|
HC NASO/OROGASTRIC TUBE PLACEMENT
|
Facility
|
IP
|
$709.00
|
|
|
Service Code
|
CPT 43753
|
| Hospital Charge Code |
900501188
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$141.80 |
| Max. Negotiated Rate |
$602.65 |
| Rate for Payer: Adventist Health Commercial |
$141.80
|
| Rate for Payer: Cash Price |
$319.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$496.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$283.60
|
| Rate for Payer: EPIC Health Plan Senior |
$283.60
|
| Rate for Payer: Galaxy Health WC |
$602.65
|
| Rate for Payer: Global Benefits Group Commercial |
$425.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$450.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$418.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$170.16
|
| Rate for Payer: Multiplan Commercial |
$567.20
|
| Rate for Payer: Networks By Design Commercial |
$460.85
|
| Rate for Payer: Prime Health Services Commercial |
$602.65
|
|
|
HC NASO/OROGASTRIC TUBE PLACEMENT
|
Facility
|
IP
|
$709.00
|
|
|
Service Code
|
CPT 43753
|
| Hospital Charge Code |
900501188
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$141.80 |
| Max. Negotiated Rate |
$602.65 |
| Rate for Payer: Adventist Health Commercial |
$141.80
|
| Rate for Payer: Cash Price |
$319.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$496.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$283.60
|
| Rate for Payer: EPIC Health Plan Senior |
$283.60
|
| Rate for Payer: Galaxy Health WC |
$602.65
|
| Rate for Payer: Global Benefits Group Commercial |
$425.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$450.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$418.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$170.16
|
| Rate for Payer: Multiplan Commercial |
$567.20
|
| Rate for Payer: Networks By Design Commercial |
$460.85
|
| Rate for Payer: Prime Health Services Commercial |
$602.65
|
|
|
HC NASO/OROGASTRIC TUBE PLACEMENT
|
Facility
|
OP
|
$709.00
|
|
|
Service Code
|
CPT 43753
|
| Hospital Charge Code |
900501188
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$32.55 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Dignity Health Medi-Cal |
$305.48
|
| Rate for Payer: Adventist Health Commercial |
$290.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$131.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$277.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$319.05
|
| Rate for Payer: Cash Price |
$319.05
|
| Rate for Payer: Cash Price |
$319.05
|
| Rate for Payer: Cigna of CA HMO |
$453.76
|
| Rate for Payer: Cigna of CA PPO |
$524.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$416.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$277.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$496.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$458.22
|
| Rate for Payer: EPIC Health Plan Senior |
$305.48
|
| Rate for Payer: Galaxy Health WC |
$602.65
|
| Rate for Payer: Global Benefits Group Commercial |
$425.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$455.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$277.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$450.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$32.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$298.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$170.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$349.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$372.13
|
| Rate for Payer: Multiplan Commercial |
$567.20
|
| Rate for Payer: Multiplan WC |
$630.41
|
| Rate for Payer: Networks By Design Commercial |
$460.85
|
| Rate for Payer: Prime Health Services Commercial |
$602.65
|
| Rate for Payer: Prime Health Services WC |
$623.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$425.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$425.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$277.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Vantage Medical Group Senior |
$277.71
|
|
|
HC NASO/OROGASTRIC TUBE PLACEMENT
|
Facility
|
OP
|
$709.00
|
|
|
Service Code
|
CPT 43753
|
| Hospital Charge Code |
900501188
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$32.55 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$141.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$277.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$319.05
|
| Rate for Payer: Cash Price |
$319.05
|
| Rate for Payer: Cash Price |
$319.05
|
| Rate for Payer: Cigna of CA HMO |
$453.76
|
| Rate for Payer: Cigna of CA PPO |
$524.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$416.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$305.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$277.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$496.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$458.22
|
| Rate for Payer: EPIC Health Plan Senior |
$305.48
|
| Rate for Payer: Galaxy Health WC |
$602.65
|
| Rate for Payer: Global Benefits Group Commercial |
$425.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$455.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$277.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$450.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$32.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$298.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$170.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$349.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$372.13
|
| Rate for Payer: Multiplan Commercial |
$567.20
|
| Rate for Payer: Multiplan WC |
$630.41
