Galaxy Health WC |
$4,267.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,012.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,348.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,912.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,107.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,204.80
|
| Rate for Payer: Multiplan Commercial |
$4,016.00
|
| Rate for Payer: Networks By Design Commercial |
$3,263.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,267.00
|
|
|
HC COLONOSCOPY W FB REMOVAL
|
Facility
|
IP
|
$5,270.00
|
|
|
Service Code
|
CPT 45379
|
| Hospital Charge Code |
906745379
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,054.00 |
| Max. Negotiated Rate |
$4,479.50 |
| Rate for Payer: Adventist Health Commercial |
$1,054.00
|
| Rate for Payer: Cash Price |
$2,371.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,108.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,108.00
|
| Rate for Payer: Galaxy Health WC |
$4,479.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,162.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,515.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,007.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,262.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,264.80
|
| Rate for Payer: Multiplan Commercial |
$4,216.00
|
| Rate for Payer: Networks By Design Commercial |
$3,425.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,479.50
|
|
|
HC COLONOSCOPY W FB REMOVAL
|
Facility
|
OP
|
$3,533.00
|
|
|
Service Code
|
CPT 45379
|
| Hospital Charge Code |
906745379
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$617.33 |
| 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 |
$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 |
$1,589.85
|
| 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 |
$617.33
|
| 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 |
$698.17
|
| 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 W POLYPECTOMY
|
Facility
|
IP
|
$4,038.00
|
|
|
Service Code
|
CPT 45384
|
| Hospital Charge Code |
906745384
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$807.60 |
| Max. Negotiated Rate |
$3,432.30 |
| Rate for Payer: Adventist Health Commercial |
$807.60
|
| Rate for Payer: Cash Price |
$1,817.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,615.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,615.20
|
| Rate for Payer: Galaxy Health WC |
$3,432.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,422.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,693.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,538.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,499.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$969.12
|
| Rate for Payer: Multiplan Commercial |
$3,230.40
|
| Rate for Payer: Networks By Design Commercial |
$2,624.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,432.30
|
|
|
HC COLONOSCOPY W POLYPECTOMY
|
Facility
|
OP
|
$2,581.00
|
|
|
Service Code
|
CPT 45384
|
| Hospital Charge Code |
906745384
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$516.20 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$516.20
|
| 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 |
$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 |
$1,161.45
|
| Rate for Payer: Cash Price |
$1,161.45
|
| Rate for Payer: Cash Price |
$1,161.45
|
| Rate for Payer: Cigna of CA HMO |
$1,651.84
|
| Rate for Payer: Cigna of CA PPO |
$1,909.94
|
| 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 |
$2,193.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,548.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,456.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$629.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,721.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$712.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$619.44
|
| 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 |
$2,064.80
|
| Rate for Payer: Networks By Design Commercial |
$1,677.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,193.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,548.60
|
| 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 W RESECTION
|
Facility
|
OP
|
$2,161.00
|
|
|
Service Code
|
CPT 44403
|
| Hospital Charge Code |
906744403
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$432.20 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$432.20
|
| 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 |
$972.45
|
| Rate for Payer: Cash Price |
$972.45
|
| Rate for Payer: Cash Price |
$972.45
|
| Rate for Payer: Cigna of CA HMO |
$1,383.04
|
| Rate for Payer: Cigna of CA PPO |
$1,599.14
|
| 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 |
$1,836.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,296.60
|
| 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 |
$1,441.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$518.64
|
| 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 |
$1,728.80
|
| Rate for Payer: Networks By Design Commercial |
$1,404.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,836.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,296.60
|
| 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 W RESECTION
|
Facility
|
IP
|
$2,161.00
|
|
|
Service Code
|
CPT 44403
|
| Hospital Charge Code |
906744403
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$432.20 |
| Max. Negotiated Rate |
$1,836.85 |
| Rate for Payer: Adventist Health Commercial |
$432.20
|
| Rate for Payer: Cash Price |
$972.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$864.40
|
| Rate for Payer: EPIC Health Plan Senior |
$864.40
|
| Rate for Payer: Galaxy Health WC |
$1,836.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,296.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,441.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$823.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,337.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$518.64
|
| Rate for Payer: Multiplan Commercial |
$1,728.80
|
| Rate for Payer: Networks By Design Commercial |
$1,404.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,836.85
|
|
|
HC COLONOSCOPY W STENT PLCMNT
|
Facility
|
OP
|
$4,306.00
|
|
|
Service Code
|
CPT 45389
|
| Hospital Charge Code |
906745389
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$861.20 |
| Max. Negotiated Rate |
$12,404.37 |
| Rate for Payer: Adventist Health Commercial |
$861.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,345.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,320.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,563.64
|
| 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 |
$1,937.70
|
| Rate for Payer: Cash Price |
$1,937.70
|
| Rate for Payer: Cash Price |
$1,937.70
|
| Rate for Payer: Cigna of CA HMO |
$2,755.84
|
| Rate for Payer: Cigna of CA PPO |
$3,186.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,345.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,320.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,563.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,210.91
|
| Rate for Payer: EPIC Health Plan Senior |
