|
HC S-ICD GEN&LEAD TEST POST IMPL
|
Facility
|
IP
|
$3,712.00
|
|
|
Service Code
|
CPT 93644
|
| Hospital Charge Code |
906811490
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$742.40 |
| Max. Negotiated Rate |
$3,155.20 |
| Rate for Payer: Adventist Health Commercial |
$742.40
|
| Rate for Payer: Cash Price |
$1,670.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,484.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,484.80
|
| Rate for Payer: Galaxy Health WC |
$3,155.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,227.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,475.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,414.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,297.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$890.88
|
| Rate for Payer: Multiplan Commercial |
$2,969.60
|
| Rate for Payer: Networks By Design Commercial |
$2,412.80
|
| Rate for Payer: Prime Health Services Commercial |
$3,155.20
|
|
|
HC S-ICD GEN&LEAD TEST POST IMPL
|
Facility
|
OP
|
$4,367.00
|
|
|
Service Code
|
CPT 93644
|
| Hospital Charge Code |
906820024
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$437.88 |
| Max. Negotiated Rate |
$6,906.11 |
| Rate for Payer: Adventist Health Commercial |
$873.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,864.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,711.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,401.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,275.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$1,965.15
|
| Rate for Payer: Cash Price |
$1,965.15
|
| Rate for Payer: Cash Price |
$1,965.15
|
| Rate for Payer: Cigna of CA HMO |
$2,794.88
|
| Rate for Payer: Cigna of CA PPO |
$3,231.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,711.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,711.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,711.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,746.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,746.80
|
| Rate for Payer: Galaxy Health WC |
$3,711.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,620.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$437.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,912.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$495.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,703.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,048.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,056.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,056.90
|
| Rate for Payer: Multiplan Commercial |
$3,493.60
|
| Rate for Payer: Networks By Design Commercial |
$2,838.55
|
| Rate for Payer: Prime Health Services Commercial |
$3,711.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,620.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,620.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,711.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,711.95
|
| Rate for Payer: Vantage Medical Group Senior |
$3,711.95
|
|
|
HC S-ICD GEN&LEAD TEST POST IMPL
|
Facility
|
IP
|
$4,367.00
|
|
|
Service Code
|
CPT 93644
|
| Hospital Charge Code |
906820024
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$873.40 |
| Max. Negotiated Rate |
$3,711.95 |
| Rate for Payer: Adventist Health Commercial |
$873.40
|
| Rate for Payer: Cash Price |
$1,965.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,746.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,746.80
|
| Rate for Payer: Galaxy Health WC |
$3,711.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,620.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,912.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,663.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,703.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,048.08
|
| Rate for Payer: Multiplan Commercial |
$3,493.60
|
| Rate for Payer: Networks By Design Commercial |
$2,838.55
|
| Rate for Payer: Prime Health Services Commercial |
$3,711.95
|
|
|
HC SICKLE CELL SCREEN
|
Facility
|
OP
|
$59.00
|
|
|
Service Code
|
CPT 85660
|
| Hospital Charge Code |
900910034
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.46 |
| Max. Negotiated Rate |
$54.66 |
| Rate for Payer: Adventist Health Commercial |
$11.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$54.66
|
| Rate for Payer: Blue Shield of California Commercial |
$39.47
|
| Rate for Payer: Blue Shield of California EPN |
$26.08
|
| Rate for Payer: Cash Price |
$26.55
|
| Rate for Payer: Cash Price |
$26.55
|
| Rate for Payer: Cigna of CA HMO |
$37.76
|
| Rate for Payer: Cigna of CA PPO |
$43.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.44
|
| Rate for Payer: EPIC Health Plan Senior |
$5.51
|
| Rate for Payer: Galaxy Health WC |
$50.15
|
| Rate for Payer: Global Benefits Group Commercial |
$35.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.38
|
| Rate for Payer: Multiplan Commercial |
$47.20
|
| Rate for Payer: Networks By Design Commercial |
$38.35
|
| Rate for Payer: Prime Health Services Commercial |
$50.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$35.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$35.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.46
|
| Rate for Payer: United Healthcare All Other HMO |
$4.46
|
| Rate for Payer: United Healthcare HMO Rider |
$4.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.46
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.06
|
| Rate for Payer: Vantage Medical Group Senior |
$5.51
|
|
|
HC SICKLE CELL SCREEN
|
Facility
|
IP
|
$96.00
|
|
|
Service Code
|
CPT 85660
|
| Hospital Charge Code |
900910034
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$81.60 |
| Rate for Payer: Adventist Health Commercial |
$19.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.40
|
| Rate for Payer: EPIC Health Plan Senior |
$38.40
|
| Rate for Payer: Galaxy Health WC |
$81.60
|
| Rate for Payer: Global Benefits Group Commercial |
$57.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$64.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.04
|
| Rate for Payer: Multiplan Commercial |
$76.80
|
| Rate for Payer: Networks By Design Commercial |
$62.40
|
| Rate for Payer: Prime Health Services Commercial |
$81.60
|
|
|
HC SIGMDSCPY DX W WO COLLECT
|
Facility
|
IP
|
$4,431.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
906745330
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$886.20 |
| Max. Negotiated Rate |
$3,766.35 |
| Rate for Payer: Adventist Health Commercial |
