|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
OP
|
$2,790.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
906749080
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$1,143.90
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$596.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,898.06
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,232.00
|
| Rate for Payer: Cigna of CA HMO |
$1,785.60
|
| Rate for Payer: Cigna of CA PPO |
$2,064.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,953.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.77
|
| Rate for Payer: EPIC Health Plan Senior |
$1,283.18
|
| Rate for Payer: Galaxy Health WC |
$2,371.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,674.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,511.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,913.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,771.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$526.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,254.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$558.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,563.15
|
| Rate for Payer: Multiplan Commercial |
$2,092.50
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: Networks By Design Commercial |
$1,813.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Preferred Health Network WC |
$1,936.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,371.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,236.52
|
| Rate for Payer: Prime Health Services WC |
$1,878.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,283.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,674.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,674.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
|
|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
IP
|
$2,790.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
906749080
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$558.00 |
| Max. Negotiated Rate |
$2,511.00 |
| Rate for Payer: Adventist Health Commercial |
$558.00
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,232.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,953.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,116.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,116.00
|
| Rate for Payer: Galaxy Health WC |
$2,371.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,674.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,511.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,771.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,646.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$558.00
|
| Rate for Payer: Multiplan Commercial |
$2,092.50
|
| Rate for Payer: Networks By Design Commercial |
$1,813.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,371.50
|
|
|
HC ABD PARACENTESIS W IMAG GUID
|
Facility
|
OP
|
$2,140.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
901249083
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$428.00 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$428.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,166.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$596.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,356.76
|
| Rate for Payer: Blue Shield of California EPN |
$853.86
|
| Rate for Payer: Cash Price |
$963.00
|
| Rate for Payer: Cash Price |
$963.00
|
| Rate for Payer: Cash Price |
$963.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,712.00
|
| Rate for Payer: Cigna of CA HMO |
$1,369.60
|
| Rate for Payer: Cigna of CA PPO |
$1,583.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,498.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.77
|
| Rate for Payer: EPIC Health Plan Senior |
$1,283.18
|
| Rate for Payer: Galaxy Health WC |
$1,819.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,284.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,926.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,913.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$476.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,358.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$526.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,633.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$428.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,563.15
|
| Rate for Payer: Multiplan Commercial |
$1,605.00
|
| Rate for Payer: Networks By Design Commercial |
$1,391.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Prime Health Services Commercial |
$1,819.00
|
| Rate for Payer: Prime Health Services Medicare |
$1,236.52
|
| Rate for Payer: Riverside University Health System MISP |
$1,283.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,284.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,284.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,070.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,070.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,070.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,070.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
|
|
HC ABD PARACENTESIS W IMAG GUID
|
Facility
|
IP
|
$2,140.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
901249083
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$428.00 |
| Max. Negotiated Rate |
$1,926.00 |
| Rate for Payer: Adventist Health Commercial |
$428.00
|
| Rate for Payer: Cash Price |
$963.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,712.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,498.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$856.00
|
| Rate for Payer: EPIC Health Plan Senior |
$856.00
|
| Rate for Payer: Galaxy Health WC |
$1,819.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,284.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,926.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,358.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,262.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$428.00
|
| Rate for Payer: Multiplan Commercial |
$1,605.00
|
| Rate for Payer: Networks By Design Commercial |
$1,391.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,819.00
|
|
|
HC ABD PARACENTESIS W IMAG GUID
|
Facility
|
OP
|
$2,140.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
901249083
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$428.00 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$428.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,166.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$963.00
|
| Rate for Payer: Cash Price |
$963.00
|
| Rate for Payer: Cash Price |
$963.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,712.00
|
| Rate for Payer: Cigna of CA HMO |
$1,369.60
|
| Rate for Payer: Cigna of CA PPO |
$1,583.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,498.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.77
|
| Rate for Payer: EPIC Health Plan Senior |
$1,283.18
|
| Rate for Payer: Galaxy Health WC |
