|
HC ERCP W/PRESS MSRMNT
|
Facility
|
IP
|
$6,331.00
|
|
|
Service Code
|
CPT 43263
|
| Hospital Charge Code |
906743263
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,266.20 |
| Max. Negotiated Rate |
$5,381.35 |
| Rate for Payer: Adventist Health Commercial |
$1,266.20
|
| Rate for Payer: Cash Price |
$2,848.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,431.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,532.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,532.40
|
| Rate for Payer: Galaxy Health WC |
$5,381.35
|
| Rate for Payer: Global Benefits Group Commercial |
$3,798.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,020.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,735.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,519.44
|
| Rate for Payer: Multiplan Commercial |
$5,064.80
|
| Rate for Payer: Networks By Design Commercial |
$4,115.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,381.35
|
|
|
HC ERCP W RMVL FB STNT
|
Facility
|
OP
|
$7,082.00
|
|
|
Service Code
|
CPT 43275
|
| Hospital Charge Code |
906743275
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$574.80 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,416.40
|
| Rate for Payer: Adventist Health Commercial |
$946.80
|
| 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 |
$2,130.30
|
| Rate for Payer: Cash Price |
$3,186.90
|
| Rate for Payer: Cash Price |
$3,186.90
|
| Rate for Payer: Cash Price |
$2,130.30
|
| Rate for Payer: Cash Price |
$2,130.30
|
| Rate for Payer: Cash Price |
$3,186.90
|
| Rate for Payer: Cigna of CA HMO |
$4,532.48
|
| Rate for Payer: Cigna of CA HMO |
$3,029.76
|
| Rate for Payer: Cigna of CA PPO |
$3,503.16
|
| Rate for Payer: Cigna of CA PPO |
$5,240.68
|
| 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 |
$4,957.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,313.80
|
| 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 |
$6,019.70
|
| Rate for Payer: Galaxy Health WC |
$4,023.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,840.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,249.20
|
| 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 |
$574.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$574.80
|
| 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 |
$4,497.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,006.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$650.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$650.07
|
| 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 |
$1,136.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,699.68
|
| 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 |
$3,787.20
|
| Rate for Payer: Multiplan Commercial |
$5,665.60
|
| Rate for Payer: Networks By Design Commercial |
$4,603.30
|
| Rate for Payer: Networks By Design Commercial |
$3,077.10
|
| Rate for Payer: Prime Health Services Commercial |
$6,019.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,023.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,249.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,840.40
|
| 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 |
$2,367.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,541.00
|
| 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 |
$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 ERCP W RMVL FB STNT
|
Facility
|
IP
|
$7,082.00
|
|
|
Service Code
|
CPT 43275
|
| Hospital Charge Code |
906743275
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,416.40 |
| Max. Negotiated Rate |
$6,019.70 |
| Rate for Payer: Adventist Health Commercial |
$1,416.40
|
| Rate for Payer: Cash Price |
$3,186.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,957.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,832.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,832.80
|
| Rate for Payer: Galaxy Health WC |
$6,019.70
|
| Rate for Payer: Global Benefits Group Commercial |
$4,249.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,497.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,178.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,699.68
|
| Rate for Payer: Multiplan Commercial |
$5,665.60
|
| Rate for Payer: Networks By Design Commercial |
$4,603.30
|
| Rate for Payer: Prime Health Services Commercial |
$6,019.70
|
|
|
HC ERCP W RMVL & XCHNG OF STNT INCL SPINC EA STNT
|
Facility
|
OP
|
$7,771.00
|
|
|
Service Code
|
CPT 43276
|
| Hospital Charge Code |
906743276
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$724.92 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,554.20
|
| Rate for Payer: Adventist Health Commercial |
$1,038.80
|
| 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 |
$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 |
$2,337.30
|
| Rate for Payer: Cash Price |
$3,496.95
|
| Rate for Payer: Cash Price |
$3,496.95
|
| Rate for Payer: Cash Price |
$2,337.30
|
| Rate for Payer: Cash Price |
$2,337.30
|
| Rate for Payer: Cash Price |
$3,496.95
|
| Rate for Payer: Cigna of CA HMO |
$4,973.44
|
| Rate for Payer: Cigna of CA HMO |
$3,324.16
|
| Rate for Payer: Cigna of CA PPO |
$3,843.56
|
| Rate for Payer: Cigna of CA PPO |
$5,750.54
|
| 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 |
$5,439.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,635.80
|
| 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 |
$6,605.35
|
| Rate for Payer: Galaxy Health WC |
$4,414.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,116.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,662.60
|
| 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 |
$724.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$724.92
|
| 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 |
$4,934.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,298.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$819.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$819.85
|
| 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 |
$1,246.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,865.04
|
| 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 |
$4,155.20
|
| Rate for Payer: Multiplan Commercial |
$6,216.80
|
| Rate for Payer: Networks By Design Commercial |
$5,051.15
|
| Rate for Payer: Networks By Design Commercial |
$3,376.10
|