$886.20
|
| Rate for Payer: Cash Price |
$1,993.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,772.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,772.40
|
| Rate for Payer: Galaxy Health WC |
$3,766.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,658.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,955.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,688.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,742.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,063.44
|
| Rate for Payer: Multiplan Commercial |
$3,544.80
|
| Rate for Payer: Networks By Design Commercial |
$2,880.15
|
| Rate for Payer: Prime Health Services Commercial |
$3,766.35
|
|
|
HC SIGMDSCPY DX W WO COLLECT
|
Facility
|
OP
|
$2,899.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
906745330
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$91.95 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$579.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$1,304.55
|
| Rate for Payer: Cash Price |
$1,304.55
|
| Rate for Payer: Cash Price |
$1,304.55
|
| Rate for Payer: Cigna of CA HMO |
$1,855.36
|
| Rate for Payer: Cigna of CA PPO |
$2,145.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,563.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1,158.42
|
| Rate for Payer: Galaxy Health WC |
$2,464.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,739.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,899.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$91.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,933.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$103.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,158.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$695.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,459.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,552.28
|
| Rate for Payer: Multiplan Commercial |
$2,319.20
|
| Rate for Payer: Networks By Design Commercial |
$1,884.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,464.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,739.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,390.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,158.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC SIGMDSCPY FLEX W POLYPECTOMY
|
Facility
|
OP
|
$3,396.00
|
|
|
Service Code
|
CPT 45333
|
| Hospital Charge Code |
906745333
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$178.26 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$679.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$1,528.20
|
| Rate for Payer: Cash Price |
$1,528.20
|
| Rate for Payer: Cash Price |
$1,528.20
|
| Rate for Payer: Cigna of CA HMO |
$2,173.44
|
| Rate for Payer: Cigna of CA PPO |
$2,513.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,563.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1,158.42
|
| Rate for Payer: Galaxy Health WC |
$2,886.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,037.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,899.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$178.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,265.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$201.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,158.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$815.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,459.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,552.28
|
| Rate for Payer: Multiplan Commercial |
$2,716.80
|
| Rate for Payer: Networks By Design Commercial |
$2,207.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,886.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,037.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,390.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,158.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC SIGMDSCPY FLEX W POLYPECTOMY
|
Facility
|
IP
|
$4,826.00
|
|
|
Service Code
|
CPT 45333
|
| Hospital Charge Code |
906745333
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$965.20 |
| Max. Negotiated Rate |
$4,102.10 |
| Rate for Payer: Adventist Health Commercial |
$965.20
|
| Rate for Payer: Cash Price |
$2,171.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,930.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,930.40
|
| Rate for Payer: Galaxy Health WC |
$4,102.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,895.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,218.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,838.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,987.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,158.24
|
| Rate for Payer: Multiplan Commercial |
$3,860.80
|
| Rate for Payer: Networks By Design Commercial |
$3,136.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,102.10
|
|
|
HC SIGMDSCPY W BLLN DILATION
|
Facility
|
IP
|
$3,008.00
|
|
|
Service Code
|
CPT 45340
|
| Hospital Charge Code |
906745340
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$601.60 |
| Max. Negotiated Rate |
$2,556.80 |
| Rate for Payer: Adventist Health Commercial |
$601.60
|
| Rate for Payer: Cash Price |
$1,353.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,203.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,203.20
|
| Rate for Payer: Galaxy Health WC |
$2,556.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,804.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,006.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,146.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,861.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$721.92
|
| Rate for Payer: Multiplan Commercial |
$2,406.40
|
| Rate for Payer: Networks By Design Commercial |
$1,955.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,556.80
|
|
|
HC SIGMDSCPY W BLLN DILATION
|
Facility
|
OP
|
$2,116.00
|
|
|
Service Code
|
CPT 45340
|
| Hospital Charge Code |
906745340
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$423.20 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$423.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,498.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$952.20
|
| Rate for Payer: Cash Price |
$952.20
|
| Rate for Payer: Cash Price |
$952.20
|
| Rate for Payer: Cigna of CA HMO |
$1,354.24
|
| Rate for Payer: Cigna of CA PPO |
$1,565.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,647.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,498.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,022.49
