|
HC UNLSTD DIAG GASTROENTEROLOGY
|
Facility
IP
|
$1,946.00
|
|
|
Service Code
|
CPT 91299
|
| Hospital Charge Code |
906791299
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$467.04 |
| Max. Negotiated Rate |
$1,654.10 |
| Rate for Payer: Cash Price |
$875.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$778.40
|
| Rate for Payer: Galaxy Health WC |
$1,654.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,167.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,297.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$741.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$467.04
|
| Rate for Payer: Multiplan Commercial |
$1,556.80
|
| Rate for Payer: Networks By Design Commercial |
$1,264.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,654.10
|
|
|
HC UNLSTD DIAG GASTROENTEROLOGY
|
Facility
OP
|
$1,179.00
|
|
|
Service Code
|
CPT 91299
|
| Hospital Charge Code |
906791299
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$195.17 |
| Max. Negotiated Rate |
$3,171.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$195.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,299.00
|
| Rate for Payer: BCBS Transplant Transplant |
$707.40
|
| Rate for Payer: Cash Price |
$530.55
|
| Rate for Payer: Cash Price |
$530.55
|
| Rate for Payer: Cash Price |
$530.55
|
| Rate for Payer: Cigna of CA PPO |
$872.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| Rate for Payer: Dignity Health Media |
$195.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$263.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$195.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$195.17
|
| Rate for Payer: Galaxy Health WC |
$1,002.15
|
| Rate for Payer: Global Benefits Group Commercial |
$707.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$884.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$320.08
|
| Rate for Payer: Heritage Provider Network Transplant |
$320.08
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$195.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$786.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$195.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$282.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$261.53
|
| Rate for Payer: Multiplan Commercial |
$943.20
|
| Rate for Payer: Networks By Design Commercial |
$766.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,002.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$707.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$707.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$589.50
|
| Rate for Payer: United Healthcare All Other HMO |
$589.50
|
| Rate for Payer: United Healthcare HMO Rider |
$589.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$589.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Vantage Medical Group Senior |
$195.17
|
|
|
HC UNLSTD DIAG GASTROENTEROLOGY
|
Facility
IP
|
$1,946.00
|
|
|
Service Code
|
CPT 91299
|
| Hospital Charge Code |
906791299
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$467.04 |
| Max. Negotiated Rate |
$1,654.10 |
| Rate for Payer: Cash Price |
$875.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$778.40
|
| Rate for Payer: Galaxy Health WC |
$1,654.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,167.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,297.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$741.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$467.04
|
| Rate for Payer: Multiplan Commercial |
$1,556.80
|
| Rate for Payer: Networks By Design Commercial |
$1,264.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,654.10
|
|
|
HC UNLSTD DIAG GASTROENTEROLOGY
|
Facility
OP
|
$1,179.00
|
|
|
Service Code
|
CPT 91299
|
| Hospital Charge Code |
906791299
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$195.17 |
| Max. Negotiated Rate |
$6,668.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$773.31
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$195.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$702.45
|
| Rate for Payer: BCBS Transplant Transplant |
$707.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$530.55
|
| Rate for Payer: Cash Price |
$530.55
|
| Rate for Payer: Cash Price |
$530.55
|
| Rate for Payer: Cigna of CA PPO |
$872.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| Rate for Payer: Dignity Health Media |
$195.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$263.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$195.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$195.17
|
| Rate for Payer: Galaxy Health WC |
$1,002.15
|
| Rate for Payer: Global Benefits Group Commercial |
$707.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$884.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$320.08
|
| Rate for Payer: Heritage Provider Network Transplant |
$320.08
|
| Rate for Payer: IEHP Medi-Cal |
$316.18
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$316.18
|
| Rate for Payer: IEHP Medicare Advantage |
$195.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$786.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$195.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$282.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$261.53
|
| Rate for Payer: Multiplan Commercial |
$943.20
|
| Rate for Payer: Networks By Design Commercial |
$766.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,002.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$214.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$707.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$234.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Vantage Medical Group Senior |
$195.17
|
|
|
HC UNLSTD MALE GENITAL SURG PROC
|
Facility
IP
|
$627.00
|
|
|
Service Code
|
CPT 55899
|
| Hospital Charge Code |
900501624
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$150.48 |
| Max. Negotiated Rate |
$532.95 |
| Rate for Payer: Cash Price |
$282.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$250.80
|
| Rate for Payer: Galaxy Health WC |
$532.95
|
| Rate for Payer: Global Benefits Group Commercial |
