|
HC VELOPHARYNGEAL STUDY
|
Facility
OP
|
$797.00
|
|
|
Service Code
|
CPT 70371
|
| Hospital Charge Code |
909001252
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$159.40 |
| Max. Negotiated Rate |
$717.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$306.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$300.89
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$459.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$336.78
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$306.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$431.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$526.25
|
| Rate for Payer: BCBS Transplant Transplant |
$478.20
|
| Rate for Payer: Blue Shield of California Commercial |
$492.55
|
| Rate for Payer: Blue Shield of California EPN |
$387.34
|
| Rate for Payer: Caremore Medicare Advantage |
$306.16
|
| Rate for Payer: Cash Price |
$358.65
|
| Rate for Payer: Cash Price |
$358.65
|
| Rate for Payer: Central Health Plan Commercial |
$637.60
|
| Rate for Payer: Cigna of CA HMO |
$510.08
|
| Rate for Payer: Cigna of CA PPO |
$589.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$459.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$413.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$306.16
|
| Rate for Payer: EPIC Health Plan Transplant |
$306.16
|
| Rate for Payer: Galaxy Health WC |
$677.45
|
| Rate for Payer: Global Benefits Group Commercial |
$478.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$717.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$597.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$502.10
|
| Rate for Payer: IEHP medi-cal |
$505.16
|
| Rate for Payer: IEHP Medicare Advantage |
$306.16
|
| Rate for Payer: Innovage PACE Commercial |
$459.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$531.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$306.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$159.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$410.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$410.25
|
| Rate for Payer: Multiplan Commercial |
$597.75
|
| Rate for Payer: Networks By Design Commercial |
$518.05
|
| Rate for Payer: Prime Health Services Commercial |
$677.45
|
| Rate for Payer: Prime Health Services Medicare |
$324.53
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$478.20
|
| Rate for Payer: Riverside University Health MISP |
$336.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$478.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$478.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$225.63
|
| Rate for Payer: United Healthcare All Other HMO |
$225.63
|
| Rate for Payer: United Healthcare HMO Rider |
$225.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$225.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$459.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$336.78
|
| Rate for Payer: Vantage Medical Group Senior |
$306.16
|
|
|
HC VENA CAVA FILTER
|
Facility
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C1880
|
| Hospital Charge Code |
909081250
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$8,896.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8,896.95
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,145.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,780.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,172.30
|
| Rate for Payer: BCBS Transplant Transplant |
$2,340.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,925.00
|
| Rate for Payer: Blue Shield of California EPN |
$2,121.60
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,925.00
|
| Rate for Payer: IEHP medi-cal |
$1,365.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Riverside University Health MISP |
$1,560.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC VENA CAVA FILTER
|
Facility
IP
|
$3,900.00
|
|
|
Service Code
|
CPT C1880
|
| Hospital Charge Code |
909081250
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Blue Shield of California EPN |
$2,082.60
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC VENIPUNCTURECUTDOWN GT 1YR
|
Facility
IP
|
$615.00
|
|
|
Service Code
|
CPT 36425
|
| Hospital Charge Code |
900501336
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$123.00 |
| Max. Negotiated Rate |
$553.50 |
| Rate for Payer: Cash Price |
$276.75
|
| Rate for Payer: Central Health Plan Commercial |
$492.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$246.00
|
| Rate for Payer: Galaxy Health WC |
$522.75
|
| Rate for Payer: Global Benefits Group Commercial |
$369.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$553.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$410.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.00
|
| Rate for Payer: Multiplan Commercial |
$461.25
|
| Rate for Payer: Networks By Design Commercial |
$399.75
|
| Rate for Payer: Prime Health Services Commercial |
$522.75
|
|
|
HC VENIPUNCTURECUTDOWN GT 1YR
|
Facility
OP
|
$615.00
|
|
|
Service Code
|
CPT 36425
|
| Hospital Charge Code |
900501336
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$123.00 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$497.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$746.73
