|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,689.00
|
| 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 Foundation Hospitals Commercial/Self Funded |
$3,346.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,109.30
|
| 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
|
$5,270.00
|
|
|
Service Code
|
CPT 45379
|
| Hospital Charge Code |
906745379
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$617.33 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,054.00
|
| Rate for Payer: Adventist Health Commercial |
$706.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Cash Price |
$1,589.85
|
| Rate for Payer: Cash Price |
$2,371.50
|
| Rate for Payer: Cash Price |
$2,371.50
|
| Rate for Payer: Cash Price |
$1,589.85
|
| Rate for Payer: Cash Price |
$1,589.85
|
| Rate for Payer: Cash Price |
$2,371.50
|
| Rate for Payer: Cigna of CA HMO |
$3,372.80
|
| Rate for Payer: Cigna of CA HMO |
$2,261.12
|
| Rate for Payer: Cigna of CA PPO |
$2,614.42
|
| Rate for Payer: Cigna of CA PPO |
$3,899.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,689.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,473.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$4,479.50
|
| Rate for Payer: Galaxy Health WC |
$3,003.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,119.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,162.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$617.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$617.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,346.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,243.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$698.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$698.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$847.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,264.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,939.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,939.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$2,826.40
|
| Rate for Payer: Multiplan Commercial |
$4,216.00
|
| Rate for Payer: Networks By Design Commercial |
$3,425.50
|
| Rate for Payer: Networks By Design Commercial |
$2,296.45
|
| Rate for Payer: Prime Health Services Commercial |
$4,479.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,003.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,162.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,119.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,766.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,635.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| 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 HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC COLONOSCOPY W POLYPECTOMY
|
Facility
|
OP
|
$4,038.00
|
|
|
Service Code
|
CPT 45384
|
| Hospital Charge Code |
906745384
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$629.85 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$807.60
|
| Rate for Payer: Adventist Health Commercial |
$516.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Cash Price |
$1,161.45
|
| Rate for Payer: Cash Price |
$1,817.10
|
| Rate for Payer: Cash Price |
$1,817.10
|
| Rate for Payer: Cash Price |
$1,161.45
|
| Rate for Payer: Cash Price |
$1,161.45
|
| Rate for Payer: Cash Price |
$1,817.10
|
| Rate for Payer: Cigna of CA HMO |
$2,584.32
|
| Rate for Payer: Cigna of CA HMO |
$1,651.84
|
| Rate for Payer: Cigna of CA PPO |
$1,909.94
|
| Rate for Payer: Cigna of CA PPO |
$2,988.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,826.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,806.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$3,432.30
|
| Rate for Payer: Galaxy Health WC |
$2,193.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,548.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,422.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$629.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$629.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,564.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,638.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$712.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$712.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$619.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$969.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,939.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,939.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$2,064.80
|
| Rate for Payer: Multiplan Commercial |
$3,230.40
|
| Rate for Payer: Networks By Design Commercial |
$2,624.70
|
| Rate for Payer: Networks By Design Commercial |
$1,677.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,432.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,193.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,422.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,548.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,290.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,019.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| 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 HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,826.60
|
| 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 Foundation Hospitals Commercial/Self Funded |
$2,564.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,382.42
|
| 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 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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$432.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| 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 |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,512.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| 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/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,372.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$518.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,939.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,062.37
|
| 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 |
$1,846.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,080.50
|
| 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 |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,512.70
|
| 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 Foundation Hospitals Commercial/Self Funded |
$1,372.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,274.99
|
| 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
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,284.00
|
| 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 Foundation Hospitals Commercial/Self Funded |
$3,886.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,610.80
|
| 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
|
$6,120.00
|
|
|
Service Code
|
CPT 45389
|
| Hospital Charge Code |
906745389
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,224.00 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,224.00
|
| Rate for Payer: Adventist Health Commercial |
$861.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,808.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,808.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$2,754.00
|
| Rate for Payer: Cash Price |
$1,937.70
|
| Rate for Payer: Cash Price |
$2,754.00
|
| Rate for Payer: Cash Price |
$1,937.70
|
| Rate for Payer: Cash Price |
$1,937.70
|
| Rate for Payer: Cash Price |
$2,754.00
|
| Rate for Payer: Cigna of CA HMO |
$2,755.84
|
| Rate for Payer: Cigna of CA HMO |
$3,916.80
|
| Rate for Payer: Cigna of CA PPO |
$3,186.44
|
| Rate for Payer: Cigna of CA PPO |
$4,528.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,589.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,589.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,808.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,808.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,284.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,014.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,883.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,883.51