| Rate for Payer: Prime Health Services Commercial |
$6,605.35
|
| Rate for Payer: Prime Health Services Commercial |
$4,414.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,662.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,116.40
|
| 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 |
$2,597.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,885.50
|
| 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 |
$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 RMVL & XCHNG OF STNT INCL SPINC EA STNT
|
Facility
|
IP
|
$7,771.00
|
|
|
Service Code
|
CPT 43276
|
| Hospital Charge Code |
906743276
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,554.20 |
| Max. Negotiated Rate |
$6,605.35 |
| Rate for Payer: Adventist Health Commercial |
$1,554.20
|
| Rate for Payer: Cash Price |
$3,496.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,439.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,108.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,108.40
|
| Rate for Payer: Galaxy Health WC |
$6,605.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,662.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,934.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,584.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,865.04
|
| Rate for Payer: Multiplan Commercial |
$6,216.80
|
| Rate for Payer: Networks By Design Commercial |
$5,051.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,605.35
|
|
|
HC ERCP W/SPHINCTERTMY
|
Facility
|
OP
|
$5,390.00
|
|
|
Service Code
|
CPT 43262
|
| Hospital Charge Code |
906743262
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$622.34 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,078.00
|
| Rate for Payer: Adventist Health Commercial |
$720.20
|
| 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 |
$1,620.45
|
| Rate for Payer: Cash Price |
$2,425.50
|
| Rate for Payer: Cash Price |
$2,425.50
|
| Rate for Payer: Cash Price |
$1,620.45
|
| Rate for Payer: Cash Price |
$1,620.45
|
| Rate for Payer: Cash Price |
$2,425.50
|
| Rate for Payer: Cigna of CA HMO |
$3,449.60
|
| Rate for Payer: Cigna of CA HMO |
$2,304.64
|
| Rate for Payer: Cigna of CA PPO |
$2,664.74
|
| Rate for Payer: Cigna of CA PPO |
$3,988.60
|
| 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 |
$3,773.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,520.70
|
| 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 |
$4,581.50
|
| Rate for Payer: Galaxy Health WC |
$3,060.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,160.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,234.00
|
| 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 |
$622.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$622.34
|
| 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 |
$3,422.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,286.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$703.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$703.84
|
| 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 |
$864.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,293.60
|
| 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 |
$2,880.80
|
| Rate for Payer: Multiplan Commercial |
$4,312.00
|
| Rate for Payer: Networks By Design Commercial |
$3,503.50
|
| Rate for Payer: Networks By Design Commercial |
$2,340.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,581.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,060.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,234.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,160.60
|
| 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 |
$1,800.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,695.00
|
| 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/SPHINCTERTMY
|
Facility
|
IP
|
$5,390.00
|
|
|
Service Code
|
CPT 43262
|
| Hospital Charge Code |
906743262
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,078.00 |
| Max. Negotiated Rate |
$4,581.50 |
| Rate for Payer: Adventist Health Commercial |
$1,078.00
|
| Rate for Payer: Cash Price |
$2,425.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,773.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,156.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,156.00
|
| Rate for Payer: Galaxy Health WC |
$4,581.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,234.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,422.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,180.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,293.60
|
| Rate for Payer: Multiplan Commercial |
$4,312.00
|
| Rate for Payer: Networks By Design Commercial |
$3,503.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,581.50
|
|
|
HC ESBL DISK CONFIRMATION
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT 87184
|
| Hospital Charge Code |
900912449
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$178.50 |
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Senior |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$123.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.40
|
| Rate for Payer: Multiplan Commercial |
$168.00
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
|
|
HC ESBL DISK CONFIRMATION
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT 87184
|
| Hospital Charge Code |
900912449
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.06 |
| Max. Negotiated Rate |
$178.50 |
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Adventist Health Commercial |
$9.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.09
|
| Rate for Payer: Blue Shield of California Commercial |
$21.21
|
| Rate for Payer: Blue Shield of California Commercial |
$146.37
|
| Rate for Payer: Blue Shield of California Commercial |
$32.06
|
| Rate for Payer: Blue Shield of California Commercial |
$96.81
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cigna of CA HMO |
$29.44
|
| Rate for Payer: Cigna of CA HMO |
$134.40
|
| Rate for Payer: Cigna of CA PPO |
$155.40
|
| Rate for Payer: Cigna of CA PPO |
$34.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$32.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.34
|
| Rate for Payer: EPIC Health Plan Senior |
$8.23
|
| Rate for Payer: EPIC Health Plan Senior |
$8.23
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Galaxy Health WC |
