|
LANTHANUM 1,000 MG CHEWABLE TABLET [43548]
|
Facility
OP
|
$12.95
|
|
|
Service Code
|
NDC 66993-424-85
|
| Hospital Charge Code |
1711937
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$2.59 |
| Max. Negotiated Rate |
$11.66 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.86
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.01
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.65
|
| Rate for Payer: BCBS Transplant Transplant |
$7.77
|
| Rate for Payer: Blue Shield of California Commercial |
$8.15
|
| Rate for Payer: Blue Shield of California EPN |
$6.33
|
| Rate for Payer: Cash Price |
$5.83
|
| Rate for Payer: Central Health Plan Commercial |
$10.36
|
| Rate for Payer: Cigna of CA HMO |
$9.06
|
| Rate for Payer: Cigna of CA PPO |
$9.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.18
|
| Rate for Payer: Galaxy Health WC |
$11.01
|
| Rate for Payer: Global Benefits Group Commercial |
$7.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.66
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.71
|
| Rate for Payer: IEHP medi-cal |
$4.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.59
|
| Rate for Payer: Multiplan Commercial |
$9.71
|
| Rate for Payer: Networks By Design Commercial |
$8.42
|
| Rate for Payer: Prime Health Services Commercial |
$11.01
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.77
|
| Rate for Payer: Riverside University Health MISP |
$5.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.77
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.48
|
| Rate for Payer: United Healthcare All Other HMO |
$6.48
|
| Rate for Payer: United Healthcare HMO Rider |
$6.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.01
|
| Rate for Payer: Vantage Medical Group Senior |
$11.01
|
|
|
LANTHANUM 1,000 MG CHEWABLE TABLET [43548]
|
Facility
IP
|
$12.95
|
|
|
Service Code
|
NDC 66993-424-85
|
| Hospital Charge Code |
1711937
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$2.59 |
| Max. Negotiated Rate |
$11.66 |
| Rate for Payer: Blue Shield of California Commercial |
$9.71
|
| Rate for Payer: Blue Shield of California EPN |
$6.92
|
| Rate for Payer: Cash Price |
$5.83
|
| Rate for Payer: Central Health Plan Commercial |
$10.36
|
| Rate for Payer: Cigna of CA HMO |
$9.06
|
| Rate for Payer: Cigna of CA PPO |
$9.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.18
|
| Rate for Payer: Galaxy Health WC |
$11.01
|
| Rate for Payer: Global Benefits Group Commercial |
$7.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.59
|
| Rate for Payer: Multiplan Commercial |
$9.71
|
| Rate for Payer: Networks By Design Commercial |
$8.42
|
| Rate for Payer: Prime Health Services Commercial |
$11.01
|
|
|
LANTHANUM 1,000 MG CHEWABLE TABLET [43548]
|
Facility
OP
|
$12.95
|
|
|
Service Code
|
NDC 66993-424-75
|
| Hospital Charge Code |
1711937
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$2.59 |
| Max. Negotiated Rate |
$11.66 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.86
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.01
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.65
|
| Rate for Payer: BCBS Transplant Transplant |
$7.77
|
| Rate for Payer: Blue Shield of California Commercial |
$8.15
|
| Rate for Payer: Blue Shield of California EPN |
$6.33
|
| Rate for Payer: Cash Price |
$5.83
|
| Rate for Payer: Central Health Plan Commercial |
$10.36
|
| Rate for Payer: Cigna of CA HMO |
$9.06
|
| Rate for Payer: Cigna of CA PPO |
$9.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.18
|
| Rate for Payer: Galaxy Health WC |
$11.01
|
| Rate for Payer: Global Benefits Group Commercial |
$7.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.66
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.71
|
| Rate for Payer: IEHP medi-cal |
$4.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.59
|
| Rate for Payer: Multiplan Commercial |
$9.71
|
| Rate for Payer: Networks By Design Commercial |
$8.42
|
| Rate for Payer: Prime Health Services Commercial |
$11.01
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.77
|
| Rate for Payer: Riverside University Health MISP |
$5.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.77
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.48
|
| Rate for Payer: United Healthcare All Other HMO |
$6.48
|
| Rate for Payer: United Healthcare HMO Rider |
$6.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.01
|
| Rate for Payer: Vantage Medical Group Senior |
$11.01
|
|
|
LANTHANUM 500 MG CHEWABLE TABLET [39975]
|
Facility
OP
|
$14.41
|
|
|
Service Code
|
NDC 54092-252-45
|
| Hospital Charge Code |
1711939
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$2.88 |
| Max. Negotiated Rate |
$12.97 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8.75
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.93
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.51
|
| Rate for Payer: BCBS Transplant Transplant |
$8.65
|
| Rate for Payer: Blue Shield of California Commercial |
$9.06
|
| Rate for Payer: Blue Shield of California EPN |
$7.05
|
| Rate for Payer: Cash Price |
$6.48
|
| Rate for Payer: Central Health Plan Commercial |
$11.53
|
| Rate for Payer: Cigna of CA HMO |
$10.09
|
| Rate for Payer: Cigna of CA PPO |
$10.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.76
|
| Rate for Payer: Galaxy Health WC |
$12.25
|
| Rate for Payer: Global Benefits Group Commercial |
$8.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.97
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$10.81
|
| Rate for Payer: IEHP medi-cal |
$5.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.88
