|
HC SIGMDSCPY W BLLN DILATION
|
Facility
|
OP
|
$3,008.00
|
|
|
Service Code
|
CPT 45340
|
| Hospital Charge Code |
906745340
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$597.32 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$601.60
|
| 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 |
$1,654.40
|
| Rate for Payer: Cash Price |
$1,654.40
|
| Rate for Payer: Cash Price |
$1,654.40
|
| Rate for Payer: Cigna of CA HMO |
$1,925.12
|
| Rate for Payer: Cigna of CA PPO |
$2,225.92
|
| 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 |
$2,556.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,804.80
|
| 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 |
$2,006.34
|
| 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 |
$721.92
|
| 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 |
$2,406.40
|
| Rate for Payer: Networks By Design Commercial |
$1,955.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,556.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,804.80
|
| 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 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 |
$1,654.40
|
| 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 BX SNGL OR MULTI
|
Facility
|
OP
|
$5,205.00
|
|
|
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 |
$1,041.00
|
| 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 |
$2,862.75
|
| Rate for Payer: Cash Price |
$2,862.75
|
| Rate for Payer: Cash Price |
$2,862.75
|
| Rate for Payer: Cigna of CA HMO |
$3,331.20
|
| Rate for Payer: Cigna of CA PPO |
$3,851.70
|
| 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 |
$4,424.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,123.00
|
| 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 |
$3,471.74
|
| 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 |
$1,249.20
|
| 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 |
$4,164.00
|
| Rate for Payer: Networks By Design Commercial |
$3,383.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,424.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,123.00
|
| 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 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 |
$2,862.75
|
| 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 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 |
$2,416.15
|
| 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
|
$4,393.00
|
|
|
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 |
$878.60
|
| 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 |
$2,416.15
|
| Rate for Payer: Cash Price |
$2,416.15
|
| Rate for Payer: Cash Price |
$2,416.15
|
| Rate for Payer: Cigna of CA HMO |
$2,811.52
|
| Rate for Payer: Cigna of CA PPO |
$3,250.82
|
| 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 |
$3,734.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,635.80
|
| 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 |
$2,930.13
|
| 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 |
$1,054.32
|
| 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 |
$3,514.40
|
| Rate for Payer: Networks By Design Commercial |
$2,855.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,734.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,635.80
|
| 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 DECMPRS
|
Facility
|
OP
|
$6,146.00
|
|
|
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 |
$1,229.20
|
| 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 |
$3,380.30
|
| Rate for Payer: Cash Price |
$3,380.30
|
| Rate for Payer: Cash Price |
$3,380.30
|
| Rate for Payer: Cigna of CA HMO |
$3,933.44
|
| Rate for Payer: Cigna of CA PPO |
$4,548.04
|
| 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 |
$5,224.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,687.60
|
| 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 |
$4,099.38
|
| 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 |
$1,475.04
|
| 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 |
$4,916.80
|
| Rate for Payer: Networks By Design Commercial |
$3,994.90
|
| Rate for Payer: Prime Health Services Commercial |
$5,224.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,687.60
|
| 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 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 |
$3,380.30
|
| 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 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 |
$2,619.10
|
| 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
|
$4,762.00
|
|
|
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 |
$952.40
|
| 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 |
$2,619.10
|
| Rate for Payer: Cash Price |
$2,619.10
|
| Rate for Payer: Cash Price |
$2,619.10
|
| Rate for Payer: Cigna of CA HMO |
$3,047.68
|
| Rate for Payer: Cigna of CA PPO |
$3,523.88
|
| 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 |
$4,047.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,857.20
|
| 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 |
$3,176.25
|
| 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 |
$1,142.88
|
| 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 |
$3,809.60
|
| Rate for Payer: Networks By Design Commercial |
$3,095.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,047.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,857.20
|
| 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 |
$2,709.30
|
| 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
|
$4,926.00
|
|
|
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 |
$985.20
|
| 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 |
$2,709.30
|
| Rate for Payer: Cash Price |
$2,709.30
|
| Rate for Payer: Cash Price |
$2,709.30
|
| Rate for Payer: Cigna of CA HMO |
$3,152.64
|
| Rate for Payer: Cigna of CA PPO |
$3,645.24
|
| 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 |
$4,187.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,955.60
|
| 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 |
$3,285.64
|
| 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 |
$1,182.24
|
| 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 |
$3,940.80
