|
HC SIALOLITHOTOMY, SUBMANDIBULAR
|
Facility
|
IP
|
$7,704.00
|
|
|
Service Code
|
CPT 42330
|
| Hospital Charge Code |
900501646
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,848.96 |
| Max. Negotiated Rate |
$6,548.40 |
| Rate for Payer: Cash Price |
$3,466.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,081.60
|
| Rate for Payer: Galaxy Health WC |
$6,548.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,622.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,138.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,935.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,848.96
|
| Rate for Payer: Multiplan Commercial |
$6,163.20
|
| Rate for Payer: Networks By Design Commercial |
$5,007.60
|
| Rate for Payer: Prime Health Services Commercial |
$6,548.40
|
|
|
HC S-ICD GEN&LEAD TEST POST IMPL
|
Facility
|
OP
|
$3,797.00
|
|
|
Service Code
|
CPT 93644
|
| Hospital Charge Code |
906811490
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$495.22 |
| Max. Negotiated Rate |
$6,668.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$738.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,227.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,088.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,088.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,278.20
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$1,708.65
|
| Rate for Payer: Cash Price |
$1,708.65
|
| Rate for Payer: Cash Price |
$1,708.65
|
| Rate for Payer: Cigna of CA HMO |
$2,430.08
|
| Rate for Payer: Cigna of CA PPO |
$2,809.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,227.45
|
| Rate for Payer: Dignity Health Media |
$3,227.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,227.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,518.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,518.80
|
| Rate for Payer: Galaxy Health WC |
$3,227.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,278.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,847.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,532.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$495.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$911.28
|
| Rate for Payer: Multiplan Commercial |
$3,037.60
|
| Rate for Payer: Networks By Design Commercial |
$2,468.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,227.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,278.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,278.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,227.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,227.45
|
| Rate for Payer: Vantage Medical Group Senior |
$3,227.45
|
|
|
HC S-ICD GEN&LEAD TEST POST IMPL
|
Facility
|
IP
|
$3,797.00
|
|
|
Service Code
|
CPT 93644
|
| Hospital Charge Code |
906811490
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$911.28 |
| Max. Negotiated Rate |
$3,227.45 |
| Rate for Payer: Cash Price |
$1,708.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,518.80
|
| Rate for Payer: Galaxy Health WC |
$3,227.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,278.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,532.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,446.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$911.28
|
| Rate for Payer: Multiplan Commercial |
$3,037.60
|
| Rate for Payer: Networks By Design Commercial |
$2,468.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,227.45
|
|
|
HC SICKLE CELL SCREEN
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
CPT 85660
|
| Hospital Charge Code |
900910034
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.46 |
| Max. Negotiated Rate |
$50.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$50.49
|
| Rate for Payer: Blue Distinction Transplant |
$12.60
|
| Rate for Payer: Blue Shield of California Commercial |
$13.57
|
| Rate for Payer: Blue Shield of California EPN |
$10.75
|
| Rate for Payer: Cash Price |
$9.45
|
| Rate for Payer: Cash Price |
$9.45
|
| Rate for Payer: Cigna of CA HMO |
$13.44
|
| Rate for Payer: Cigna of CA PPO |
$15.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.26
|
| Rate for Payer: Dignity Health Media |
$5.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.51
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.51
|
| Rate for Payer: Galaxy Health WC |
$17.85
|
| Rate for Payer: Global Benefits Group Commercial |
$12.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$15.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.04
|
| Rate for Payer: Heritage Provider Network Transplant |
$9.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.38
|
| Rate for Payer: Multiplan Commercial |
$16.80
|
| Rate for Payer: Networks By Design Commercial |
$13.65
|
| Rate for Payer: Prime Health Services Commercial |
$17.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.46
|
| Rate for Payer: United Healthcare All Other HMO |
$4.46
|
| Rate for Payer: United Healthcare HMO Rider |
$4.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.06
|
| Rate for Payer: Vantage Medical Group Senior |
$5.51
|
|
|
HC SIGMDSCPY DX W WO COLLECT
|
Facility
|
IP
|
$5,488.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
906745330
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,317.12 |
| Max. Negotiated Rate |
$4,664.80 |
| Rate for Payer: Cash Price |
$2,469.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,195.20
|
| Rate for Payer: Galaxy Health WC |
$4,664.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,292.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,660.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,090.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,317.12
|
| Rate for Payer: Multiplan Commercial |
$4,390.40
|
| Rate for Payer: Networks By Design Commercial |
$3,567.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,664.80
|
|
|
HC SIGMDSCPY DX W WO COLLECT
|
Facility
|
OP
|
$3,411.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
906745330
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$103.99 |
| 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 |
$2,046.60
|
| 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 |
$1,534.95
|
| Rate for Payer: Cash Price |
$1,534.95
|
| Rate for Payer: Cigna of CA PPO |
$2,524.14
|
| 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 |