|
| Rate for Payer: Networks By Design Commercial |
$460.85
|
| Rate for Payer: Prime Health Services Commercial |
$602.65
|
| Rate for Payer: Prime Health Services WC |
$623.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$425.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$354.50
|
| Rate for Payer: United Healthcare All Other HMO |
$354.50
|
| Rate for Payer: United Healthcare HMO Rider |
$354.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$354.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$277.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Vantage Medical Group Senior |
$277.71
|
|
|
HC NASOPHARYNGOGRAM
|
Facility
|
IP
|
$878.00
|
|
|
Service Code
|
CPT 70370
|
| Hospital Charge Code |
909001253
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$175.60 |
| Max. Negotiated Rate |
$746.30 |
| Rate for Payer: Adventist Health Commercial |
$175.60
|
| Rate for Payer: Cash Price |
$395.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$614.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$351.20
|
| Rate for Payer: EPIC Health Plan Senior |
$351.20
|
| Rate for Payer: Galaxy Health WC |
$746.30
|
| Rate for Payer: Global Benefits Group Commercial |
$526.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$557.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$518.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$210.72
|
| Rate for Payer: Multiplan Commercial |
$702.40
|
| Rate for Payer: Networks By Design Commercial |
$570.70
|
| Rate for Payer: Prime Health Services Commercial |
$746.30
|
|
|
HC NASOPHARYNGOGRAM
|
Facility
|
OP
|
$878.00
|
|
|
Service Code
|
CPT 70370
|
| Hospital Charge Code |
909001253
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$63.99 |
| Max. Negotiated Rate |
$746.30 |
| Rate for Payer: Adventist Health Commercial |
$175.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$474.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$384.76
|
| Rate for Payer: Blue Shield of California Commercial |
$369.64
|
| Rate for Payer: Blue Shield of California Commercial |
$560.16
|
| Rate for Payer: Cash Price |
$395.10
|
| Rate for Payer: Cash Price |
$395.10
|
| Rate for Payer: Cigna of CA HMO |
$561.92
|
| Rate for Payer: Cigna of CA PPO |
$649.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$614.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.68
|
| Rate for Payer: EPIC Health Plan Senior |
$123.12
|
| Rate for Payer: Galaxy Health WC |
$746.30
|
| Rate for Payer: Global Benefits Group Commercial |
$526.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$183.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$63.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$557.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$72.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$156.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$210.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$141.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$149.99
|
| Rate for Payer: Multiplan Commercial |
$702.40
|
| Rate for Payer: Networks By Design Commercial |
$570.70
|
| Rate for Payer: Prime Health Services Commercial |
$746.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$526.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$526.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$225.63
|
| Rate for Payer: United Healthcare All Other HMO |
$225.63
|
| Rate for Payer: United Healthcare HMO Rider |
$225.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$225.63
|
| Rate for Payer: Upland Medical Group Pediatric |
$111.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Vantage Medical Group Senior |
$111.93
|
|
|
HC NASOPHARYNGOSCOPY W/ENDOSCOPE
|
Facility
|
IP
|
$715.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
905601701
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$143.00 |
| Max. Negotiated Rate |
$607.75 |
| Rate for Payer: Adventist Health Commercial |
$143.00
|
| Rate for Payer: Cash Price |
$321.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$500.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$286.00
|
| Rate for Payer: EPIC Health Plan Senior |
$286.00
|
| Rate for Payer: Galaxy Health WC |
$607.75
|
| Rate for Payer: Global Benefits Group Commercial |
$429.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$454.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$421.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$171.60
|
| Rate for Payer: Multiplan Commercial |
$572.00
|
| Rate for Payer: Networks By Design Commercial |
$464.75
|
| Rate for Payer: Prime Health Services Commercial |
$607.75
|
|
|
HC NASOPHARYNGOSCOPY W/ENDOSCOPE
|
Facility
|
OP
|
$715.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
905601701
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$79.40 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$143.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$385.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$282.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$256.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$321.75
|
| Rate for Payer: Cash Price |
$321.75
|
| Rate for Payer: Cash Price |
$321.75
|
| Rate for Payer: Cigna of CA HMO |
$457.60
|
| Rate for Payer: Cigna of CA PPO |
$529.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$385.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$282.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$256.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$500.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$423.60