$39.10
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Global Benefits Group Commercial |
$27.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.27
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$29.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.02
|
| Rate for Payer: Multiplan Commercial |
$36.80
|
| Rate for Payer: Multiplan Commercial |
$168.00
|
| Rate for Payer: Networks By Design Commercial |
$29.90
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
| Rate for Payer: Prime Health Services Commercial |
$39.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$126.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$126.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.06
|
| Rate for Payer: United Healthcare All Other HMO |
$6.06
|
| Rate for Payer: United Healthcare All Other HMO |
$6.06
|
| Rate for Payer: United Healthcare HMO Rider |
$6.06
|
| Rate for Payer: United Healthcare HMO Rider |
$6.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.06
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.48
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.23
|
| Rate for Payer: Vantage Medical Group Senior |
$7.48
|
| Rate for Payer: Vantage Medical Group Senior |
$7.48
|
|
|
HC ESOPH ACID REFLX TEST
|
Facility
|
IP
|
$3,494.00
|
|
|
Service Code
|
CPT 91034
|
| Hospital Charge Code |
906791033
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$698.80 |
| Max. Negotiated Rate |
$2,969.90 |
| Rate for Payer: Adventist Health Commercial |
$698.80
|
| Rate for Payer: Cash Price |
$1,572.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,445.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,397.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,397.60
|
| Rate for Payer: Galaxy Health WC |
$2,969.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,096.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,218.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,061.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$838.56
|
| Rate for Payer: Multiplan Commercial |
$2,795.20
|
| Rate for Payer: Networks By Design Commercial |
$2,271.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,969.90
|
|
|
HC ESOPH ACID REFLX TEST
|
Facility
|
OP
|
$2,087.00
|
|
|
Service Code
|
CPT 91034
|
| Hospital Charge Code |
906791033
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$130.38 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$417.40
|
| Rate for Payer: Adventist Health Commercial |
$698.80
|
| 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 |
$719.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$479.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$479.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,339.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,242.10
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| 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: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Cash Price |
$1,572.30
|
| Rate for Payer: Cash Price |
$939.15
|
| Rate for Payer: Cash Price |
$939.15
|
| Rate for Payer: Cash Price |
$939.15
|
| Rate for Payer: Cash Price |
$1,572.30
|
| Rate for Payer: Cash Price |
$1,572.30
|
| Rate for Payer: Cigna of CA HMO |
$2,236.16
|
| Rate for Payer: Cigna of CA HMO |
$1,335.68
|
| Rate for Payer: Cigna of CA PPO |
$2,585.56
|
| Rate for Payer: Cigna of CA PPO |
$1,544.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$719.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$719.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$527.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$527.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$479.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$479.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,445.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,460.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$791.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$791.90
|
| Rate for Payer: EPIC Health Plan Senior |
$527.93
|
| Rate for Payer: EPIC Health Plan Senior |
$527.93
|
| Rate for Payer: Galaxy Health WC |
$1,773.95
|
| Rate for Payer: Galaxy Health WC |
$2,969.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,096.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,252.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$787.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$787.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$130.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$130.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$479.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$479.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,218.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,325.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$147.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$147.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$671.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$671.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$500.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$838.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$604.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$604.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$643.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$643.12
|
| Rate for Payer: Multiplan Commercial |
$2,795.20
|
| Rate for Payer: Multiplan Commercial |
$1,669.60
|
| Rate for Payer: Networks By Design Commercial |
$2,271.10
|
| Rate for Payer: Networks By Design Commercial |
$1,356.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,969.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,773.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,096.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,252.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$575.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$575.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,747.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,043.50
|
| 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: Upland Medical Group Pediatric |
$479.94
|
| Rate for Payer: Upland Medical Group Pediatric |
$479.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Vantage Medical Group Senior |
$479.94
|