$2,899.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,046.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,558.25
|
| 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 |
$2,275.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$103.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$818.64
|
| 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 |
$2,728.80
|
| Rate for Payer: Networks By Design Commercial |
$2,217.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,899.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,046.60
|
| 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 SIGMDSCPY FLEX W POLYPECTOMY
|
Facility
|
OP
|
$3,995.00
|
|
|
Service Code
|
CPT 45333
|
| Hospital Charge Code |
906745333
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$201.61 |
| 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 |
$2,397.00
|
| 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 |
$1,797.75
|
| Rate for Payer: Cash Price |
$1,797.75
|
| Rate for Payer: Cigna of CA PPO |
$2,956.30
|
| 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 |
$3,395.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,397.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,996.25
|
| 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 |
$2,664.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$201.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$958.80
|
| 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 |
$3,196.00
|
| Rate for Payer: Networks By Design Commercial |
$2,596.75
|
| Rate for Payer: Prime Health Services Commercial |
$3,395.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,397.00
|
| 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 SIGMDSCPY FLEX W POLYPECTOMY
|
Facility
|
IP
|
$5,977.00
|
|
|
Service Code
|
CPT 45333
|
| Hospital Charge Code |
906745333
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,434.48 |
| Max. Negotiated Rate |
$5,080.45 |
| Rate for Payer: Cash Price |
$2,689.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,390.80
|
| Rate for Payer: Galaxy Health WC |
$5,080.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,586.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,986.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,277.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,434.48
|
| Rate for Payer: Multiplan Commercial |
$4,781.60
|
| Rate for Payer: Networks By Design Commercial |
$3,885.05
|
| Rate for Payer: Prime Health Services Commercial |
$5,080.45
|
|
|
HC SIGMDSCPY W BLLN DILATION
|
Facility
|
OP
|
$2,490.00
|
|
|
Service Code
|
CPT 45340
|
| Hospital Charge Code |
906745340
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$597.60 |
| 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 |
$1,494.00
|
| 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 |
$1,120.50
|
| Rate for Payer: Cash Price |
$1,120.50
|
| Rate for Payer: Cigna of CA PPO |
$1,842.60
|
| 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 |
$2,116.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,494.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,867.50
|
| 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 |
$1,660.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$675.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$597.60
|
| 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 |
$1,992.00
|
| Rate for Payer: Networks By Design Commercial |
$1,618.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,116.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,494.00
|
| 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 SIGMDSCPY W BLLN DILATION
|
Facility
|
IP
|
$3,726.00
|
|
|
Service Code
|
CPT 45340
|
| Hospital Charge Code |
906745340
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$894.24 |
| Max. Negotiated Rate |
$3,167.10 |
| Rate for Payer: Cash Price |
$1,676.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,490.40
|
| Rate for Payer: Galaxy Health WC |
$3,167.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,235.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,485.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,419.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$894.24
|
| Rate for Payer: Multiplan Commercial |
$2,980.80
|
| Rate for Payer: Networks By Design Commercial |
$2,421.90
|
| Rate for Payer: Prime Health Services Commercial |
$3,167.10
|
|
|
HC SIGMDSCPY W BX SNGL OR MULTI
|
Facility
|
OP
|
$4,307.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
906745331
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$137.24 |
| 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 |
$2,584.20
|
| 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 |
$1,938.15
|
| Rate for Payer: Cash Price |
$1,938.15
|
| Rate for Payer: Cigna of CA PPO |
$3,187.18
|
| 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 |
$3,660.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,584.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,230.25
|
| 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 |
$2,872.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,033.68
|
| 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 |
$3,445.60
|
| Rate for Payer: Networks By Design Commercial |
$2,799.55
|
| Rate for Payer: Prime Health Services Commercial |
$3,660.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,584.20
|
| 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 SIGMDSCPY W BX SNGL OR MULTI
|
Facility
|
IP
|
$6,446.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
906745331
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,547.04 |
| Max. Negotiated Rate |
$5,479.10 |
| Rate for Payer: Cash Price |
$2,900.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,578.40
|
| Rate for Payer: Galaxy Health WC |
$5,479.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,867.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,299.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,455.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,547.04
|
| Rate for Payer: Multiplan Commercial |
$5,156.80
|
| Rate for Payer: Networks By Design Commercial |
$4,189.90
|
| Rate for Payer: Prime Health Services Commercial |
$5,479.10
|
|
|
HC SIGMDSCPY W CNTRL BLEEDING
|
Facility
|
IP
|