$376.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$418.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$238.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.48
|
| Rate for Payer: Multiplan Commercial |
$501.60
|
| Rate for Payer: Networks By Design Commercial |
$407.55
|
| Rate for Payer: Prime Health Services Commercial |
$532.95
|
|
|
HC UNLSTD MALE GENITAL SURG PROC
|
Facility
OP
|
$627.00
|
|
|
Service Code
|
CPT 55899
|
| Hospital Charge Code |
900501624
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$150.48 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$463.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$339.67
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$308.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,299.00
|
| Rate for Payer: BCBS Transplant Transplant |
$376.20
|
| Rate for Payer: Cash Price |
$282.15
|
| Rate for Payer: Cash Price |
$282.15
|
| Rate for Payer: Cash Price |
$282.15
|
| Rate for Payer: Cigna of CA PPO |
$463.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$463.18
|
| Rate for Payer: Dignity Health Media |
$308.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$339.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$416.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$308.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$308.79
|
| Rate for Payer: Galaxy Health WC |
$532.95
|
| Rate for Payer: Global Benefits Group Commercial |
$376.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$470.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$506.42
|
| Rate for Payer: Heritage Provider Network Transplant |
$506.42
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$308.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$418.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$308.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$389.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$413.78
|
| Rate for Payer: Multiplan Commercial |
$501.60
|
| Rate for Payer: Networks By Design Commercial |
$407.55
|
| Rate for Payer: Prime Health Services Commercial |
$532.95
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$376.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$376.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$313.50
|
| Rate for Payer: United Healthcare All Other HMO |
$313.50
|
| Rate for Payer: United Healthcare HMO Rider |
$313.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$313.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$463.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$339.67
|
| Rate for Payer: Vantage Medical Group Senior |
$308.79
|
|
|
HC UNLSTD PROCEDURE TRACHEA BRONC
|
Facility
IP
|
$2,103.00
|
|
|
Service Code
|
CPT 31899
|
| Hospital Charge Code |
900501511
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$504.72 |
| Max. Negotiated Rate |
$1,787.55 |
| Rate for Payer: Cash Price |
$946.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$841.20
|
| Rate for Payer: Galaxy Health WC |
$1,787.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,261.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,402.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$801.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$504.72
|
| Rate for Payer: Multiplan Commercial |
$1,682.40
|
| Rate for Payer: Networks By Design Commercial |
$1,366.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,787.55
|
|
|
HC UNLSTD PROCEDURE TRACHEA BRONC
|
Facility
OP
|
$2,103.00
|
|
|
Service Code
|
CPT 31899
|
| Hospital Charge Code |
900501511
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$247.49 |
| Max. Negotiated Rate |
$3,429.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$247.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,299.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,261.80
|
| Rate for Payer: Cash Price |
$946.35
|
| Rate for Payer: Cash Price |
$946.35
|
| Rate for Payer: Cash Price |
$946.35
|
| Rate for Payer: Cigna of CA PPO |
$1,556.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$371.24
|
| Rate for Payer: Dignity Health Media |
$247.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$272.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$334.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$247.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$247.49
|
| Rate for Payer: Galaxy Health WC |
$1,787.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,261.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,577.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$405.88
|
| Rate for Payer: Heritage Provider Network Transplant |
$405.88
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$247.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,402.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$247.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$504.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$311.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$331.64
|
| Rate for Payer: Multiplan Commercial |
$1,682.40
|
| Rate for Payer: Networks By Design Commercial |
$1,366.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,787.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,261.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,261.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,051.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,051.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,051.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,051.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Vantage Medical Group Senior |
$247.49
|
|
|
HC UNLSTD PROC PALATE/UVULA
|
Facility
OP
|
$257.00
|
|
|
Service Code
|
CPT 42299
|
| Hospital Charge Code |
900501745
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$61.68 |
| Max. Negotiated Rate |
$3,171.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$305.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,299.00
|
| Rate for Payer: BCBS Transplant Transplant |
$154.20
|
| Rate for Payer: Cash Price |
$115.65
|
| Rate for Payer: Cash Price |
$115.65
|
| Rate for Payer: Cash Price |
$115.65
|
| Rate for Payer: Cigna of CA PPO |
