|
HC PROC DENTOALVEOLAR STRUCTR
|
Facility
|
IP
|
$6,224.00
|
|
|
Service Code
|
CPT 41899
|
| Hospital Charge Code |
900501221
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,493.76 |
| Max. Negotiated Rate |
$5,290.40 |
| Rate for Payer: Cash Price |
$2,800.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,489.60
|
| Rate for Payer: Galaxy Health WC |
$5,290.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,734.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,151.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,371.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,493.76
|
| Rate for Payer: Multiplan Commercial |
$4,979.20
|
| Rate for Payer: Networks By Design Commercial |
$4,045.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,290.40
|
|
|
HC PROCEDURE ANUS
|
Facility
|
OP
|
$1,429.00
|
|
|
Service Code
|
CPT 46999
|
| Hospital Charge Code |
900501653
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$342.96 |
| Max. Negotiated Rate |
$3,429.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,299.00
|
| Rate for Payer: Blue Distinction Transplant |
$857.40
|
| Rate for Payer: Cash Price |
$643.05
|
| Rate for Payer: Cash Price |
$643.05
|
| Rate for Payer: Cash Price |
$643.05
|
| Rate for Payer: Cigna of CA PPO |
$1,057.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Dignity Health Media |
$1,141.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,256.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$1,214.65
|
| Rate for Payer: Global Benefits Group Commercial |
$857.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,071.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,872.77
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,872.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,141.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$953.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$342.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,438.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$1,143.20
|
| Rate for Payer: Networks By Design Commercial |
$928.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,214.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$857.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$714.50
|
| Rate for Payer: United Healthcare All Other HMO |
$714.50
|
| Rate for Payer: United Healthcare HMO Rider |
$714.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$714.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC PROCEDURE ANUS
|
Facility
|
IP
|
$1,429.00
|
|
|
Service Code
|
CPT 46999
|
| Hospital Charge Code |
900501653
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$342.96 |
| Max. Negotiated Rate |
$1,214.65 |
| Rate for Payer: Cash Price |
$643.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$571.60
|
| Rate for Payer: Galaxy Health WC |
$1,214.65
|
| Rate for Payer: Global Benefits Group Commercial |
$857.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$953.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$544.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$342.96
|
| Rate for Payer: Multiplan Commercial |
$1,143.20
|
| Rate for Payer: Networks By Design Commercial |
$928.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,214.65
|
|
|
HC PROCEDURE CARDIAC SURG
|
Facility
|
OP
|
$1,160.00
|
|
|
Service Code
|
CPT 33999
|
| Hospital Charge Code |
900501696
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$278.40 |
| Max. Negotiated Rate |
$3,171.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$784.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,299.00
|
| Rate for Payer: Blue Distinction Transplant |
$696.00
|
| Rate for Payer: Cash Price |
$522.00
|
| Rate for Payer: Cash Price |
$522.00
|
| Rate for Payer: Cash Price |
$522.00
|
| Rate for Payer: Cigna of CA PPO |
$858.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Dignity Health Media |
$784.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$863.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,059.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$784.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$784.90
|
| Rate for Payer: Galaxy Health WC |
$986.00
|
| Rate for Payer: Global Benefits Group Commercial |
$696.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$870.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,287.24
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,287.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$784.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$773.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$278.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$988.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,051.77
|
| Rate for Payer: Multiplan Commercial |
$928.00
|
| Rate for Payer: Networks By Design Commercial |
$754.00
|
| Rate for Payer: Prime Health Services Commercial |
$986.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$696.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$580.00
|
| Rate for Payer: United Healthcare All Other HMO |
$580.00
|
| Rate for Payer: United Healthcare HMO Rider |
$580.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$580.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: Vantage Medical Group Senior |
$784.90
|
|
|
HC PROCEDURE CARDIAC SURG
|
Facility
|
IP
|
$1,160.00
|
|
|
Service Code
|
CPT 33999
|
| Hospital Charge Code |
900501696
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$278.40 |
| Max. Negotiated Rate |
$986.00 |
| Rate for Payer: Cash Price |
$522.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$464.00
|
| Rate for Payer: Galaxy Health WC |
$986.00
|
| Rate for Payer: Global Benefits Group Commercial |
$696.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$773.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$441.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$278.40
|
| Rate for Payer: Multiplan Commercial |
$928.00
|
| Rate for Payer: Networks By Design Commercial |
$754.00
|
| Rate for Payer: Prime Health Services Commercial |
$986.00
|
|
|
HC PROCEDURE NOSE
|
Facility
|
OP
|
$659.00
|
|
|
Service Code
|
CPT 30999
|
