|
HC PACER LEAD REMOVE, DUAL A & V
|
Facility
IP
|
$5,957.00
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
906811364
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,429.68 |
| Max. Negotiated Rate |
$5,063.45 |
| Rate for Payer: Cash Price |
$2,680.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,382.80
|
| Rate for Payer: Galaxy Health WC |
$5,063.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,574.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,973.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,269.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,429.68
|
| Rate for Payer: Multiplan Commercial |
$4,765.60
|
| Rate for Payer: Networks By Design Commercial |
$3,872.05
|
| Rate for Payer: Prime Health Services Commercial |
$5,063.45
|
|
|
HC PACER LEAD REMOVE,SNGL A OR V
|
Facility
IP
|
$5,957.00
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
906811363
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,429.68 |
| Max. Negotiated Rate |
$5,063.45 |
| Rate for Payer: Cash Price |
$2,680.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,382.80
|
| Rate for Payer: Galaxy Health WC |
$5,063.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,574.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,973.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,269.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,429.68
|
| Rate for Payer: Multiplan Commercial |
$4,765.60
|
| Rate for Payer: Networks By Design Commercial |
$3,872.05
|
| Rate for Payer: Prime Health Services Commercial |
$5,063.45
|
|
|
HC PACER LEAD REMOVE,SNGL A OR V
|
Facility
OP
|
$5,957.00
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
906811363
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$505.76 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,906.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,574.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4,128.35
|
| Rate for Payer: Blue Shield of California EPN |
$2,686.96
|
| Rate for Payer: Cash Price |
$2,680.65
|
| Rate for Payer: Cash Price |
$2,680.65
|
| Rate for Payer: Cigna of CA PPO |
$4,408.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Dignity Health Media |
$4,906.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,397.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,623.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,906.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,906.54
|
| Rate for Payer: Galaxy Health WC |
$5,063.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,574.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,467.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,046.73
|
| Rate for Payer: Heritage Provider Network Transplant |
$8,046.73
|
| Rate for Payer: IEHP Medi-Cal |
$7,948.59
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$7,948.59
|
| Rate for Payer: IEHP Medicare Advantage |
$4,906.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,973.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$505.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,906.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,429.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,182.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,574.76
|
| Rate for Payer: Multiplan Commercial |
$4,765.60
|
| Rate for Payer: Networks By Design Commercial |
$3,872.05
|
| Rate for Payer: Prime Health Services Commercial |
$5,063.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,574.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,574.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,359.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,397.19
|
| Rate for Payer: Vantage Medical Group Senior |
$4,906.54
|
|
|
HC PACER POCKET REVISION/RELOCATE
|
Facility
IP
|
$4,436.00
|
|
|
Service Code
|
CPT 33222
|
| Hospital Charge Code |
906811357
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,064.64 |
| Max. Negotiated Rate |
$3,770.60 |
| Rate for Payer: Cash Price |
$1,996.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,774.40
|
| Rate for Payer: Galaxy Health WC |
$3,770.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,661.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,958.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,690.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,064.64
|
| Rate for Payer: Multiplan Commercial |
$3,548.80
|
| Rate for Payer: Networks By Design Commercial |
$2,883.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,770.60
|
|
|
HC PACER POCKET REVISION/RELOCATE
|
Facility
OP
|
$4,436.00
|
|
|
Service Code
|
CPT 33222
|
| Hospital Charge Code |
906811357
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$584.29 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,417.74
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,506.34
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,278.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,661.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,612.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,351.09
|
| Rate for Payer: Cash Price |
$1,996.20
|
| Rate for Payer: Cash Price |
$1,996.20
|
| Rate for Payer: Cigna of CA PPO |
$3,282.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,417.74
|
| Rate for Payer: Dignity Health Media |
$2,278.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,506.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,075.96
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,278.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,278.49
|
| Rate for Payer: Galaxy Health WC |
