|
HC EPS VENT &/OR ATRIAL MAPPING
|
Facility
|
IP
|
$7,546.00
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
906811323
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,509.20 |
| Max. Negotiated Rate |
$6,414.10 |
| Rate for Payer: Adventist Health Commercial |
$1,509.20
|
| Rate for Payer: Cash Price |
$3,395.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,282.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,018.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,018.40
|
| Rate for Payer: Galaxy Health WC |
$6,414.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4,527.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,791.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,452.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,811.04
|
| Rate for Payer: Multiplan Commercial |
$6,036.80
|
| Rate for Payer: Networks By Design Commercial |
$4,904.90
|
| Rate for Payer: Prime Health Services Commercial |
$6,414.10
|
|
|
HC EPS VENT &/OR ATRIAL MAPPING
|
Facility
|
OP
|
$7,546.00
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
906811323
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$493.85 |
| Max. Negotiated Rate |
$9,323.00 |
| Rate for Payer: Adventist Health Commercial |
$1,509.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$817.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,414.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,150.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,659.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,323.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$3,395.70
|
| Rate for Payer: Cash Price |
$3,395.70
|
| Rate for Payer: Cash Price |
$3,395.70
|
| Rate for Payer: Cash Price |
$3,395.70
|
| Rate for Payer: Cigna of CA HMO |
$4,829.44
|
| Rate for Payer: Cigna of CA PPO |
$5,584.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,414.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,414.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,414.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,282.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,018.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,018.40
|
| Rate for Payer: Galaxy Health WC |
$6,414.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4,527.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$493.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,791.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$558.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,452.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,811.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,282.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,282.20
|
| Rate for Payer: Multiplan Commercial |
$6,036.80
|
| Rate for Payer: Networks By Design Commercial |
$4,904.90
|
| Rate for Payer: Prime Health Services Commercial |
$6,414.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,527.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,527.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,414.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,414.10
|
| Rate for Payer: Vantage Medical Group Senior |
$6,414.10
|
|
|
HC EPS VENTRICULAR PACING
|
Facility
|
IP
|
$7,245.00
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
906811325
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,449.00 |
| Max. Negotiated Rate |
$6,158.25 |
| Rate for Payer: Adventist Health Commercial |
$1,449.00
|
| Rate for Payer: Cash Price |
$3,260.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,071.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,898.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,898.00
|
| Rate for Payer: Galaxy Health WC |
$6,158.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,347.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,600.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,274.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,738.80
|
| Rate for Payer: Multiplan Commercial |
$5,796.00
|
| Rate for Payer: Networks By Design Commercial |
$4,709.25
|
| Rate for Payer: Prime Health Services Commercial |
$6,158.25
|
|
|
HC EPS VENTRICULAR PACING
|
Facility
|
OP
|
$7,245.00
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
906811325
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$177.88 |
| Max. Negotiated Rate |
$16,552.26 |
| Rate for Payer: Adventist Health Commercial |
$1,449.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$486.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,031.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$3,260.25
|
| Rate for Payer: Cash Price |
$3,260.25
|
| Rate for Payer: Cash Price |
$3,260.25
|
| Rate for Payer: Cash Price |
$3,260.25
|
| Rate for Payer: Cigna of CA HMO |
$4,636.80
|
| Rate for Payer: Cigna of CA PPO |
$5,361.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,034.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,031.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,071.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,552.26
|
| Rate for Payer: EPIC Health Plan Senior |
$11,034.84
|
| Rate for Payer: Galaxy Health WC |
$6,158.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,347.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$16,451.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$177.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,031.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,600.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$201.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,044.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,738.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,639.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,442.44
|
| Rate for Payer: Multiplan Commercial |
$5,796.00
|
| Rate for Payer: Networks By Design Commercial |
$4,709.25
|
| Rate for Payer: Prime Health Services Commercial |
$6,158.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,347.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,347.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,031.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,047.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,034.84
|
| Rate for Payer: Vantage Medical Group Senior |
$10,031.67
|
|
|
HC ERCP BILIARY/SPHINCT
|
Facility
|
OP
|
$2,120.00
|
|
|
Service Code
|
CPT 74328
|
| Hospital Charge Code |
909001862
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$193.42 |
| Max. Negotiated Rate |