$1,819.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,284.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,926.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,913.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$476.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,358.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$526.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,633.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$428.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,563.15
|
| Rate for Payer: Multiplan Commercial |
$1,605.00
|
| Rate for Payer: Networks By Design Commercial |
$1,391.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Prime Health Services Commercial |
$1,819.00
|
| Rate for Payer: Prime Health Services Medicare |
$1,236.52
|
| Rate for Payer: Riverside University Health System MISP |
$1,283.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,284.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,399.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,070.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
|
|
HC ABD PARACENTESIS W IMAG GUID
|
Facility
|
IP
|
$2,140.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
901249083
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$428.00 |
| Max. Negotiated Rate |
$1,926.00 |
| Rate for Payer: Adventist Health Commercial |
$428.00
|
| Rate for Payer: Cash Price |
$963.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,712.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,498.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$856.00
|
| Rate for Payer: EPIC Health Plan Senior |
$856.00
|
| Rate for Payer: Galaxy Health WC |
$1,819.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,284.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,926.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,358.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,262.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$428.00
|
| Rate for Payer: Multiplan Commercial |
$1,605.00
|
| Rate for Payer: Networks By Design Commercial |
$1,391.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,819.00
|
|
|
HC ABD PARACENTESIS WO IMAGE GUID
|
Facility
|
OP
|
$2,886.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
901200098
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$100.53 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$577.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,166.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,898.06
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$1,298.70
|
| Rate for Payer: Cash Price |
$1,298.70
|
| Rate for Payer: Cash Price |
$1,298.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,308.80
|
| Rate for Payer: Cigna of CA HMO |
$1,847.04
|
| Rate for Payer: Cigna of CA PPO |
$2,135.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,020.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.77
|
| Rate for Payer: EPIC Health Plan Senior |
$1,283.18
|
| Rate for Payer: Galaxy Health WC |
$2,453.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,731.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,597.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,913.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$100.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,832.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$111.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,633.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$577.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,563.15
|
| Rate for Payer: Multiplan Commercial |
$2,164.50
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: Networks By Design Commercial |
$1,875.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Preferred Health Network WC |
$1,936.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,453.10
|
| Rate for Payer: Prime Health Services Medicare |
$1,236.52
|
| Rate for Payer: Prime Health Services WC |
$1,878.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,283.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,731.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,443.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
|
|
HC ABD PARACENTESIS WO IMAGE GUID
|
Facility
|
OP
|
$2,886.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
906749081
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$100.53 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$577.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,166.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,898.06
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$1,298.70
|
| Rate for Payer: Cash Price |
$1,298.70
|
| Rate for Payer: Cash Price |
$1,298.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,308.80
|
| Rate for Payer: Cigna of CA HMO |
$1,847.04
|
| Rate for Payer: Cigna of CA PPO |
$2,135.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,020.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.77
|
| Rate for Payer: EPIC Health Plan Senior |
$1,283.18
|
| Rate for Payer: Galaxy Health WC |
$2,453.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,731.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,597.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,913.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$100.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,832.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$111.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,633.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$577.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,563.15
|
| Rate for Payer: Multiplan Commercial |
$2,164.50
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: Networks By Design Commercial |
$1,875.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Preferred Health Network WC |
$1,936.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,453.10
|
| Rate for Payer: Prime Health Services Medicare |
$1,236.52
|
| Rate for Payer: Prime Health Services WC |
$1,878.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,283.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,731.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,443.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
|
|
HC ABD PARACENTESIS WO IMAGE GUID
|
Facility
|
IP
|
$2,886.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
901200098
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$577.20 |
| Max. Negotiated Rate |
$2,597.40 |
| Rate for Payer: Adventist Health Commercial |
$577.20
|
| Rate for Payer: Cash Price |
$1,298.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,308.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,020.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,154.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,154.40
|
| Rate for Payer: Galaxy Health WC |
$2,453.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,731.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,597.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,832.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,702.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$577.20
|
| Rate for Payer: Multiplan Commercial |