|
| Rate for Payer: EPIC Health Plan Senior |
$282.40
|
| Rate for Payer: Galaxy Health WC |
$607.75
|
| Rate for Payer: Global Benefits Group Commercial |
$429.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$421.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$256.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$454.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$79.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$275.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$171.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$323.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$344.02
|
| Rate for Payer: Multiplan Commercial |
$572.00
|
| Rate for Payer: Multiplan WC |
$393.03
|
| Rate for Payer: Networks By Design Commercial |
$464.75
|
| Rate for Payer: Prime Health Services Commercial |
$607.75
|
| Rate for Payer: Prime Health Services WC |
$389.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$429.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$357.50
|
| Rate for Payer: United Healthcare All Other HMO |
$357.50
|
| Rate for Payer: United Healthcare HMO Rider |
$357.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$357.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$256.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$385.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$282.40
|
| Rate for Payer: Vantage Medical Group Senior |
$256.73
|
|
|
HC NASOPHARYNGOSCOPY W/ENDOSCOPE
|
Facility
|
IP
|
$715.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
905601701
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$143.00 |
| Max. Negotiated Rate |
$607.75 |
| Rate for Payer: Adventist Health Commercial |
$143.00
|
| Rate for Payer: Cash Price |
$321.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$500.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$286.00
|
| Rate for Payer: EPIC Health Plan Senior |
$286.00
|
| Rate for Payer: Galaxy Health WC |
$607.75
|
| Rate for Payer: Global Benefits Group Commercial |
$429.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$454.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$421.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$171.60
|
| Rate for Payer: Multiplan Commercial |
$572.00
|
| Rate for Payer: Networks By Design Commercial |
$464.75
|
| Rate for Payer: Prime Health Services Commercial |
$607.75
|
|
|
HC NASOPHARYNGOSCOPY W/ENDOSCOPE
|
Facility
|
OP
|
$715.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
905601701
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$79.40 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$293.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$410.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$385.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$282.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$256.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$321.75
|
| Rate for Payer: Cash Price |
$321.75
|
| Rate for Payer: Cash Price |
$321.75
|
| Rate for Payer: Cigna of CA HMO |
$457.60
|
| Rate for Payer: Cigna of CA PPO |
$529.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$385.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$282.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$256.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$500.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$423.60
|
| Rate for Payer: EPIC Health Plan Senior |
$282.40
|
| Rate for Payer: Galaxy Health WC |
$607.75
|
| Rate for Payer: Global Benefits Group Commercial |
$429.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$421.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$256.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$454.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$79.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$275.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$171.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$323.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$344.02
|
| Rate for Payer: Multiplan Commercial |
$572.00
|
| Rate for Payer: Multiplan WC |
$393.03
|
| Rate for Payer: Networks By Design Commercial |
$464.75
|
| Rate for Payer: Prime Health Services Commercial |
$607.75
|
| Rate for Payer: Prime Health Services WC |
$389.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$429.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$429.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$256.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$385.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$282.40
|
| Rate for Payer: Vantage Medical Group Senior |
$256.73
|
|
|
HC NASOPHARYNGOSCOPY W ENDOSCOPE MCAL
|
Facility
|
IP
|
$715.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
907000031
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$143.00 |
| Max. Negotiated Rate |
$607.75 |
| Rate for Payer: Adventist Health Commercial |
$143.00
|
| Rate for Payer: Cash Price |
$321.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$500.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$286.00
|
| Rate for Payer: EPIC Health Plan Senior |
$286.00
|
| Rate for Payer: Galaxy Health WC |
$607.75
|
| Rate for Payer: Global Benefits Group Commercial |
$429.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$454.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$421.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$171.60
|
| Rate for Payer: Multiplan Commercial |
$572.00
|
| Rate for Payer: Networks By Design Commercial |
$464.75
|