|
| Rate for Payer: EPIC Health Plan Senior |
$1,498.14
|
| Rate for Payer: Galaxy Health WC |
$1,798.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,269.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,456.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$597.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,411.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$675.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$507.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,887.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,007.51
|
| Rate for Payer: Multiplan Commercial |
$1,692.80
|
| Rate for Payer: Networks By Design Commercial |
$1,375.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,798.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,269.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,797.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,498.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,498.14
|
|
|
HC SIGMDSCPY W BX SNGL OR MULTI
|
Facility
|
IP
|
$5,205.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
906745331
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,041.00 |
| Max. Negotiated Rate |
$4,424.25 |
| Rate for Payer: Adventist Health Commercial |
$1,041.00
|
| Rate for Payer: Cash Price |
$2,342.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,082.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,082.00
|
| Rate for Payer: Galaxy Health WC |
$4,424.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,123.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,471.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,983.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,221.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,249.20
|
| Rate for Payer: Multiplan Commercial |
$4,164.00
|
| Rate for Payer: Networks By Design Commercial |
$3,383.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,424.25
|
|
|
HC SIGMDSCPY W BX SNGL OR MULTI
|
Facility
|
OP
|
$3,661.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
906745331
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$121.35 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$732.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$1,647.45
|
| Rate for Payer: Cash Price |
$1,647.45
|
| Rate for Payer: Cash Price |
$1,647.45
|
| Rate for Payer: Cigna of CA HMO |
$2,343.04
|
| Rate for Payer: Cigna of CA PPO |
$2,709.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,563.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1,158.42
|
| Rate for Payer: Galaxy Health WC |
$3,111.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,196.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,899.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$121.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,441.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,158.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$878.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,459.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,552.28
|
| Rate for Payer: Multiplan Commercial |
$2,928.80
|
| Rate for Payer: Networks By Design Commercial |
$2,379.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,111.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,196.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,390.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,158.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC SIGMDSCPY W CNTRL BLEEDING
|
Facility
|
IP
|
$4,393.00
|
|
|
Service Code
|
CPT 45334
|
| Hospital Charge Code |
906745334
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$878.60 |
| Max. Negotiated Rate |
$3,734.05 |
| Rate for Payer: Adventist Health Commercial |
$878.60
|
| Rate for Payer: Cash Price |
$1,976.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,757.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,757.20
|
| Rate for Payer: Galaxy Health WC |
$3,734.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,635.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,930.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,673.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,719.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,054.32
|
| Rate for Payer: Multiplan Commercial |
$3,514.40
|
| Rate for Payer: Networks By Design Commercial |
$2,855.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,734.05
|
|
|
HC SIGMDSCPY W CNTRL BLEEDING
|
Facility
|
OP
|
$3,091.00
|
|
|
Service Code
|
CPT 45334
|
| Hospital Charge Code |
906745334
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$207.03 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$618.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,498.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$1,390.95
|
| Rate for Payer: Cash Price |
$1,390.95
|
| Rate for Payer: Cash Price |
$1,390.95
|
| Rate for Payer: Cigna of CA HMO |
$1,978.24
|
| Rate for Payer: Cigna of CA PPO |
$2,287.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,647.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,498.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,022.49
|
| Rate for Payer: EPIC Health Plan Senior |
$1,498.14
|
| Rate for Payer: Galaxy Health WC |
$2,627.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,854.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,456.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$207.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,061.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$234.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$741.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,887.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,007.51
|
| Rate for Payer: Multiplan Commercial |
$2,472.80
|
| Rate for Payer: Networks By Design Commercial |
$2,009.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,627.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,854.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,797.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,498.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,498.14
|
|
|
HC SIGMDSCPY W DECMPRS
|
Facility
|
IP
|
$6,146.00
|
|
|
Service Code
|
CPT 45337
|
| Hospital Charge Code |
906745337
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,229.20 |
| Max. Negotiated Rate |
$5,224.10 |
| Rate for Payer: Adventist Health Commercial |
$1,229.20
|
| Rate for Payer: Cash Price |