$5,441.00
|
|
|
Service Code
|
CPT 45334
|
| Hospital Charge Code |
906745334
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,305.84 |
| Max. Negotiated Rate |
$4,624.85 |
| Rate for Payer: Cash Price |
$2,448.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,176.40
|
| Rate for Payer: Galaxy Health WC |
$4,624.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,264.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,629.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,073.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,305.84
|
| Rate for Payer: Multiplan Commercial |
$4,352.80
|
| Rate for Payer: Networks By Design Commercial |
$3,536.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,624.85
|
|
|
HC SIGMDSCPY W CNTRL BLEEDING
|
Facility
|
OP
|
$3,637.00
|
|
|
Service Code
|
CPT 45334
|
| Hospital Charge Code |
906745334
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$234.14 |
| 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 |
$2,182.20
|
| 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 |
$1,636.65
|
| Rate for Payer: Cash Price |
$1,636.65
|
| Rate for Payer: Cigna of CA PPO |
$2,691.38
|
| 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 |
$3,091.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,182.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,727.75
|
| 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 |
$2,425.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$234.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$872.88
|
| 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 |
$2,909.60
|
| Rate for Payer: Networks By Design Commercial |
$2,364.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,091.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,182.20
|
| 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 SIGMDSCPY W DECMPRS
|
Facility
|
IP
|
$7,611.00
|
|
|
Service Code
|
CPT 45337
|
| Hospital Charge Code |
906745337
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,826.64 |
| Max. Negotiated Rate |
$6,469.35 |
| Rate for Payer: Cash Price |
$3,424.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,044.40
|
| Rate for Payer: Galaxy Health WC |
$6,469.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,566.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,076.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,899.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,826.64
|
| Rate for Payer: Multiplan Commercial |
$6,088.80
|
| Rate for Payer: Networks By Design Commercial |
$4,947.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,469.35
|
|
|
HC SIGMDSCPY W DECMPRS
|
Facility
|
OP
|
$5,087.00
|
|
|
Service Code
|
CPT 45337
|
| Hospital Charge Code |
906745337
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$236.97 |
| 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 |
$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 |
$3,052.20
|
| 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 |
$2,289.15
|
| Rate for Payer: Cash Price |
$2,289.15
|
| Rate for Payer: Cigna of CA PPO |
$3,764.38
|
| 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 |
$4,323.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,052.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,815.25
|
| 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 |
$3,393.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$236.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,220.88
|
| 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 |
$4,069.60
|
| Rate for Payer: Networks By Design Commercial |
$3,306.55
|
| Rate for Payer: Prime Health Services Commercial |
$4,323.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,052.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,370.32
|
| 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 |
$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 SIGMDSCPY W ENDO US
|
Facility
|
IP
|
$5,897.00
|
|
|
Service Code
|
CPT 45341
|
| Hospital Charge Code |
906745341
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,415.28 |
| Max. Negotiated Rate |
$5,012.45 |
| Rate for Payer: Cash Price |
$2,653.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,358.80
|
| Rate for Payer: Galaxy Health WC |
$5,012.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,538.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,933.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,246.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,415.28
|
| Rate for Payer: Multiplan Commercial |
$4,717.60
|
| Rate for Payer: Networks By Design Commercial |
$3,833.05
|
| Rate for Payer: Prime Health Services Commercial |
$5,012.45
|
|
|
HC SIGMDSCPY W ENDO US
|
Facility
|
OP
|
$3,369.00
|
|
|
Service Code
|
CPT 45341
|
| Hospital Charge Code |
906745341
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$328.22 |
| 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 |
$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 |
$2,021.40
|
| 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 |
$1,516.05
|
| Rate for Payer: Cash Price |
$1,516.05
|
| Rate for Payer: Cigna of CA PPO |
$2,493.06
|
| 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 |
$2,863.65
|
| Rate for Payer: Global Benefits Group Commercial |
$2,021.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,526.75
|
| 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 |
$2,247.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$328.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$808.56
|
| 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 |
$2,695.20
|
| Rate for Payer: Networks By Design Commercial |
$2,189.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,863.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,021.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,370.32
|
| 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 |
$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 SIGMDSCPY W FB RMVL
|
Facility
|
IP
|
$6,100.00
|
|
|
Service Code
|
CPT 45332
|
| Hospital Charge Code |
906745332
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,464.00 |
| Max. Negotiated Rate |
$5,185.00 |
| Rate for Payer: Cash Price |
$2,745.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,440.00
|
| Rate for Payer: Galaxy Health WC |