$1,802.00 |
| Rate for Payer: Adventist Health Commercial |
$424.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$593.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,802.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,166.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,590.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$925.04
|
| Rate for Payer: Blue Shield of California Commercial |
$892.52
|
| Rate for Payer: Blue Shield of California Commercial |
$1,352.56
|
| Rate for Payer: Cash Price |
$954.00
|
| Rate for Payer: Cash Price |
$954.00
|
| Rate for Payer: Cigna of CA HMO |
$1,356.80
|
| Rate for Payer: Cigna of CA PPO |
$1,568.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,802.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,802.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,802.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,484.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$848.00
|
| Rate for Payer: EPIC Health Plan Senior |
$848.00
|
| Rate for Payer: Galaxy Health WC |
$1,802.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,272.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$193.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,346.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$218.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,250.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$508.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,484.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,484.00
|
| Rate for Payer: Multiplan Commercial |
$1,696.00
|
| Rate for Payer: Networks By Design Commercial |
$1,378.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,802.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,272.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,272.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,060.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,060.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,060.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,060.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,802.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,802.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,802.00
|
|
|
HC ERCP BILIARY/SPHINCT
|
Facility
|
IP
|
$2,120.00
|
|
|
Service Code
|
CPT 74328
|
| Hospital Charge Code |
909001862
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$424.00 |
| Max. Negotiated Rate |
$1,802.00 |
| Rate for Payer: Adventist Health Commercial |
$424.00
|
| Rate for Payer: Cash Price |
$954.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,484.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$848.00
|
| Rate for Payer: EPIC Health Plan Senior |
$848.00
|
| Rate for Payer: Galaxy Health WC |
$1,802.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,272.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,346.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,250.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$508.80
|
| Rate for Payer: Multiplan Commercial |
$1,696.00
|
| Rate for Payer: Networks By Design Commercial |
$1,378.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,802.00
|
|
|
HC ERCP COMBINED SPHINCT
|
Facility
|
OP
|
$2,524.00
|
|
|
Service Code
|
CPT 74330
|
| Hospital Charge Code |
909001863
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$193.42 |
| Max. Negotiated Rate |
$2,145.40 |
| Rate for Payer: Adventist Health Commercial |
$504.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$883.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,145.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,388.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,893.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$925.04
|
| Rate for Payer: Blue Shield of California Commercial |
$1,610.31
|
| Rate for Payer: Blue Shield of California Commercial |
$1,062.60
|
| Rate for Payer: Cash Price |
$1,135.80
|
| Rate for Payer: Cash Price |
$1,135.80
|
| Rate for Payer: Cigna of CA HMO |
$1,615.36
|
| Rate for Payer: Cigna of CA PPO |
$1,867.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,145.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,145.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,145.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,766.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,009.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,009.60
|
| Rate for Payer: Galaxy Health WC |
$2,145.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,514.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$193.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,602.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$218.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,489.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$605.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,766.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,766.80
|
| Rate for Payer: Multiplan Commercial |
$2,019.20
|
| Rate for Payer: Networks By Design Commercial |
$1,640.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,145.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,514.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,514.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,262.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,262.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,262.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,262.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,145.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,145.40
|
| Rate for Payer: Vantage Medical Group Senior |
$2,145.40
|
|
|
HC ERCP COMBINED SPHINCT
|
Facility
|
IP
|
$2,524.00
|
|
|
Service Code
|
CPT 74330
|
| Hospital Charge Code |
909001863
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$504.80 |
| Max. Negotiated Rate |
$2,145.40 |
| Rate for Payer: Adventist Health Commercial |
$504.80
|
| Rate for Payer: Cash Price |
$1,135.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,766.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,009.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,009.60
|
| Rate for Payer: Galaxy Health WC |
$2,145.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,514.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,602.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,489.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$605.76
|
| Rate for Payer: Multiplan Commercial |
$2,019.20
|