| Rate for Payer: Vantage Medical Group Senior |
$479.94
|
|
|
HC ESOPHAG DIAG W BALLOON DILATION
|
Facility
|
OP
|
$4,573.00
|
|
|
Service Code
|
CPT 43220
|
| Hospital Charge Code |
909000188
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$300.22 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$914.60
|
| Rate for Payer: Adventist Health Commercial |
$611.40
|
| 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 |
$5,641.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| 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 |
$1,375.65
|
| Rate for Payer: Cash Price |
$1,375.65
|
| Rate for Payer: Cash Price |
$2,057.85
|
| Rate for Payer: Cash Price |
$1,375.65
|
| Rate for Payer: Cash Price |
$2,057.85
|
| Rate for Payer: Cash Price |
$2,057.85
|
| Rate for Payer: Cigna of CA HMO |
$1,956.48
|
| Rate for Payer: Cigna of CA HMO |
$2,926.72
|
| Rate for Payer: Cigna of CA PPO |
$3,384.02
|
| Rate for Payer: Cigna of CA PPO |
$2,262.18
|
| 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 |
$2,139.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,201.10
|
| 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 |
$3,887.05
|
| Rate for Payer: Galaxy Health WC |
$2,598.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,743.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,834.20
|
| 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 |
$2,903.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,941.19
|
| 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 |
$1,097.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$733.68
|
| 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 |
$2,445.60
|
| Rate for Payer: Multiplan Commercial |
$3,658.40
|
| Rate for Payer: Multiplan WC |
$3,840.40
|
| Rate for Payer: Multiplan WC |
$3,840.40
|
| Rate for Payer: Networks By Design Commercial |
$2,972.45
|
| Rate for Payer: Networks By Design Commercial |
$1,987.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,887.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,598.45
|
| Rate for Payer: Prime Health Services WC |
$3,801.22
|
| Rate for Payer: Prime Health Services WC |
$3,801.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,743.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,834.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,286.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,528.50
|
| 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 ESOPHAG DIAG W BALLOON DILATION
|
Facility
|
OP
|
$4,573.00
|
|
|
Service Code
|
CPT 43220
|
| Hospital Charge Code |
909000188
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$300.22 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$914.60
|
| Rate for Payer: Adventist Health Commercial |
$611.40
|
| 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 |
$5,641.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| 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 |
$1,375.65
|
| Rate for Payer: Cash Price |
$2,057.85
|
| Rate for Payer: Cash Price |
$2,057.85
|
| Rate for Payer: Cash Price |
$1,375.65
|
| Rate for Payer: Cash Price |
$1,375.65
|
| Rate for Payer: Cash Price |
$2,057.85
|
| Rate for Payer: Cigna of CA HMO |
$2,926.72
|
| Rate for Payer: Cigna of CA HMO |
$1,956.48
|
| Rate for Payer: Cigna of CA PPO |
$2,262.18
|
| Rate for Payer: Cigna of CA PPO |
$3,384.02
|
| 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 |
$3,201.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,139.90
|
| 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 |
$3,887.05
|
| Rate for Payer: Galaxy Health WC |
$2,598.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,834.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,743.80
|
| 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 |
$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 |
$2,903.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,941.19
|
| 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 |
$733.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,097.52
|
| 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 |
$2,445.60
|
| Rate for Payer: Multiplan Commercial |
$3,658.40
|
| Rate for Payer: Networks By Design Commercial |
$2,972.45
|
| Rate for Payer: Networks By Design Commercial |
$1,987.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,887.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,598.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,743.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,834.20
|
| 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 |
$1,528.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,286.50
|
| 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 ESOPHAG DIAG W BALLOON DILATION
|
Facility
|
IP
|
$4,573.00
|
|
|
Service Code
|
CPT 43220
|
| Hospital Charge Code |
909000188
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$914.60 |
| Max. Negotiated Rate |
$3,887.05 |
| Rate for Payer: Adventist Health Commercial |
$914.60
|
| Rate for Payer: Cash Price |
$2,057.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,201.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,829.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,829.20
|
| Rate for Payer: Galaxy Health WC |
$3,887.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,743.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,903.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,698.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,097.52
|
| Rate for Payer: Multiplan Commercial |
$3,658.40
|
| Rate for Payer: Networks By Design Commercial |
$2,972.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,887.05
|
|
|
HC ESOPHAG DIAG W BALLOON DILATION
|
Facility
|
IP
|
$4,573.00
|
|
|
Service Code
|
CPT 43220
|
| Hospital Charge Code |
909000188
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$914.60 |
| Max. Negotiated Rate |
$3,887.05 |
| Rate for Payer: Adventist Health Commercial |
$914.60
|
| Rate for Payer: Cash Price |
$2,057.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,201.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,829.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,829.20
|
| Rate for Payer: Galaxy Health WC |