$190.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: Dignity Health Media |
$305.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$218.45
|
| Rate for Payer: Global Benefits Group Commercial |
$154.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$192.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$500.51
|
| Rate for Payer: Heritage Provider Network Transplant |
$500.51
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$305.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$171.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$205.60
|
| Rate for Payer: Networks By Design Commercial |
$167.05
|
| Rate for Payer: Prime Health Services Commercial |
$218.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$154.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$154.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$128.50
|
| Rate for Payer: United Healthcare All Other HMO |
$128.50
|
| Rate for Payer: United Healthcare HMO Rider |
$128.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$128.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC UNLSTD PROC PALATE/UVULA
|
Facility
IP
|
$257.00
|
|
|
Service Code
|
CPT 42299
|
| Hospital Charge Code |
900501745
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$61.68 |
| Max. Negotiated Rate |
$218.45 |
| Rate for Payer: Cash Price |
$115.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$102.80
|
| Rate for Payer: Galaxy Health WC |
$218.45
|
| Rate for Payer: Global Benefits Group Commercial |
$154.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$171.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$97.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.68
|
| Rate for Payer: Multiplan Commercial |
$205.60
|
| Rate for Payer: Networks By Design Commercial |
$167.05
|
| Rate for Payer: Prime Health Services Commercial |
$218.45
|
|
|
HC UNLSTD TEAR DUCT SYSTEM SURGRY
|
Facility
OP
|
$692.00
|
|
|
Service Code
|
CPT 68899
|
| Hospital Charge Code |
900501716
|
|
Hospital Revenue Code
|
490
|
| Min. Negotiated Rate |
$166.08 |
| Max. Negotiated Rate |
$1,834.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$453.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$545.97
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$400.38
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$363.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$412.29
|
| Rate for Payer: BCBS Transplant Transplant |
$415.20
|
| Rate for Payer: Blue Shield of California Commercial |
$510.00
|
| Rate for Payer: Blue Shield of California EPN |
$404.13
|
| Rate for Payer: Cash Price |
$311.40
|
| Rate for Payer: Cash Price |
$311.40
|
| Rate for Payer: Cigna of CA PPO |
$512.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$545.97
|
| Rate for Payer: Dignity Health Media |
$363.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$400.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$491.37
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$363.98
|
| Rate for Payer: EPIC Health Plan Transplant |
$363.98
|
| Rate for Payer: Galaxy Health WC |
$588.20
|
| Rate for Payer: Global Benefits Group Commercial |
$415.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$519.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$596.93
|
| Rate for Payer: Heritage Provider Network Transplant |
$596.93
|
| Rate for Payer: IEHP Medi-Cal |
$589.65
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$589.65
|
| Rate for Payer: IEHP Medicare Advantage |
$363.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$461.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$363.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$166.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$458.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$487.73
|
| Rate for Payer: Multiplan Commercial |
$553.60
|
| Rate for Payer: Networks By Design Commercial |
$449.80
|
| Rate for Payer: Prime Health Services Commercial |
$588.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$415.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$415.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$415.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$545.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$400.38
|
| Rate for Payer: Vantage Medical Group Senior |
$363.98
|
|
|
HC UNLSTD TEAR DUCT SYSTEM SURGRY
|
Facility
IP
|
$692.00
|
|
|
Service Code
|
CPT 68899
|
| Hospital Charge Code |
900501716
|
|
Hospital Revenue Code
|
490
|
| Min. Negotiated Rate |
$166.08 |
| Max. Negotiated Rate |
$588.20 |
| Rate for Payer: Cash Price |
$311.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$276.80
|
| Rate for Payer: Galaxy Health WC |
$588.20
|
| Rate for Payer: Global Benefits Group Commercial |
$415.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$461.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$263.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$166.08
|
| Rate for Payer: Multiplan Commercial |
$553.60
|
| Rate for Payer: Networks By Design Commercial |
$449.80
|
| Rate for Payer: Prime Health Services Commercial |
$588.20
|
|
|
HC UNLST PROC CASTING/STRAPPING
|
Facility
IP
|
$516.00
|
|
|
Service Code
|
CPT 29799
|
| Hospital Charge Code |
900501651
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$123.84 |
| Max. Negotiated Rate |
$438.60 |
| Rate for Payer: Cash Price |
$232.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$206.40
|
| Rate for Payer: Galaxy Health WC |
$438.60
|
| Rate for Payer: Global Benefits Group Commercial |
$309.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$344.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$196.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.84
|
| Rate for Payer: Multiplan Commercial |
$412.80
|
| Rate for Payer: Networks By Design Commercial |
$335.40
|
| Rate for Payer: Prime Health Services Commercial |
$438.60
|
|
|
HC UNLST PROC CASTING/STRAPPING
|
Facility
OP
|
$516.00
|
|
|
Service Code
|
CPT 29799
|
| Hospital Charge Code |
900501651
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$123.84 |
| Max. Negotiated Rate |