| Rate for Payer: Prime Health Services Commercial |
$607.75
|
|
|
HC NASOPHARYNGOSCOPY W ENDOSCOPE MCAL
|
Facility
|
OP
|
$715.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
907000031
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$70.21 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$293.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$410.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$385.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$282.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$256.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$439.00
|
| Rate for Payer: Blue Shield of California Commercial |
$291.00
|
| Rate for Payer: Cash Price |
$321.75
|
| Rate for Payer: Cash Price |
$321.75
|
| Rate for Payer: Cash Price |
$321.75
|
| Rate for Payer: Cash Price |
$321.75
|
| Rate for Payer: Cigna of CA HMO |
$457.60
|
| Rate for Payer: Cigna of CA PPO |
$529.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$385.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$282.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$256.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$500.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$423.60
|
| Rate for Payer: EPIC Health Plan Senior |
$282.40
|
| Rate for Payer: Galaxy Health WC |
$607.75
|
| Rate for Payer: Global Benefits Group Commercial |
$429.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$421.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$70.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$256.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$454.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$79.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$359.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$171.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$323.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$344.02
|
| Rate for Payer: Multiplan Commercial |
$572.00
|
| Rate for Payer: Networks By Design Commercial |
$464.75
|
| Rate for Payer: Prime Health Services Commercial |
$607.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$429.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$308.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$256.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$385.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$282.40
|
| Rate for Payer: Vantage Medical Group Senior |
$256.73
|
|
|
HC NASOTRACHEAL SUCTIONING
|
Facility
|
OP
|
$326.00
|
|
|
Service Code
|
CPT 31720
|
| Hospital Charge Code |
900800380
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$65.20 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$65.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$318.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$422.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$309.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$281.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$146.70
|
| Rate for Payer: Cash Price |
$146.70
|
| Rate for Payer: Cash Price |
$146.70
|
| Rate for Payer: Cigna of CA HMO |
$208.64
|
| Rate for Payer: Cigna of CA PPO |
$241.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$422.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$309.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$281.64
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$228.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$464.71
|
| Rate for Payer: EPIC Health Plan Senior |
$309.80
|
| Rate for Payer: Galaxy Health WC |
$277.10
|
| Rate for Payer: Global Benefits Group Commercial |
$195.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$461.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$85.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$281.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$207.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$96.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$394.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$354.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$377.40
|
| Rate for Payer: Multiplan Commercial |
$260.80
|
| Rate for Payer: Networks By Design Commercial |
$211.90
|
| Rate for Payer: Prime Health Services Commercial |
$277.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$195.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$195.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$163.00
|
| Rate for Payer: United Healthcare All Other HMO |
$163.00
|
| Rate for Payer: United Healthcare HMO Rider |
$163.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$163.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$281.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$422.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$309.80
|
| Rate for Payer: Vantage Medical Group Senior |
$281.64
|
|
|
HC NASOTRACHEAL SUCTIONING
|
Facility
|
IP
|
$326.00
|
|
|
Service Code
|
CPT 31720
|
| Hospital Charge Code |
900800380
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$65.20 |
| Max. Negotiated Rate |
$277.10 |
| Rate for Payer: Multiplan Commercial |
$260.80
|
| Rate for Payer: Networks By Design Commercial |
$211.90
|
| Rate for Payer: Adventist Health Commercial |
$65.20
|
| Rate for Payer: Cash Price |
$146.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$228.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.40
|
| Rate for Payer: EPIC Health Plan Senior |
$130.40
|
| Rate for Payer: Galaxy Health WC |
$277.10
|
| Rate for Payer: Global Benefits Group Commercial |
