|
HC ENDOMYCARDIAL BIOPSY
|
Facility
|
IP
|
$5,733.00
|
|
|
Service Code
|
CPT 93505
|
| Hospital Charge Code |
906811308
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,146.60 |
| Max. Negotiated Rate |
$4,873.05 |
| Rate for Payer: Adventist Health Commercial |
$1,146.60
|
| Rate for Payer: Cash Price |
$2,579.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,013.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,293.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,293.20
|
| Rate for Payer: Galaxy Health WC |
$4,873.05
|
| Rate for Payer: Global Benefits Group Commercial |
$3,439.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,640.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,382.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,375.92
|
| Rate for Payer: Multiplan Commercial |
$4,586.40
|
| Rate for Payer: Networks By Design Commercial |
$3,726.45
|
| Rate for Payer: Prime Health Services Commercial |
$4,873.05
|
|
|
HC ENDO POLY HIP, PNEU/HYD/ROT
|
Facility
|
OP
|
$13,267.75
|
|
|
Service Code
|
CPT L5961
|
| Hospital Charge Code |
905355961
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$3,184.26 |
| Max. Negotiated Rate |
$11,277.59 |
| Rate for Payer: Adventist Health Commercial |
$5,439.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,277.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,297.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,950.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,030.97
|
| Rate for Payer: Blue Shield of California Commercial |
$10,202.90
|
| Rate for Payer: Blue Shield of California Commercial |
$6,726.75
|
| Rate for Payer: Cash Price |
$5,970.49
|
| Rate for Payer: Cigna of CA HMO |
$9,287.42
|
| Rate for Payer: Cigna of CA PPO |
$9,287.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,277.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,277.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11,277.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,287.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,307.10
|
| Rate for Payer: EPIC Health Plan Senior |
$5,307.10
|
| Rate for Payer: Galaxy Health WC |
$11,277.59
|
| Rate for Payer: Global Benefits Group Commercial |
$7,960.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,425.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,827.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,184.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,287.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,287.42
|
| Rate for Payer: Multiplan Commercial |
$10,614.20
|
| Rate for Payer: Networks By Design Commercial |
$6,633.88
|
| Rate for Payer: Prime Health Services Commercial |
$11,277.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,960.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,960.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,979.39
|
| Rate for Payer: United Healthcare All Other HMO |
$4,846.71
|
| Rate for Payer: United Healthcare HMO Rider |
$4,741.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,345.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,277.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,277.59
|
| Rate for Payer: Vantage Medical Group Senior |
$11,277.59
|
|
|
HC ENDO POLY HIP, PNEU/HYD/ROT
|
Facility
|
OP
|
$13,267.75
|
|
|
Service Code
|
CPT L5961
|
| Hospital Charge Code |
915355961
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$3,184.26 |
| Max. Negotiated Rate |
$11,277.59 |
| Rate for Payer: Adventist Health Commercial |
$5,439.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,277.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,297.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,950.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,030.97
|
| Rate for Payer: Blue Shield of California Commercial |
$10,202.90
|
| Rate for Payer: Blue Shield of California Commercial |
$6,726.75
|
| Rate for Payer: Cash Price |
$5,970.49
|
| Rate for Payer: Cigna of CA HMO |
$9,287.42
|
| Rate for Payer: Cigna of CA PPO |
$9,287.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,277.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,277.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11,277.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,287.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,307.10
|
| Rate for Payer: EPIC Health Plan Senior |
$5,307.10
|
| Rate for Payer: Galaxy Health WC |
$11,277.59
|
| Rate for Payer: Global Benefits Group Commercial |
$7,960.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,425.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,827.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,184.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,287.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,287.42
|
| Rate for Payer: Multiplan Commercial |
$10,614.20
|
| Rate for Payer: Networks By Design Commercial |
$6,633.88
|
| Rate for Payer: Prime Health Services Commercial |
$11,277.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,960.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,960.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,979.39
|
| Rate for Payer: United Healthcare All Other HMO |
$4,846.71
|
| Rate for Payer: United Healthcare HMO Rider |
$4,741.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,345.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,277.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,277.59
|
| Rate for Payer: Vantage Medical Group Senior |
$11,277.59
|
|
|
HC ENDO POLY HIP, PNEU/HYD/ROT
|
Facility
|
IP
|
$13,267.75
|
|
|
Service Code
|
CPT L5961
|
| Hospital Charge Code |
915355961
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$2,653.55 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$2,653.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$5,970.49
|
| Rate for Payer: Cash Price |
$5,970.49
|
| Rate for Payer: Cigna of CA HMO |
$9,287.42
|
| Rate for Payer: Cigna of CA PPO |