|
| Rate for Payer: Networks By Design Commercial |
$3,201.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,187.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,955.60
|
| 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
|
OP
|
$3,868.00
|
|
|
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 |
$773.60
|
| 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 |
$2,127.40
|
| Rate for Payer: Cash Price |
$2,127.40
|
| Rate for Payer: Cash Price |
$2,127.40
|
| Rate for Payer: Cigna of CA HMO |
$2,475.52
|
| Rate for Payer: Cigna of CA PPO |
$2,862.32
|
| 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 |
$3,287.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,320.80
|
| 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 |
$2,579.96
|
| 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 |
$928.32
|
| 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 |
$3,094.40
|
| Rate for Payer: Networks By Design Commercial |
$2,514.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,287.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,320.80
|
| 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
|
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 |
$2,127.40
|
| 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 |
$1,233.65
|
| Rate for Payer: Cash Price |
$1,233.65
|
| 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
|
$2,243.00
|
|
|
Service Code
|
CPT 45339
|
| Hospital Charge Code |
906745339
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$448.60 |
| Max. Negotiated Rate |
$1,906.55 |
| Rate for Payer: Adventist Health Commercial |
$448.60
|
| Rate for Payer: Cash Price |
$1,233.65
|
| 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: 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
|
|
|
HC SIGMDSCPY W TUMOR ABLATION
|
Facility
|
OP
|
$3,198.00
|
|
|
Service Code
|
CPT 45346
|
| Hospital Charge Code |
906745346
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$639.60 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$639.60
|
| 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 |
$1,758.90
|
| Rate for Payer: Cash Price |
$1,758.90
|
| Rate for Payer: Cash Price |
$1,758.90
|
| Rate for Payer: Cigna of CA HMO |
$2,046.72
|
| Rate for Payer: Cigna of CA PPO |
$2,366.52
|
| 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 |
$2,718.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,918.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,456.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,133.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$767.52
|
| 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 |
$2,558.40
|
| Rate for Payer: Networks By Design Commercial |
$2,078.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,718.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,918.80
|
| 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 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 |
$1,758.90
|
| 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
|
|
|
HC SIGMDSCPY W TUMOR SNARE RMVL
|
Facility
|
OP
|
$3,514.00
|
|
|
Service Code
|
CPT 45338
|
| Hospital Charge Code |
906745338
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$240.81 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$702.80
|
| 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 |
$1,932.70
|
| Rate for Payer: Cash Price |
$1,932.70
|
| Rate for Payer: Cash Price |
$1,932.70
|
| Rate for Payer: Cigna of CA HMO |
$2,248.96
|
| Rate for Payer: Cigna of CA PPO |
$2,600.36
|
| 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 |
$2,986.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,108.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,456.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$240.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,343.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$272.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$843.36
|
| 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 |
$2,811.20
|
| Rate for Payer: Networks By Design Commercial |
$2,284.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,986.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,108.40
|
| 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 TUMOR SNARE RMVL
|
Facility
|
IP
|
$3,514.00
|
|
|
Service Code
|
CPT 45338
|
| Hospital Charge Code |
906745338
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$702.80 |
| Max. Negotiated Rate |
$2,986.90 |
| Rate for Payer: Adventist Health Commercial |
$702.80
|
| Rate for Payer: Cash Price |
$1,932.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,405.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,405.60
|
| Rate for Payer: Galaxy Health WC |
$2,986.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,108.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,343.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,338.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,175.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$843.36
|
| Rate for Payer: Multiplan Commercial |
$2,811.20
|
| Rate for Payer: Networks By Design Commercial |
$2,284.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,986.90
|
|
|
HC SIGMOIDOSCOPY W ENDO MCSL RESC
|
Facility
|
IP
|
$2,104.00
|
|
|
Service Code
|
CPT 45349
|
| Hospital Charge Code |
906745349
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$420.80 |
| Max. Negotiated Rate |
$1,788.40 |
| Rate for Payer: Adventist Health Commercial |
$420.80
|
| Rate for Payer: Cash Price |
$1,157.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$841.60
|
| Rate for Payer: EPIC Health Plan Senior |
$841.60
|
| Rate for Payer: Galaxy Health WC |
$1,788.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,262.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,403.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$801.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,302.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$504.96
|
| Rate for Payer: Multiplan Commercial |
$1,683.20
|
| Rate for Payer: Networks By Design Commercial |
$1,367.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,788.40