$3,887.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,743.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,903.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,698.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,097.52
|
| Rate for Payer: Multiplan Commercial |
$3,658.40
|
| Rate for Payer: Networks By Design Commercial |
$2,972.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,887.05
|
|
|
HC ESOPHAGEAL DILATATION
|
Facility
|
IP
|
$1,158.00
|
|
|
Service Code
|
CPT 74360
|
| Hospital Charge Code |
909001829
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$231.60 |
| Max. Negotiated Rate |
$984.30 |
| Rate for Payer: Adventist Health Commercial |
$231.60
|
| Rate for Payer: Cash Price |
$521.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$810.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$463.20
|
| Rate for Payer: EPIC Health Plan Senior |
$463.20
|
| Rate for Payer: Galaxy Health WC |
$984.30
|
| Rate for Payer: Global Benefits Group Commercial |
$694.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$735.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$683.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.92
|
| Rate for Payer: Multiplan Commercial |
$926.40
|
| Rate for Payer: Networks By Design Commercial |
$752.70
|
| Rate for Payer: Prime Health Services Commercial |
$984.30
|
|
|
HC ESOPHAGEAL DILATATION
|
Facility
|
OP
|
$1,158.00
|
|
|
Service Code
|
CPT 74360
|
| Hospital Charge Code |
909001829
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$183.09 |
| Max. Negotiated Rate |
$984.30 |
| Rate for Payer: Adventist Health Commercial |
$231.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$652.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$984.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$636.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$868.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$924.97
|
| Rate for Payer: Blue Shield of California Commercial |
$738.80
|
| Rate for Payer: Blue Shield of California Commercial |
$487.52
|
| Rate for Payer: Cash Price |
$521.10
|
| Rate for Payer: Cash Price |
$521.10
|
| Rate for Payer: Cigna of CA HMO |
$741.12
|
| Rate for Payer: Cigna of CA PPO |
$856.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$984.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$984.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$984.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$810.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$463.20
|
| Rate for Payer: EPIC Health Plan Senior |
$463.20
|
| Rate for Payer: Galaxy Health WC |
$984.30
|
| Rate for Payer: Global Benefits Group Commercial |
$694.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$183.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$735.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$207.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$683.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$810.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$810.60
|
| Rate for Payer: Multiplan Commercial |
$926.40
|
| Rate for Payer: Networks By Design Commercial |
$752.70
|
| Rate for Payer: Prime Health Services Commercial |
$984.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$694.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$694.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$579.00
|
| Rate for Payer: United Healthcare All Other HMO |
$579.00
|
| Rate for Payer: United Healthcare HMO Rider |
$579.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$579.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$984.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$984.30
|
| Rate for Payer: Vantage Medical Group Senior |
$984.30
|
|
|
HC ESOPHAGOGASTRIC TMPONAD W/BLLN
|
Facility
|
OP
|
$3,313.00
|
|
|
Service Code
|
CPT 43460
|
| Hospital Charge Code |
906743460
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$154.49 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$662.60
|
| Rate for Payer: Adventist Health Commercial |
$870.60
|
| 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 |
$3,700.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,816.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,394.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,822.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,484.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,264.75
|
| 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 |
$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: Cash Price |
$1,490.85
|
| Rate for Payer: Cash Price |
$1,958.85
|
| Rate for Payer: Cash Price |
$1,490.85
|
| Rate for Payer: Cash Price |
$1,490.85
|
| Rate for Payer: Cash Price |
$1,958.85
|
| Rate for Payer: Cash Price |
$1,958.85
|
| Rate for Payer: Cigna of CA HMO |
$2,785.92
|
| Rate for Payer: Cigna of CA HMO |
$2,120.32
|
| Rate for Payer: Cigna of CA PPO |
$3,221.22
|
| Rate for Payer: Cigna of CA PPO |
$2,451.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,700.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,816.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,816.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,700.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,700.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,816.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,319.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,047.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,741.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,325.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,741.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,325.20
|
| Rate for Payer: Galaxy Health WC |
$2,816.05
|
| Rate for Payer: Galaxy Health WC |
$3,700.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,987.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,611.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$154.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$154.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,103.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,764.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$174.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$174.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,568.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,954.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$795.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,044.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,047.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,319.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,047.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,319.10