|
| Rate for Payer: EPIC Health Plan Senior |
$8,589.01
|
| Rate for Payer: EPIC Health Plan Senior |
$8,589.01
|
| Rate for Payer: Galaxy Health WC |
$3,660.10
|
| Rate for Payer: Galaxy Health WC |
$5,202.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,583.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,672.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,805.43
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,805.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,808.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,808.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,734.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,886.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,931.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,931.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,033.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,468.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,838.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,838.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,462.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,462.97
|
| Rate for Payer: Multiplan Commercial |
$4,896.00
|
| Rate for Payer: Multiplan Commercial |
$3,444.80
|
| Rate for Payer: Networks By Design Commercial |
$2,798.90
|
| Rate for Payer: Networks By Design Commercial |
$3,978.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,202.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,660.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,672.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,583.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,369.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,369.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,060.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,153.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| 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 HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,808.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,808.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Vantage Medical Group Senior |
$7,808.19
|
| Rate for Payer: Vantage Medical Group Senior |
$7,808.19
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,433.50
|
| 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 Foundation Hospitals Commercial/Self Funded |
$3,114.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,893.95
|
| 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 SUBMUCOSAL INJ
|
Facility
|
OP
|
$4,905.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
906745381
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$693.64 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$981.00
|
| Rate for Payer: Adventist Health Commercial |
$776.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Cash Price |
$1,746.90
|
| Rate for Payer: Cash Price |
$2,207.25
|
| Rate for Payer: Cash Price |
$2,207.25
|
| Rate for Payer: Cash Price |
$1,746.90
|
| Rate for Payer: Cash Price |
$1,746.90
|
| Rate for Payer: Cash Price |
$2,207.25
|
| Rate for Payer: Cigna of CA HMO |
$3,139.20
|
| Rate for Payer: Cigna of CA HMO |
$2,484.48
|
| Rate for Payer: Cigna of CA PPO |
$2,872.68
|
| Rate for Payer: Cigna of CA PPO |
$3,629.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,433.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,717.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$4,169.25
|
| Rate for Payer: Galaxy Health WC |
$3,299.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,329.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,943.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$693.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$693.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,114.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,465.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$784.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$784.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$931.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,177.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,939.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,939.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$3,105.60
|
| Rate for Payer: Multiplan Commercial |
$3,924.00
|
| Rate for Payer: Networks By Design Commercial |
$3,188.25
|
| Rate for Payer: Networks By Design Commercial |
$2,523.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,169.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,299.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,943.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,329.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,941.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,452.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| 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 HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,861.20
|
| 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 Foundation Hospitals Commercial/Self Funded |
$3,502.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,254.44
|
| 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
|
$5,516.00
|
|
|
Service Code
|
CPT 45385
|
| Hospital Charge Code |
906745385
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$672.37 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,103.20
|
| Rate for Payer: Adventist Health Commercial |
$776.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Cash Price |
$1,746.90
|
| Rate for Payer: Cash Price |
$2,482.20
|
| Rate for Payer: Cash Price |
$2,482.20
|
| Rate for Payer: Cash Price |
$1,746.90
|
| Rate for Payer: Cash Price |
$1,746.90
|
| Rate for Payer: Cash Price |
$2,482.20
|
| Rate for Payer: Cigna of CA HMO |
$3,530.24
|
| Rate for Payer: Cigna of CA HMO |
$2,484.48
|
| Rate for Payer: Cigna of CA PPO |
$2,872.68
|
| Rate for Payer: Cigna of CA PPO |
$4,081.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,861.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,717.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$4,688.60
|
| Rate for Payer: Galaxy Health WC |
$3,299.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,329.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,309.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$672.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$672.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,502.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,465.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$760.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$760.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$931.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,323.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,939.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,939.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$3,105.60
|
| Rate for Payer: Multiplan Commercial |
$4,412.80
|
| Rate for Payer: Networks By Design Commercial |
$3,585.40
|
| Rate for Payer: Networks By Design Commercial |
$2,523.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,688.60
|
| Rate for Payer: Prime Health Services Commercial |
$3,299.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,309.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,329.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,941.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,758.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| 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 HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC COLONSCOPY STOMA W RMVL
|
Facility
|
OP
|
$4,581.00
|
|
|
