|
HC SPHINCTEROTOME 0.021INX480 5.5FR
|
Facility
|
IP
|
$1,375.40
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
900100362
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$275.08 |
| Max. Negotiated Rate |
$1,237.86 |
| Rate for Payer: Adventist Health Commercial |
$275.08
|
| Rate for Payer: Cash Price |
$756.47
|
| Rate for Payer: Central Health Plan Commercial |
$1,100.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$550.16
|
| Rate for Payer: EPIC Health Plan Senior |
$550.16
|
| Rate for Payer: Galaxy Health WC |
$1,169.09
|
| Rate for Payer: Global Benefits Group Commercial |
$825.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,237.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$917.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$524.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$851.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$275.08
|
| Rate for Payer: Multiplan Commercial |
$1,031.55
|
| Rate for Payer: Networks By Design Commercial |
$894.01
|
| Rate for Payer: Prime Health Services Commercial |
$1,169.09
|
|
|
HC SPHINCTEROTOME 0.021INX480 5.5FR
|
Facility
|
OP
|
$1,375.40
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
900100362
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$275.08 |
| Max. Negotiated Rate |
$1,237.86 |
| Rate for Payer: Adventist Health Commercial |
$275.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$835.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,169.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$756.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,031.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$665.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$807.77
|
| Rate for Payer: Blue Shield of California Commercial |
$840.37
|
| Rate for Payer: Blue Shield of California EPN |
$548.78
|
| Rate for Payer: Cash Price |
$756.47
|
| Rate for Payer: Central Health Plan Commercial |
$1,100.32
|
| Rate for Payer: Cigna of CA HMO |
$880.26
|
| Rate for Payer: Cigna of CA PPO |
$1,017.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,169.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,169.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,169.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$550.16
|
| Rate for Payer: EPIC Health Plan Senior |
$550.16
|
| Rate for Payer: Galaxy Health WC |
$1,169.09
|
| Rate for Payer: Global Benefits Group Commercial |
$825.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,237.86
|
| Rate for Payer: InnovAge PACE Commercial |
$687.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$917.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$524.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$851.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$275.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$962.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$962.78
|
| Rate for Payer: Multiplan Commercial |
$1,031.55
|
| Rate for Payer: Networks By Design Commercial |
$894.01
|
| Rate for Payer: Prime Health Services Commercial |
$1,169.09
|
| Rate for Payer: Riverside University Health System MISP |
$550.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$825.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$825.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$687.70
|
| Rate for Payer: United Healthcare All Other HMO |
$687.70
|
| Rate for Payer: United Healthcare HMO Rider |
$687.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$687.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,169.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,169.09
|
| Rate for Payer: Vantage Medical Group Senior |
$1,169.09
|
|
|
HC SPHINCTEROTOME 0.021INX480 5.5FR
|
Facility
|
OP
|
$1,656.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
900100363
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$331.20 |
| Max. Negotiated Rate |
$1,490.40 |
| Rate for Payer: Adventist Health Commercial |
$331.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,005.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,407.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$910.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,242.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$801.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$972.57
|
| Rate for Payer: Blue Shield of California Commercial |
$1,011.82
|
| Rate for Payer: Blue Shield of California EPN |
$660.74
|
| Rate for Payer: Cash Price |
$910.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,324.80
|
| Rate for Payer: Cigna of CA HMO |
$1,059.84
|
| Rate for Payer: Cigna of CA PPO |
$1,225.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,407.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,407.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,407.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$662.40
|
| Rate for Payer: EPIC Health Plan Senior |
$662.40
|
| Rate for Payer: Galaxy Health WC |
$1,407.60
|
| Rate for Payer: Global Benefits Group Commercial |
$993.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,490.40
|
| Rate for Payer: InnovAge PACE Commercial |
$828.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,104.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$630.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,025.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$331.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,159.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,159.20
|
| Rate for Payer: Multiplan Commercial |
$1,242.00
|
| Rate for Payer: Networks By Design Commercial |
$1,076.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,407.60
|
| Rate for Payer: Riverside University Health System MISP |
$662.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$993.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$993.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$828.00
|
| Rate for Payer: United Healthcare All Other HMO |
$828.00
|
| Rate for Payer: United Healthcare HMO Rider |
$828.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$828.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,407.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,407.60
|
| Rate for Payer: Vantage Medical Group Senior |
$1,407.60
|
|
|
HC SPHINCTEROTOME 0.035IN 7FR
|
Facility
|
IP
|