$195.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$207.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$192.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.24
|
| Rate for Payer: Prime Health Services Commercial |
$277.10
|
|
|
HC NASOTRACHEAL SUCTIONING
|
Facility
|
IP
|
$326.00
|
|
|
Service Code
|
CPT 31720
|
| Hospital Charge Code |
900800380
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$65.20 |
| Max. Negotiated Rate |
$277.10 |
| Rate for Payer: Adventist Health Commercial |
$65.20
|
| Rate for Payer: Cash Price |
$146.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$228.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.40
|
| Rate for Payer: EPIC Health Plan Senior |
$130.40
|
| Rate for Payer: Galaxy Health WC |
$277.10
|
| Rate for Payer: Global Benefits Group Commercial |
$195.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$207.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$192.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.24
|
| Rate for Payer: Multiplan Commercial |
$260.80
|
| Rate for Payer: Networks By Design Commercial |
$211.90
|
| Rate for Payer: Prime Health Services Commercial |
$277.10
|
|
|
HC NASOTRACHEAL SUCTIONING
|
Facility
|
OP
|
$326.00
|
|
|
Service Code
|
CPT 31720
|
| Hospital Charge Code |
900800380
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$65.20 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$65.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$318.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$422.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$309.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$281.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$146.70
|
| Rate for Payer: Cash Price |
$146.70
|
| Rate for Payer: Cash Price |
$146.70
|
| Rate for Payer: Cigna of CA HMO |
$208.64
|
| Rate for Payer: Cigna of CA PPO |
$241.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$422.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$309.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$281.64
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$228.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$464.71
|
| Rate for Payer: EPIC Health Plan Senior |
$309.80
|
| Rate for Payer: Galaxy Health WC |
$277.10
|
| Rate for Payer: Global Benefits Group Commercial |
$195.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$461.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$85.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$281.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$207.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$96.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$394.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$354.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$377.40
|
| Rate for Payer: Multiplan Commercial |
$260.80
|
| Rate for Payer: Networks By Design Commercial |
$211.90
|
| Rate for Payer: Prime Health Services Commercial |
$277.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$195.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$195.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$163.00
|
| Rate for Payer: United Healthcare All Other HMO |
$163.00
|
| Rate for Payer: United Healthcare HMO Rider |
$163.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$163.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$281.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$422.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$309.80
|
| Rate for Payer: Vantage Medical Group Senior |
$281.64
|
|
|
HC N BLOCK,SPHENOPALATINE GANGLIN
|
Facility
|
IP
|
$1,351.00
|
|
|
Service Code
|
CPT 64505
|
| Hospital Charge Code |
900501686
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$270.20 |
| Max. Negotiated Rate |
$1,148.35 |
| Rate for Payer: Adventist Health Commercial |
$270.20
|
| Rate for Payer: Cash Price |
$607.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$945.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$540.40
|
| Rate for Payer: EPIC Health Plan Senior |
$540.40
|
| Rate for Payer: Galaxy Health WC |
$1,148.35
|
| Rate for Payer: Global Benefits Group Commercial |
$810.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$857.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$797.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$324.24
|
| Rate for Payer: Multiplan Commercial |
$1,080.80
|
| Rate for Payer: Networks By Design Commercial |
$878.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,148.35
|
|
|
HC N BLOCK,SPHENOPALATINE GANGLIN
|
Facility
|
OP
|
$1,351.00
|
|
|
Service Code
|
CPT 64505
|
| Hospital Charge Code |
900501686
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$115.29 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Cigna of CA PPO |
$999.74
|
| Rate for Payer: Adventist Health Commercial |
$270.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$394.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$607.95
|
| Rate for Payer: Cash Price |
$607.95
|
| Rate for Payer: Cash Price |
$607.95
|
| Rate for Payer: Cigna of CA HMO |
$864.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$394.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$945.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$651.40
|
| Rate for Payer: EPIC Health Plan Senior |
$434.27
|
| Rate for Payer: Galaxy Health WC |
$1,148.35
|
| Rate for Payer: Global Benefits Group Commercial |