Service Code
|
CPT 44394
|
| Hospital Charge Code |
906744394
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$521.64 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$916.20
|
| Rate for Payer: Adventist Health Commercial |
$644.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Cash Price |
$1,450.80
|
| Rate for Payer: Cash Price |
$2,061.45
|
| Rate for Payer: Cash Price |
$2,061.45
|
| Rate for Payer: Cash Price |
$1,450.80
|
| Rate for Payer: Cash Price |
$1,450.80
|
| Rate for Payer: Cash Price |
$2,061.45
|
| Rate for Payer: Cigna of CA HMO |
$2,931.84
|
| Rate for Payer: Cigna of CA HMO |
$2,063.36
|
| Rate for Payer: Cigna of CA PPO |
$2,385.76
|
| Rate for Payer: Cigna of CA PPO |
$3,389.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,206.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,256.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$3,893.85
|
| Rate for Payer: Galaxy Health WC |
$2,740.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,934.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,748.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$521.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$521.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,908.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,047.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$589.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$589.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$773.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,099.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,939.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,939.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$2,579.20
|
| Rate for Payer: Multiplan Commercial |
$3,664.80
|
| Rate for Payer: Networks By Design Commercial |
$2,977.65
|
| Rate for Payer: Networks By Design Commercial |
$2,095.60
|
| Rate for Payer: Prime Health Services Commercial |
$3,893.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,740.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,748.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,934.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,612.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,290.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| 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 HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,206.70
|
| 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 Foundation Hospitals Commercial/Self Funded |
$2,908.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,702.79
|
| 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
|
OP
|
$1,704.00
|
|
|
Service Code
|
CPT 44390
|
| Hospital Charge Code |
906744390
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$295.23 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$340.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| 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 |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,192.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| 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/Senior |
$1,961.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$295.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,082.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$333.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$408.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,507.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,602.75
|
| 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 |
$1,435.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$852.00
|
| 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 |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,192.80
|
| 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 Foundation Hospitals Commercial/Self Funded |
$1,082.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,005.36
|
| 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 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 |
$626.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$489.27
|
| Rate for Payer: Blue Shield of California Commercial |
$1,009.32
|
| Rate for Payer: Blue Shield of California Commercial |
$666.02
|
| 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 |
$338.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,107.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| 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/Senior |
$369.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$87.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,004.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$98.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$379.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$284.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$302.29
|
| 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 |
$225.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,107.40
|
| 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 Foundation Hospitals Commercial/Self Funded |
$1,004.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$933.38
|
| 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 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 |
$6,869.74 |
| Rate for Payer: Adventist Health Commercial |
$884.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,579.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,163.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| 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 |
$6,245.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,579.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,163.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,096.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,869.74
|
| Rate for Payer: EPIC Health Plan Senior |
$4,579.83
|
| 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/Senior |
$6,828.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,163.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,809.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$571.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,475.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,061.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,245.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,579.06
|
| 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 |
$4,163.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,579.83
|
| Rate for Payer: Vantage Medical Group Senior |
$4,163.48
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,096.80
|
| 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 Foundation Hospitals Commercial/Self Funded |
$2,809.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,610.16
|
| 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
|
$1,340.00
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
906757420
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$258.97 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$268.00
|
| Rate for Payer: Adventist Health Commercial |
$192.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$391.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$391.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$603.00
|
| Rate for Payer: Cash Price |
$603.00
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cash Price |
$603.00
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cigna of CA HMO |
$615.04
|
| Rate for Payer: Cigna of CA HMO |
$857.60
|
| Rate for Payer: Cigna of CA PPO |
$991.60
|
| Rate for Payer: Cigna of CA PPO |
$711.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$672.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$938.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.68
|
| Rate for Payer: EPIC Health Plan Senior |
$431.12
|
| Rate for Payer: EPIC Health Plan Senior |
$431.12
|
| Rate for Payer: Galaxy Health WC |
$1,139.00
|