$3,171.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$295.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$216.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$196.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,299.00
|
| Rate for Payer: BCBS Transplant Transplant |
$309.60
|
| Rate for Payer: Cash Price |
$232.20
|
| Rate for Payer: Cash Price |
$232.20
|
| Rate for Payer: Cash Price |
$232.20
|
| Rate for Payer: Cigna of CA PPO |
$381.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$295.30
|
| Rate for Payer: Dignity Health Media |
$196.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$216.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$265.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$196.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$196.87
|
| Rate for Payer: Galaxy Health WC |
$438.60
|
| Rate for Payer: Global Benefits Group Commercial |
$309.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$387.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$322.87
|
| Rate for Payer: Heritage Provider Network Transplant |
$322.87
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$196.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$344.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$196.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$248.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$263.81
|
| Rate for Payer: Multiplan Commercial |
$412.80
|
| Rate for Payer: Networks By Design Commercial |
$335.40
|
| Rate for Payer: Prime Health Services Commercial |
$438.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$309.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$309.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$258.00
|
| Rate for Payer: United Healthcare All Other HMO |
$258.00
|
| Rate for Payer: United Healthcare HMO Rider |
$258.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$258.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$295.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$216.56
|
| Rate for Payer: Vantage Medical Group Senior |
$196.87
|
|
|
HC UNLST PROC TONGUE FLOOR OF MOUTH
|
Facility
OP
|
$502.00
|
|
|
Service Code
|
CPT 41599
|
| Hospital Charge Code |
900501220
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$120.48 |
| Max. Negotiated Rate |
$3,171.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$305.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,299.00
|
| Rate for Payer: BCBS Transplant Transplant |
$301.20
|
| Rate for Payer: Cash Price |
$225.90
|
| Rate for Payer: Cash Price |
$225.90
|
| Rate for Payer: Cash Price |
$225.90
|
| Rate for Payer: Cigna of CA PPO |
$371.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: Dignity Health Media |
$305.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$426.70
|
| Rate for Payer: Global Benefits Group Commercial |
$301.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$376.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$500.51
|
| Rate for Payer: Heritage Provider Network Transplant |
$500.51
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$305.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$334.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$401.60
|
| Rate for Payer: Networks By Design Commercial |
$326.30
|
| Rate for Payer: Prime Health Services Commercial |
$426.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$301.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$301.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$251.00
|
| Rate for Payer: United Healthcare All Other HMO |
$251.00
|
| Rate for Payer: United Healthcare HMO Rider |
$251.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$251.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC UNLST PROC TONGUE FLOOR OF MOUTH
|
Facility
IP
|
$502.00
|
|
|
Service Code
|
CPT 41599
|
| Hospital Charge Code |
900501220
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$120.48 |
| Max. Negotiated Rate |
$426.70 |
| Rate for Payer: Cash Price |
$225.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$200.80
|
| Rate for Payer: Galaxy Health WC |
$426.70
|
| Rate for Payer: Global Benefits Group Commercial |
$301.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$334.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$191.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.48
|
| Rate for Payer: Multiplan Commercial |
$401.60
|
| Rate for Payer: Networks By Design Commercial |
$326.30
|
| Rate for Payer: Prime Health Services Commercial |
$426.70
|
|
|
HC UNOS REGISTRATION HEART
|
Facility
OP
|
$1,201.00
|
|
| Hospital Charge Code |
902200120
|
|
Hospital Revenue Code
|
810
|
| Min. Negotiated Rate |
$288.24 |
| Max. Negotiated Rate |
$1,020.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$787.74
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,020.85
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$660.55
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$660.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$715.56
|
| Rate for Payer: BCBS Transplant Transplant |
$720.60
|
| Rate for Payer: Blue Shield of California Commercial |
$885.14
|
| Rate for Payer: Blue Shield of California EPN |
$701.38
|
| Rate for Payer: Cash Price |
$540.45
|
| Rate for Payer: Cigna of CA HMO |
$768.64
|
| Rate for Payer: Cigna of CA PPO |
$888.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,020.85
|
| Rate for Payer: Dignity Health Media |
$1,020.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,020.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$480.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$480.40
|
| Rate for Payer: Galaxy Health WC |
$1,020.85
|
| Rate for Payer: Global Benefits Group Commercial |
$720.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$900.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$801.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$457.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$288.24
|
| Rate for Payer: Multiplan Commercial |
$960.80
|
| Rate for Payer: Networks By Design Commercial |
$780.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,020.85