|
| Rate for Payer: Multiplan Commercial |
$10.81
|
| Rate for Payer: Networks By Design Commercial |
$9.37
|
| Rate for Payer: Prime Health Services Commercial |
$12.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$8.65
|
| Rate for Payer: Riverside University Health MISP |
$5.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.20
|
| Rate for Payer: United Healthcare All Other HMO |
$7.20
|
| Rate for Payer: United Healthcare HMO Rider |
$7.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.25
|
| Rate for Payer: Vantage Medical Group Senior |
$12.25
|
|
|
LANTHANUM 500 MG CHEWABLE TABLET [39975]
|
Facility
IP
|
$14.41
|
|
|
Service Code
|
NDC 54092-252-45
|
| Hospital Charge Code |
1711939
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$2.88 |
| Max. Negotiated Rate |
$12.97 |
| Rate for Payer: Blue Shield of California Commercial |
$10.81
|
| Rate for Payer: Blue Shield of California EPN |
$7.69
|
| Rate for Payer: Cash Price |
$6.48
|
| Rate for Payer: Central Health Plan Commercial |
$11.53
|
| Rate for Payer: Cigna of CA HMO |
$10.09
|
| Rate for Payer: Cigna of CA PPO |
$10.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.76
|
| Rate for Payer: Galaxy Health WC |
$12.25
|
| Rate for Payer: Global Benefits Group Commercial |
$8.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.88
|
| Rate for Payer: Multiplan Commercial |
$10.81
|
| Rate for Payer: Networks By Design Commercial |
$9.37
|
| Rate for Payer: Prime Health Services Commercial |
$12.25
|
|
|
Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy
|
Facility
OP
|
$27,445.00
|
|
|
Service Code
|
CPT 59151
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,572.00 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,209.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,813.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,209.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$7,209.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,813.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,732.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,209.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,209.21
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,823.10
|
| Rate for Payer: IEHP medi-cal |
$11,895.20
|
| Rate for Payer: IEHP Medicare Advantage |
$7,209.21
|
| Rate for Payer: Innovage PACE Commercial |
$10,813.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,209.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,660.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,660.34
|
| Rate for Payer: Prime Health Services Medicare |
$7,641.76
|
| Rate for Payer: Riverside University Health MISP |
$7,930.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,813.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: Vantage Medical Group Senior |
$7,209.21
|
|
|
Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)
|
Facility
OP
|
$25,512.00
|
|
|
Service Code
|
CPT 49320
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,383.18 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,209.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,813.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,209.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Caremore Medicare Advantage |
$7,209.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,813.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,732.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,209.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,209.21
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,823.10
|
| Rate for Payer: IEHP medi-cal |
$11,895.20
|
| Rate for Payer: IEHP Medicare Advantage |
$7,209.21
|
| Rate for Payer: Innovage PACE Commercial |
$10,813.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,209.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,660.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,660.34
|
| Rate for Payer: Prime Health Services Medicare |
$7,641.76
|
| Rate for Payer: Riverside University Health MISP |
$7,930.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,813.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: Vantage Medical Group Senior |
$7,209.21
|
|
|
Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency
|
Facility
OP
|
$27,445.00
|
|
|
Service Code
|
CPT 58674
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,183.44 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$12,861.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12,861.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$17,583.26
|
| Rate for Payer: Blue Shield of California Commercial |
$5,824.53
|
| Rate for Payer: Blue Shield of California EPN |
$4,183.44
|
| Rate for Payer: Caremore Medicare Advantage |
$12,861.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,291.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,362.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,861.31
|
| Rate for Payer: EPIC Health Plan Transplant |
$12,861.31
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21,092.55
|
| Rate for Payer: IEHP medi-cal |
$21,221.16
|
| Rate for Payer: IEHP Medicare Advantage |
$12,861.31
|
| Rate for Payer: Innovage PACE Commercial |
$19,291.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,861.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,234.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,234.16
|
| Rate for Payer: Multiplan WC |
$17,583.26
|
| Rate for Payer: Preferred Health Network WC |
$17,942.10
|
| Rate for Payer: Prime Health Services Medicare |
$13,632.99
|
| Rate for Payer: Prime Health Services WC |