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$547.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$497.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$369.00
|
| Rate for Payer: Blue Shield of California Commercial |
$386.84
|
| Rate for Payer: Blue Shield of California EPN |
$300.74
|
| Rate for Payer: Caremore Medicare Advantage |
$497.82
|
| Rate for Payer: Cash Price |
$276.75
|
| Rate for Payer: Cash Price |
$276.75
|
| Rate for Payer: Cash Price |
$276.75
|
| Rate for Payer: Central Health Plan Commercial |
$492.00
|
| Rate for Payer: Cigna of CA HMO |
$393.60
|
| Rate for Payer: Cigna of CA PPO |
$455.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$746.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$672.06
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$497.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$497.82
|
| Rate for Payer: Galaxy Health WC |
$522.75
|
| Rate for Payer: Global Benefits Group Commercial |
$369.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$553.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$461.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$816.42
|
| Rate for Payer: IEHP medi-cal |
$821.40
|
| Rate for Payer: IEHP Medicare Advantage |
$497.82
|
| Rate for Payer: Innovage PACE Commercial |
$746.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$410.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$497.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$667.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$667.08
|
| Rate for Payer: Multiplan Commercial |
$461.25
|
| Rate for Payer: Networks By Design Commercial |
$399.75
|
| Rate for Payer: Prime Health Services Commercial |
$522.75
|
| Rate for Payer: Prime Health Services Medicare |
$527.69
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$369.00
|
| Rate for Payer: Riverside University Health MISP |
$547.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$369.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$369.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$307.50
|
| Rate for Payer: United Healthcare All Other HMO |
$307.50
|
| Rate for Payer: United Healthcare HMO Rider |
$307.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$307.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$746.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$547.60
|
| Rate for Payer: Vantage Medical Group Senior |
$497.82
|
|
|
HC VENIPUNCTURECUTDOWN GT 1YR
|
Facility
IP
|
$615.00
|
|
|
Service Code
|
CPT 36425
|
| Hospital Charge Code |
900501336
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$123.00 |
| Max. Negotiated Rate |
$553.50 |
| Rate for Payer: Cash Price |
$276.75
|
| Rate for Payer: Central Health Plan Commercial |
$492.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$246.00
|
| Rate for Payer: Galaxy Health WC |
$522.75
|
| Rate for Payer: Global Benefits Group Commercial |
$369.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$553.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$410.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.00
|
| Rate for Payer: Multiplan Commercial |
$461.25
|
| Rate for Payer: Networks By Design Commercial |
$399.75
|
| Rate for Payer: Prime Health Services Commercial |
$522.75
|
|
|
HC VENIPUNCTURECUTDOWN GT 1YR
|
Facility
OP
|
$615.00
|
|
|
Service Code
|
CPT 36425
|
| Hospital Charge Code |
900501336
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$123.00 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$746.73
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$547.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$497.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$369.00
|
| Rate for Payer: Caremore Medicare Advantage |
$497.82
|
| Rate for Payer: Cash Price |
$276.75
|
| Rate for Payer: Cash Price |
$276.75
|
| Rate for Payer: Cash Price |
$276.75
|
| Rate for Payer: Cash Price |
$276.75
|
| Rate for Payer: Central Health Plan Commercial |
$492.00
|
| Rate for Payer: Cigna of CA PPO |
$455.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$746.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$672.06
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$497.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$497.82
|
| Rate for Payer: Galaxy Health WC |
$522.75
|
| Rate for Payer: Global Benefits Group Commercial |
$369.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$553.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$461.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$816.42
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$497.82
|
| Rate for Payer: Innovage PACE Commercial |
$746.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$410.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$497.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$667.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$667.08
|
| Rate for Payer: Multiplan Commercial |
$461.25
|
| Rate for Payer: Networks By Design Commercial |
$399.75
|
| Rate for Payer: Prime Health Services Commercial |
$522.75
|
| Rate for Payer: Prime Health Services Medicare |
$527.69
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$369.00