$897.00
|
|
| Hospital Charge Code |
900100365
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$179.40 |
| Max. Negotiated Rate |
$807.30 |
| Rate for Payer: Adventist Health Commercial |
$179.40
|
| Rate for Payer: Cash Price |
$493.35
|
| Rate for Payer: Central Health Plan Commercial |
$717.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$358.80
|
| Rate for Payer: EPIC Health Plan Senior |
$358.80
|
| Rate for Payer: Galaxy Health WC |
$762.45
|
| Rate for Payer: Global Benefits Group Commercial |
$538.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$807.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$598.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$341.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$555.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$179.40
|
| Rate for Payer: Multiplan Commercial |
$672.75
|
| Rate for Payer: Networks By Design Commercial |
$583.05
|
| Rate for Payer: Prime Health Services Commercial |
$762.45
|
|
|
HC SPHINCTEROTOME 0.035IN 7FR
|
Facility
|
OP
|
$897.00
|
|
| Hospital Charge Code |
900100365
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$179.40 |
| Max. Negotiated Rate |
$807.30 |
| Rate for Payer: Adventist Health Commercial |
$179.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$544.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$762.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$672.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$434.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$526.81
|
| Rate for Payer: Blue Shield of California Commercial |
$548.07
|
| Rate for Payer: Blue Shield of California EPN |
$357.90
|
| Rate for Payer: Cash Price |
$493.35
|
| Rate for Payer: Central Health Plan Commercial |
$717.60
|
| Rate for Payer: Cigna of CA HMO |
$574.08
|
| Rate for Payer: Cigna of CA PPO |
$663.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$762.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$762.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$762.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$358.80
|
| Rate for Payer: EPIC Health Plan Senior |
$358.80
|
| Rate for Payer: Galaxy Health WC |
$762.45
|
| Rate for Payer: Global Benefits Group Commercial |
$538.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$807.30
|
| Rate for Payer: InnovAge PACE Commercial |
$448.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$598.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$341.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$555.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$179.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$627.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$627.90
|
| Rate for Payer: Multiplan Commercial |
$672.75
|
| Rate for Payer: Networks By Design Commercial |
$583.05
|
| Rate for Payer: Prime Health Services Commercial |
$762.45
|
| Rate for Payer: Riverside University Health System MISP |
$358.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$538.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$538.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$448.50
|
| Rate for Payer: United Healthcare All Other HMO |
$448.50
|
| Rate for Payer: United Healthcare HMO Rider |
$448.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$448.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$762.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$762.45
|
| Rate for Payer: Vantage Medical Group Senior |
$762.45
|
|
|
HC SPHINCTEROTOME 0.035INX260CM 7FR
|
Facility
|
IP
|
$1,495.00
|
|
| Hospital Charge Code |
900100366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$299.00 |
| Max. Negotiated Rate |
$1,345.50 |
| Rate for Payer: Adventist Health Commercial |
$299.00
|
| Rate for Payer: Cash Price |
$822.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,196.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$598.00
|
| Rate for Payer: EPIC Health Plan Senior |
$598.00
|
| Rate for Payer: Galaxy Health WC |
$1,270.75
|
| Rate for Payer: Global Benefits Group Commercial |
$897.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,345.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$997.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$569.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$925.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$299.00
|
| Rate for Payer: Multiplan Commercial |
$1,121.25
|
| Rate for Payer: Networks By Design Commercial |
$971.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,270.75
|
|
|
HC SPHINCTEROTOME 0.035INX260CM 7FR
|
Facility
|
OP
|
$1,495.00
|
|
| Hospital Charge Code |
900100366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$299.00 |
| Max. Negotiated Rate |
$1,345.50 |
| Rate for Payer: Adventist Health Commercial |
$299.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$907.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,270.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$822.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,121.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$723.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$878.01
|
| Rate for Payer: Blue Shield of California Commercial |
$913.45
|
| Rate for Payer: Blue Shield of California EPN |
$596.50
|
| Rate for Payer: Cash Price |
$822.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,196.00
|
| Rate for Payer: Cigna of CA HMO |
$956.80
|
| Rate for Payer: Cigna of CA PPO |
$1,106.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,270.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,270.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,270.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$598.00
|
| Rate for Payer: EPIC Health Plan Senior |
$598.00
|
| Rate for Payer: Galaxy Health WC |
$1,270.75
|
| Rate for Payer: Global Benefits Group Commercial |
$897.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,345.50
|
| Rate for Payer: InnovAge PACE Commercial |
$747.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$997.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$569.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$925.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$299.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,046.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,046.50
|