|
|
|
HC SIGMOIDOSCOPY W ENDO MCSL RESC
|
Facility
|
OP
|
$2,104.00
|
|
|
Service Code
|
CPT 45349
|
| Hospital Charge Code |
906745349
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$420.80 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$420.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,226.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,832.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,484.48
|
| 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 |
$1,157.20
|
| Rate for Payer: Cash Price |
$1,157.20
|
| Rate for Payer: Cash Price |
$1,157.20
|
| Rate for Payer: Cigna of CA HMO |
$1,346.56
|
| Rate for Payer: Cigna of CA PPO |
$1,556.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,226.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,832.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,484.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,704.05
|
| Rate for Payer: EPIC Health Plan Senior |
$3,484.48
|
| Rate for Payer: Galaxy Health WC |
$1,788.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,262.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,714.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,484.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,403.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,484.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$504.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,390.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,669.20
|
| Rate for Payer: Multiplan Commercial |
$1,683.20
|
| Rate for Payer: Networks By Design Commercial |
$1,367.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,788.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,262.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,181.38
|
| 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 |
$3,484.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,226.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,832.93
|
| Rate for Payer: Vantage Medical Group Senior |
$3,484.48
|
|
|
HC SIGMOIDOSCOPY W STENT PLCMNT
|
Facility
|
IP
|
$4,411.00
|
|
|
Service Code
|
CPT 45345
|
| Hospital Charge Code |
906745345
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$882.20 |
| Max. Negotiated Rate |
$3,749.35 |
| Rate for Payer: Adventist Health Commercial |
$882.20
|
| Rate for Payer: Cash Price |
$2,426.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,764.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,764.40
|
| Rate for Payer: Galaxy Health WC |
$3,749.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,646.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,942.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,680.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,730.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,058.64
|
| Rate for Payer: Multiplan Commercial |
$3,528.80
|
| Rate for Payer: Networks By Design Commercial |
$2,867.15
|
| Rate for Payer: Prime Health Services Commercial |
$3,749.35
|
|
|
HC SIGMOIDOSCOPY W STENT PLCMNT
|
Facility
|
OP
|
$4,411.00
|
|
|
Service Code
|
CPT 45345
|
| Hospital Charge Code |
906745345
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$882.20 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$882.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,749.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,426.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,308.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,708.80
|
| 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 |
$2,426.05
|
| Rate for Payer: Cash Price |
$2,426.05
|
| Rate for Payer: Cigna of CA HMO |
$2,823.04
|
| Rate for Payer: Cigna of CA PPO |
$3,264.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,749.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,749.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,749.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,764.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,764.40
|
| Rate for Payer: Galaxy Health WC |
$3,749.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,646.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,942.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,680.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,730.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,058.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,087.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,087.70
|
| Rate for Payer: Multiplan Commercial |
$3,528.80
|
| Rate for Payer: Networks By Design Commercial |
$2,867.15
|
| Rate for Payer: Prime Health Services Commercial |
$3,749.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,646.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,646.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,205.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,205.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,205.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,205.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,749.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,749.35
|
| Rate for Payer: Vantage Medical Group Senior |
$3,749.35
|
|
|
HC SIGMOIDOSCOPY W STENT PLCMNT
|
Facility
|
IP
|
$6,289.00
|
|
|
Service Code
|
CPT 45347
|
| Hospital Charge Code |
906745347
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,257.80 |
| Max. Negotiated Rate |
$5,345.65 |
| Rate for Payer: Adventist Health Commercial |
$1,257.80
|
| Rate for Payer: Cash Price |
$3,458.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,515.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,515.60
|
| Rate for Payer: Galaxy Health WC |
$5,345.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,773.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,194.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,396.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,892.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,509.36
|
| Rate for Payer: Multiplan Commercial |
$5,031.20
|
| Rate for Payer: Networks By Design Commercial |
$4,087.85
|
| Rate for Payer: Prime Health Services Commercial |
$5,345.65
|
|