$3,770.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,661.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,327.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,736.72
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,736.72
|
| Rate for Payer: IEHP Medi-Cal |
$3,691.15
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$3,691.15
|
| Rate for Payer: IEHP Medicare Advantage |
$2,278.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,958.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$584.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,278.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,064.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,870.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,053.18
|
| Rate for Payer: Multiplan Commercial |
$3,548.80
|
| Rate for Payer: Networks By Design Commercial |
$2,883.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,770.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,661.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,661.60
|
| 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 |
$3,417.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,506.34
|
| Rate for Payer: Vantage Medical Group Senior |
$2,278.49
|
|
|
HC PACER UPGRADE SINGLE TO DUAL
|
Facility
IP
|
$36,419.00
|
|
|
Service Code
|
CPT 33214
|
| Hospital Charge Code |
906811362
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,740.56 |
| Max. Negotiated Rate |
$30,956.15 |
| Rate for Payer: Cash Price |
$16,388.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,567.60
|
| Rate for Payer: Galaxy Health WC |
$30,956.15
|
| Rate for Payer: Global Benefits Group Commercial |
$21,851.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24,291.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,875.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,740.56
|
| Rate for Payer: Multiplan Commercial |
$29,135.20
|
| Rate for Payer: Networks By Design Commercial |
$23,672.35
|
| Rate for Payer: Prime Health Services Commercial |
$30,956.15
|
|
|
HC PACER UPGRADE SINGLE TO DUAL
|
Facility
OP
|
$36,419.00
|
|
|
Service Code
|
CPT 33214
|
| Hospital Charge Code |
906811362
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$754.05 |
| Max. Negotiated Rate |
$51,156.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,341.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,201.00
|
| Rate for Payer: BCBS Transplant Transplant |
$21,851.40
|
| Rate for Payer: Blue Shield of California Commercial |
$10,844.87
|
| Rate for Payer: Blue Shield of California EPN |
$7,058.45
|
| Rate for Payer: Cash Price |
$16,388.55
|
| Rate for Payer: Cash Price |
$16,388.55
|
| Rate for Payer: Cash Price |
$16,388.55
|
| Rate for Payer: Cigna of CA PPO |
$26,950.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Dignity Health Media |
$13,341.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,675.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,011.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,341.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,341.78
|
| Rate for Payer: Galaxy Health WC |
$30,956.15
|
| Rate for Payer: Global Benefits Group Commercial |
$21,851.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$27,314.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,880.52
|
| Rate for Payer: Heritage Provider Network Transplant |
$21,880.52
|
| Rate for Payer: IEHP Medi-Cal |
$21,613.68
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$21,613.68
|
| Rate for Payer: IEHP Medicare Advantage |
$13,341.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24,291.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$754.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,341.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,740.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,810.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,877.99
|
| Rate for Payer: Multiplan Commercial |
$29,135.20
|
| Rate for Payer: Multiplan WC |
$18,240.12
|
| Rate for Payer: Networks By Design Commercial |
$23,672.35
|
| Rate for Payer: Prime Health Services Commercial |
$30,956.15
|
| Rate for Payer: Prime Health Services WC |
$18,054.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$21,851.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21,851.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$41,597.00
|
| Rate for Payer: United Healthcare All Other HMO |
$51,156.00
|
| Rate for Payer: United Healthcare HMO Rider |
$35,783.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32,722.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,012.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,675.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13,341.78
|
|
|
HC PAIN MANAGEMENT SERVICES
|
Facility
OP
|
$11,817.00
|
|
| Hospital Charge Code |
900700075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,836.08 |
| Max. Negotiated Rate |
$10,044.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,750.77
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,044.45
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6,499.35
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6,499.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,040.57
|
| Rate for Payer: BCBS Transplant Transplant |
$7,090.20
|
| 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 |
$5,317.65
|
| Rate for Payer: Cash Price |
$5,317.65
|
| Rate for Payer: Cigna of CA PPO |
$8,744.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,044.45
|
| Rate for Payer: Dignity Health Media |