| Rate for Payer: Networks By Design Commercial |
$1,640.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,145.40
|
|
|
HC ERCP DIAG W/ OR W/O COLLECT SP
|
Facility
|
OP
|
$6,977.00
|
|
|
Service Code
|
CPT 43260
|
| Hospital Charge Code |
906743260
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$519.14 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,395.40
|
| Rate for Payer: Adventist Health Commercial |
$746.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,958.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,958.78
|
| 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 |
$1,678.95
|
| Rate for Payer: Cash Price |
$3,139.65
|
| Rate for Payer: Cash Price |
$3,139.65
|
| Rate for Payer: Cash Price |
$1,678.95
|
| Rate for Payer: Cash Price |
$1,678.95
|
| Rate for Payer: Cash Price |
$3,139.65
|
| Rate for Payer: Cigna of CA HMO |
$4,465.28
|
| Rate for Payer: Cigna of CA HMO |
$2,387.84
|
| Rate for Payer: Cigna of CA PPO |
$2,760.94
|
| Rate for Payer: Cigna of CA PPO |
$5,162.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,454.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,454.66
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,958.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,958.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,883.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,611.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,181.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,181.99
|
| Rate for Payer: EPIC Health Plan Senior |
$5,454.66
|
| Rate for Payer: EPIC Health Plan Senior |
$5,454.66
|
| Rate for Payer: Galaxy Health WC |
$5,930.45
|
| Rate for Payer: Galaxy Health WC |
$3,171.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,238.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,186.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,132.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,132.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$519.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$519.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,958.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,958.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,430.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,369.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$587.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$587.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,942.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,942.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$895.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,674.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,248.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,248.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,644.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,644.77
|
| Rate for Payer: Multiplan Commercial |
$2,984.80
|
| Rate for Payer: Multiplan Commercial |
$5,581.60
|
| Rate for Payer: Networks By Design Commercial |
$4,535.05
|
| Rate for Payer: Networks By Design Commercial |
$2,425.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,930.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,171.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,186.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,238.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,950.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,950.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,865.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,488.50
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,958.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,958.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Vantage Medical Group Senior |
$4,958.78
|
| Rate for Payer: Vantage Medical Group Senior |
$4,958.78
|
|
|
HC ERCP DIAG W/ OR W/O COLLECT SP
|
Facility
|
IP
|
$6,977.00
|
|
|
Service Code
|
CPT 43260
|
| Hospital Charge Code |
906743260
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,395.40 |
| Max. Negotiated Rate |
$5,930.45 |
| Rate for Payer: Adventist Health Commercial |
$1,395.40
|
| Rate for Payer: Cash Price |
$3,139.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,883.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,790.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,790.80
|
| Rate for Payer: Galaxy Health WC |
$5,930.45
|
| Rate for Payer: Global Benefits Group Commercial |
$4,186.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,430.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,116.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,674.48
|
| Rate for Payer: Multiplan Commercial |
$5,581.60
|
| Rate for Payer: Networks By Design Commercial |
$4,535.05
|
| Rate for Payer: Prime Health Services Commercial |
$5,930.45
|
|
|
HC ERCP DUCT STENT PLACEMENT
|
Facility
|
OP
|
$8,356.00
|
|
|
Service Code
|
CPT 43274
|
| Hospital Charge Code |
900100019
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$696.76 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Adventist Health Commercial |
$1,671.20
|
| Rate for Payer: Adventist Health Commercial |
$1,116.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,808.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,808.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$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 |
$2,512.80
|
| Rate for Payer: Cash Price |
$3,760.20
|
| Rate for Payer: Cash Price |
$3,760.20
|
| Rate for Payer: Cash Price |
$2,512.80
|
| Rate for Payer: Cash Price |
$2,512.80
|
| Rate for Payer: Cash Price |
$3,760.20
|
| Rate for Payer: Cigna of CA HMO |
$5,347.84
|
| Rate for Payer: Cigna of CA HMO |
$3,573.76
|
| Rate for Payer: Cigna of CA PPO |
$4,132.16
|
| Rate for Payer: Cigna of CA PPO |
$6,183.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,589.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,589.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,808.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,808.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,849.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,908.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,883.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,883.51
|
| Rate for Payer: EPIC Health Plan Senior |
$8,589.01
|
| Rate for Payer: EPIC Health Plan Senior |
$8,589.01
|
| Rate for Payer: Galaxy Health WC |
$7,102.60
|
| Rate for Payer: Galaxy Health WC |