$2,765.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,458.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,458.40
|
| Rate for Payer: Galaxy Health WC |
$5,224.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,687.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,099.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,341.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,804.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,475.04
|
| Rate for Payer: Multiplan Commercial |
$4,916.80
|
| Rate for Payer: Networks By Design Commercial |
$3,994.90
|
| Rate for Payer: Prime Health Services Commercial |
$5,224.10
|
|
|
HC SIGMDSCPY W DECMPRS
|
Facility
|
OP
|
$4,324.00
|
|
|
Service Code
|
CPT 45337
|
| Hospital Charge Code |
906745337
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$209.53 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$864.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$1,945.80
|
| Rate for Payer: Cash Price |
$1,945.80
|
| Rate for Payer: Cash Price |
$1,945.80
|
| Rate for Payer: Cigna of CA HMO |
$2,767.36
|
| Rate for Payer: Cigna of CA PPO |
$3,199.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,563.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1,158.42
|
| Rate for Payer: Galaxy Health WC |
$3,675.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,594.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,899.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$209.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,884.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$236.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,158.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,037.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,459.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,552.28
|
| Rate for Payer: Multiplan Commercial |
$3,459.20
|
| Rate for Payer: Networks By Design Commercial |
$2,810.60
|
| Rate for Payer: Prime Health Services Commercial |
$3,675.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,594.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,390.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,158.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC SIGMDSCPY W ENDO US
|
Facility
|
IP
|
$4,762.00
|
|
|
Service Code
|
CPT 45341
|
| Hospital Charge Code |
906745341
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$952.40 |
| Max. Negotiated Rate |
$4,047.70 |
| Rate for Payer: Adventist Health Commercial |
$952.40
|
| Rate for Payer: Cash Price |
$2,142.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,904.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,904.80
|
| Rate for Payer: Galaxy Health WC |
$4,047.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,857.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,176.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,814.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,947.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,142.88
|
| Rate for Payer: Multiplan Commercial |
$3,809.60
|
| Rate for Payer: Networks By Design Commercial |
$3,095.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,047.70
|
|
|
HC SIGMDSCPY W ENDO US
|
Facility
|
OP
|
$2,864.00
|
|
|
Service Code
|
CPT 45341
|
| Hospital Charge Code |
906745341
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$290.22 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$572.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Cigna of CA HMO |
$1,832.96
|
| Rate for Payer: Cigna of CA PPO |
$2,119.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,563.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1,158.42
|
| Rate for Payer: Galaxy Health WC |
$2,434.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,718.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,899.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$290.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,910.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$328.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,158.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$687.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,459.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,552.28
|
| Rate for Payer: Multiplan Commercial |
$2,291.20
|
| Rate for Payer: Networks By Design Commercial |
$1,861.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,434.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,718.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,390.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,158.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC SIGMDSCPY W FB RMVL
|
Facility
|
IP
|
$4,926.00
|
|
|
Service Code
|
CPT 45332
|
| Hospital Charge Code |
906745332
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$985.20 |
| Max. Negotiated Rate |
$4,187.10 |
| Rate for Payer: Adventist Health Commercial |
$985.20
|
| Rate for Payer: Cash Price |
$2,216.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,970.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,970.40
|
| Rate for Payer: Galaxy Health WC |
$4,187.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,955.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,285.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,876.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,049.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,182.24
|
| Rate for Payer: Multiplan Commercial |
$3,940.80
|
| Rate for Payer: Networks By Design Commercial |
$3,201.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,187.10
|
|
|
HC SIGMDSCPY W FB RMVL
|
Facility
|
OP
|
$2,773.00
|
|
|
Service Code
|
CPT 45332
|
| Hospital Charge Code |
906745332
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$157.62 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$554.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,498.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$1,247.85
|
| Rate for Payer: Cash Price |
$1,247.85
|
| Rate for Payer: Cash Price |
$1,247.85
|
| Rate for Payer: Cigna of CA HMO |
$1,774.72
|
| Rate for Payer: Cigna of CA PPO |
$2,052.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,647.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,498.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,022.49
|
| Rate for Payer: EPIC Health Plan Senior |
$1,498.14
|
| Rate for Payer: Galaxy Health WC |