| Hospital Charge Code |
900501667
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$158.16 |
| Max. Negotiated Rate |
$3,429.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$305.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,299.00
|
| Rate for Payer: Blue Distinction Transplant |
$395.40
|
| Rate for Payer: Cash Price |
$296.55
|
| Rate for Payer: Cash Price |
$296.55
|
| Rate for Payer: Cash Price |
$296.55
|
| Rate for Payer: Cigna of CA PPO |
$487.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: Dignity Health Media |
$305.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$560.15
|
| Rate for Payer: Global Benefits Group Commercial |
$395.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$494.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$500.51
|
| Rate for Payer: Heritage Provider Network Transplant |
$500.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$305.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$439.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$527.20
|
| Rate for Payer: Networks By Design Commercial |
$428.35
|
| Rate for Payer: Prime Health Services Commercial |
$560.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$395.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$329.50
|
| Rate for Payer: United Healthcare All Other HMO |
$329.50
|
| Rate for Payer: United Healthcare HMO Rider |
$329.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$329.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC PROCEDURE NOSE
|
Facility
|
IP
|
$659.00
|
|
|
Service Code
|
CPT 30999
|
| Hospital Charge Code |
900501667
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$158.16 |
| Max. Negotiated Rate |
$560.15 |
| Rate for Payer: Cash Price |
$296.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$263.60
|
| Rate for Payer: Galaxy Health WC |
$560.15
|
| Rate for Payer: Global Benefits Group Commercial |
$395.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$439.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$251.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.16
|
| Rate for Payer: Multiplan Commercial |
$527.20
|
| Rate for Payer: Networks By Design Commercial |
$428.35
|
| Rate for Payer: Prime Health Services Commercial |
$560.15
|
|
|
HC PROC PHARYNX ADENOIDS
|
Facility
|
IP
|
$3,431.00
|
|
|
Service Code
|
CPT 42999
|
| Hospital Charge Code |
900501360
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$823.44 |
| Max. Negotiated Rate |
$2,916.35 |
| Rate for Payer: Cash Price |
$1,543.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,372.40
|
| Rate for Payer: Galaxy Health WC |
$2,916.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,058.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,288.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,307.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$823.44
|
| Rate for Payer: Multiplan Commercial |
$2,744.80
|
| Rate for Payer: Networks By Design Commercial |
$2,230.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,916.35
|
|
|
HC PROC PHARYNX ADENOIDS
|
Facility
|
OP
|
$3,431.00
|
|
|
Service Code
|
CPT 42999
|
| Hospital Charge Code |
900501360
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$305.19 |
| Max. Negotiated Rate |
$3,429.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$305.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,299.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,058.60
|
| Rate for Payer: Cash Price |
$1,543.95
|
| Rate for Payer: Cash Price |
$1,543.95
|
| Rate for Payer: Cash Price |
$1,543.95
|
| Rate for Payer: Cigna of CA PPO |
$2,538.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: Dignity Health Media |
$305.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$2,916.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,058.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,573.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$500.51
|
| Rate for Payer: Heritage Provider Network Transplant |
$500.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$305.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,288.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$823.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$2,744.80
|
| Rate for Payer: Networks By Design Commercial |
$2,230.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,916.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,058.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,715.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,715.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,715.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,715.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC PROC RECTUM
|
Facility
|
IP
|
$1,293.00
|
|
|
Service Code
|
CPT 45999
|
| Hospital Charge Code |
900501387
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$310.32 |
| Max. Negotiated Rate |
$1,099.05 |
| Rate for Payer: Cash Price |
$581.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$517.20
|
| Rate for Payer: Galaxy Health WC |
$1,099.05
|
| Rate for Payer: Global Benefits Group Commercial |
$775.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$862.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$492.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$310.32
|
| Rate for Payer: Multiplan Commercial |
$1,034.40
|
| Rate for Payer: Networks By Design Commercial |
$840.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,099.05
|
|
|
HC PROC RECTUM
|
Facility
|
OP
|
$1,293.00
|
|
|
Service Code
|
CPT 45999
|
| Hospital Charge Code |
900501387
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$310.32 |
| Max. Negotiated Rate |
$3,171.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,299.00
|
| Rate for Payer: Blue Distinction Transplant |
$775.80
|
| Rate for Payer: Cash Price |
$581.85
|
| Rate for Payer: Cash Price |
$581.85
|
| Rate for Payer: Cash Price |
$581.85
|
| Rate for Payer: Cigna of CA PPO |
$956.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Dignity Health Media |
$1,141.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,256.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$1,099.05