$4,746.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,350.40
|
| Rate for Payer: Global Benefits Group Commercial |
$5,013.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,805.43
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,805.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$696.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$696.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,808.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,808.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,306.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,545.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$788.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$788.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,931.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,931.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,340.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,005.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,838.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,838.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,462.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,462.97
|
| Rate for Payer: Multiplan Commercial |
$4,467.20
|
| Rate for Payer: Multiplan Commercial |
$6,684.80
|
| Rate for Payer: Networks By Design Commercial |
$5,431.40
|
| Rate for Payer: Networks By Design Commercial |
$3,629.60
|
| Rate for Payer: Prime Health Services Commercial |
$7,102.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,746.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,013.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,350.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,369.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,369.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,792.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,178.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,808.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,808.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Vantage Medical Group Senior |
$7,808.19
|
| Rate for Payer: Vantage Medical Group Senior |
$7,808.19
|
|
|
HC ERCP DUCT STENT PLACEMENT
|
Facility
|
IP
|
$8,356.00
|
|
|
Service Code
|
CPT 43274
|
| Hospital Charge Code |
900100019
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,671.20 |
| Max. Negotiated Rate |
$7,102.60 |
| Rate for Payer: Adventist Health Commercial |
$1,671.20
|
| Rate for Payer: Cash Price |
$3,760.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,849.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,342.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,342.40
|
| Rate for Payer: Galaxy Health WC |
$7,102.60
|
| Rate for Payer: Global Benefits Group Commercial |
$5,013.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,306.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,930.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,005.44
|
| Rate for Payer: Multiplan Commercial |
$6,684.80
|
| Rate for Payer: Networks By Design Commercial |
$5,431.40
|
| Rate for Payer: Prime Health Services Commercial |
$7,102.60
|
|
|
HC ERCP EA DUCT/AMPULLA DILATATION
|
Facility
|
IP
|
$10,267.00
|
|
|
Service Code
|
CPT 43277
|
| Hospital Charge Code |
900100020
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,053.40 |
| Max. Negotiated Rate |
$8,726.95 |
| Rate for Payer: Adventist Health Commercial |
$2,053.40
|
| Rate for Payer: Cash Price |
$4,620.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,186.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,106.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,106.80
|
| Rate for Payer: Galaxy Health WC |
$8,726.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,160.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,519.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,057.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,464.08
|
| Rate for Payer: Multiplan Commercial |
$8,213.60
|
| Rate for Payer: Networks By Design Commercial |
$6,673.55
|
| Rate for Payer: Prime Health Services Commercial |
$8,726.95
|
|
|
HC ERCP EA DUCT/AMPULLA DILATATION
|
Facility
|
OP
|
$6,862.00
|
|
|
Service Code
|
CPT 43277
|
| Hospital Charge Code |
900100020
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$577.94 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,372.40
|
| Rate for Payer: Adventist Health Commercial |
$2,053.40
|
| 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 |
$7,438.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,958.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,958.78
|
| 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 |
$4,620.15
|
| Rate for Payer: Cash Price |
$3,087.90
|
| Rate for Payer: Cash Price |
$3,087.90
|
| Rate for Payer: Cash Price |
$4,620.15
|
| Rate for Payer: Cash Price |
$4,620.15
|
| Rate for Payer: Cash Price |
$3,087.90
|
| Rate for Payer: Cigna of CA HMO |
$4,391.68
|
| Rate for Payer: Cigna of CA HMO |
$6,570.88
|
| Rate for Payer: Cigna of CA PPO |
$7,597.58
|
| Rate for Payer: Cigna of CA PPO |
$5,077.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,454.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,454.66
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,958.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,958.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,803.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,186.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,181.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,181.99
|
| Rate for Payer: EPIC Health Plan Senior |
$5,454.66
|
| Rate for Payer: EPIC Health Plan Senior |
$5,454.66
|
| Rate for Payer: Galaxy Health WC |
$5,832.70
|
| Rate for Payer: Galaxy Health WC |
$8,726.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,160.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,117.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,132.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,132.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$577.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$577.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,958.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,958.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,357.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,519.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$653.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$653.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,942.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,942.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,464.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,646.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,248.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,248.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,644.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,644.77