$2,357.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,663.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,456.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$157.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,849.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$178.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$665.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,887.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,007.51
|
| Rate for Payer: Multiplan Commercial |
$2,218.40
|
| Rate for Payer: Networks By Design Commercial |
$1,802.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,357.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,663.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,797.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,498.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,498.14
|
|
|
HC SIGMDSCPY W TRNS-EN US
|
Facility
|
OP
|
$2,606.00
|
|
|
Service Code
|
CPT 45342
|
| Hospital Charge Code |
906745342
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$333.38 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$521.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,498.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$1,172.70
|
| Rate for Payer: Cash Price |
$1,172.70
|
| Rate for Payer: Cash Price |
$1,172.70
|
| Rate for Payer: Cigna of CA HMO |
$1,667.84
|
| Rate for Payer: Cigna of CA PPO |
$1,928.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,647.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,498.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,022.49
|
| Rate for Payer: EPIC Health Plan Senior |
$1,498.14
|
| Rate for Payer: Galaxy Health WC |
$2,215.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,563.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,456.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$333.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,738.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$377.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$625.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,887.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,007.51
|
| Rate for Payer: Multiplan Commercial |
$2,084.80
|
| Rate for Payer: Networks By Design Commercial |
$1,693.90
|
| Rate for Payer: Prime Health Services Commercial |
$2,215.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,563.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,797.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,498.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,498.14
|
|
|
HC SIGMDSCPY W TRNS-EN US
|
Facility
|
IP
|
$3,868.00
|
|
|
Service Code
|
CPT 45342
|
| Hospital Charge Code |
906745342
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$773.60 |
| Max. Negotiated Rate |
$3,287.80 |
| Rate for Payer: Adventist Health Commercial |
$773.60
|
| Rate for Payer: Cash Price |
$1,740.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,547.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,547.20
|
| Rate for Payer: Galaxy Health WC |
$3,287.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,320.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,579.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,473.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,394.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$928.32
|
| Rate for Payer: Multiplan Commercial |
$3,094.40
|
| Rate for Payer: Networks By Design Commercial |
$2,514.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,287.80
|
|
|
HC SIGMDSCPY W TUMOR ABLATION
|
Facility
|
OP
|
$2,243.00
|
|
|
Service Code
|
CPT 45339
|
| Hospital Charge Code |
906745339
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$448.60 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$448.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,906.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,233.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,682.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,377.43
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$1,009.35
|
| Rate for Payer: Cash Price |
$1,009.35
|
| Rate for Payer: Cigna of CA HMO |
$1,435.52
|
| Rate for Payer: Cigna of CA PPO |
$1,659.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,906.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,906.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,906.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$897.20
|
| Rate for Payer: EPIC Health Plan Senior |
$897.20
|
| Rate for Payer: Galaxy Health WC |
$1,906.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,345.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,496.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$854.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,388.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$538.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,570.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,570.10
|
| Rate for Payer: Multiplan Commercial |
$1,794.40
|
| Rate for Payer: Networks By Design Commercial |
$1,457.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,906.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,345.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,345.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,121.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,121.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,121.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,121.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,906.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,906.55
|
| Rate for Payer: Vantage Medical Group Senior |
$1,906.55
|
|
|
HC SIGMDSCPY W TUMOR ABLATION
|
Facility
|
IP
|
$3,198.00
|
|
|
Service Code
|
CPT 45346
|
| Hospital Charge Code |
906745346
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$639.60 |
| Max. Negotiated Rate |
$2,718.30 |
| Rate for Payer: Adventist Health Commercial |
$639.60
|
| Rate for Payer: Cash Price |
$1,439.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,279.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,279.20
|
| Rate for Payer: Galaxy Health WC |
$2,718.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,918.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,133.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,218.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,979.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$767.52
|
| Rate for Payer: Multiplan Commercial |
$2,558.40
|
| Rate for Payer: Networks By Design Commercial |
$2,078.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,718.30
|
|