$7,563.64
|
| Rate for Payer: Galaxy Health WC |
$3,660.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,583.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$12,404.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,563.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,872.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,563.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,033.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,135.28
|
| Rate for Payer: Multiplan Commercial |
$3,444.80
|
| Rate for Payer: Networks By Design Commercial |
$2,798.90
|
| Rate for Payer: Prime Health Services Commercial |
$3,660.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,583.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,076.37
|
| 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 |
$7,563.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,345.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,320.00
|
| Rate for Payer: Vantage Medical Group Senior |
$7,563.64
|
|
|
HC COLONOSCOPY W STENT PLCMNT
|
Facility
|
IP
|
$6,120.00
|
|
|
Service Code
|
CPT 45389
|
| Hospital Charge Code |
906745389
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,224.00 |
| Max. Negotiated Rate |
$5,202.00 |
| Rate for Payer: Adventist Health Commercial |
$1,224.00
|
| Rate for Payer: Cash Price |
$2,754.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,448.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,448.00
|
| Rate for Payer: Galaxy Health WC |
$5,202.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,672.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,082.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,331.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,788.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,468.80
|
| Rate for Payer: Multiplan Commercial |
$4,896.00
|
| Rate for Payer: Networks By Design Commercial |
$3,978.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,202.00
|
|
|
HC COLONOSCOPY W STENT PLCMNT
|
Facility
|
OP
|
$4,293.00
|
|
|
Service Code
|
CPT 45387
|
| Hospital Charge Code |
906745387
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$858.60 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$858.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,649.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,361.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,219.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,636.33
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$1,931.85
|
| Rate for Payer: Cash Price |
$1,931.85
|
| Rate for Payer: Cigna of CA HMO |
$2,747.52
|
| Rate for Payer: Cigna of CA PPO |
$3,176.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,649.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,649.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,649.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,717.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,717.20
|
| Rate for Payer: Galaxy Health WC |
$3,649.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,575.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,863.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,635.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,657.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,030.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,005.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,005.10
|
| Rate for Payer: Multiplan Commercial |
$3,434.40
|
| Rate for Payer: Networks By Design Commercial |
$2,790.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,649.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,575.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,575.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,146.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,146.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,146.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,146.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,649.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,649.05
|
| Rate for Payer: Vantage Medical Group Senior |
$3,649.05
|
|
|
HC COLONOSCOPY W STENT PLCMNT
|
Facility
|
OP
|
$4,401.00
|
|
|
Service Code
|
CPT 44397
|
| Hospital Charge Code |
906744397
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$880.20 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$880.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,740.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,420.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,300.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,702.65
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$1,980.45
|
| Rate for Payer: Cash Price |
$1,980.45
|
| Rate for Payer: Cigna of CA HMO |
$2,816.64
|
| Rate for Payer: Cigna of CA PPO |
$3,256.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,740.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,740.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,740.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,760.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,760.40
|
| Rate for Payer: Galaxy Health WC |
$3,740.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,640.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,935.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,676.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,724.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,056.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,080.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,080.70
|
| Rate for Payer: Multiplan Commercial |
$3,520.80
|
| Rate for Payer: Networks By Design Commercial |
$2,860.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,740.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,640.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,640.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,200.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,200.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,200.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,200.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,740.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,740.85
|
| Rate for Payer: Vantage Medical Group Senior |
$3,740.85
|
|
|
HC COLONOSCOPY W SUBMUCOSAL INJ
|
Facility
|
OP
|
$3,882.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
906745381
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$693.64 |
| 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 |
$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 |
$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 |
$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 |
$3,299.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,329.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,456.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$693.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,589.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$784.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$931.68
|
| 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 |
$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 |