|
| Rate for Payer: Global Benefits Group Commercial |
$775.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$969.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,872.77
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,872.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,141.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$862.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$310.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,438.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$1,034.40
|
| Rate for Payer: Networks By Design Commercial |
$840.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,099.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$775.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$646.50
|
| Rate for Payer: United Healthcare All Other HMO |
$646.50
|
| Rate for Payer: United Healthcare HMO Rider |
$646.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$646.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC PROC SK MUC MEMB & SUB
|
Facility
|
OP
|
$1,633.00
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
900501051
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$250.14 |
| Max. Negotiated Rate |
$3,429.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$250.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,299.00
|
| Rate for Payer: Blue Distinction Transplant |
$979.80
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Cigna of CA PPO |
$1,208.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: Dignity Health Media |
$250.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$275.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$250.14
|
| Rate for Payer: Galaxy Health WC |
$1,388.05
|
| Rate for Payer: Global Benefits Group Commercial |
$979.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,224.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$410.23
|
| Rate for Payer: Heritage Provider Network Transplant |
$410.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$250.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,089.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$391.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$315.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.19
|
| Rate for Payer: Multiplan Commercial |
$1,306.40
|
| Rate for Payer: Networks By Design Commercial |
$1,061.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,388.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$979.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$816.50
|
| Rate for Payer: United Healthcare All Other HMO |
$816.50
|
| Rate for Payer: United Healthcare HMO Rider |
$816.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$816.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
|
HC PROC SK MUC MEMB & SUB
|
Facility
|
IP
|
$1,633.00
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
900501051
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$391.92 |
| Max. Negotiated Rate |
$1,388.05 |
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$653.20
|
| Rate for Payer: Galaxy Health WC |
$1,388.05
|
| Rate for Payer: Global Benefits Group Commercial |
$979.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,089.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$622.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$391.92
|
| Rate for Payer: Multiplan Commercial |
$1,306.40
|
| Rate for Payer: Networks By Design Commercial |
$1,061.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,388.05
|
|
|
HC PROCTOSIGMODISOCPY W REMOVAL
|
Facility
|
OP
|
$2,048.00
|
|
|
Service Code
|
CPT 45309
|
| Hospital Charge Code |
906745309
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$186.75 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,228.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cigna of CA PPO |
$1,515.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Dignity Health Media |
$1,474.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,621.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Galaxy Health WC |
$1,740.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,228.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,536.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,418.05
|
| Rate for Payer: Heritage Provider Network Transplant |
$2,418.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2,388.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$2,388.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,474.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,366.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$186.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$491.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,857.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Multiplan Commercial |
$1,638.40
|
| Rate for Payer: Networks By Design Commercial |
$1,331.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,740.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,228.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,769.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC PROCTOSIGMODISOCPY W REMOVAL
|
Facility
|
IP
|
$3,065.00
|
|
|
Service Code
|
CPT 45309
|
| Hospital Charge Code |
906745309
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$735.60 |
| Max. Negotiated Rate |
$2,605.25 |
| Rate for Payer: Cash Price |
$1,379.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,226.00
|
| Rate for Payer: Galaxy Health WC |
$2,605.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,839.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,044.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,167.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$735.60
|
| Rate for Payer: Multiplan Commercial |
$2,452.00
|
| Rate for Payer: Networks By Design Commercial |
$1,992.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,605.25
|
|
|
HC PROCTOSIGMOIDOSCOPY RIGID/DIL
|
Facility
|
IP
|
$2,821.00
|
|
|
Service Code
|
CPT 45303
|
| Hospital Charge Code |
906745303
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$677.04 |
| Max. Negotiated Rate |
$2,397.85 |
| Rate for Payer: Cash Price |