|
| Rate for Payer: Riverside University Health MISP |
$547.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$369.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$307.50
|
| Rate for Payer: United Healthcare All Other HMO |
$307.50
|
| Rate for Payer: United Healthcare HMO Rider |
$307.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$307.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$746.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$547.60
|
| Rate for Payer: Vantage Medical Group Senior |
$497.82
|
|
|
HC VENIPUNCTURE GT 3 YRS OLD
|
Facility
OP
|
$134.00
|
|
|
Service Code
|
CPT 36410
|
| Hospital Charge Code |
910100005
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49.27
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$113.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$73.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$73.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$64.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.17
|
| Rate for Payer: BCBS Transplant Transplant |
$80.40
|
| Rate for Payer: Blue Shield of California Commercial |
$82.81
|
| Rate for Payer: Blue Shield of California EPN |
$65.12
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Cigna of CA HMO |
$85.76
|
| Rate for Payer: Cigna of CA PPO |
$99.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$53.60
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$100.50
|
| Rate for Payer: IEHP medi-cal |
$46.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$89.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$80.40
|
| Rate for Payer: Riverside University Health MISP |
$53.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$80.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$80.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$67.00
|
| Rate for Payer: United Healthcare All Other HMO |
$67.00
|
| Rate for Payer: United Healthcare HMO Rider |
$67.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$67.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$113.90
|
| Rate for Payer: Vantage Medical Group Senior |
$113.90
|
|
|
HC VENIPUNCTURE GT 3 YRS OLD
|
Facility
IP
|
$134.00
|
|
|
Service Code
|
CPT 36410
|
| Hospital Charge Code |
910100005
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.60
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$89.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
|
|
HC VENIPUNCTURE GT 3 YRS OLD
|
Facility
IP
|
$134.00
|
|
|
Service Code
|
CPT 36410
|
| Hospital Charge Code |
910100005
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.60
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$89.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
|
|
HC VENIPUNCTURE GT 3 YRS OLD
|
Facility
OP
|
$134.00
|
|
|
Service Code
|
CPT 36410
|
| Hospital Charge Code |
910100005
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49.27
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$113.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$73.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$73.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$80.40
|
| Rate for Payer: Blue Shield of California Commercial |
$84.29
|
| Rate for Payer: Blue Shield of California EPN |
$65.53
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Cigna of CA HMO |
$85.76
|
| Rate for Payer: Cigna of CA PPO |
$99.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$53.60
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$100.50
|
| Rate for Payer: IEHP medi-cal |
$46.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$89.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$80.40
|
| Rate for Payer: Riverside University Health MISP |
$53.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$80.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$80.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$67.00
|
| Rate for Payer: United Healthcare All Other HMO |
$67.00
|
| Rate for Payer: United Healthcare HMO Rider |
$67.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$67.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$113.90
|
| Rate for Payer: Vantage Medical Group Senior |
$113.90
|
|
|
HC VENIPUNCTURE W SPECIMEN
|
Facility
OP
|
$58.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
906536415
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.43 |
| Max. Negotiated Rate |
$52.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$8.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15.83
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.86
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.43
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.00
|
| Rate for Payer: BCBS Transplant Transplant |
$34.80
|
| Rate for Payer: Blue Shield of California Commercial |
$35.84
|
| Rate for Payer: Blue Shield of California EPN |
$28.19
|
| Rate for Payer: Caremore Medicare Advantage |
$8.57
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Central Health Plan Commercial |
$46.40
|
| Rate for Payer: Cigna of CA HMO |
$37.12
|
| Rate for Payer: Cigna of CA PPO |
$42.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.57
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.57
|