|
| Rate for Payer: Multiplan Commercial |
$8,213.60
|
| Rate for Payer: Multiplan Commercial |
$5,489.60
|
| Rate for Payer: Networks By Design Commercial |
$4,460.30
|
| Rate for Payer: Networks By Design Commercial |
$6,673.55
|
| Rate for Payer: Prime Health Services Commercial |
$5,832.70
|
| Rate for Payer: Prime Health Services Commercial |
$8,726.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,117.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,160.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,950.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,950.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,133.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,431.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,958.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,958.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Vantage Medical Group Senior |
$4,958.78
|
| Rate for Payer: Vantage Medical Group Senior |
$4,958.78
|
|
|
HC ERCP LESION ABLAT W DILATION
|
Facility
|
IP
|
$5,455.00
|
|
|
Service Code
|
CPT 43278
|
| Hospital Charge Code |
906743278
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,091.00 |
| Max. Negotiated Rate |
$4,636.75 |
| Rate for Payer: Adventist Health Commercial |
$1,091.00
|
| Rate for Payer: Cash Price |
$2,454.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,818.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,182.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,182.00
|
| Rate for Payer: Galaxy Health WC |
$4,636.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,273.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,463.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,218.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,309.20
|
| Rate for Payer: Multiplan Commercial |
$4,364.00
|
| Rate for Payer: Networks By Design Commercial |
$3,545.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,636.75
|
|
|
HC ERCP LESION ABLAT W DILATION
|
Facility
|
OP
|
$5,455.00
|
|
|
Service Code
|
CPT 43278
|
| Hospital Charge Code |
906743278
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$657.37 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,091.00
|
| Rate for Payer: Adventist Health Commercial |
$860.60
|
| 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 |
$7,438.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,958.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,958.78
|
| 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 |
$1,936.35
|
| Rate for Payer: Cash Price |
$2,454.75
|
| Rate for Payer: Cash Price |
$2,454.75
|
| Rate for Payer: Cash Price |
$1,936.35
|
| Rate for Payer: Cash Price |
$1,936.35
|
| Rate for Payer: Cash Price |
$2,454.75
|
| Rate for Payer: Cigna of CA HMO |
$3,491.20
|
| Rate for Payer: Cigna of CA HMO |
$2,753.92
|
| Rate for Payer: Cigna of CA PPO |
$3,184.22
|
| Rate for Payer: Cigna of CA PPO |
$4,036.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,454.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,454.66
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,958.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,958.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,818.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,012.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,181.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,181.99
|
| Rate for Payer: EPIC Health Plan Senior |
$5,454.66
|
| Rate for Payer: EPIC Health Plan Senior |
$5,454.66
|
| Rate for Payer: Galaxy Health WC |
$4,636.75
|
| Rate for Payer: Galaxy Health WC |
$3,657.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,581.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,273.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,132.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,132.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$657.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$657.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,958.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,958.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,463.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,732.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$743.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$743.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,942.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,942.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,032.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,309.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,248.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,248.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,644.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,644.77
|
| Rate for Payer: Multiplan Commercial |
$3,442.40
|
| Rate for Payer: Multiplan Commercial |
$4,364.00
|
| Rate for Payer: Networks By Design Commercial |
$3,545.75
|
| Rate for Payer: Networks By Design Commercial |
$2,796.95
|
| Rate for Payer: Prime Health Services Commercial |
$4,636.75
|
| Rate for Payer: Prime Health Services Commercial |
$3,657.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,273.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,581.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,950.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,950.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,151.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,727.50
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,958.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,958.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Vantage Medical Group Senior |
$4,958.78
|
| Rate for Payer: Vantage Medical Group Senior |
$4,958.78
|
|
|
HC ERCP PANCREATIC/SPHINCT
|
Facility
|
IP
|
$1,918.00
|
|
|
Service Code
|
CPT 74329
|
| Hospital Charge Code |
909001830
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$383.60 |
| Max. Negotiated Rate |
$1,630.30 |
| Rate for Payer: Adventist Health Commercial |
$383.60
|
| Rate for Payer: Cash Price |