$17,403.84
|
| Rate for Payer: Riverside University Health MISP |
$14,147.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: Vantage Medical Group Senior |
$12,861.31
|
|
|
Laparoscopy, surgical, appendectomy
|
Facility
OP
|
$27,445.00
|
|
|
Service Code
|
CPT 44970
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,209.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,813.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,209.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$7,209.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,813.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,732.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,209.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,209.21
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,823.10
|
| Rate for Payer: IEHP medi-cal |
$11,895.20
|
| Rate for Payer: IEHP Medicare Advantage |
$7,209.21
|
| Rate for Payer: Innovage PACE Commercial |
$10,813.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,209.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,660.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,660.34
|
| Rate for Payer: Prime Health Services Medicare |
$7,641.76
|
| Rate for Payer: Riverside University Health MISP |
$7,930.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,813.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: Vantage Medical Group Senior |
$7,209.21
|
|
|
Laparoscopy, surgical; cholecystectomy
|
Facility
OP
|
$27,445.00
|
|
|
Service Code
|
CPT 47562
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,603.71 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,209.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,813.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,209.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$7,209.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,813.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,732.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,209.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,209.21
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,823.10
|
| Rate for Payer: IEHP medi-cal |
$11,895.20
|
| Rate for Payer: IEHP Medicare Advantage |
$7,209.21
|
| Rate for Payer: Innovage PACE Commercial |
$10,813.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,209.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,660.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,660.34
|
| Rate for Payer: Prime Health Services Medicare |
$7,641.76
|
| Rate for Payer: Riverside University Health MISP |
$7,930.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,813.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: Vantage Medical Group Senior |
$7,209.21
|
|
|
Laparoscopy, surgical; cholecystectomy with cholangiography
|
Facility
OP
|
$27,445.00
|
|
|
Service Code
|
CPT 47563
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,603.71 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,209.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,813.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,209.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$7,209.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,813.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,732.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,209.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,209.21
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,823.10
|
| Rate for Payer: IEHP medi-cal |
$11,895.20
|
| Rate for Payer: IEHP Medicare Advantage |
$7,209.21
|
| Rate for Payer: Innovage PACE Commercial |
$10,813.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,209.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,660.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,660.34
|
| Rate for Payer: Prime Health Services Medicare |
$7,641.76
|
| Rate for Payer: Riverside University Health MISP |
$7,930.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,813.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: Vantage Medical Group Senior |
$7,209.21
|
|
|
Laparoscopy, surgical, colpopexy (suspension of vaginal apex)
|
Facility
OP
|
$27,445.00
|
|
|
Service Code
|
CPT 57425
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$12,861.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12,861.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$17,583.26
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$12,861.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,291.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,362.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,861.31
|
| Rate for Payer: EPIC Health Plan Transplant |
$12,861.31
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21,092.55
|
| Rate for Payer: IEHP medi-cal |
$21,221.16
|
| Rate for Payer: IEHP Medicare Advantage |
$12,861.31
|
| Rate for Payer: Innovage PACE Commercial |
$19,291.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,861.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,234.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,234.16
|
| Rate for Payer: Multiplan WC |
$17,583.26
|
| Rate for Payer: Preferred Health Network WC |
$17,942.10
|
| Rate for Payer: Prime Health Services Medicare |
$13,632.99
|
| Rate for Payer: Prime Health Services WC |
$17,403.84
|
| Rate for Payer: Riverside University Health MISP |
$14,147.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: Vantage Medical Group Senior |
$12,861.31
|
|
|
Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure)
|
Facility
OP
|
$27,445.00
|
|
|
Service Code
|
CPT 44180