| Rate for Payer: Galaxy Health WC |
$49.30
|
| Rate for Payer: Global Benefits Group Commercial |
$34.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$52.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$43.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.05
|
| Rate for Payer: IEHP medi-cal |
$14.14
|
| Rate for Payer: IEHP Medicare Advantage |
$8.57
|
| Rate for Payer: Innovage PACE Commercial |
$12.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.48
|
| Rate for Payer: Multiplan Commercial |
$43.50
|
| Rate for Payer: Networks By Design Commercial |
$37.70
|
| Rate for Payer: Prime Health Services Commercial |
$49.30
|
| Rate for Payer: Prime Health Services Medicare |
$9.08
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$34.80
|
| Rate for Payer: Riverside University Health MISP |
$9.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.43
|
| Rate for Payer: United Healthcare All Other HMO |
$2.43
|
| Rate for Payer: United Healthcare HMO Rider |
$2.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.43
|
| Rate for Payer: Vantage Medical Group Senior |
$8.57
|
|
|
HC VENIPUNCTURE W SPECIMEN
|
Facility
OP
|
$58.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
900510279
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.43 |
| Max. Negotiated Rate |
$52.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$8.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15.83
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.86
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.43
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.00
|
| Rate for Payer: BCBS Transplant Transplant |
$34.80
|
| Rate for Payer: Blue Shield of California Commercial |
$35.84
|
| Rate for Payer: Blue Shield of California EPN |
$28.19
|
| Rate for Payer: Caremore Medicare Advantage |
$8.57
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Central Health Plan Commercial |
$46.40
|
| Rate for Payer: Cigna of CA HMO |
$37.12
|
| Rate for Payer: Cigna of CA PPO |
$42.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.57
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.57
|
| Rate for Payer: Galaxy Health WC |
$49.30
|
| Rate for Payer: Global Benefits Group Commercial |
$34.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$52.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$43.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.05
|
| Rate for Payer: IEHP medi-cal |
$14.14
|
| Rate for Payer: IEHP Medicare Advantage |
$8.57
|
| Rate for Payer: Innovage PACE Commercial |
$12.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.48
|
| Rate for Payer: Multiplan Commercial |
$43.50
|
| Rate for Payer: Networks By Design Commercial |
$37.70
|
| Rate for Payer: Prime Health Services Commercial |
$49.30
|
| Rate for Payer: Prime Health Services Medicare |
$9.08
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$34.80
|
| Rate for Payer: Riverside University Health MISP |
$9.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.43
|
| Rate for Payer: United Healthcare All Other HMO |
$2.43
|
| Rate for Payer: United Healthcare HMO Rider |
$2.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.43
|
| Rate for Payer: Vantage Medical Group Senior |
$8.57
|
|
|
HC VENIPUNCTURE W SPECIMEN
|
Facility
IP
|
$67.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
906536415
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.40 |
| Max. Negotiated Rate |
$60.30 |
| Rate for Payer: Cash Price |
$30.15
|
| Rate for Payer: Central Health Plan Commercial |
$53.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.80
|
| Rate for Payer: Galaxy Health WC |
$56.95
|
| Rate for Payer: Global Benefits Group Commercial |
$40.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$60.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.40
|
| Rate for Payer: Multiplan Commercial |
$50.25
|
| Rate for Payer: Networks By Design Commercial |
$43.55
|
| Rate for Payer: Prime Health Services Commercial |
$56.95
|
|
|
HC VENIPUNCTURE W SPECIMEN
|
Facility
IP
|
$67.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
900510279
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.40 |
| Max. Negotiated Rate |
$60.30 |
| Rate for Payer: Cash Price |
$30.15
|
| Rate for Payer: Central Health Plan Commercial |
$53.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.80
|
| Rate for Payer: Galaxy Health WC |
$56.95
|
| Rate for Payer: Global Benefits Group Commercial |
$40.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$60.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.40
|
| Rate for Payer: Multiplan Commercial |
$50.25
|
| Rate for Payer: Networks By Design Commercial |
$43.55
|
| Rate for Payer: Prime Health Services Commercial |
$56.95
|
|
|
HC VENIPUNCTURE W/SPECIMEN
|
Facility
IP
|
$67.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
900910099
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.40 |
| Max. Negotiated Rate |
$60.30 |
| Rate for Payer: Cash Price |
$30.15
|
| Rate for Payer: Central Health Plan Commercial |
$53.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.80
|
| Rate for Payer: Galaxy Health WC |
$56.95
|
| Rate for Payer: Global Benefits Group Commercial |