$863.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,342.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$767.20
|
| Rate for Payer: EPIC Health Plan Senior |
$767.20
|
| Rate for Payer: Galaxy Health WC |
$1,630.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,150.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,217.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,131.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.32
|
| Rate for Payer: Multiplan Commercial |
$1,534.40
|
| Rate for Payer: Networks By Design Commercial |
$1,246.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,630.30
|
|
|
HC ERCP PANCREATIC/SPHINCT
|
Facility
|
OP
|
$1,918.00
|
|
|
Service Code
|
CPT 74329
|
| Hospital Charge Code |
909001830
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$193.42 |
| Max. Negotiated Rate |
$1,630.30 |
| Rate for Payer: Adventist Health Commercial |
$383.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$472.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,630.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,054.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,438.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$925.04
|
| Rate for Payer: Blue Shield of California Commercial |
$807.48
|
| Rate for Payer: Blue Shield of California Commercial |
$1,223.68
|
| Rate for Payer: Cash Price |
$863.10
|
| Rate for Payer: Cash Price |
$863.10
|
| Rate for Payer: Cigna of CA HMO |
$1,227.52
|
| Rate for Payer: Cigna of CA PPO |
$1,419.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,630.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,630.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,630.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,342.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$767.20
|
| Rate for Payer: EPIC Health Plan Senior |
$767.20
|
| Rate for Payer: Galaxy Health WC |
$1,630.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,150.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$193.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,217.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$218.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,131.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,342.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,342.60
|
| Rate for Payer: Multiplan Commercial |
$1,534.40
|
| Rate for Payer: Networks By Design Commercial |
$1,246.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,630.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,150.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,150.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$959.00
|
| Rate for Payer: United Healthcare All Other HMO |
$959.00
|
| Rate for Payer: United Healthcare HMO Rider |
$959.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$959.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,630.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,630.30
|
| Rate for Payer: Vantage Medical Group Senior |
$1,630.30
|
|
|
HC ERCP W/BX SNGL OR MULTI
|
Facility
|
IP
|
$5,582.00
|
|
|
Service Code
|
CPT 43261
|
| Hospital Charge Code |
906743261
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,116.40 |
| Max. Negotiated Rate |
$4,744.70 |
| Rate for Payer: Adventist Health Commercial |
$1,116.40
|
| Rate for Payer: Cash Price |
$2,511.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,907.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,232.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,232.80
|
| Rate for Payer: Galaxy Health WC |
$4,744.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,349.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,544.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,293.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,339.68
|
| Rate for Payer: Multiplan Commercial |
$4,465.60
|
| Rate for Payer: Networks By Design Commercial |
$3,628.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,744.70
|
|
|
HC ERCP W/BX SNGL OR MULTI
|
Facility
|
OP
|
$5,582.00
|
|
|
Service Code
|
CPT 43261
|
| Hospital Charge Code |
906743261
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$572.93 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,116.40
|
| Rate for Payer: Adventist Health Commercial |
$746.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,958.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,958.78
|
| 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 |
$1,678.95
|
| Rate for Payer: Cash Price |
$2,511.90
|
| Rate for Payer: Cash Price |
$2,511.90
|
| Rate for Payer: Cash Price |
$1,678.95
|
| Rate for Payer: Cash Price |
$1,678.95
|
| Rate for Payer: Cash Price |
$2,511.90
|
| Rate for Payer: Cigna of CA HMO |
$3,572.48
|
| Rate for Payer: Cigna of CA HMO |
$2,387.84
|
| Rate for Payer: Cigna of CA PPO |
$2,760.94
|
| Rate for Payer: Cigna of CA PPO |
$4,130.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,454.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,454.66
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,958.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,958.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,907.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,611.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,181.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,181.99
|
| Rate for Payer: EPIC Health Plan Senior |
$5,454.66
|
| Rate for Payer: EPIC Health Plan Senior |
$5,454.66
|
| Rate for Payer: Galaxy Health WC |
$4,744.70
|
| Rate for Payer: Galaxy Health WC |
$3,171.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,238.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,349.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,132.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,132.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$572.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$572.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,958.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,958.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,544.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,369.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$647.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$647.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,942.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,942.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$895.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,339.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,248.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,248.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,644.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,644.77