$10,044.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,044.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,726.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,726.80
|
| Rate for Payer: Galaxy Health WC |
$10,044.45
|
| Rate for Payer: Global Benefits Group Commercial |
$7,090.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8,862.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,881.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,502.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,836.08
|
| Rate for Payer: Multiplan Commercial |
$9,453.60
|
| Rate for Payer: Networks By Design Commercial |
$7,681.05
|
| Rate for Payer: Prime Health Services Commercial |
$10,044.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7,090.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,090.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,908.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,908.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,908.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,908.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,044.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,044.45
|
| Rate for Payer: Vantage Medical Group Senior |
$10,044.45
|
|
|
HC PAIN MANAGEMENT SERVICES
|
Facility
IP
|
$11,817.00
|
|
| Hospital Charge Code |
900700075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,836.08 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$5,317.65
|
| Rate for Payer: Cash Price |
$5,317.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,726.80
|
| Rate for Payer: Galaxy Health WC |
$10,044.45
|
| Rate for Payer: Global Benefits Group Commercial |
$7,090.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,881.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,502.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,836.08
|
| Rate for Payer: Multiplan Commercial |
$9,453.60
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$10,044.45
|
|
|
HC PANCREAS BIOPSY PERCUTANEOUS
|
Facility
OP
|
$2,911.00
|
|
|
Service Code
|
CPT 48102
|
| Hospital Charge Code |
909000153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$698.64 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,746.60
|
| 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 |
$1,309.95
|
| Rate for Payer: Cash Price |
$1,309.95
|
| Rate for Payer: Cigna of CA PPO |
$2,154.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Dignity Health Media |
$2,025.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
| Rate for Payer: Galaxy Health WC |
$2,474.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,746.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,183.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,322.13
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,322.13
|
| Rate for Payer: IEHP Medi-Cal |
$3,281.62
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$3,281.62
|
| Rate for Payer: IEHP Medicare Advantage |
$2,025.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,941.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$719.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$698.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,552.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
| Rate for Payer: Multiplan Commercial |
$2,328.80
|
| Rate for Payer: Networks By Design Commercial |
$1,892.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,474.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,746.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,746.60
|
| 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 |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC PANCREAS BIOPSY PERCUTANEOUS
|
Facility
IP
|
$2,911.00
|
|
|
Service Code
|
CPT 48102
|
| Hospital Charge Code |
909000153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$698.64 |
| Max. Negotiated Rate |
$2,474.35 |
| Rate for Payer: Cash Price |
$1,309.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,164.40
|
| Rate for Payer: Galaxy Health WC |
$2,474.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,746.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,941.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,109.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$698.64
|
| Rate for Payer: Multiplan Commercial |
$2,328.80
|
| Rate for Payer: Networks By Design Commercial |
$1,892.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,474.35
|
|
|
HC PANCREAS CELLVIZIO
|
Facility
OP
|
$945.00
|
|
|
Service Code
|
CPT 48999
|
| Hospital Charge Code |
906748999
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$226.80 |
| Max. Negotiated Rate |
$4,248.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$619.83
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$879.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$563.03
|
| Rate for Payer: BCBS Transplant Transplant |
$567.00
|
| 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 |
$425.25
|
| Rate for Payer: Cash Price |
$425.25
|
| Rate for Payer: Cigna of CA PPO |
$699.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Dignity Health Media |
$879.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$966.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,186.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.07
|
| Rate for Payer: Galaxy Health WC |
$803.25
|
| Rate for Payer: Global Benefits Group Commercial |
$567.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$708.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,441.67
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,441.67
|
| Rate for Payer: IEHP Medi-Cal |
$1,424.09