$9,287.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,287.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,307.10
|
| Rate for Payer: EPIC Health Plan Senior |
$5,307.10
|
| Rate for Payer: Galaxy Health WC |
$11,277.59
|
| Rate for Payer: Global Benefits Group Commercial |
$7,960.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,425.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,827.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,184.26
|
| Rate for Payer: Multiplan Commercial |
$10,614.20
|
| Rate for Payer: Networks By Design Commercial |
$8,624.04
|
| Rate for Payer: Prime Health Services Commercial |
$11,277.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,979.39
|
| Rate for Payer: United Healthcare All Other HMO |
$4,846.71
|
| Rate for Payer: United Healthcare HMO Rider |
$4,741.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,345.19
|
|
|
HC ENDO POLY HIP, PNEU/HYD/ROT
|
Facility
|
IP
|
$13,267.75
|
|
|
Service Code
|
CPT L5961
|
| Hospital Charge Code |
905355961
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$2,653.55 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$2,653.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$5,970.49
|
| Rate for Payer: Cash Price |
$5,970.49
|
| Rate for Payer: Cigna of CA HMO |
$9,287.42
|
| Rate for Payer: Cigna of CA PPO |
$9,287.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,287.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,307.10
|
| Rate for Payer: EPIC Health Plan Senior |
$5,307.10
|
| Rate for Payer: Galaxy Health WC |
$11,277.59
|
| Rate for Payer: Global Benefits Group Commercial |
$7,960.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,425.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,827.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,184.26
|
| Rate for Payer: Multiplan Commercial |
$10,614.20
|
| Rate for Payer: Networks By Design Commercial |
$8,624.04
|
| Rate for Payer: Prime Health Services Commercial |
$11,277.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,979.39
|
| Rate for Payer: United Healthcare All Other HMO |
$4,846.71
|
| Rate for Payer: United Healthcare HMO Rider |
$4,741.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,345.19
|
|
|
HC ENDO RESTORE2 W CLLCTN ADPTR 7.0-8.5MM
|
Facility
|
OP
|
$230.00
|
|
| Hospital Charge Code |
900800921
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.00 |
| Max. Negotiated Rate |
$195.50 |
| Rate for Payer: Adventist Health Commercial |
$46.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$150.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$195.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$126.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$172.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$147.59
|
| Rate for Payer: Cash Price |
$103.50
|
| Rate for Payer: Cigna of CA HMO |
$147.20
|
| Rate for Payer: Cigna of CA PPO |
$170.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$195.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$195.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$195.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$161.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$92.00
|
| Rate for Payer: EPIC Health Plan Senior |
$92.00
|
| Rate for Payer: Galaxy Health WC |
$195.50
|
| Rate for Payer: Global Benefits Group Commercial |
$138.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$146.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$83.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$135.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$161.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$161.00
|
| Rate for Payer: Multiplan Commercial |
$184.00
|
| Rate for Payer: Networks By Design Commercial |
$149.50
|
| Rate for Payer: Prime Health Services Commercial |
$195.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$138.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$138.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$115.00
|
| Rate for Payer: United Healthcare All Other HMO |
$115.00
|
| Rate for Payer: United Healthcare HMO Rider |
$115.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$115.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$195.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$195.50
|
| Rate for Payer: Vantage Medical Group Senior |
$195.50
|
|
|
HC ENDO RESTORE2 W CLLCTN ADPTR 7.0-8.5MM
|
Facility
|
IP
|
$230.00
|
|
| Hospital Charge Code |
900800921
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.00 |
| Max. Negotiated Rate |
$195.50 |
| Rate for Payer: Adventist Health Commercial |
$46.00
|
| Rate for Payer: Cash Price |
$103.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$161.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$92.00
|
| Rate for Payer: EPIC Health Plan Senior |
$92.00
|
| Rate for Payer: Galaxy Health WC |
$195.50
|
| Rate for Payer: Global Benefits Group Commercial |
$138.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$146.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$135.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.20
|
| Rate for Payer: Multiplan Commercial |
$184.00
|
| Rate for Payer: Networks By Design Commercial |
$149.50
|
| Rate for Payer: Prime Health Services Commercial |
$195.50
|
|
|
HC ENDOSCOPIC PANCREATOSCOPY
|
Facility
|
IP
|
$6,899.00
|
|
|
Service Code
|
CPT 43273
|
| Hospital Charge Code |
906743273
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,379.80 |
| Max. Negotiated Rate |
$5,864.15 |
| Rate for Payer: Adventist Health Commercial |
$1,379.80
|
| Rate for Payer: Cash Price |
$3,104.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,829.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,759.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,759.60
|
| Rate for Payer: Galaxy Health WC |
$5,864.15
|
| Rate for Payer: Global Benefits Group Commercial |
$4,139.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,380.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,070.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,655.76