|
| Rate for Payer: Multiplan Commercial |
$2,984.80
|
| Rate for Payer: Multiplan Commercial |
$4,465.60
|
| Rate for Payer: Networks By Design Commercial |
$3,628.30
|
| Rate for Payer: Networks By Design Commercial |
$2,425.15
|
| Rate for Payer: Prime Health Services Commercial |
$4,744.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,171.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,349.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,238.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,950.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,950.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,865.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,791.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,958.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,958.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Vantage Medical Group Senior |
$4,958.78
|
| Rate for Payer: Vantage Medical Group Senior |
$4,958.78
|
|
|
HC ERCP W/ENDO RETRO DESTRUCTION
|
Facility
|
OP
|
$9,578.00
|
|
|
Service Code
|
CPT 43265
|
| Hospital Charge Code |
906743265
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,915.60 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,915.60
|
| Rate for Payer: Adventist Health Commercial |
$1,098.40
|
| 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 |
$11,712.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,808.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,808.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$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 |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Cash Price |
$4,310.10
|
| Rate for Payer: Cash Price |
$2,471.40
|
| Rate for Payer: Cash Price |
$2,471.40
|
| Rate for Payer: Cash Price |
$2,471.40
|
| Rate for Payer: Cash Price |
$4,310.10
|
| Rate for Payer: Cash Price |
$4,310.10
|
| Rate for Payer: Cigna of CA HMO |
$3,514.88
|
| Rate for Payer: Cigna of CA HMO |
$6,129.92
|
| Rate for Payer: Cigna of CA PPO |
$4,064.08
|
| Rate for Payer: Cigna of CA PPO |
$7,087.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,589.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,589.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,808.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,808.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,704.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,844.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,883.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,883.51
|
| Rate for Payer: EPIC Health Plan Senior |
$8,589.01
|
| Rate for Payer: EPIC Health Plan Senior |
$8,589.01
|
| Rate for Payer: Galaxy Health WC |
$4,668.20
|
| Rate for Payer: Galaxy Health WC |
$8,141.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,746.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,295.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,805.43
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,805.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,808.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,808.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,082.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,487.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,993.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,476.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,931.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,931.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,298.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,318.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,838.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,838.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,462.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,462.97
|
| Rate for Payer: Multiplan Commercial |
$4,393.60
|
| Rate for Payer: Multiplan Commercial |
$7,662.40
|
| Rate for Payer: Networks By Design Commercial |
$6,225.70
|
| Rate for Payer: Networks By Design Commercial |
$3,569.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,668.20
|
| Rate for Payer: Prime Health Services Commercial |
$8,141.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,746.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,295.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,369.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,369.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,789.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,746.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,808.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,808.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Vantage Medical Group Senior |
$7,808.19
|
| Rate for Payer: Vantage Medical Group Senior |
$7,808.19
|
|
|
HC ERCP W/ENDO RETRO DESTRUCTION
|
Facility
|
IP
|
$9,578.00
|
|
|
Service Code
|
CPT 43265
|
| Hospital Charge Code |
906743265
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,915.60 |
| Max. Negotiated Rate |
$8,141.30 |
| Rate for Payer: Adventist Health Commercial |
$1,915.60
|
| Rate for Payer: Cash Price |
$4,310.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,704.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,831.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,831.20
|
| Rate for Payer: Galaxy Health WC |
$8,141.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,746.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,082.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,651.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,298.72
|
| Rate for Payer: Multiplan Commercial |
$7,662.40
|
| Rate for Payer: Networks By Design Commercial |
$6,225.70
|
| Rate for Payer: Prime Health Services Commercial |
$8,141.30
|
|
|
HC ERCP W/ENDO RETRO RMVL CALCULU
|
Facility
|
IP
|
$10,124.00
|
|
|
Service Code
|
CPT 43264
|
| Hospital Charge Code |
906743264
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,024.80 |
| Max. Negotiated Rate |
$8,605.40 |
| Rate for Payer: Adventist Health Commercial |
$2,024.80
|
| Rate for Payer: Cash Price |
$4,555.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,086.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,049.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,049.60