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$1,424.09
|
| Rate for Payer: IEHP Medicare Advantage |
$879.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$630.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$226.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,107.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,177.95
|
| Rate for Payer: Multiplan Commercial |
$756.00
|
| Rate for Payer: Networks By Design Commercial |
$614.25
|
| Rate for Payer: Prime Health Services Commercial |
$803.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$966.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$567.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,054.88
|
| 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 |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
|
HC PANCREAS CELLVIZIO
|
Facility
IP
|
$1,473.00
|
|
|
Service Code
|
CPT 48999
|
| Hospital Charge Code |
906748999
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$353.52 |
| Max. Negotiated Rate |
$1,252.05 |
| Rate for Payer: Cash Price |
$662.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$589.20
|
| Rate for Payer: Galaxy Health WC |
$1,252.05
|
| Rate for Payer: Global Benefits Group Commercial |
$883.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$982.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$561.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$353.52
|
| Rate for Payer: Multiplan Commercial |
$1,178.40
|
| Rate for Payer: Networks By Design Commercial |
$957.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,252.05
|
|
|
HC PANCREATIC PSDOCYST EXT DRN
|
Facility
IP
|
$629.00
|
|
|
Service Code
|
CPT 48510
|
| Hospital Charge Code |
909000155
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$150.96 |
| Max. Negotiated Rate |
$534.65 |
| Rate for Payer: Cash Price |
$283.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$251.60
|
| Rate for Payer: Galaxy Health WC |
$534.65
|
| Rate for Payer: Global Benefits Group Commercial |
$377.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$419.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$239.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.96
|
| Rate for Payer: Multiplan Commercial |
$503.20
|
| Rate for Payer: Networks By Design Commercial |
$408.85
|
| Rate for Payer: Prime Health Services Commercial |
$534.65
|
|
|
HC PANCREATIC PSDOCYST EXT DRN
|
Facility
OP
|
$629.00
|
|
|
Service Code
|
CPT 48510
|
| Hospital Charge Code |
909000155
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$150.96 |
| Max. Negotiated Rate |
$8,241.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6,168.48
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$534.65
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$345.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$345.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,241.00
|
| Rate for Payer: BCBS Transplant Transplant |
$377.40
|
| 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 |
$283.05
|
| Rate for Payer: Cash Price |
$283.05
|
| Rate for Payer: Cigna of CA PPO |
$465.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$534.65
|
| Rate for Payer: Dignity Health Media |
$534.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$534.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$251.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$251.60
|
| Rate for Payer: Galaxy Health WC |
$534.65
|
| Rate for Payer: Global Benefits Group Commercial |
$377.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$471.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$419.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$241.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.96
|
| Rate for Payer: Multiplan Commercial |
$503.20
|
| Rate for Payer: Networks By Design Commercial |
$408.85
|
| Rate for Payer: Prime Health Services Commercial |
$534.65
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$377.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$377.40
|
| 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 |
$534.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$534.65
|
| Rate for Payer: Vantage Medical Group Senior |
$534.65
|
|
|
HC PAP S EAR-THIN PREP PG
|
Facility
IP
|
$60.00
|
|
|
Service Code
|
CPT 88142
|
| Hospital Charge Code |
903800211
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.00
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.40
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
|
|
HC PAP S EAR-THIN PREP PG
|
Facility
OP
|
$60.00
|
|
|
Service Code
|
CPT 88142
|
| Hospital Charge Code |
903800211
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$168.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$168.45
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$30.39
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$22.29
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$20.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$128.99
|
| Rate for Payer: BCBS Transplant Transplant |
$36.00
|
| Rate for Payer: Blue Shield of California Commercial |
$38.76
|
| Rate for Payer: Blue Shield of California EPN |
$30.72
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cigna of CA HMO |
$38.40
|
| Rate for Payer: Cigna of CA PPO |
$44.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.39
|
| Rate for Payer: Dignity Health Media |
$20.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.35
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20.26
|
| Rate for Payer: EPIC Health Plan Transplant |
$20.26
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$45.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$33.23