$810.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$647.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$394.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$857.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$115.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$424.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$324.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$497.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$529.02
|
| Rate for Payer: Multiplan Commercial |
$1,080.80
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: Networks By Design Commercial |
$878.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,148.35
|
| Rate for Payer: Prime Health Services WC |
$591.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$810.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$675.50
|
| Rate for Payer: United Healthcare All Other HMO |
$675.50
|
| Rate for Payer: United Healthcare HMO Rider |
$675.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$675.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$394.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Vantage Medical Group Senior |
$394.79
|
|
|
HC N-CARDIAC VASC FLOW IMAG
|
Facility
|
OP
|
$1,724.00
|
|
|
Service Code
|
CPT 78445
|
| Hospital Charge Code |
909301349
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$202.99 |
| Max. Negotiated Rate |
$1,465.40 |
| Rate for Payer: Adventist Health Commercial |
$344.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,062.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$514.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,106.29
|
| Rate for Payer: Blue Shield of California Commercial |
$725.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,099.91
|
| Rate for Payer: Cash Price |
$775.80
|
| Rate for Payer: Cash Price |
$775.80
|
| Rate for Payer: Cigna of CA HMO |
$1,103.36
|
| Rate for Payer: Cigna of CA PPO |
$1,275.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$771.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$565.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$514.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,206.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$848.38
|
| Rate for Payer: EPIC Health Plan Senior |
$565.59
|
| Rate for Payer: Galaxy Health WC |
$1,465.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,034.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$843.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$202.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$514.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,094.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$229.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$719.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$413.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$647.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$688.99
|
| Rate for Payer: Multiplan Commercial |
$1,379.20
|
| Rate for Payer: Networks By Design Commercial |
$1,120.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,465.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,034.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,034.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.46
|
| Rate for Payer: United Healthcare All Other HMO |
$396.46
|
| Rate for Payer: United Healthcare HMO Rider |
$396.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$396.46
|
| Rate for Payer: Upland Medical Group Pediatric |
$514.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Vantage Medical Group Senior |
$514.17
|
|
|
HC N-CARDIAC VASC FLOW IMAG
|
Facility
|
IP
|
$1,724.00
|
|
|
Service Code
|
CPT 78445
|
| Hospital Charge Code |
909301349
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$344.80 |
| Max. Negotiated Rate |
$1,465.40 |
| Rate for Payer: Adventist Health Commercial |
$344.80
|
| Rate for Payer: Cash Price |
$775.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,206.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$689.60
|
| Rate for Payer: EPIC Health Plan Senior |
$689.60
|
| Rate for Payer: Galaxy Health WC |
$1,465.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,034.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,094.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,017.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$413.76
|
| Rate for Payer: Multiplan Commercial |
$1,379.20
|
| Rate for Payer: Networks By Design Commercial |
$1,120.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,465.40
|
|
|
HC NECK SOFT TISSUE
|
Facility
|
IP
|
$723.00
|
|
|
Service Code
|
CPT 70360
|
| Hospital Charge Code |
909001201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$144.60 |
| Max. Negotiated Rate |
$614.55 |
| Rate for Payer: Adventist Health Commercial |
$144.60
|
| Rate for Payer: Cash Price |
$325.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$506.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$289.20
|
| Rate for Payer: EPIC Health Plan Senior |
$289.20
|
| Rate for Payer: Galaxy Health WC |
$614.55
|
| Rate for Payer: Global Benefits Group Commercial |
$433.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$459.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$426.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.52
|
| Rate for Payer: Multiplan Commercial |
$578.40
|
| Rate for Payer: Networks By Design Commercial |
$469.95
|
| Rate for Payer: Prime Health Services Commercial |
$614.55
|
|
|
HC NECK SOFT TISSUE
|
Facility
|
OP
|
$723.00
|
|
|
Service Code
|
CPT 70360
|
| Hospital Charge Code |
909001201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$29.06 |
| Max. Negotiated Rate |
$614.55 |