| Rate for Payer: Multiplan Commercial |
$1,121.25
|
| Rate for Payer: Networks By Design Commercial |
$971.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,270.75
|
| Rate for Payer: Riverside University Health System MISP |
$598.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$897.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$897.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$747.50
|
| Rate for Payer: United Healthcare All Other HMO |
$747.50
|
| Rate for Payer: United Healthcare HMO Rider |
$747.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$747.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,270.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,270.75
|
| Rate for Payer: Vantage Medical Group Senior |
$1,270.75
|
|
|
HC SPHINCTEROTOME 25MM 7FRX200CM
|
Facility
|
OP
|
$575.00
|
|
| Hospital Charge Code |
900100361
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$115.00 |
| Max. Negotiated Rate |
$517.50 |
| Rate for Payer: Adventist Health Commercial |
$115.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$349.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$488.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$316.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$431.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$278.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$337.70
|
| Rate for Payer: Blue Shield of California Commercial |
$351.32
|
| Rate for Payer: Blue Shield of California EPN |
$229.43
|
| Rate for Payer: Cash Price |
$316.25
|
| Rate for Payer: Central Health Plan Commercial |
$460.00
|
| Rate for Payer: Cigna of CA HMO |
$368.00
|
| Rate for Payer: Cigna of CA PPO |
$425.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$488.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$488.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$488.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$230.00
|
| Rate for Payer: EPIC Health Plan Senior |
$230.00
|
| Rate for Payer: Galaxy Health WC |
$488.75
|
| Rate for Payer: Global Benefits Group Commercial |
$345.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$517.50
|
| Rate for Payer: InnovAge PACE Commercial |
$287.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$383.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$219.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$355.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$402.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$402.50
|
| Rate for Payer: Multiplan Commercial |
$431.25
|
| Rate for Payer: Networks By Design Commercial |
$373.75
|
| Rate for Payer: Prime Health Services Commercial |
$488.75
|
| Rate for Payer: Riverside University Health System MISP |
$230.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$345.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$345.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$287.50
|
| Rate for Payer: United Healthcare All Other HMO |
$287.50
|
| Rate for Payer: United Healthcare HMO Rider |
$287.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$287.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$488.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$488.75
|
| Rate for Payer: Vantage Medical Group Senior |
$488.75
|
|
|
HC SPHINCTEROTOME 25MM 7FRX200CM
|
Facility
|
IP
|
$575.00
|
|
| Hospital Charge Code |
900100361
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$115.00 |
| Max. Negotiated Rate |
$517.50 |
| Rate for Payer: Adventist Health Commercial |
$115.00
|
| Rate for Payer: Cash Price |
$316.25
|
| Rate for Payer: Central Health Plan Commercial |
$460.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$230.00
|
| Rate for Payer: EPIC Health Plan Senior |
$230.00
|
| Rate for Payer: Galaxy Health WC |
$488.75
|
| Rate for Payer: Global Benefits Group Commercial |
$345.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$517.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$383.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$219.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$355.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.00
|
| Rate for Payer: Multiplan Commercial |
$431.25
|
| Rate for Payer: Networks By Design Commercial |
$373.75
|
| Rate for Payer: Prime Health Services Commercial |
$488.75
|
|
|
HC SPHINCTEROTOME 5MM 4.4FRX30MM
|
Facility
|
IP
|
$1,048.11
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
900100357
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$209.62 |
| Max. Negotiated Rate |
$943.30 |
| Rate for Payer: Adventist Health Commercial |
$209.62
|
| Rate for Payer: Cash Price |
$576.46
|
| Rate for Payer: Central Health Plan Commercial |
$838.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$419.24
|
| Rate for Payer: EPIC Health Plan Senior |
$419.24
|
| Rate for Payer: Galaxy Health WC |
$890.89
|
| Rate for Payer: Global Benefits Group Commercial |
$628.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$943.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$699.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$399.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$648.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$209.62
|
| Rate for Payer: Multiplan Commercial |
$786.08
|
| Rate for Payer: Networks By Design Commercial |
$681.27
|
| Rate for Payer: Prime Health Services Commercial |
$890.89
|
|
|
HC SPHINCTEROTOME 5MM 4.4FRX30MM
|
Facility
|
OP
|
$1,048.11
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
900100357
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$209.62 |
| Max. Negotiated Rate |
$943.30 |
| Rate for Payer: Adventist Health Commercial |
$209.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$636.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$890.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$576.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$786.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$507.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$615.56
|
| Rate for Payer: Blue Shield of California Commercial |
$640.40
|
| Rate for Payer: Blue Shield of California EPN |
$418.20
|
| Rate for Payer: Cash Price |
$576.46
|
| Rate for Payer: Central Health Plan Commercial |
$838.49
|
| Rate for Payer: Cigna of CA HMO |
$670.79
|
| Rate for Payer: Cigna of CA PPO |