$40.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$60.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.40
|
| Rate for Payer: Multiplan Commercial |
$50.25
|
| Rate for Payer: Networks By Design Commercial |
$43.55
|
| Rate for Payer: Prime Health Services Commercial |
$56.95
|
|
|
HC VENIPUNCTURE W/SPECIMEN
|
Facility
OP
|
$58.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
900910099
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.43 |
| Max. Negotiated Rate |
$52.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$8.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15.83
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.86
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.43
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.00
|
| Rate for Payer: BCBS Transplant Transplant |
$34.80
|
| Rate for Payer: Blue Shield of California Commercial |
$35.84
|
| Rate for Payer: Blue Shield of California EPN |
$28.19
|
| Rate for Payer: Caremore Medicare Advantage |
$8.57
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Central Health Plan Commercial |
$46.40
|
| Rate for Payer: Cigna of CA HMO |
$37.12
|
| Rate for Payer: Cigna of CA PPO |
$42.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.57
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.57
|
| Rate for Payer: Galaxy Health WC |
$49.30
|
| Rate for Payer: Global Benefits Group Commercial |
$34.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$52.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$43.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.05
|
| Rate for Payer: IEHP medi-cal |
$14.14
|
| Rate for Payer: IEHP Medicare Advantage |
$8.57
|
| Rate for Payer: Innovage PACE Commercial |
$12.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.48
|
| Rate for Payer: Multiplan Commercial |
$43.50
|
| Rate for Payer: Networks By Design Commercial |
$37.70
|
| Rate for Payer: Prime Health Services Commercial |
$49.30
|
| Rate for Payer: Prime Health Services Medicare |
$9.08
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$34.80
|
| Rate for Payer: Riverside University Health MISP |
$9.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.43
|
| Rate for Payer: United Healthcare All Other HMO |
$2.43
|
| Rate for Payer: United Healthcare HMO Rider |
$2.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.43
|
| Rate for Payer: Vantage Medical Group Senior |
$8.57
|
|
|
HC VENOGRAM ADRENAL BILAT
|
Facility
OP
|
$11,597.00
|
|
|
Service Code
|
CPT 75842
|
| Hospital Charge Code |
909081638
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$948.46 |
| Max. Negotiated Rate |
$11,329.02 |
| Rate for Payer: Adventist Health Medi-Cal |
$6,866.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$948.46
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6,866.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,622.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,199.02
|
| Rate for Payer: BCBS Transplant Transplant |
$6,958.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,166.95
|
| Rate for Payer: Blue Shield of California EPN |
$5,636.14
|
| Rate for Payer: Caremore Medicare Advantage |
$6,866.07
|
| Rate for Payer: Cash Price |
$5,218.65
|
| Rate for Payer: Cash Price |
$5,218.65
|
| Rate for Payer: Central Health Plan Commercial |
$9,277.60
|
| Rate for Payer: Cigna of CA HMO |
$7,422.08
|
| Rate for Payer: Cigna of CA PPO |
$8,581.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,299.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,269.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6,866.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,866.07
|
| Rate for Payer: Galaxy Health WC |
$9,857.45
|
| Rate for Payer: Global Benefits Group Commercial |
$6,958.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,437.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8,697.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,260.35
|
| Rate for Payer: IEHP medi-cal |
$11,329.02
|
| Rate for Payer: IEHP Medicare Advantage |
$6,866.07
|
| Rate for Payer: Innovage PACE Commercial |
$10,299.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,735.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,866.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,319.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,200.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,200.53
|
| Rate for Payer: Multiplan Commercial |
$8,697.75
|
| Rate for Payer: Networks By Design Commercial |
$7,538.05
|
| Rate for Payer: Prime Health Services Commercial |
$9,857.45
|
| Rate for Payer: Prime Health Services Medicare |
$7,278.03
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6,958.20
|
| Rate for Payer: Riverside University Health MISP |
$7,552.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,958.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,958.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: Vantage Medical Group Senior |
$6,866.07
|
|
|
HC VENOGRAM ADRENAL BILAT
|
Facility
IP
|
$11,597.00
|
|
|
Service Code
|
CPT 75842
|
| Hospital Charge Code |
909081638
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,319.40 |
| Max. Negotiated Rate |
$10,437.30 |