|
| Rate for Payer: Heritage Provider Network Transplant |
$33.23
|
| Rate for Payer: IEHP Medi-Cal |
$32.82
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$32.82
|
| Rate for Payer: IEHP Medicare Advantage |
$20.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.15
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$36.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.41
|
| Rate for Payer: United Healthcare All Other HMO |
$16.41
|
| Rate for Payer: United Healthcare HMO Rider |
$16.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.29
|
| Rate for Payer: Vantage Medical Group Senior |
$20.26
|
|
|
HC PAP SMEAR-CONVENTIONAL PG
|
Facility
IP
|
$25.00
|
|
|
Service Code
|
CPT 88164
|
| Hospital Charge Code |
903800212
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$21.25 |
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Multiplan Commercial |
$20.00
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
|
|
HC PAP SMEAR-CONVENTIONAL PG
|
Facility
OP
|
$25.00
|
|
|
Service Code
|
CPT 88164
|
| Hospital Charge Code |
903800212
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$87.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$87.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$19.04
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$17.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.17
|
| Rate for Payer: BCBS Transplant Transplant |
$15.00
|
| Rate for Payer: Blue Shield of California Commercial |
$16.15
|
| Rate for Payer: Blue Shield of California EPN |
$12.80
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cigna of CA HMO |
$16.00
|
| Rate for Payer: Cigna of CA PPO |
$18.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.96
|
| Rate for Payer: Dignity Health Media |
$17.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.37
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$17.31
|
| Rate for Payer: EPIC Health Plan Transplant |
$17.31
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$18.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$28.39
|
| Rate for Payer: Heritage Provider Network Transplant |
$28.39
|
| Rate for Payer: IEHP Medi-Cal |
$28.04
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$28.04
|
| Rate for Payer: IEHP Medicare Advantage |
$17.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.20
|
| Rate for Payer: Multiplan Commercial |
$20.00
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.90
|
| Rate for Payer: United Healthcare All Other HMO |
$12.90
|
| Rate for Payer: United Healthcare HMO Rider |
$12.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.04
|
| Rate for Payer: Vantage Medical Group Senior |
$17.31
|
|
|
HC PARACENTESIS EYE RML BLOOD
|
Facility
OP
|
$6,236.00
|
|
|
Service Code
|
CPT 65815
|
| Hospital Charge Code |
950442303
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$432.92 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,367.44
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,202.79
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,911.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,741.60
|
| Rate for Payer: Cash Price |
$2,806.20
|
| Rate for Payer: Cash Price |
$2,806.20
|
| Rate for Payer: Cash Price |
$2,806.20
|
| Rate for Payer: Cigna of CA PPO |
$4,614.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,367.44
|
| Rate for Payer: Dignity Health Media |
$2,911.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,202.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,930.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,911.63
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,911.63
|
| Rate for Payer: Galaxy Health WC |
$5,300.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,741.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,677.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,775.07
|
| Rate for Payer: Heritage Provider Network Transplant |
$4,775.07
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$2,911.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,159.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$432.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,911.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,496.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,668.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,901.58
|
| Rate for Payer: Multiplan Commercial |
$4,988.80
|
| Rate for Payer: Networks By Design Commercial |
$4,053.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,300.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,741.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,741.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,118.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,118.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,118.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,118.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,367.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,202.79
|
| Rate for Payer: Vantage Medical Group Senior |
$2,911.63
|
|
|
HC PARACENTESIS EYE RML BLOOD
|
Facility
IP
|
$6,236.00
|
|
|
Service Code
|
CPT 65815
|
| Hospital Charge Code |
950442303
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,496.64 |
| Max. Negotiated Rate |
$5,300.60 |
| Rate for Payer: Cash Price |
$2,806.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,494.40
|
| Rate for Payer: Galaxy Health WC |
$5,300.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,741.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,159.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,375.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,496.64