|
| Rate for Payer: Multiplan Commercial |
$2,650.40
|
| Rate for Payer: Multiplan Commercial |
$3,482.40
|
| Rate for Payer: Networks By Design Commercial |
$2,153.45
|
| Rate for Payer: Networks By Design Commercial |
$2,829.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,700.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,816.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,611.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,987.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,987.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,611.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,656.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,176.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,700.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,816.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,816.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,700.05
|
| Rate for Payer: Vantage Medical Group Senior |
$3,700.05
|
| Rate for Payer: Vantage Medical Group Senior |
$2,816.05
|
|
|
HC ESOPHAGOGASTRIC TMPONAD W/BLLN
|
Facility
|
IP
|
$3,313.00
|
|
|
Service Code
|
CPT 43460
|
| Hospital Charge Code |
906743460
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$662.60 |
| Max. Negotiated Rate |
$2,816.05 |
| Rate for Payer: Adventist Health Commercial |
$662.60
|
| Rate for Payer: Cash Price |
$1,490.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,319.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,325.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,325.20
|
| Rate for Payer: Galaxy Health WC |
$2,816.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,987.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,103.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,954.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$795.12
|
| Rate for Payer: Multiplan Commercial |
$2,650.40
|
| Rate for Payer: Networks By Design Commercial |
$2,153.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,816.05
|
|
|
HC ESOPHAGOSCOPY W BLLN LT 30MM
|
Facility
|
OP
|
$4,573.00
|
|
|
Service Code
|
CPT 43220
|
| Hospital Charge Code |
900501292
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$339.53 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$914.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| 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 Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$2,057.85
|
| Rate for Payer: Cash Price |
$2,057.85
|
| Rate for Payer: Cash Price |
$2,057.85
|
| Rate for Payer: Cigna of CA HMO |
$2,926.72
|
| Rate for Payer: Cigna of CA PPO |
$3,384.02
|
| 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 Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,201.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$3,887.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,743.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,903.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$339.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,653.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,097.52
|
| 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: Multiplan Commercial |
$3,658.40
|
| Rate for Payer: Multiplan WC |
$3,840.40
|
| Rate for Payer: Networks By Design Commercial |
$2,972.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,887.05
|
| Rate for Payer: Prime Health Services WC |
$3,801.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,743.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,286.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,286.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,286.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,286.50
|
| 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 Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ESOPHAGOSCOPY W BLLN LT 30MM
|
Facility
|
IP
|
$4,573.00
|
|
|
Service Code
|
CPT 43220
|
| Hospital Charge Code |
900501292
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$914.60 |
| Max. Negotiated Rate |
$3,887.05 |
| Rate for Payer: Adventist Health Commercial |
$914.60
|
| Rate for Payer: Cash Price |
$2,057.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,201.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,829.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,829.20
|
| Rate for Payer: Galaxy Health WC |
$3,887.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,743.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,903.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,698.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,097.52
|
| Rate for Payer: Multiplan Commercial |
$3,658.40
|
| Rate for Payer: Networks By Design Commercial |
$2,972.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,887.05
|
|
|
HC ESOPHAGOSCOPY W OPTICAL ENDOMI
|
Facility
|
IP
|
$3,052.00
|
|
|
Service Code
|
CPT 43206
|
| Hospital Charge Code |
906743206
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$610.40 |
| Max. Negotiated Rate |
$2,594.20 |
| Rate for Payer: Adventist Health Commercial |
$610.40
|
| Rate for Payer: Cash Price |
$1,373.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,136.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,220.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,220.80
|
| Rate for Payer: Galaxy Health WC |
$2,594.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,831.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,938.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,800.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$732.48
|
| Rate for Payer: Multiplan Commercial |
$2,441.60
|
| Rate for Payer: Networks By Design Commercial |
$1,983.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,594.20
|
|
|
HC ESOPHAGOSCOPY W OPTICAL ENDOMI
|
Facility
|
OP
|
$3,052.00
|
|
|
Service Code
|
CPT 43206
|
| Hospital Charge Code |
906743206
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$610.40 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$610.40