$1,797.77
|
| 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 W SUBMUCOSAL INJ
|
Facility
|
IP
|
$4,905.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
906745381
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$981.00 |
| Max. Negotiated Rate |
$4,169.25 |
| Rate for Payer: Adventist Health Commercial |
$981.00
|
| Rate for Payer: Cash Price |
$2,207.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,962.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,962.00
|
| Rate for Payer: Galaxy Health WC |
$4,169.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,943.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,271.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,868.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,036.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,177.20
|
| Rate for Payer: Multiplan Commercial |
$3,924.00
|
| Rate for Payer: Networks By Design Commercial |
$3,188.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,169.25
|
|
|
HC COLONOSCOPY W/TUMOR SNARE RMVL
|
Facility
|
IP
|
$5,516.00
|
|
|
Service Code
|
CPT 45385
|
| Hospital Charge Code |
906745385
|
|
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 W/TUMOR SNARE RMVL
|
Facility
|
OP
|
$3,882.00
|
|
|
Service Code
|
CPT 45385
|
| Hospital Charge Code |
906745385
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$672.37 |
| 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 |
$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 |
$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 |
$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 |
$3,299.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,329.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,456.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$672.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,589.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$760.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$931.68
|
| 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 |
$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 |
$1,797.77
|
| 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 COLONSCOPY STOMA W RMVL
|
Facility
|
OP
|
$3,224.00
|
|
|
Service Code
|
CPT 44394
|
| Hospital Charge Code |
906744394
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$521.64 |
| 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 |
$521.64
|
| 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 |
$589.95
|
| 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 COLONSCOPY STOMA W RMVL
|
Facility
|
IP
|
$4,581.00
|
|
|
Service Code
|
CPT 44394
|
| Hospital Charge Code |
906744394
|
|
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
|
|
|
HC COLON VIA STOMA W FB REMOVAL
|
Facility
|
IP
|
$1,704.00
|
|
|
Service Code
|
CPT 44390
|
| Hospital Charge Code |
906744390
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$340.80 |
| Max. Negotiated Rate |
$1,448.40 |
| Rate for Payer: Adventist Health Commercial |
$340.80
|
| Rate for Payer: Cash Price |
$766.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$681.60
|
| Rate for Payer: EPIC Health Plan Senior |
$681.60
|
| Rate for Payer: Galaxy Health WC |
$1,448.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,022.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,136.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$649.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,054.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$408.96
|
| Rate for Payer: Multiplan Commercial |
$1,363.20
|
| Rate for Payer: Networks By Design Commercial |
$1,107.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,448.40
|
|
|
HC COLON VIA STOMA W FB REMOVAL
|
Facility
|
OP
|
$1,704.00
|
|
|
Service Code
|
CPT 44390
|
| Hospital Charge Code |
906744390
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$295.23 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$340.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| 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 |
$1,845.77
|
| Rate for Payer: Cash Price |
$766.80
|
| Rate for Payer: Cash Price |
$766.80
|
| Rate for Payer: Cash Price |
$766.80
|
| Rate for Payer: Cigna of CA HMO |
$1,090.56
|
| Rate for Payer: Cigna of CA PPO |
$1,260.96
|
| 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 |
$1,448.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,022.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,899.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$295.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,136.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$333.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,158.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$408.96
|
| 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 |
$1,363.20
|
| Rate for Payer: Networks By Design Commercial |
$1,107.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,448.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,022.40
|
| 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 COLON W SNGL CONTRAST ENEMA
|
Facility
|
IP
|
$1,582.00
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
909001806
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$316.40 |
| Max. Negotiated Rate |
$1,344.70 |
| Rate for Payer: Adventist Health Commercial |
$316.40
|
| Rate for Payer: Cash Price |
$711.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$632.80
|
| Rate for Payer: EPIC Health Plan Senior |
$632.80
|
| Rate for Payer: Galaxy Health WC |
$1,344.70
|
| Rate for Payer: Global Benefits Group Commercial |
$949.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,055.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$602.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$979.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$379.68
|
| Rate for Payer: Multiplan Commercial |
$1,265.60
|
| Rate for Payer: Networks By Design Commercial |
$1,028.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,344.70
|
|
|
HC COLON W SNGL CONTRAST ENEMA
|
Facility
|
OP
|
$1,582.00
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
909001806
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$87.21 |
| Max. Negotiated Rate |
$1,344.70 |
| Rate for Payer: Adventist Health Commercial |
$316.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,037.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$226.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$468.21
|
| Rate for Payer: Blue Shield of California Commercial |
$968.18
|
| Rate for Payer: Blue Shield of California EPN |
$639.13
|
| Rate for Payer: Cash Price |
$711.90
|
| Rate for Payer: Cash Price |
$711.90
|
| Rate for Payer: Cigna of CA HMO |
$1,012.48
|
| Rate for Payer: Cigna of CA PPO |
$1,170.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$339.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$226.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$305.36
|
| Rate for Payer: EPIC Health Plan Senior |
$226.19
|
| Rate for Payer: Galaxy Health WC |
$1,344.70
|
| Rate for Payer: Global Benefits Group Commercial |