$775.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$890.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$890.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$890.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$419.24
|
| Rate for Payer: EPIC Health Plan Senior |
$419.24
|
| Rate for Payer: Galaxy Health WC |
$890.89
|
| Rate for Payer: Global Benefits Group Commercial |
$628.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$943.30
|
| Rate for Payer: InnovAge PACE Commercial |
$524.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$699.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$399.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$648.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$209.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$733.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$733.68
|
| Rate for Payer: Multiplan Commercial |
$786.08
|
| Rate for Payer: Networks By Design Commercial |
$681.27
|
| Rate for Payer: Prime Health Services Commercial |
$890.89
|
| Rate for Payer: Riverside University Health System MISP |
$419.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$628.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$628.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$524.05
|
| Rate for Payer: United Healthcare All Other HMO |
$524.05
|
| Rate for Payer: United Healthcare HMO Rider |
$524.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$524.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$890.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$890.89
|
| Rate for Payer: Vantage Medical Group Senior |
$890.89
|
|
|
HC SPHINCTEROTOME 5MM 4.9FRX20MM
|
Facility
|
OP
|
$1,048.11
|
|
| Hospital Charge Code |
900100358
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$209.62 |
| Max. Negotiated Rate |
$943.30 |
| Rate for Payer: Adventist Health Commercial |
$209.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$636.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$890.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$576.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$786.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$507.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$615.56
|
| Rate for Payer: Blue Shield of California Commercial |
$640.40
|
| Rate for Payer: Blue Shield of California EPN |
$418.20
|
| Rate for Payer: Cash Price |
$576.46
|
| Rate for Payer: Central Health Plan Commercial |
$838.49
|
| Rate for Payer: Cigna of CA HMO |
$670.79
|
| Rate for Payer: Cigna of CA PPO |
$775.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$890.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$890.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$890.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$419.24
|
| Rate for Payer: EPIC Health Plan Senior |
$419.24
|
| Rate for Payer: Galaxy Health WC |
$890.89
|
| Rate for Payer: Global Benefits Group Commercial |
$628.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$943.30
|
| Rate for Payer: InnovAge PACE Commercial |
$524.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$699.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$399.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$648.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$209.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$733.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$733.68
|
| Rate for Payer: Multiplan Commercial |
$786.08
|
| Rate for Payer: Networks By Design Commercial |
$681.27
|
| Rate for Payer: Prime Health Services Commercial |
$890.89
|
| Rate for Payer: Riverside University Health System MISP |
$419.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$628.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$628.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$524.05
|
| Rate for Payer: United Healthcare All Other HMO |
$524.05
|
| Rate for Payer: United Healthcare HMO Rider |
$524.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$524.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$890.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$890.89
|
| Rate for Payer: Vantage Medical Group Senior |
$890.89
|
|
|
HC SPHINCTEROTOME 5MM 4.9FRX20MM
|
Facility
|
IP
|
$1,048.11
|
|
| Hospital Charge Code |
900100358
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$209.62 |
| Max. Negotiated Rate |
$943.30 |
| Rate for Payer: Adventist Health Commercial |
$209.62
|
| Rate for Payer: Cash Price |
$576.46
|
| Rate for Payer: Central Health Plan Commercial |
$838.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$419.24
|
| Rate for Payer: EPIC Health Plan Senior |
$419.24
|
| Rate for Payer: Galaxy Health WC |
$890.89
|
| Rate for Payer: Global Benefits Group Commercial |
$628.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$943.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$699.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$399.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$648.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$209.62
|
| Rate for Payer: Multiplan Commercial |
$786.08
|
| Rate for Payer: Networks By Design Commercial |
$681.27
|
| Rate for Payer: Prime Health Services Commercial |
$890.89
|
|
|
HC SPHINCTEROTOME 5MM 4.9FRX30MM
|
Facility
|
OP
|
$1,145.40
|
|
| Hospital Charge Code |
900100359
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$229.08 |
| Max. Negotiated Rate |
$1,030.86 |
| Rate for Payer: Adventist Health Commercial |
$229.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$695.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$973.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$629.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$859.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$554.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$672.69
|
| Rate for Payer: Blue Shield of California Commercial |
$699.84
|
| Rate for Payer: Blue Shield of California EPN |
$457.01
|
| Rate for Payer: Cash Price |
$629.97
|
| Rate for Payer: Central Health Plan Commercial |
$916.32
|
| Rate for Payer: Cigna of CA HMO |
$733.06
|
| Rate for Payer: Cigna of CA PPO |
$847.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$973.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$973.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$973.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$458.16