| Rate for Payer: Cash Price |
$5,218.65
|
| Rate for Payer: Central Health Plan Commercial |
$9,277.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,638.80
|
| Rate for Payer: Galaxy Health WC |
$9,857.45
|
| Rate for Payer: Global Benefits Group Commercial |
$6,958.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,437.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,735.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,319.40
|
| Rate for Payer: Multiplan Commercial |
$8,697.75
|
| Rate for Payer: Networks By Design Commercial |
$7,538.05
|
| Rate for Payer: Prime Health Services Commercial |
$9,857.45
|
|
|
HC VENOGRAM ADRENAL UNILAT
|
Facility
OP
|
$7,731.00
|
|
|
Service Code
|
CPT 75840
|
| Hospital Charge Code |
909081579
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$845.25 |
| Max. Negotiated Rate |
$6,957.90 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$845.25
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,622.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,199.02
|
| Rate for Payer: BCBS Transplant Transplant |
$4,638.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4,777.76
|
| Rate for Payer: Blue Shield of California EPN |
$3,757.27
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$3,478.95
|
| Rate for Payer: Cash Price |
$3,478.95
|
| Rate for Payer: Central Health Plan Commercial |
$6,184.80
|
| Rate for Payer: Cigna of CA HMO |
$4,947.84
|
| Rate for Payer: Cigna of CA PPO |
$5,720.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$6,571.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,638.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,957.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,798.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: IEHP medi-cal |
$6,571.21
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Innovage PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,156.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,546.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$5,798.25
|
| Rate for Payer: Networks By Design Commercial |
$5,025.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,571.35
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,638.60
|
| Rate for Payer: Riverside University Health MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,638.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,638.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC VENOGRAM ADRENAL UNILAT
|
Facility
IP
|
$7,731.00
|
|
|
Service Code
|
CPT 75840
|
| Hospital Charge Code |
909081579
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,546.20 |
| Max. Negotiated Rate |
$6,957.90 |
| Rate for Payer: Cash Price |
$3,478.95
|
| Rate for Payer: Central Health Plan Commercial |
$6,184.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,092.40
|
| Rate for Payer: Galaxy Health WC |
$6,571.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,638.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,957.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,156.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,546.20
|
| Rate for Payer: Multiplan Commercial |
$5,798.25
|
| Rate for Payer: Networks By Design Commercial |
$5,025.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,571.35
|
|
|
HC VENOGRAM EPIDURAL
|
Facility
OP
|
$11,948.00
|
|
|
Service Code
|
CPT 75872
|
| Hospital Charge Code |
909081642
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$784.90 |
| Max. Negotiated Rate |
$10,753.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$784.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,255.98
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,177.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$784.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,622.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,199.02
|
| Rate for Payer: BCBS Transplant Transplant |
$7,168.80
|
| Rate for Payer: Blue Shield of California Commercial |
$7,383.86
|
| Rate for Payer: Blue Shield of California EPN |
$5,806.73
|
| Rate for Payer: Caremore Medicare Advantage |
$784.90
|
| Rate for Payer: Cash Price |
$5,376.60
|
| Rate for Payer: Cash Price |
$5,376.60
|
| Rate for Payer: Central Health Plan Commercial |
$9,558.40
|
| Rate for Payer: Cigna of CA HMO |
$7,646.72
|
| Rate for Payer: Cigna of CA PPO |
$8,841.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,177.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,059.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$784.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$784.90
|
| Rate for Payer: Galaxy Health WC |
$10,155.80
|
| Rate for Payer: Global Benefits Group Commercial |
$7,168.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,753.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8,961.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,287.24
|
| Rate for Payer: IEHP medi-cal |
$1,295.08
|
| Rate for Payer: IEHP Medicare Advantage |
$784.90
|
| Rate for Payer: Innovage PACE Commercial |
$1,177.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,969.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,389.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,051.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,051.77