|
| Rate for Payer: Adventist Health Commercial |
$408.20
|
| 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 |
$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 |
$5,641.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| 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 |
$1,373.40
|
| Rate for Payer: Cash Price |
$918.45
|
| Rate for Payer: Cash Price |
$1,373.40
|
| Rate for Payer: Cash Price |
$918.45
|
| Rate for Payer: Cash Price |
$918.45
|
| Rate for Payer: Cash Price |
$1,373.40
|
| Rate for Payer: Cigna of CA HMO |
$1,306.24
|
| Rate for Payer: Cigna of CA HMO |
$1,953.28
|
| Rate for Payer: Cigna of CA PPO |
$1,510.34
|
| Rate for Payer: Cigna of CA PPO |
$2,258.48
|
| 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 |
$2,136.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,428.70
|
| 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 |
$1,734.85
|
| Rate for Payer: Galaxy Health WC |
$2,594.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,224.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,831.20
|
| 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) 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 |
$1,296.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,938.02
|
| 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 |
$489.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$732.48
|
| 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 |
$2,441.60
|
| Rate for Payer: Multiplan Commercial |
$1,632.80
|
| Rate for Payer: Networks By Design Commercial |
$1,326.65
|
| Rate for Payer: Networks By Design Commercial |
$1,983.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,594.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,734.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,831.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,224.60
|
| 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 |
$1,526.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,020.50
|
| 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 ESOPHAGOSCOPY W/WO SPECIMEN
|
Facility
|
OP
|
$3,070.00
|
|
|
Service Code
|
CPT 43200
|
| Hospital Charge Code |
906743200
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$320.44 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$614.00
|
| Rate for Payer: Adventist Health Commercial |
$918.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$1,381.50
|
| Rate for Payer: Cash Price |
$1,381.50
|
| Rate for Payer: Cash Price |
$2,066.85
|
| Rate for Payer: Cash Price |
$2,066.85
|
| Rate for Payer: Cash Price |
$1,381.50
|
| Rate for Payer: Cash Price |
$2,066.85
|
| Rate for Payer: Cigna of CA HMO |
$2,939.52
|
| Rate for Payer: Cigna of CA HMO |
$1,964.80
|
| Rate for Payer: Cigna of CA PPO |
$2,271.80
|
| Rate for Payer: Cigna of CA PPO |
$3,398.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,215.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,149.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.77
|
| Rate for Payer: EPIC Health Plan Senior |
$1,283.18
|
| Rate for Payer: EPIC Health Plan Senior |
$1,283.18
|
| Rate for Payer: Galaxy Health WC |
$2,609.50
|
| Rate for Payer: Galaxy Health WC |
$3,904.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,755.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,842.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,913.11
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,913.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,949.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,916.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$320.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$320.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,254.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,254.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$736.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,102.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,469.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,469.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,563.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,563.15
|
| Rate for Payer: Multiplan Commercial |
$3,674.40
|
| Rate for Payer: Multiplan Commercial |
$2,456.00
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: Networks By Design Commercial |
$2,985.45
|
| Rate for Payer: Networks By Design Commercial |
$1,995.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,609.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,904.05
|
| Rate for Payer: Prime Health Services WC |
$1,878.70
|
| Rate for Payer: Prime Health Services WC |
$1,878.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,755.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,842.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,535.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,296.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,296.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,535.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,535.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,296.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,535.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,296.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,166.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
|
|
HC ESOPHAGOSCOPY W/WO SPECIMEN
|
Facility
|
IP
|
$4,593.00
|
|
|
Service Code
|
CPT 43200
|
| Hospital Charge Code |
906743200
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$918.60 |
| Max. Negotiated Rate |
$3,904.05 |
| Rate for Payer: Adventist Health Commercial |
$918.60
|
| Rate for Payer: Cash Price |
$2,066.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,215.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,837.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,837.20
|
| Rate for Payer: Galaxy Health WC |
$3,904.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,755.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,916.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,709.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,102.32
|
| Rate for Payer: Multiplan Commercial |
$3,674.40
|
| Rate for Payer: Networks By Design Commercial |
$2,985.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,904.05
|
|