$1,269.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,128.40
|
| Rate for Payer: Galaxy Health WC |
$2,397.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,692.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,881.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,074.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$677.04
|
| Rate for Payer: Multiplan Commercial |
$2,256.80
|
| Rate for Payer: Networks By Design Commercial |
$1,833.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,397.85
|
|
|
HC PROCTOSIGMOIDOSCOPY RIGID/DIL
|
Facility
|
OP
|
$1,886.00
|
|
|
Service Code
|
CPT 45303
|
| Hospital Charge Code |
906745303
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$77.80 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,131.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$848.70
|
| Rate for Payer: Cash Price |
$848.70
|
| Rate for Payer: Cigna of CA PPO |
$1,395.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Dignity Health Media |
$1,474.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,621.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Galaxy Health WC |
$1,603.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,131.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,414.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,418.05
|
| Rate for Payer: Heritage Provider Network Transplant |
$2,418.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2,388.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$2,388.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,474.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,257.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$452.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,857.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Multiplan Commercial |
$1,508.80
|
| Rate for Payer: Networks By Design Commercial |
$1,225.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,603.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,131.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC PROCTOSIGMOIDOSCOPY RIGID/DIL
|
Facility
|
IP
|
$2,821.00
|
|
|
Service Code
|
CPT 45303
|
| Hospital Charge Code |
906745303
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$677.04 |
| Max. Negotiated Rate |
$2,397.85 |
| Rate for Payer: Cash Price |
$1,269.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,128.40
|
| Rate for Payer: Galaxy Health WC |
$2,397.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,692.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,881.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,074.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$677.04
|
| Rate for Payer: Multiplan Commercial |
$2,256.80
|
| Rate for Payer: Networks By Design Commercial |
$1,833.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,397.85
|
|
|
HC PROCTOSIGMOIDOSCOPY RIGID/DIL
|
Facility
|
OP
|
$1,886.00
|
|
|
Service Code
|
CPT 45303
|
| Hospital Charge Code |
906745303
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$77.80 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,131.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$848.70
|
| Rate for Payer: Cash Price |
$848.70
|
| Rate for Payer: Cigna of CA PPO |
$1,395.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Dignity Health Media |
$1,474.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,621.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Galaxy Health WC |
$1,603.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,131.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,414.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,418.05
|
| Rate for Payer: Heritage Provider Network Transplant |
$2,418.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2,388.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$2,388.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,474.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,257.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$452.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,857.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Multiplan Commercial |
$1,508.80
|
| Rate for Payer: Networks By Design Commercial |
$1,225.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,603.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,131.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,769.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC PROCTOSIGMOIDOSCOPY W FB RMVL
|
Facility
|
IP
|
$8,211.00
|
|
|
Service Code
|
CPT 45307
|
| Hospital Charge Code |
906745307
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,970.64 |
| Max. Negotiated Rate |
$6,979.35 |
| Rate for Payer: Cash Price |
$3,694.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,284.40
|
| Rate for Payer: Galaxy Health WC |
$6,979.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,926.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,476.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,128.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,970.64
|
| Rate for Payer: Multiplan Commercial |
$6,568.80
|
| Rate for Payer: Networks By Design Commercial |
$5,337.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,979.35
|
|
|
HC PROCTOSIGMOIDOSCOPY W FB RMVL
|
Facility
|
OP
|
$4,390.00
|
|
|
Service Code
|
CPT 45307
|
| Hospital Charge Code |
906745307
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$147.14 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,262.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,858.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,508.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,634.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$1,975.50
|
| Rate for Payer: Cash Price |
$1,975.50
|
| Rate for Payer: Cigna of CA PPO |
$3,248.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,262.22
|
| Rate for Payer: Dignity Health Media |
$3,508.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,858.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,736.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,508.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,508.15