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,383.18 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,209.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,813.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,209.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Caremore Medicare Advantage |
$7,209.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,813.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,732.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,209.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,209.21
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,823.10
|
| Rate for Payer: IEHP medi-cal |
$11,895.20
|
| Rate for Payer: IEHP Medicare Advantage |
$7,209.21
|
| Rate for Payer: Innovage PACE Commercial |
$10,813.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,209.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,660.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,660.34
|
| Rate for Payer: Prime Health Services Medicare |
$7,641.76
|
| Rate for Payer: Riverside University Health MISP |
$7,930.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,813.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: Vantage Medical Group Senior |
$7,209.21
|
|
|
Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet procedures)
|
Facility
OP
|
$27,445.00
|
|
|
Service Code
|
CPT 43280
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$8,405.00 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$12,861.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12,861.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,254.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$17,583.26
|
| Rate for Payer: Blue Shield of California Commercial |
$12,373.72
|
| Rate for Payer: Blue Shield of California EPN |
$8,887.36
|
| Rate for Payer: Caremore Medicare Advantage |
$12,861.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,291.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,362.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,861.31
|
| Rate for Payer: EPIC Health Plan Transplant |
$12,861.31
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21,092.55
|
| Rate for Payer: IEHP medi-cal |
$21,221.16
|
| Rate for Payer: IEHP Medicare Advantage |
$12,861.31
|
| Rate for Payer: Innovage PACE Commercial |
$19,291.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,861.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,234.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,234.16
|
| Rate for Payer: Multiplan WC |
$17,583.26
|
| Rate for Payer: Preferred Health Network WC |
$17,942.10
|
| Rate for Payer: Prime Health Services Medicare |
$13,632.99
|
| Rate for Payer: Prime Health Services WC |
$17,403.84
|
| Rate for Payer: Riverside University Health MISP |
$14,147.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: Vantage Medical Group Senior |
$12,861.31
|
|
|
Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only
|
Facility
OP
|
$19,907.00
|
|
|
Service Code
|
CPT 43772
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,183.44 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,785.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,177.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,263.53
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,785.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,824.53
|
| Rate for Payer: Blue Shield of California EPN |
$4,183.44
|
| Rate for Payer: Caremore Medicare Advantage |
$4,785.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,177.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,459.79
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,785.03
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,785.03
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,847.45
|
| Rate for Payer: IEHP medi-cal |
$7,895.30
|
| Rate for Payer: IEHP Medicare Advantage |
$4,785.03
|
| Rate for Payer: Innovage PACE Commercial |
$7,177.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,785.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,411.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,411.94
|
| Rate for Payer: Prime Health Services Medicare |
$5,072.13
|
| Rate for Payer: Riverside University Health MISP |
$5,263.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,177.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,263.53
|
| Rate for Payer: Vantage Medical Group Senior |
$4,785.03
|
|
|
Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy (roux limb 150 cm or less)
|
Facility
OP
|
$27,445.00
|
|
|
Service Code
|
CPT 43644
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8,700.85
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
|
|
Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal of surface myomas
|
Facility
OP
|
$25,512.00
|
|
|
Service Code
|
CPT 58545
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,572.00 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,209.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,417.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,813.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,209.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Blue Shield of California Commercial |
$12,373.72
|
| Rate for Payer: Blue Shield of California EPN |
$8,887.36
|
| Rate for Payer: Caremore Medicare Advantage |
$7,209.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,813.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,732.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,209.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,209.21
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,823.10