|
| Rate for Payer: EPIC Health Plan Senior |
$458.16
|
| Rate for Payer: Galaxy Health WC |
$973.59
|
| Rate for Payer: Global Benefits Group Commercial |
$687.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,030.86
|
| Rate for Payer: InnovAge PACE Commercial |
$572.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$763.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$436.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$709.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$229.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$801.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$801.78
|
| Rate for Payer: Multiplan Commercial |
$859.05
|
| Rate for Payer: Networks By Design Commercial |
$744.51
|
| Rate for Payer: Prime Health Services Commercial |
$973.59
|
| Rate for Payer: Riverside University Health System MISP |
$458.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$687.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$687.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$572.70
|
| Rate for Payer: United Healthcare All Other HMO |
$572.70
|
| Rate for Payer: United Healthcare HMO Rider |
$572.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$572.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$973.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$973.59
|
| Rate for Payer: Vantage Medical Group Senior |
$973.59
|
|
|
HC SPHINCTEROTOME 5MM 4.9FRX30MM
|
Facility
|
IP
|
$1,145.40
|
|
| Hospital Charge Code |
900100359
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$229.08 |
| Max. Negotiated Rate |
$1,030.86 |
| Rate for Payer: Adventist Health Commercial |
$229.08
|
| Rate for Payer: Cash Price |
$629.97
|
| Rate for Payer: Central Health Plan Commercial |
$916.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$458.16
|
| Rate for Payer: EPIC Health Plan Senior |
$458.16
|
| Rate for Payer: Galaxy Health WC |
$973.59
|
| Rate for Payer: Global Benefits Group Commercial |
$687.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,030.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$763.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$436.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$709.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$229.08
|
| Rate for Payer: Multiplan Commercial |
$859.05
|
| Rate for Payer: Networks By Design Commercial |
$744.51
|
| Rate for Payer: Prime Health Services Commercial |
$973.59
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$3,180.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
906562270
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$636.00 |
| Max. Negotiated Rate |
$2,862.00 |
| Rate for Payer: Adventist Health Commercial |
$636.00
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,544.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,272.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,272.00
|
| Rate for Payer: Galaxy Health WC |
$2,703.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,908.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,862.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,121.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,211.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,968.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$636.00
|
| Rate for Payer: Multiplan Commercial |
$2,385.00
|
| Rate for Payer: Networks By Design Commercial |
$2,067.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,703.00
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$3,180.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
909000180
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$636.00 |
| Max. Negotiated Rate |
$2,862.00 |
| Rate for Payer: Adventist Health Commercial |
$636.00
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,544.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,272.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,272.00
|
| Rate for Payer: Galaxy Health WC |
$2,703.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,908.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,862.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,121.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,211.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,968.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$636.00
|
| Rate for Payer: Multiplan Commercial |
$2,385.00
|
| Rate for Payer: Networks By Design Commercial |
$2,067.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,703.00
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$3,180.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
909000180
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$636.00 |
| Max. Negotiated Rate |
$2,862.00 |
| Rate for Payer: Adventist Health Commercial |
$636.00
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,544.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,272.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,272.00
|
| Rate for Payer: Galaxy Health WC |
$2,703.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,908.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,862.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,121.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,211.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,968.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$636.00
|
| Rate for Payer: Multiplan Commercial |
$2,385.00
|
| Rate for Payer: Networks By Design Commercial |
$2,067.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,703.00
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$3,180.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
909000180
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$140.89 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$636.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$879.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$967.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,942.98
|
| Rate for Payer: Blue Shield of California EPN |
$1,268.82
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,544.00
|
| Rate for Payer: Cigna of CA HMO |
$2,035.20
|
| Rate for Payer: Cigna of CA PPO |
$2,353.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$967.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$879.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,187.89