|
| Rate for Payer: Multiplan Commercial |
$5,519.20
|
| Rate for Payer: Networks By Design Commercial |
$4,484.35
|
| Rate for Payer: Prime Health Services Commercial |
$5,864.15
|
|
|
HC ENDOSCOPIC PANCREATOSCOPY
|
Facility
|
OP
|
$6,389.00
|
|
|
Service Code
|
CPT 43273
|
| Hospital Charge Code |
906743273
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$157.00 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,277.80
|
| Rate for Payer: Adventist Health Commercial |
$1,379.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,864.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,430.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,794.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,513.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,791.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,174.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Cash Price |
$2,875.05
|
| Rate for Payer: Cash Price |
$3,104.55
|
| Rate for Payer: Cash Price |
$2,875.05
|
| Rate for Payer: Cash Price |
$2,875.05
|
| Rate for Payer: Cash Price |
$3,104.55
|
| Rate for Payer: Cash Price |
$3,104.55
|
| Rate for Payer: Cigna of CA HMO |
$4,415.36
|
| Rate for Payer: Cigna of CA HMO |
$4,088.96
|
| Rate for Payer: Cigna of CA PPO |
$5,105.26
|
| Rate for Payer: Cigna of CA PPO |
$4,727.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,864.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,430.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,430.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,864.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,864.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,430.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,472.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,829.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,759.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,555.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,759.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,555.60
|
| Rate for Payer: Galaxy Health WC |
$5,430.65
|
| Rate for Payer: Galaxy Health WC |
$5,864.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,833.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,139.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$157.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$157.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,057.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,380.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$177.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$177.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,070.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,769.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,533.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,655.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,829.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,472.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,829.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,472.30
|
| Rate for Payer: Multiplan Commercial |
$5,111.20
|
| Rate for Payer: Multiplan Commercial |
$5,519.20
|
| Rate for Payer: Networks By Design Commercial |
$4,152.85
|
| Rate for Payer: Networks By Design Commercial |
$4,484.35
|
| Rate for Payer: Prime Health Services Commercial |
$5,864.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,430.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,139.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,833.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,833.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,139.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,194.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,449.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,864.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,430.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,430.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,864.15
|
| Rate for Payer: Vantage Medical Group Senior |
$5,864.15
|
| Rate for Payer: Vantage Medical Group Senior |
$5,430.65
|
|
|
HC ENDOSCOPIC STUDY SWALLOW FUNCT MCAL
|
Facility
|
OP
|
$975.00
|
|
|
Service Code
|
CPT 92612
|
| Hospital Charge Code |
907000015
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$193.07 |
| Max. Negotiated Rate |
$828.75 |
| Rate for Payer: Adventist Health Commercial |
$399.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$447.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$828.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$536.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$731.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$478.00
|
| Rate for Payer: Blue Shield of California Commercial |
$291.00
|
| Rate for Payer: Blue Shield of California Commercial |
$439.00
|
| Rate for Payer: Cash Price |
$438.75
|
| Rate for Payer: Cash Price |
$438.75
|
| Rate for Payer: Cash Price |
$438.75
|
| Rate for Payer: Cash Price |
$438.75
|
| Rate for Payer: Cigna of CA HMO |
$624.00
|
| Rate for Payer: Cigna of CA PPO |
$721.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$828.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$828.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$828.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$682.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$390.00
|
| Rate for Payer: EPIC Health Plan Senior |
$390.00
|
| Rate for Payer: Galaxy Health WC |
$828.75
|
| Rate for Payer: Global Benefits Group Commercial |
$585.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$193.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$619.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$218.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$575.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$234.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$682.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$682.50
|