$949.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$370.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$87.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$226.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,055.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$226.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$379.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$285.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$303.09
|
| Rate for Payer: Multiplan Commercial |
$1,265.60
|
| Rate for Payer: Networks By Design Commercial |
$1,028.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,344.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$949.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$949.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$219.73
|
| Rate for Payer: United Healthcare All Other HMO |
$219.73
|
| Rate for Payer: United Healthcare HMO Rider |
$219.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$219.73
|
| Rate for Payer: Upland Medical Group Pediatric |
$226.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Vantage Medical Group Senior |
$226.19
|
|
|
HC COLPORRHAPHY
|
Facility
|
OP
|
$4,424.00
|
|
|
Service Code
|
CPT 57200
|
| Hospital Charge Code |
900501301
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$571.94 |
| Max. Negotiated Rate |
$6,625.45 |
| Rate for Payer: Adventist Health Commercial |
$884.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,059.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,443.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,039.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$1,990.80
|
| Rate for Payer: Cash Price |
$1,990.80
|
| Rate for Payer: Cash Price |
$1,990.80
|
| Rate for Payer: Cigna of CA HMO |
$2,831.36
|
| Rate for Payer: Cigna of CA PPO |
$3,273.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,059.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,443.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,039.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,453.88
|
| Rate for Payer: EPIC Health Plan Senior |
$4,039.91
|
| Rate for Payer: Galaxy Health WC |
$3,760.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,654.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,625.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,039.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,950.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$571.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,039.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,061.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,090.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,413.48
|
| Rate for Payer: Multiplan Commercial |
$3,539.20
|
| Rate for Payer: Multiplan WC |
$6,436.87
|
| Rate for Payer: Networks By Design Commercial |
$2,875.60
|
| Rate for Payer: Prime Health Services Commercial |
$3,760.40
|
| Rate for Payer: Prime Health Services WC |
$6,371.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,654.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,212.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,212.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,212.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,212.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,039.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,059.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,443.90
|
| Rate for Payer: Vantage Medical Group Senior |
$4,039.91
|
|
|
HC COLPORRHAPHY
|
Facility
|
IP
|
$4,424.00
|
|
|
Service Code
|
CPT 57200
|
| Hospital Charge Code |
900501301
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$884.80 |
| Max. Negotiated Rate |
$3,760.40 |
| Rate for Payer: Adventist Health Commercial |
$884.80
|
| Rate for Payer: Cash Price |
$1,990.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,769.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,769.60
|
| Rate for Payer: Galaxy Health WC |
$3,760.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,654.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,950.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,685.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,738.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,061.76
|
| Rate for Payer: Multiplan Commercial |
$3,539.20
|
| Rate for Payer: Networks By Design Commercial |
$2,875.60
|
| Rate for Payer: Prime Health Services Commercial |
$3,760.40
|
|
|
HC COLPOSCOPY VAG W CRVIX
|
Facility
|
OP
|
$961.00
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
906757420
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$192.20 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$192.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$386.50
|
| 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 |
$570.02
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cigna of CA HMO |
$615.04
|
| Rate for Payer: Cigna of CA PPO |
$711.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$579.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$425.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$386.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$521.77
|
| Rate for Payer: EPIC Health Plan Senior |
$386.50
|
| Rate for Payer: Galaxy Health WC |
$816.85
|
| Rate for Payer: Global Benefits Group Commercial |
$576.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$633.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$228.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$386.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$640.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$258.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$386.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$486.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$517.91
|
| Rate for Payer: Multiplan Commercial |
$768.80
|
| Rate for Payer: Networks By Design Commercial |
$624.65
|
| Rate for Payer: Prime Health Services Commercial |
$816.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$576.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$463.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$386.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Vantage Medical Group Senior |
$386.50
|
|
|
HC COLPOSCOPY VAG W CRVIX
|
Facility
|
IP
|
$1,340.00
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
906757420
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$268.00 |
| Max. Negotiated Rate |
$1,139.00 |
| Rate for Payer: Adventist Health Commercial |
$268.00
|
| Rate for Payer: Cash Price |
$603.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$536.00
|
| Rate for Payer: EPIC Health Plan Senior |
$536.00
|
| Rate for Payer: Galaxy Health WC |
$1,139.00
|
| Rate for Payer: Global Benefits Group Commercial |
$804.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$893.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$510.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$829.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.60
|
| Rate for Payer: Multiplan Commercial |
$1,072.00
|
| Rate for Payer: Networks By Design Commercial |
$871.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,139.00
|
|