|
| Rate for Payer: Galaxy Health WC |
$3,731.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,634.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,292.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,753.37
|
| Rate for Payer: Heritage Provider Network Transplant |
$5,753.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5,683.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$5,683.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,508.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,928.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$147.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,508.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,053.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,420.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,700.92
|
| Rate for Payer: Multiplan Commercial |
$3,512.00
|
| Rate for Payer: Networks By Design Commercial |
$2,853.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,731.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,634.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,209.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,262.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,858.96
|
| Rate for Payer: Vantage Medical Group Senior |
$3,508.15
|
|
|
HC PROCTOSIGMOIDOSCOPY W WO COLL
|
Facility
|
IP
|
$5,994.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
900501380
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,438.56 |
| Max. Negotiated Rate |
$5,094.90 |
| Rate for Payer: Cash Price |
$2,697.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,397.60
|
| Rate for Payer: Galaxy Health WC |
$5,094.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,596.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,998.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,283.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,438.56
|
| Rate for Payer: Multiplan Commercial |
$4,795.20
|
| Rate for Payer: Networks By Design Commercial |
$3,896.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,094.90
|
|
|
HC PROCTOSIGMOIDOSCOPY W WO COLL
|
Facility
|
OP
|
$3,205.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
906745300
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$68.61 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,923.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$1,442.25
|
| Rate for Payer: Cash Price |
$1,442.25
|
| Rate for Payer: Cigna of CA PPO |
$2,371.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Dignity Health Media |
$1,141.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,256.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$2,724.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,923.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,403.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,872.77
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,872.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,849.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$1,849.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,141.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,137.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$68.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$769.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,438.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$2,564.00
|
| Rate for Payer: Networks By Design Commercial |
$2,083.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,724.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,923.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,370.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC PROCTOSIGMOIDOSCOPY W WO COLL
|
Facility
|
OP
|
$5,994.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
900501380
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$68.61 |
| Max. Negotiated Rate |
$5,094.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,596.40
|
| Rate for Payer: Cash Price |
$2,697.30
|
| Rate for Payer: Cash Price |
$2,697.30
|
| Rate for Payer: Cash Price |
$2,697.30
|
| Rate for Payer: Cigna of CA PPO |
$4,435.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Dignity Health Media |
$1,141.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,256.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$5,094.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,596.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,495.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,872.77
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,872.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,141.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,998.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$68.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,438.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,438.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$4,795.20
|
| Rate for Payer: Networks By Design Commercial |
$3,896.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,094.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,596.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,997.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,997.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,997.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,997.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC PROCTOSIGMOIDOSCOPY W WO COLL
|
Facility
|
IP
|
$5,994.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
906745300
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,438.56 |
| Max. Negotiated Rate |
$5,094.90 |
| Rate for Payer: Cash Price |
$2,697.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,397.60
|
| Rate for Payer: Galaxy Health WC |
$5,094.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,596.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,998.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,283.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,438.56
|
| Rate for Payer: Multiplan Commercial |
$4,795.20
|
| Rate for Payer: Networks By Design Commercial |
$3,896.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,094.90
|
|