| Rate for Payer: Multiplan Commercial |
$780.00
|
| Rate for Payer: Networks By Design Commercial |
$633.75
|
| Rate for Payer: Prime Health Services Commercial |
$828.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$585.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$585.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$828.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$828.75
|
| Rate for Payer: Vantage Medical Group Senior |
$828.75
|
|
|
HC ENDOSCOPIC STUDY SWALLOW FUNCT MCAL
|
Facility
|
IP
|
$975.00
|
|
|
Service Code
|
CPT 92612
|
| Hospital Charge Code |
907000015
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$195.00 |
| Max. Negotiated Rate |
$828.75 |
| Rate for Payer: Adventist Health Commercial |
$195.00
|
| Rate for Payer: Cash Price |
$438.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$682.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$390.00
|
| Rate for Payer: EPIC Health Plan Senior |
$390.00
|
| Rate for Payer: Galaxy Health WC |
$828.75
|
| Rate for Payer: Global Benefits Group Commercial |
$585.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$619.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$575.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$234.00
|
| Rate for Payer: Multiplan Commercial |
$780.00
|
| Rate for Payer: Networks By Design Commercial |
$633.75
|
| Rate for Payer: Prime Health Services Commercial |
$828.75
|
|
|
HC ENDOSCOPIC US EXAM
|
Facility
|
IP
|
$2,829.00
|
|
|
Service Code
|
CPT 43237
|
| Hospital Charge Code |
906743237
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$565.80 |
| Max. Negotiated Rate |
$2,404.65 |
| Rate for Payer: Adventist Health Commercial |
$565.80
|
| Rate for Payer: Cash Price |
$1,273.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,980.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,131.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,131.60
|
| Rate for Payer: Galaxy Health WC |
$2,404.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,697.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,796.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,669.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$678.96
|
| Rate for Payer: Multiplan Commercial |
$2,263.20
|
| Rate for Payer: Networks By Design Commercial |
$1,838.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,404.65
|
|
|
HC ENDOSCOPIC US EXAM
|
Facility
|
OP
|
$2,829.00
|
|
|
Service Code
|
CPT 43237
|
| Hospital Charge Code |
906743237
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$210.15 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$565.80
|
| Rate for Payer: Adventist Health Commercial |
$302.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Cash Price |
$680.40
|
| Rate for Payer: Cash Price |
$1,273.05
|
| Rate for Payer: Cash Price |
$1,273.05
|
| Rate for Payer: Cash Price |
$680.40
|
| Rate for Payer: Cash Price |
$680.40
|
| Rate for Payer: Cash Price |
$1,273.05
|
| Rate for Payer: Cigna of CA HMO |
$1,810.56
|
| Rate for Payer: Cigna of CA HMO |
$967.68
|
| Rate for Payer: Cigna of CA PPO |
$1,118.88
|
| Rate for Payer: Cigna of CA PPO |
$2,093.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,980.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,058.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$2,404.65
|
| Rate for Payer: Galaxy Health WC |
$1,285.20
|
| Rate for Payer: Global Benefits Group Commercial |
$907.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,697.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$210.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$210.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,796.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$960.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$237.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$237.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$362.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$678.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,109.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,109.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$1,209.60
|
| Rate for Payer: Multiplan Commercial |
$2,263.20
|
| Rate for Payer: Networks By Design Commercial |
$1,838.85
|
| Rate for Payer: Networks By Design Commercial |
$982.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,404.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,285.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,697.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$907.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$756.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,414.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ENDO SM INT CNTRL BLEEDING
|
Facility
|
OP
|
$4,168.00
|
|
|
Service Code
|
CPT 44366
|
| Hospital Charge Code |
906744366
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$394.67 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$833.60
|
| Rate for Payer: Adventist Health Commercial |
$617.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$1,875.60
|
| Rate for Payer: Cash Price |
$1,875.60
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$1,875.60
|
| Rate for Payer: Cigna of CA HMO |
$2,667.52
|
| Rate for Payer: Cigna of CA HMO |
$1,976.32
|
| Rate for Payer: Cigna of CA PPO |
$2,285.12
|
| Rate for Payer: Cigna of CA PPO |
$3,084.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,917.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,161.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$3,542.80
|
| Rate for Payer: Galaxy Health WC |
$2,624.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,852.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,500.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$394.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$394.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,646.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,960.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$446.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$446.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$741.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,000.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,109.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,109.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$2,470.40