|
| Rate for Payer: IEHP medi-cal |
$11,895.20
|
| Rate for Payer: IEHP Medicare Advantage |
$7,209.21
|
| Rate for Payer: Innovage PACE Commercial |
$10,813.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,209.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,660.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,660.34
|
| Rate for Payer: Prime Health Services Medicare |
$7,641.76
|
| Rate for Payer: Riverside University Health MISP |
$7,930.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,813.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: Vantage Medical Group Senior |
$7,209.21
|
|
|
Laparoscopy, surgical, myomectomy, excision; 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g
|
Facility
OP
|
$27,445.00
|
|
|
Service Code
|
CPT 58546
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,877.00 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$12,861.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12,861.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$17,583.26
|
| Rate for Payer: Blue Shield of California Commercial |
$12,373.72
|
| Rate for Payer: Blue Shield of California EPN |
$8,887.36
|
| Rate for Payer: Caremore Medicare Advantage |
$12,861.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,291.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,362.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,861.31
|
| Rate for Payer: EPIC Health Plan Transplant |
$12,861.31
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21,092.55
|
| Rate for Payer: IEHP medi-cal |
$21,221.16
|
| Rate for Payer: IEHP Medicare Advantage |
$12,861.31
|
| Rate for Payer: Innovage PACE Commercial |
$19,291.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,861.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,234.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,234.16
|
| Rate for Payer: Multiplan WC |
$17,583.26
|
| Rate for Payer: Preferred Health Network WC |
$17,942.10
|
| Rate for Payer: Prime Health Services Medicare |
$13,632.99
|
| Rate for Payer: Prime Health Services WC |
$17,403.84
|
| Rate for Payer: Riverside University Health MISP |
$14,147.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: Vantage Medical Group Senior |
$12,861.31
|
|
|
Laparoscopy, surgical; nephrectomy, including partial ureterectomy
|
Facility
OP
|
$11,071.00
|
|
|
Service Code
|
CPT 50546
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,212.08 |
| Max. Negotiated Rate |
$11,071.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
|
|
Laparoscopy, surgical; partial nephrectomy
|
Facility
OP
|
$27,445.00
|
|
|
Service Code
|
CPT 50543
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,603.71 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$12,861.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12,861.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,254.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$17,583.26
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$12,861.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,291.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,362.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,861.31
|
| Rate for Payer: EPIC Health Plan Transplant |
$12,861.31
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21,092.55
|
| Rate for Payer: IEHP medi-cal |
$21,221.16
|
| Rate for Payer: IEHP Medicare Advantage |
$12,861.31
|
| Rate for Payer: Innovage PACE Commercial |
$19,291.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,861.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,234.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,234.16
|
| Rate for Payer: Multiplan WC |
$17,583.26
|
| Rate for Payer: Preferred Health Network WC |
$17,942.10
|
| Rate for Payer: Prime Health Services Medicare |
$13,632.99
|
| Rate for Payer: Prime Health Services WC |
$17,403.84
|
| Rate for Payer: Riverside University Health MISP |
$14,147.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: Vantage Medical Group Senior |
$12,861.31
|
|
|
Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed
|
Facility
OP
|
$48,045.00
|
|
|
Service Code
|
CPT 55866
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,212.08 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$12,861.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12,861.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,254.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$17,583.26
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$12,861.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,291.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,362.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,861.31
|
| Rate for Payer: EPIC Health Plan Transplant |
$12,861.31
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21,092.55
|
| Rate for Payer: IEHP medi-cal |
$21,221.16
|
| Rate for Payer: IEHP Medicare Advantage |
$12,861.31
|
| Rate for Payer: Innovage PACE Commercial |
$19,291.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,861.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,234.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,234.16
|
| Rate for Payer: Multiplan WC |
$17,583.26
|
| Rate for Payer: Preferred Health Network WC |
$17,942.10
|
| Rate for Payer: Prime Health Services Medicare |
$13,632.99
|
| Rate for Payer: Prime Health Services WC |
$17,403.84
|
| Rate for Payer: Riverside University Health MISP |
$14,147.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: Vantage Medical Group Senior |
$12,861.31
|
|
|
Laparoscopy, surgical; pyeloplasty
|
Facility
OP