|
| Rate for Payer: EPIC Health Plan Senior |
$879.92
|
| Rate for Payer: Galaxy Health WC |
$2,703.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,908.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,862.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,443.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$140.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.92
|
| Rate for Payer: InnovAge PACE Commercial |
$1,319.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,121.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$636.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,179.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,179.09
|
| Rate for Payer: Multiplan Commercial |
$2,385.00
|
| Rate for Payer: Networks By Design Commercial |
$2,067.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$879.92
|
| Rate for Payer: Prime Health Services Commercial |
$2,703.00
|
| Rate for Payer: Prime Health Services Medicare |
$932.72
|
| Rate for Payer: Riverside University Health System MISP |
$967.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,908.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,908.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,590.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,590.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,590.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,590.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$879.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$967.91
|
| Rate for Payer: Vantage Medical Group Senior |
$879.92
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$3,180.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
909000180
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$155.63 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$1,303.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$967.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,402.00
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,544.00
|
| Rate for Payer: Cigna of CA HMO |
$2,035.20
|
| Rate for Payer: Cigna of CA PPO |
$2,353.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$967.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$879.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,187.89
|
| Rate for Payer: EPIC Health Plan Senior |
$879.92
|
| Rate for Payer: Galaxy Health WC |
$2,703.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,908.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,862.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,443.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.92
|
| Rate for Payer: InnovAge PACE Commercial |
$1,319.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,121.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$636.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,179.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,179.09
|
| Rate for Payer: Multiplan Commercial |
$2,385.00
|
| Rate for Payer: Multiplan WC |
$1,402.00
|
| Rate for Payer: Networks By Design Commercial |
$2,067.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$879.92
|
| Rate for Payer: Preferred Health Network WC |
$1,430.61
|
| Rate for Payer: Prime Health Services Commercial |
$2,703.00
|
| Rate for Payer: Prime Health Services Medicare |
$932.72
|
| Rate for Payer: Prime Health Services WC |
$1,387.69
|
| Rate for Payer: Riverside University Health System MISP |
$967.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,908.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,908.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$879.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$967.91
|
| Rate for Payer: Vantage Medical Group Senior |
$879.92
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$3,180.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
909000180
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$636.00 |
| Max. Negotiated Rate |
$2,862.00 |
| Rate for Payer: Adventist Health Commercial |
$636.00
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,544.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,272.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,272.00
|
| Rate for Payer: Galaxy Health WC |
$2,703.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,908.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,862.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,121.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,211.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,968.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$636.00
|
| Rate for Payer: Multiplan Commercial |
$2,385.00
|
| Rate for Payer: Networks By Design Commercial |
$2,067.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,703.00
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$3,180.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
909000180
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$155.63 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$636.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$967.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,402.00
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,544.00
|
| Rate for Payer: Cigna of CA HMO |
$2,035.20
|
| Rate for Payer: Cigna of CA PPO |
$2,353.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$967.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$879.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,187.89
|
| Rate for Payer: EPIC Health Plan Senior |
$879.92
|
| Rate for Payer: Galaxy Health WC |
$2,703.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,908.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,862.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,443.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.92
|
| Rate for Payer: InnovAge PACE Commercial |
$1,319.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,121.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$636.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,179.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,179.09
|
| Rate for Payer: Multiplan Commercial |
$2,385.00
|
| Rate for Payer: Multiplan WC |
$1,402.00
|
| Rate for Payer: Networks By Design Commercial |
$2,067.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$879.92