| Rate for Payer: Galaxy Health WC |
$816.85
|
| Rate for Payer: Global Benefits Group Commercial |
$576.60
|
| Rate for Payer: Global Benefits Group Commercial |
$804.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$642.77
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$642.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$850.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$610.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$258.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$258.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$421.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$421.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$493.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$493.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$525.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$525.19
|
| Rate for Payer: Multiplan Commercial |
$768.80
|
| Rate for Payer: Multiplan Commercial |
$1,072.00
|
| Rate for Payer: Multiplan WC |
$615.83
|
| Rate for Payer: Multiplan WC |
$615.83
|
| Rate for Payer: Networks By Design Commercial |
$624.65
|
| Rate for Payer: Networks By Design Commercial |
$871.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,139.00
|
| Rate for Payer: Prime Health Services Commercial |
$816.85
|
| Rate for Payer: Prime Health Services WC |
$609.55
|
| Rate for Payer: Prime Health Services WC |
$609.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$576.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$804.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$670.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$480.50
|
| Rate for Payer: United Healthcare All Other HMO |
$480.50
|
| Rate for Payer: United Healthcare All Other HMO |
$670.00
|
| Rate for Payer: United Healthcare HMO Rider |
$670.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$670.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$480.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$391.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$391.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Vantage Medical Group Senior |
$391.93
|
| Rate for Payer: Vantage Medical Group Senior |
$391.93
|
|
|
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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$192.20
|
| Rate for Payer: Adventist Health Commercial |
$268.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$391.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$391.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Cash Price |
$603.00
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cash Price |
$603.00
|
| Rate for Payer: Cash Price |
$603.00
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cigna of CA HMO |
$615.04
|
| Rate for Payer: Cigna of CA HMO |
$857.60
|
| Rate for Payer: Cigna of CA PPO |
$991.60
|
| Rate for Payer: Cigna of CA PPO |
$711.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$672.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$938.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.68
|
| Rate for Payer: EPIC Health Plan Senior |
$431.12
|
| Rate for Payer: EPIC Health Plan Senior |
$431.12
|
| Rate for Payer: Galaxy Health WC |
$816.85
|
| Rate for Payer: Galaxy Health WC |
$1,139.00
|
| Rate for Payer: Global Benefits Group Commercial |
$804.00
|
| Rate for Payer: Global Benefits Group Commercial |
$576.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$642.77
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$642.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$228.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$228.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$610.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$850.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$258.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$258.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$548.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$548.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$493.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$493.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$525.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$525.19
|
| Rate for Payer: Multiplan Commercial |
$1,072.00
|
| Rate for Payer: Multiplan Commercial |
$768.80
|
| Rate for Payer: Networks By Design Commercial |
$624.65
|
| Rate for Payer: Networks By Design Commercial |
$871.00
|
| Rate for Payer: Prime Health Services Commercial |
$816.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,139.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$576.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$804.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$470.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$470.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$670.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$480.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| 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 HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$391.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$391.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Vantage Medical Group Senior |
$391.93
|
| Rate for Payer: Vantage Medical Group Senior |
$391.93
|
|
|
HC COLPOSCOPY VAG W CRVIX
|
Facility
|
IP
|
$1,340.00
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
906757420
|
|
Hospital Revenue Code
|
750
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$938.00
|
| 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 Foundation Hospitals Commercial/Self Funded |
$850.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$790.60
|
| 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
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$938.00
|
| 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 Foundation Hospitals Commercial/Self Funded |
$850.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$790.60
|
| 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
|
|
|
HC COLPOSCOPY W/BIOPSY CERVIX
|
Facility
|
OP
|
$1,607.00
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
902890150
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$163.67 |
| Max. Negotiated Rate |
$6,716.00 |
| Rate for Payer: Adventist Health Commercial |
$658.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$948.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$391.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$723.15
|
| Rate for Payer: Cash Price |
$723.15
|
| Rate for Payer: Cash Price |
$723.15
|
| Rate for Payer: Cigna of CA HMO |
$1,028.48
|
| Rate for Payer: Cigna of CA PPO |
$1,189.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,124.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.68
|
| Rate for Payer: EPIC Health Plan Senior |
$431.12
|
| Rate for Payer: Galaxy Health WC |
$1,365.95
|
| Rate for Payer: Global Benefits Group Commercial |
$964.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$642.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,020.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$163.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$421.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$385.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$493.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$525.19
|
| Rate for Payer: Multiplan Commercial |
$1,285.60
|
| Rate for Payer: Multiplan WC |
$615.83
|
| Rate for Payer: Networks By Design Commercial |
$1,044.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,365.95
|
| Rate for Payer: Prime Health Services WC |
$609.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$964.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$964.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$391.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Vantage Medical Group Senior |
$391.93
|
|