|
| Rate for Payer: Galaxy Health WC |
$8,605.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,074.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,428.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,973.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,429.76
|
| Rate for Payer: Multiplan Commercial |
$8,099.20
|
| Rate for Payer: Networks By Design Commercial |
$6,580.60
|
| Rate for Payer: Prime Health Services Commercial |
$8,605.40
|
|
|
HC ERCP W/ENDO RETRO RMVL CALCULU
|
Facility
|
OP
|
$6,778.00
|
|
|
Service Code
|
CPT 43264
|
| Hospital Charge Code |
906743264
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$644.85 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,355.60
|
| Rate for Payer: Adventist Health Commercial |
$2,024.80
|
| 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 |
$7,438.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,958.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,958.78
|
| 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 |
$4,555.80
|
| Rate for Payer: Cash Price |
$3,050.10
|
| Rate for Payer: Cash Price |
$3,050.10
|
| Rate for Payer: Cash Price |
$4,555.80
|
| Rate for Payer: Cash Price |
$4,555.80
|
| Rate for Payer: Cash Price |
$3,050.10
|
| Rate for Payer: Cigna of CA HMO |
$4,337.92
|
| Rate for Payer: Cigna of CA HMO |
$6,479.36
|
| Rate for Payer: Cigna of CA PPO |
$7,491.76
|
| Rate for Payer: Cigna of CA PPO |
$5,015.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,454.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,454.66
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,958.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,958.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,744.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,086.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,181.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,181.99
|
| Rate for Payer: EPIC Health Plan Senior |
$5,454.66
|
| Rate for Payer: EPIC Health Plan Senior |
$5,454.66
|
| Rate for Payer: Galaxy Health WC |
$5,761.30
|
| Rate for Payer: Galaxy Health WC |
$8,605.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,074.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,066.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,132.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,132.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$644.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$644.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,958.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,958.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,304.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,428.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$729.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$729.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,942.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,942.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,429.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,626.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,248.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,248.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,644.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,644.77
|
| Rate for Payer: Multiplan Commercial |
$8,099.20
|
| Rate for Payer: Multiplan Commercial |
$5,422.40
|
| Rate for Payer: Networks By Design Commercial |
$4,405.70
|
| Rate for Payer: Networks By Design Commercial |
$6,580.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,761.30
|
| Rate for Payer: Prime Health Services Commercial |
$8,605.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,066.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,074.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,950.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,950.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,062.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,389.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,958.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,958.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Vantage Medical Group Senior |
$4,958.78
|
| Rate for Payer: Vantage Medical Group Senior |
$4,958.78
|
|
|
HC ERCP W/PRESS MSRMNT
|
Facility
|
OP
|
$6,331.00
|
|
|
Service Code
|
CPT 43263
|
| Hospital Charge Code |
906743263
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$448.46 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,266.20
|
| Rate for Payer: Adventist Health Commercial |
$846.60
|
| 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 |
$1,904.85
|
| Rate for Payer: Cash Price |
$2,848.95
|
| Rate for Payer: Cash Price |
$2,848.95
|
| Rate for Payer: Cash Price |
$1,904.85
|
| Rate for Payer: Cash Price |
$1,904.85
|
| Rate for Payer: Cash Price |
$2,848.95
|
| Rate for Payer: Cigna of CA HMO |
$4,051.84
|
| Rate for Payer: Cigna of CA HMO |
$2,709.12
|
| Rate for Payer: Cigna of CA PPO |
$3,132.42
|
| Rate for Payer: Cigna of CA PPO |
$4,684.94
|
| 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 |
$4,431.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,963.10
|
| 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 |
$5,381.35
|
| Rate for Payer: Galaxy Health WC |
$3,598.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,539.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,798.60
|
| 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 |
$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 |
$4,020.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,687.95
|
| 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 |
$1,015.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,519.44
|
| 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 |
$3,386.40
|
| Rate for Payer: Multiplan Commercial |
$5,064.80
|
| Rate for Payer: Networks By Design Commercial |
$4,115.15
|
| Rate for Payer: Networks By Design Commercial |
$2,751.45
|
| Rate for Payer: Prime Health Services Commercial |
$5,381.35
|
| Rate for Payer: Prime Health Services Commercial |
$3,598.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,798.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,539.80
|
| 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 |
$2,116.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,165.50
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| 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
|
|