|
| Rate for Payer: Preferred Health Network WC |
$1,430.61
|
| Rate for Payer: Prime Health Services Commercial |
$2,703.00
|
| Rate for Payer: Prime Health Services Medicare |
$932.72
|
| Rate for Payer: Prime Health Services WC |
$1,387.69
|
| Rate for Payer: Riverside University Health System MISP |
$967.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,908.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,590.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,590.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,590.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,590.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$879.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$967.91
|
| Rate for Payer: Vantage Medical Group Senior |
$879.92
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$3,180.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
909000180
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$140.89 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$636.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$879.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$967.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,402.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,544.00
|
| Rate for Payer: Cigna of CA HMO |
$2,035.20
|
| Rate for Payer: Cigna of CA PPO |
$2,353.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$967.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$879.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,187.89
|
| Rate for Payer: EPIC Health Plan Senior |
$879.92
|
| Rate for Payer: Galaxy Health WC |
$2,703.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,908.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,862.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,443.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$140.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.92
|
| Rate for Payer: InnovAge PACE Commercial |
$1,319.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,121.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$636.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,179.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,179.09
|
| Rate for Payer: Multiplan Commercial |
$2,385.00
|
| Rate for Payer: Multiplan WC |
$1,402.00
|
| Rate for Payer: Networks By Design Commercial |
$2,067.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$879.92
|
| Rate for Payer: Preferred Health Network WC |
$1,430.61
|
| Rate for Payer: Prime Health Services Commercial |
$2,703.00
|
| Rate for Payer: Prime Health Services Medicare |
$932.72
|
| Rate for Payer: Prime Health Services WC |
$1,387.69
|
| Rate for Payer: Riverside University Health System MISP |
$967.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,908.00
|
| 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 |
$879.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$967.91
|
| Rate for Payer: Vantage Medical Group Senior |
$879.92
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$3,180.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
909000180
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$636.00 |
| Max. Negotiated Rate |
$2,862.00 |
| Rate for Payer: Adventist Health Commercial |
$636.00
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,544.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,272.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,272.00
|
| Rate for Payer: Galaxy Health WC |
$2,703.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,908.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,862.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,121.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,211.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,968.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$636.00
|
| Rate for Payer: Multiplan Commercial |
$2,385.00
|
| Rate for Payer: Networks By Design Commercial |
$2,067.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,703.00
|
|
|
HC SPINAL LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$3,180.00
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
906562270
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$140.89 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$636.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$879.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$967.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,402.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Cash Price |
$1,749.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,544.00
|
| Rate for Payer: Cigna of CA HMO |
$2,035.20
|
| Rate for Payer: Cigna of CA PPO |
$2,353.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$967.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$879.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,187.89
|
| Rate for Payer: EPIC Health Plan Senior |
$879.92
|
| Rate for Payer: Galaxy Health WC |
$2,703.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,908.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,862.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,443.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$140.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.92
|
| Rate for Payer: InnovAge PACE Commercial |
$1,319.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,121.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$636.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,179.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,179.09
|
| Rate for Payer: Multiplan Commercial |
$2,385.00
|
| Rate for Payer: Multiplan WC |
$1,402.00
|
| Rate for Payer: Networks By Design Commercial |
$2,067.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$879.92
|
| Rate for Payer: Preferred Health Network WC |
$1,430.61
|
| Rate for Payer: Prime Health Services Commercial |
$2,703.00
|
| Rate for Payer: Prime Health Services Medicare |
$932.72
|
| Rate for Payer: Prime Health Services WC |
$1,387.69
|
| Rate for Payer: Riverside University Health System MISP |
$967.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,908.00
|
| 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 |
$879.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$967.91
|
| Rate for Payer: Vantage Medical Group Senior |
$879.92
|
|