|
| Rate for Payer: Multiplan Commercial |
$8,961.00
|
| Rate for Payer: Networks By Design Commercial |
$7,766.20
|
| Rate for Payer: Prime Health Services Commercial |
$10,155.80
|
| Rate for Payer: Prime Health Services Medicare |
$831.99
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7,168.80
|
| Rate for Payer: Riverside University Health MISP |
$863.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,168.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,168.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,688.24
|
| Rate for Payer: United Healthcare All Other HMO |
$1,688.24
|
| Rate for Payer: United Healthcare HMO Rider |
$1,688.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,688.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: Vantage Medical Group Senior |
$784.90
|
|
|
HC VENOGRAM EPIDURAL
|
Facility
IP
|
$11,948.00
|
|
|
Service Code
|
CPT 75872
|
| Hospital Charge Code |
909081642
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,389.60 |
| Max. Negotiated Rate |
$10,753.20 |
| Rate for Payer: Cash Price |
$5,376.60
|
| Rate for Payer: Central Health Plan Commercial |
$9,558.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,779.20
|
| Rate for Payer: Galaxy Health WC |
$10,155.80
|
| Rate for Payer: Global Benefits Group Commercial |
$7,168.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,753.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,969.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,389.60
|
| Rate for Payer: Multiplan Commercial |
$8,961.00
|
| Rate for Payer: Networks By Design Commercial |
$7,766.20
|
| Rate for Payer: Prime Health Services Commercial |
$10,155.80
|
|
|
HC VENOGRAM EXRTM BILATERAL
|
Facility
OP
|
$5,973.00
|
|
|
Service Code
|
CPT 75822
|
| Hospital Charge Code |
906811381
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$306.55 |
| Max. Negotiated Rate |
$5,375.70 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,001.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$570.19
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$306.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$373.91
|
| Rate for Payer: BCBS Transplant Transplant |
$3,583.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,691.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,902.88
|
| Rate for Payer: Caremore Medicare Advantage |
$2,001.01
|
| Rate for Payer: Cash Price |
$2,687.85
|
| Rate for Payer: Cash Price |
$2,687.85
|
| Rate for Payer: Central Health Plan Commercial |
$4,778.40
|
| Rate for Payer: Cigna of CA HMO |
$3,822.72
|
| Rate for Payer: Cigna of CA PPO |
$4,420.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,701.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,001.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,001.01
|
| Rate for Payer: Galaxy Health WC |
$5,077.05
|
| Rate for Payer: Global Benefits Group Commercial |
$3,583.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,375.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,479.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,281.66
|
| Rate for Payer: IEHP medi-cal |
$3,301.67
|
| Rate for Payer: IEHP Medicare Advantage |
$2,001.01
|
| Rate for Payer: Innovage PACE Commercial |
$3,001.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,983.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,194.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,681.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,681.35
|
| Rate for Payer: Multiplan Commercial |
$4,479.75
|
| Rate for Payer: Networks By Design Commercial |
$3,882.45
|
| Rate for Payer: Prime Health Services Commercial |
$5,077.05
|
| Rate for Payer: Prime Health Services Medicare |
$2,121.07
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,583.80
|
| Rate for Payer: Riverside University Health MISP |
$2,201.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,583.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,583.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,688.24
|
| Rate for Payer: United Healthcare All Other HMO |
$1,688.24
|
| Rate for Payer: United Healthcare HMO Rider |
$1,688.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,688.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Vantage Medical Group Senior |
$2,001.01
|
|
|
HC VENOGRAM EXRTM BILATERAL
|
Facility
IP
|
$5,973.00
|
|
|
Service Code
|
CPT 75822
|
| Hospital Charge Code |
906811381
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,194.60 |
| Max. Negotiated Rate |
$5,375.70 |
| Rate for Payer: Cash Price |
$2,687.85
|
| Rate for Payer: Central Health Plan Commercial |
$4,778.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,389.20
|
| Rate for Payer: Galaxy Health WC |
$5,077.05
|
| Rate for Payer: Global Benefits Group Commercial |
$3,583.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,375.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,983.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,194.60
|
| Rate for Payer: Multiplan Commercial |
$4,479.75
|
| Rate for Payer: Networks By Design Commercial |
$3,882.45
|
| Rate for Payer: Prime Health Services Commercial |
$5,077.05
|
|