|
$27,445.00
|
|
|
Service Code
|
CPT 50544
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$12,861.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12,861.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$17,583.26
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$12,861.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,291.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,362.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,861.31
|
| Rate for Payer: EPIC Health Plan Transplant |
$12,861.31
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21,092.55
|
| Rate for Payer: IEHP medi-cal |
$21,221.16
|
| Rate for Payer: IEHP Medicare Advantage |
$12,861.31
|
| Rate for Payer: Innovage PACE Commercial |
$19,291.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,861.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,234.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,234.16
|
| Rate for Payer: Multiplan WC |
$17,583.26
|
| Rate for Payer: Preferred Health Network WC |
$17,942.10
|
| Rate for Payer: Prime Health Services Medicare |
$13,632.99
|
| Rate for Payer: Prime Health Services WC |
$17,403.84
|
| Rate for Payer: Riverside University Health MISP |
$14,147.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: Vantage Medical Group Senior |
$12,861.31
|
|
|
Laparoscopy, surgical; repair initial inguinal hernia
|
Facility
OP
|
$27,445.00
|
|
|
Service Code
|
CPT 49650
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,183.44 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,209.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,813.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,209.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,824.53
|
| Rate for Payer: Blue Shield of California EPN |
$4,183.44
|
| Rate for Payer: Caremore Medicare Advantage |
$7,209.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,813.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,732.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,209.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,209.21
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,823.10
|
| Rate for Payer: IEHP medi-cal |
$11,895.20
|
| Rate for Payer: IEHP Medicare Advantage |
$7,209.21
|
| Rate for Payer: Innovage PACE Commercial |
$10,813.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,209.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,660.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,660.34
|
| Rate for Payer: Prime Health Services Medicare |
$7,641.76
|
| Rate for Payer: Riverside University Health MISP |
$7,930.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,813.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: Vantage Medical Group Senior |
$7,209.21
|
|
|
Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh
|
Facility
OP
|
$27,445.00
|
|
|
Service Code
|
CPT 43282
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,603.71 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$12,861.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12,861.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,254.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$17,583.26
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$12,861.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,291.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,362.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,861.31
|
| Rate for Payer: EPIC Health Plan Transplant |
$12,861.31
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21,092.55
|
| Rate for Payer: IEHP medi-cal |
$21,221.16
|
| Rate for Payer: IEHP Medicare Advantage |
$12,861.31
|
| Rate for Payer: Innovage PACE Commercial |
$19,291.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,861.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,234.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,234.16
|
| Rate for Payer: Multiplan WC |
$17,583.26
|
| Rate for Payer: Preferred Health Network WC |
$17,942.10
|
| Rate for Payer: Prime Health Services Medicare |
$13,632.99
|
| Rate for Payer: Prime Health Services WC |
$17,403.84
|
| Rate for Payer: Riverside University Health MISP |
$14,147.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: Vantage Medical Group Senior |
$12,861.31
|
|
|
Laparoscopy, surgical; repair recurrent inguinal hernia
|
Facility
OP
|
$27,445.00
|
|
|
Service Code
|
CPT 49651
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,419.00 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,209.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,813.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,209.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$7,209.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,813.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,732.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,209.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,209.21
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,823.10
|
| Rate for Payer: IEHP medi-cal |
$11,895.20
|
| Rate for Payer: IEHP Medicare Advantage |
$7,209.21
|
| Rate for Payer: Innovage PACE Commercial |
$10,813.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,209.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,660.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,660.34
|
| Rate for Payer: Prime Health Services Medicare |
$7,641.76
|
| Rate for Payer: Riverside University Health MISP |
$7,930.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,813.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: Vantage Medical Group Senior |
$7,209.21
|
|