|
| Rate for Payer: Multiplan Commercial |
$4,988.80
|
| Rate for Payer: Networks By Design Commercial |
$4,053.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,300.60
|
|
|
HC PARANASAL SINUS LTD
|
Facility
OP
|
$805.00
|
|
|
Service Code
|
CPT 70210
|
| Hospital Charge Code |
909001142
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$41.08 |
| Max. Negotiated Rate |
$684.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$141.76
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$113.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$161.55
|
| Rate for Payer: BCBS Transplant Transplant |
$483.00
|
| Rate for Payer: Blue Shield of California Commercial |
$475.76
|
| Rate for Payer: Blue Shield of California EPN |
$377.54
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Cigna of CA HMO |
$515.20
|
| Rate for Payer: Cigna of CA PPO |
$595.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$170.31
|
| Rate for Payer: Dignity Health Media |
$113.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$124.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$153.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$113.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$113.54
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$603.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$186.21
|
| Rate for Payer: Heritage Provider Network Transplant |
$186.21
|
| Rate for Payer: IEHP Medi-Cal |
$183.93
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$183.93
|
| Rate for Payer: IEHP Medicare Advantage |
$113.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$536.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$113.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$193.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$143.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$152.14
|
| Rate for Payer: Multiplan Commercial |
$644.00
|
| Rate for Payer: Networks By Design Commercial |
$523.25
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$483.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$483.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$483.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Vantage Medical Group Senior |
$113.54
|
|
|
HC PARANASAL SINUS LTD
|
Facility
IP
|
$805.00
|
|
|
Service Code
|
CPT 70210
|
| Hospital Charge Code |
909001142
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$193.20 |
| Max. Negotiated Rate |
$684.25 |
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.00
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$536.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$306.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$193.20
|
| Rate for Payer: Multiplan Commercial |
$644.00
|
| Rate for Payer: Networks By Design Commercial |
$523.25
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
|
|
HC PARASITE SCREEN
|
Facility
OP
|
$46.00
|
|
|
Service Code
|
CPT 87272
|
| Hospital Charge Code |
900911729
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.70 |
| Max. Negotiated Rate |
$82.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$77.24
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17.97
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$82.00
|
| Rate for Payer: BCBS Transplant Transplant |
$27.60
|
| Rate for Payer: Blue Shield of California Commercial |
$29.72
|
| Rate for Payer: Blue Shield of California EPN |
$23.55
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cigna of CA HMO |
$29.44
|
| Rate for Payer: Cigna of CA PPO |
$34.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.97
|
| Rate for Payer: Dignity Health Media |
$11.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11.98
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.98
|
| Rate for Payer: Galaxy Health WC |
$39.10
|
| Rate for Payer: Global Benefits Group Commercial |
$27.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$34.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.65
|
| Rate for Payer: Heritage Provider Network Transplant |
$19.65
|
| Rate for Payer: IEHP Medi-Cal |
$19.41
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$19.41
|
| Rate for Payer: IEHP Medicare Advantage |
$11.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.05
|
| Rate for Payer: Multiplan Commercial |
$36.80
|
| Rate for Payer: Networks By Design Commercial |
$29.90
|
| Rate for Payer: Prime Health Services Commercial |
$39.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$27.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.70
|
| Rate for Payer: United Healthcare All Other HMO |
$9.70
|
| Rate for Payer: United Healthcare HMO Rider |
$9.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.18
|
| Rate for Payer: Vantage Medical Group Senior |
$11.98
|
|
|
HC PARATHYROID
|
Facility
IP
|
$1,570.00
|
|
|
Service Code
|
CPT 78071
|
| Hospital Charge Code |
909301309
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$376.80 |
| Max. Negotiated Rate |
$1,334.50 |
| Rate for Payer: Networks By Design Commercial |
$1,020.50
|
| Rate for Payer: Cash Price |
$706.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$628.00
|
| Rate for Payer: Galaxy Health WC |
$1,334.50
|
| Rate for Payer: Global Benefits Group Commercial |
$942.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,047.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$598.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$376.80
|
| Rate for Payer: Multiplan Commercial |
$1,256.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,334.50
|
|