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$720.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$720.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$720.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$600.50
|
| Rate for Payer: United Healthcare All Other HMO |
$600.50
|
| Rate for Payer: United Healthcare HMO Rider |
$600.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$600.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,020.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,020.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,020.85
|
|
|
HC UNOS REGISTRATION HEART
|
Facility
IP
|
$1,201.00
|
|
| Hospital Charge Code |
902200120
|
|
Hospital Revenue Code
|
810
|
| Min. Negotiated Rate |
$288.24 |
| Max. Negotiated Rate |
$1,020.85 |
| Rate for Payer: Cash Price |
$540.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$480.40
|
| Rate for Payer: Galaxy Health WC |
$1,020.85
|
| Rate for Payer: Global Benefits Group Commercial |
$720.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$801.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$457.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$288.24
|
| Rate for Payer: Multiplan Commercial |
$960.80
|
| Rate for Payer: Networks By Design Commercial |
$780.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,020.85
|
|
|
HC UNOS REGISTRATION KIDNEY
|
Facility
OP
|
$1,201.00
|
|
| Hospital Charge Code |
904700020
|
|
Hospital Revenue Code
|
810
|
| Min. Negotiated Rate |
$288.24 |
| Max. Negotiated Rate |
$1,020.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$787.74
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,020.85
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$660.55
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$660.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$715.56
|
| Rate for Payer: BCBS Transplant Transplant |
$720.60
|
| Rate for Payer: Blue Shield of California Commercial |
$885.14
|
| Rate for Payer: Blue Shield of California EPN |
$701.38
|
| Rate for Payer: Cash Price |
$540.45
|
| Rate for Payer: Cigna of CA HMO |
$768.64
|
| Rate for Payer: Cigna of CA PPO |
$888.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,020.85
|
| Rate for Payer: Dignity Health Media |
$1,020.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,020.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$480.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$480.40
|
| Rate for Payer: Galaxy Health WC |
$1,020.85
|
| Rate for Payer: Global Benefits Group Commercial |
$720.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$900.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$801.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$457.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$288.24
|
| Rate for Payer: Multiplan Commercial |
$960.80
|
| Rate for Payer: Networks By Design Commercial |
$780.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,020.85
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$720.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$720.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$720.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$600.50
|
| Rate for Payer: United Healthcare All Other HMO |
$600.50
|
| Rate for Payer: United Healthcare HMO Rider |
$600.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$600.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,020.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,020.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,020.85
|
|
|
HC UNOS REGISTRATION KIDNEY
|
Facility
IP
|
$1,201.00
|
|
| Hospital Charge Code |
904700020
|
|
Hospital Revenue Code
|
810
|
| Min. Negotiated Rate |
$288.24 |
| Max. Negotiated Rate |
$1,020.85 |
| Rate for Payer: Cash Price |
$540.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$480.40
|
| Rate for Payer: Galaxy Health WC |
$1,020.85
|
| Rate for Payer: Global Benefits Group Commercial |
$720.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$801.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$457.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$288.24
|
| Rate for Payer: Multiplan Commercial |
$960.80
|
| Rate for Payer: Networks By Design Commercial |
$780.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,020.85
|
|
|
HC UNSCHED DIALYSIS ESRD PT OP
|
Facility
IP
|
$1,672.00
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
940100257
|
|
Hospital Revenue Code
|
829
|
| Min. Negotiated Rate |
$401.28 |
| Max. Negotiated Rate |
$1,421.20 |
| Rate for Payer: Cash Price |
$752.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$668.80
|
| Rate for Payer: Galaxy Health WC |
$1,421.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,003.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,115.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$637.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$401.28
|
| Rate for Payer: Multiplan Commercial |
$1,337.60
|
| Rate for Payer: Networks By Design Commercial |
$1,086.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,421.20
|
|
|
HC UNSCHED DIALYSIS ESRD PT OP
|
Facility
OP
|
$1,672.00
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
940100257
|
|
Hospital Revenue Code
|
829
|
| Min. Negotiated Rate |
$107.54 |
| Max. Negotiated Rate |
$1,533.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$486.17
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,309.65
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$960.41
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$873.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$996.18
|
| Rate for Payer: BCBS Transplant Transplant |
$1,003.20
|
| Rate for Payer: Cash Price |
$752.40
|
| Rate for Payer: Cash Price |
$752.40
|
| Rate for Payer: Cash Price |
$752.40
|
| Rate for Payer: Cigna of CA HMO |
$1,070.08
|
| Rate for Payer: Cigna of CA PPO |
$1,237.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,309.65
|
| Rate for Payer: Dignity Health Media |
$873.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$960.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,178.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$873.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$873.10