|
| Rate for Payer: Multiplan Commercial |
$3,334.40
|
| Rate for Payer: Networks By Design Commercial |
$2,709.20
|
| Rate for Payer: Networks By Design Commercial |
$2,007.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,542.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,624.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,500.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,852.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,544.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,084.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ENDO SM INT CNTRL BLEEDING
|
Facility
|
IP
|
$4,168.00
|
|
|
Service Code
|
CPT 44366
|
| Hospital Charge Code |
906744366
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$833.60 |
| Max. Negotiated Rate |
$3,542.80 |
| Rate for Payer: Adventist Health Commercial |
$833.60
|
| Rate for Payer: Cash Price |
$1,875.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,917.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,667.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,667.20
|
| Rate for Payer: Galaxy Health WC |
$3,542.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,500.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,646.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,459.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,000.32
|
| Rate for Payer: Multiplan Commercial |
$3,334.40
|
| Rate for Payer: Networks By Design Commercial |
$2,709.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,542.80
|
|
|
HC ENDO SM INTEST ENDO W/BX SNGL OR MUL
|
Facility
|
OP
|
$5,836.00
|
|
|
Service Code
|
CPT 44361
|
| Hospital Charge Code |
906744361
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$300.22 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,167.20
|
| Rate for Payer: Adventist Health Commercial |
$1,073.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Cash Price |
$2,626.20
|
| Rate for Payer: Cash Price |
$2,626.20
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Cash Price |
$2,626.20
|
| Rate for Payer: Cigna of CA HMO |
$3,735.04
|
| Rate for Payer: Cigna of CA HMO |
$3,435.52
|
| Rate for Payer: Cigna of CA PPO |
$3,972.32
|
| Rate for Payer: Cigna of CA PPO |
$4,318.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,085.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,757.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$4,960.60
|
| Rate for Payer: Galaxy Health WC |
$4,562.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,220.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,501.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$300.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$300.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,705.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,408.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$339.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$339.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,288.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,400.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,109.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,109.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$4,294.40
|
| Rate for Payer: Multiplan Commercial |
$4,668.80
|
| Rate for Payer: Networks By Design Commercial |
$3,793.40
|
| Rate for Payer: Networks By Design Commercial |
$3,489.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,960.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,562.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,501.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,220.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,684.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,918.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ENDO SM INTEST ENDO W/BX SNGL OR MUL
|
Facility
|
IP
|
$5,836.00
|
|
|
Service Code
|
CPT 44361
|
| Hospital Charge Code |
906744361
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,167.20 |
| Max. Negotiated Rate |
$4,960.60 |
| Rate for Payer: Adventist Health Commercial |
$1,167.20
|
| Rate for Payer: Cash Price |
$2,626.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,085.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,334.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,334.40
|
| Rate for Payer: Galaxy Health WC |
$4,960.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,501.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,705.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,443.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,400.64
|
| Rate for Payer: Multiplan Commercial |
$4,668.80
|
| Rate for Payer: Networks By Design Commercial |
$3,793.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,960.60
|
|
|
HC ENDO SM INTEST W WO CO
|
Facility
|
OP
|
$5,796.00
|
|
|
Service Code
|
CPT 44360
|
| Hospital Charge Code |
906744360
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$255.81 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Adventist Health Commercial |
$1,159.20
|
| Rate for Payer: Adventist Health Commercial |
$1,073.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Cash Price |
$2,608.20
|
| Rate for Payer: Cash Price |
$2,608.20
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Cash Price |
$2,608.20
|
| Rate for Payer: Cigna of CA HMO |
$3,709.44
|
| Rate for Payer: Cigna of CA HMO |
$3,435.52
|
| Rate for Payer: Cigna of CA PPO |
$3,972.32
|
| Rate for Payer: Cigna of CA PPO |
$4,289.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,057.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,757.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$4,926.60
|