$5,185.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,660.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,068.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,324.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,464.00
|
| Rate for Payer: Multiplan Commercial |
$4,880.00
|
| Rate for Payer: Networks By Design Commercial |
$3,965.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,185.00
|
|
|
HC SIGMDSCPY W FB RMVL
|
Facility
|
OP
|
$3,262.00
|
|
|
Service Code
|
CPT 45332
|
| Hospital Charge Code |
906745332
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$178.26 |
| 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 |
$1,957.20
|
| 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 |
$1,467.90
|
| Rate for Payer: Cash Price |
$1,467.90
|
| Rate for Payer: Cigna of CA PPO |
$2,413.88
|
| 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 |
$2,772.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,957.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,446.50
|
| 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 |
$2,175.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$178.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$782.88
|
| 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 |
$2,609.60
|
| Rate for Payer: Networks By Design Commercial |
$2,120.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,772.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,957.20
|
| 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 SIGMDSCPY W TRNS-EN US
|
Facility
|
IP
|
$4,791.00
|
|
|
Service Code
|
CPT 45342
|
| Hospital Charge Code |
906745342
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,149.84 |
| Max. Negotiated Rate |
$4,072.35 |
| Rate for Payer: Cash Price |
$2,155.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,916.40
|
| Rate for Payer: Galaxy Health WC |
$4,072.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,874.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,195.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,825.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,149.84
|
| Rate for Payer: Multiplan Commercial |
$3,832.80
|
| Rate for Payer: Networks By Design Commercial |
$3,114.15
|
| Rate for Payer: Prime Health Services Commercial |
$4,072.35
|
|
|
HC SIGMDSCPY W TRNS-EN US
|
Facility
|
OP
|
$3,066.00
|
|
|
Service Code
|
CPT 45342
|
| Hospital Charge Code |
906745342
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$377.04 |
| 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 |
$1,839.60
|
| 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 |
$1,379.70
|
| Rate for Payer: Cash Price |
$1,379.70
|
| Rate for Payer: Cigna of CA PPO |
$2,268.84
|
| 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 |
$2,606.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,839.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,299.50
|
| 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 |
$2,045.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$377.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$735.84
|
| 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 |
$2,452.80
|
| Rate for Payer: Networks By Design Commercial |
$1,992.90
|
| Rate for Payer: Prime Health Services Commercial |
$2,606.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,839.60
|
| 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 SIGMDSCPY W TUMOR ABLATION
|
Facility
|
IP
|
$3,961.00
|
|
|
Service Code
|
CPT 45346
|
| Hospital Charge Code |
906745346
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$950.64 |
| Max. Negotiated Rate |
$3,366.85 |
| Rate for Payer: Cash Price |
$1,782.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,584.40
|
| Rate for Payer: Galaxy Health WC |
$3,366.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,376.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,641.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,509.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$950.64
|
| Rate for Payer: Multiplan Commercial |
$3,168.80
|
| Rate for Payer: Networks By Design Commercial |
$2,574.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,366.85
|
|
|
HC SIGMDSCPY W TUMOR ABLATION
|
Facility
|
OP
|
$2,647.00
|
|
|
Service Code
|
CPT 45346
|
| Hospital Charge Code |
906745346
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$635.28 |
| 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 |
$1,588.20
|
| 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 |
$1,191.15
|
| Rate for Payer: Cash Price |
$1,191.15
|
| Rate for Payer: Cigna of CA PPO |
$1,958.78
|
| 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 |
$2,249.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,588.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,985.25
|
| 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 |
$1,765.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$635.28
|
| 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 |
$2,117.60
|
| Rate for Payer: Networks By Design Commercial |
$1,720.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,249.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,588.20
|
| 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 SIGMDSCPY W TUMOR SNARE RMVL
|
Facility
|
OP
|
$2,909.00
|
|
|
Service Code
|
CPT 45338
|
| Hospital Charge Code |
906745338
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$272.35 |
| 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 |
$1,745.40
|
| 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 |
$1,309.05
|
| Rate for Payer: Cash Price |
$1,309.05
|
| Rate for Payer: Cigna of CA PPO |
$2,152.66
|
| 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 |
$2,472.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,745.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,181.75
|
| 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 |
$1,940.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$272.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$698.16
|
| 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 |
$2,327.20
|
| Rate for Payer: Networks By Design Commercial |
$1,890.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,472.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,745.40
|
| 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
|
|