|
| Rate for Payer: Galaxy Health WC |
$1,421.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,003.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,254.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,431.88
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,431.88
|
| Rate for Payer: IEHP Medi-Cal |
$1,414.42
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$1,414.42
|
| Rate for Payer: IEHP Medicare Advantage |
$873.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,115.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$107.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$873.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$401.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,100.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,169.95
|
| Rate for Payer: Multiplan Commercial |
$1,337.60
|
| Rate for Payer: Networks By Design Commercial |
$1,086.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,421.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,003.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,003.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,003.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,490.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,533.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,114.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,019.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,309.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$960.41
|
| Rate for Payer: Vantage Medical Group Senior |
$873.10
|
|
|
HC UPPER GI ENDOSCOPY W OPTCL END
|
Facility
IP
|
$3,781.00
|
|
|
Service Code
|
CPT 43252
|
| Hospital Charge Code |
906743252
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$907.44 |
| Max. Negotiated Rate |
$3,213.85 |
| Rate for Payer: Cash Price |
$1,701.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,512.40
|
| Rate for Payer: Galaxy Health WC |
$3,213.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,268.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,521.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,440.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$907.44
|
| Rate for Payer: Multiplan Commercial |
$3,024.80
|
| Rate for Payer: Networks By Design Commercial |
$2,457.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,213.85
|
|
|
HC UPPER GI ENDOSCOPY W OPTCL END
|
Facility
OP
|
$2,527.00
|
|
|
Service Code
|
CPT 43252
|
| Hospital Charge Code |
906743252
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$606.48 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,377.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,516.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,612.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,351.09
|
| Rate for Payer: Cash Price |
$1,137.15
|
| Rate for Payer: Cash Price |
$1,137.15
|
| Rate for Payer: Cigna of CA PPO |
$1,869.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Dignity Health Media |
$2,377.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,615.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,209.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,377.45
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,377.45
|
| Rate for Payer: Galaxy Health WC |
$2,147.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,516.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,895.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,899.02
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,899.02
|
| Rate for Payer: IEHP Medi-Cal |
$3,851.47
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$3,851.47
|
| Rate for Payer: IEHP Medicare Advantage |
$2,377.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,685.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,377.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$606.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,995.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,185.78
|
| Rate for Payer: Multiplan Commercial |
$2,021.60
|
| Rate for Payer: Networks By Design Commercial |
$1,642.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,147.95
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,615.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,516.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,852.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: Vantage Medical Group Senior |
$2,377.45
|
|
|
HC UPPER GI ENDOSCOPY W/RMVL FB
|
Facility
OP
|
$5,475.00
|
|
|
Service Code
|
CPT 43247
|
| Hospital Charge Code |
900501341
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$485.26 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,285.00
|
| Rate for Payer: Cash Price |
$2,463.75
|
| Rate for Payer: Cash Price |
$2,463.75
|
| Rate for Payer: Cash Price |
$2,463.75
|
| Rate for Payer: Cigna of CA PPO |
$4,051.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$4,653.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,285.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,106.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,857.45
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,857.45
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$1,132.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,651.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$485.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,314.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,427.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$4,380.00
|
| Rate for Payer: Networks By Design Commercial |
$3,558.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,653.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,285.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,285.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,737.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,737.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,737.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,737.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