| Rate for Payer: Galaxy Health WC |
$4,562.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,220.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,477.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$255.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$255.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,680.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,408.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$289.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$289.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,288.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,391.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,109.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,109.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$4,294.40
|
| Rate for Payer: Multiplan Commercial |
$4,636.80
|
| Rate for Payer: Networks By Design Commercial |
$3,767.40
|
| Rate for Payer: Networks By Design Commercial |
$3,489.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,926.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,562.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,477.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,220.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,684.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,898.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ENDO SM INTEST W WO CO
|
Facility
|
IP
|
$5,796.00
|
|
|
Service Code
|
CPT 44360
|
| Hospital Charge Code |
906744360
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,159.20 |
| Max. Negotiated Rate |
$4,926.60 |
| Rate for Payer: Adventist Health Commercial |
$1,159.20
|
| Rate for Payer: Cash Price |
$2,608.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,057.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,318.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,318.40
|
| Rate for Payer: Galaxy Health WC |
$4,926.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,477.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,680.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,419.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,391.04
|
| Rate for Payer: Multiplan Commercial |
$4,636.80
|
| Rate for Payer: Networks By Design Commercial |
$3,767.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,926.60
|
|
|
HC ENDO SM INT ILEUM DIAG
|
Facility
|
OP
|
$6,410.00
|
|
|
Service Code
|
CPT 44376
|
| Hospital Charge Code |
906744376
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$424.07 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,282.00
|
| Rate for Payer: Adventist Health Commercial |
$1,117.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Cash Price |
$2,515.05
|
| Rate for Payer: Cash Price |
$2,884.50
|
| Rate for Payer: Cash Price |
$2,884.50
|
| Rate for Payer: Cash Price |
$2,515.05
|
| Rate for Payer: Cash Price |
$2,515.05
|
| Rate for Payer: Cash Price |
$2,884.50
|
| Rate for Payer: Cigna of CA HMO |
$4,102.40
|
| Rate for Payer: Cigna of CA HMO |
$3,576.96
|
| Rate for Payer: Cigna of CA PPO |
$4,135.86
|
| Rate for Payer: Cigna of CA PPO |
$4,743.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,487.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,912.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$5,448.50
|
| Rate for Payer: Galaxy Health WC |
$4,750.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,353.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,846.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$424.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$424.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,070.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,549.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$479.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$479.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,341.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,538.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,109.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,109.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$4,471.20
|
| Rate for Payer: Multiplan Commercial |
$5,128.00
|
| Rate for Payer: Networks By Design Commercial |
$4,166.50
|
| Rate for Payer: Networks By Design Commercial |
$3,632.85
|
| Rate for Payer: Prime Health Services Commercial |
$5,448.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,750.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,846.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,353.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,794.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,205.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ENDO SM INT ILEUM DIAG
|
Facility
|
IP
|
$6,410.00
|
|
|
Service Code
|
CPT 44376
|
| Hospital Charge Code |
906744376
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,282.00 |
| Max. Negotiated Rate |
$5,448.50 |
| Rate for Payer: Adventist Health Commercial |
$1,282.00
|
| Rate for Payer: Cash Price |
$2,884.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,487.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,564.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,564.00
|
| Rate for Payer: Galaxy Health WC |
$5,448.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,846.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,070.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,781.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,538.40
|
| Rate for Payer: Multiplan Commercial |
$5,128.00
|
| Rate for Payer: Networks By Design Commercial |
$4,166.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,448.50
|
|
|
HC ENDO SM INT ILEUM W BX
|
Facility
|
IP
|
$4,168.00
|
|
|
Service Code
|
CPT 44377
|
| Hospital Charge Code |
906744377
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$833.60 |
| Max. Negotiated Rate |
$3,542.80 |
| Rate for Payer: Cash Price |
$1,875.60
|
| Rate for Payer: Adventist Health Commercial |