| Rate for Payer: Cigna of CA PPO |
$535.02
|
| Rate for Payer: Adventist Health Commercial |
$144.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$138.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$125.50
|
| Rate for Payer: Blue Shield of California Commercial |
$304.38
|
| Rate for Payer: Blue Shield of California Commercial |
$461.27
|
| Rate for Payer: Cash Price |
$325.35
|
| Rate for Payer: Cash Price |
$325.35
|
| Rate for Payer: Cigna of CA HMO |
$462.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$506.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.68
|
| Rate for Payer: EPIC Health Plan Senior |
$123.12
|
| Rate for Payer: Galaxy Health WC |
$614.55
|
| Rate for Payer: Global Benefits Group Commercial |
$433.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$183.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$29.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$459.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$32.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$156.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$141.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$149.99
|
| Rate for Payer: Multiplan Commercial |
$578.40
|
| Rate for Payer: Networks By Design Commercial |
$469.95
|
| Rate for Payer: Prime Health Services Commercial |
$614.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$433.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$433.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$111.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Vantage Medical Group Senior |
$111.93
|
|
|
HC NEDL BARD TRANS-SEPTAL
|
Facility
|
IP
|
$1,012.00
|
|
| Hospital Charge Code |
906812363
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.40 |
| Max. Negotiated Rate |
$860.20 |
| Rate for Payer: Adventist Health Commercial |
$202.40
|
| Rate for Payer: Cash Price |
$455.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$708.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$404.80
|
| Rate for Payer: EPIC Health Plan Senior |
$404.80
|
| Rate for Payer: Galaxy Health WC |
$860.20
|
| Rate for Payer: Global Benefits Group Commercial |
$607.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$642.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$597.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$242.88
|
| Rate for Payer: Multiplan Commercial |
$809.60
|
| Rate for Payer: Networks By Design Commercial |
$657.80
|
| Rate for Payer: Prime Health Services Commercial |
$860.20
|
|
|
HC NEDL BARD TRANS-SEPTAL
|
Facility
|
OP
|
$1,012.00
|
|
| Hospital Charge Code |
906812363
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.40 |
| Max. Negotiated Rate |
$860.20 |
| Rate for Payer: Adventist Health Commercial |
$202.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$663.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$860.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$556.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$759.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$649.40
|
| Rate for Payer: Cash Price |
$455.40
|
| Rate for Payer: Cigna of CA HMO |
$647.68
|
| Rate for Payer: Cigna of CA PPO |
$748.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$860.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$860.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$860.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$708.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$404.80
|
| Rate for Payer: EPIC Health Plan Senior |
$404.80
|
| Rate for Payer: Galaxy Health WC |
$860.20
|
| Rate for Payer: Global Benefits Group Commercial |
$607.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$642.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$367.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$597.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$242.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$708.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$708.40
|
| Rate for Payer: Multiplan Commercial |
$809.60
|
| Rate for Payer: Networks By Design Commercial |
$657.80
|
| Rate for Payer: Prime Health Services Commercial |
$860.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$607.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$607.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$506.00
|
| Rate for Payer: United Healthcare HMO Rider |
$506.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$506.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$860.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$860.20
|
| Rate for Payer: Vantage Medical Group Senior |
$860.20
|
|
|
HC NEDL BAYLIS RF TRANSEPTAL
|
Facility
|
IP
|
$2,277.00
|
|
| Hospital Charge Code |
906812470
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$455.40 |
| Max. Negotiated Rate |
$1,935.45 |
| Rate for Payer: Adventist Health Commercial |
$455.40
|
| Rate for Payer: Cash Price |
$1,024.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,593.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$910.80
|
| Rate for Payer: EPIC Health Plan Senior |
$910.80
|
| Rate for Payer: Galaxy Health WC |
$1,935.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,366.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,445.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,343.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$546.48
|
| Rate for Payer: Multiplan Commercial |
$1,821.60
|
| Rate for Payer: Networks By Design Commercial |
$1,480.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,935.45
|
|