$833.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,917.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,667.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,667.20
|
| Rate for Payer: Galaxy Health WC |
$3,542.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,500.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,646.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,459.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,000.32
|
| Rate for Payer: Multiplan Commercial |
$3,334.40
|
| Rate for Payer: Networks By Design Commercial |
$2,709.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,542.80
|
|
|
HC ENDO SM INT ILEUM W BX
|
Facility
|
OP
|
$4,168.00
|
|
|
Service Code
|
CPT 44377
|
| Hospital Charge Code |
906744377
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$448.46 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$833.60
|
| Rate for Payer: Adventist Health Commercial |
$617.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$1,875.60
|
| Rate for Payer: Cash Price |
$1,875.60
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$1,875.60
|
| Rate for Payer: Cigna of CA HMO |
$2,667.52
|
| Rate for Payer: Cigna of CA HMO |
$1,976.32
|
| Rate for Payer: Cigna of CA PPO |
$2,285.12
|
| Rate for Payer: Cigna of CA PPO |
$3,084.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,917.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,161.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$3,542.80
|
| Rate for Payer: Galaxy Health WC |
$2,624.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,852.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,500.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$448.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$448.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,646.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,960.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$507.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$507.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$741.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,000.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,109.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,109.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$2,470.40
|
| Rate for Payer: Multiplan Commercial |
$3,334.40
|
| Rate for Payer: Networks By Design Commercial |
$2,709.20
|
| Rate for Payer: Networks By Design Commercial |
$2,007.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,542.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,624.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,500.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,852.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,544.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,084.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ENDO SM INT ILEUM W CNTRL BLEEDING
|
Facility
|
IP
|
$4,168.00
|
|
|
Service Code
|
CPT 44378
|
| Hospital Charge Code |
906744378
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$833.60 |
| Max. Negotiated Rate |
$3,542.80 |
| Rate for Payer: Adventist Health Commercial |
$833.60
|
| Rate for Payer: Cash Price |
$1,875.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,917.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,667.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,667.20
|
| Rate for Payer: Galaxy Health WC |
$3,542.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,500.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,646.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,459.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,000.32
|
| Rate for Payer: Multiplan Commercial |
$3,334.40
|
| Rate for Payer: Networks By Design Commercial |
$2,709.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,542.80
|
|
|
HC ENDO SM INT ILEUM W CNTRL BLEEDING
|
Facility
|
OP
|
$4,168.00
|
|
|
Service Code
|
CPT 44378
|
| Hospital Charge Code |
906744378
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$584.81 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$833.60
|
| Rate for Payer: Adventist Health Commercial |
$617.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$1,875.60
|
| Rate for Payer: Cash Price |
$1,875.60
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$1,875.60
|
| Rate for Payer: Cigna of CA HMO |
$2,667.52
|
| Rate for Payer: Cigna of CA HMO |
$1,976.32
|
| Rate for Payer: Cigna of CA PPO |
$2,285.12
|
| Rate for Payer: Cigna of CA PPO |
$3,084.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,917.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,161.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$3,542.80
|
| Rate for Payer: Galaxy Health WC |
$2,624.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,852.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,500.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$584.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$584.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,646.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,960.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$661.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$661.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$741.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,000.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,109.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,109.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$2,470.40
|
| Rate for Payer: Multiplan Commercial |
$3,334.40
|
| Rate for Payer: Networks By Design Commercial |
$2,709.20
|
| Rate for Payer: Networks By Design Commercial |
$2,007.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,542.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,624.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,500.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,852.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,544.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,084.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