$2,164.50
|
| Rate for Payer: Networks By Design Commercial |
$1,875.90
|
| Rate for Payer: Prime Health Services Commercial |
$2,453.10
|
|
|
HC ABD PARACENTESIS WO IMAGE GUID
|
Facility
|
IP
|
$2,886.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
906749081
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$577.20 |
| Max. Negotiated Rate |
$2,597.40 |
| Rate for Payer: Adventist Health Commercial |
$577.20
|
| Rate for Payer: Cash Price |
$1,298.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,308.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,020.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,154.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,154.40
|
| Rate for Payer: Galaxy Health WC |
$2,453.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,731.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,597.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,832.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,702.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$577.20
|
| Rate for Payer: Multiplan Commercial |
$2,164.50
|
| Rate for Payer: Networks By Design Commercial |
$1,875.90
|
| Rate for Payer: Prime Health Services Commercial |
$2,453.10
|
|
|
HC ABD PARACENTESIS WO IMAGE GUIDE
|
Facility
|
IP
|
$2,886.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
901249082
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$577.20 |
| Max. Negotiated Rate |
$2,597.40 |
| Rate for Payer: Adventist Health Commercial |
$577.20
|
| Rate for Payer: Cash Price |
$1,298.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,308.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,020.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,154.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,154.40
|
| Rate for Payer: Galaxy Health WC |
$2,453.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,731.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,597.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,832.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,702.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$577.20
|
| Rate for Payer: Multiplan Commercial |
$2,164.50
|
| Rate for Payer: Networks By Design Commercial |
$1,875.90
|
| Rate for Payer: Prime Health Services Commercial |
$2,453.10
|
|
|
HC ABD PARACENTESIS WO IMAGE GUIDE
|
Facility
|
OP
|
$2,886.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
901249082
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$100.53 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$577.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,166.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,898.06
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$1,298.70
|
| Rate for Payer: Cash Price |
$1,298.70
|
| Rate for Payer: Cash Price |
$1,298.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,308.80
|
| Rate for Payer: Cigna of CA HMO |
$1,847.04
|
| Rate for Payer: Cigna of CA PPO |
$2,135.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,020.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.77
|
| Rate for Payer: EPIC Health Plan Senior |
$1,283.18
|
| Rate for Payer: Galaxy Health WC |
$2,453.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,731.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,597.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,913.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$100.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,832.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$111.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,633.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$577.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,563.15
|
| Rate for Payer: Multiplan Commercial |
$2,164.50
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: Networks By Design Commercial |
$1,875.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Preferred Health Network WC |
$1,936.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,453.10
|
| Rate for Payer: Prime Health Services Medicare |
$1,236.52
|
| Rate for Payer: Prime Health Services WC |
$1,878.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,283.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,731.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,443.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
|
|
HC ABD PARACENTESIS WO IMAGE GUIDE
|
Facility
|
OP
|
$2,886.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
901249082
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$100.53 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$577.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,166.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$1,298.70
|
| Rate for Payer: Cash Price |
$1,298.70
|
| Rate for Payer: Cash Price |
$1,298.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,308.80
|
| Rate for Payer: Cigna of CA HMO |
$1,847.04
|
| Rate for Payer: Cigna of CA PPO |
$2,135.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,020.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.77
|
| Rate for Payer: EPIC Health Plan Senior |
$1,283.18
|
| Rate for Payer: Galaxy Health WC |
$2,453.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,731.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,597.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,913.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$100.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,832.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$111.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,633.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$577.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,563.15
|
| Rate for Payer: Multiplan Commercial |
$2,164.50
|
| Rate for Payer: Networks By Design Commercial |
$1,875.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Prime Health Services Commercial |
$2,453.10
|
| Rate for Payer: Prime Health Services Medicare |
$1,236.52
|
| Rate for Payer: Riverside University Health System MISP |
$1,283.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,731.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,399.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,443.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
|
|
HC ABD PARACENTESIS WO IMAGE GUIDE
|
Facility
|
IP
|
$2,886.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
901249082
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$577.20 |
| Max. Negotiated Rate |
$2,597.40 |
| Rate for Payer: Adventist Health Commercial |
$577.20
|
| Rate for Payer: Cash Price |
$1,298.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,308.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,020.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,154.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,154.40
|
| Rate for Payer: Galaxy Health WC |
$2,453.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,731.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,597.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,832.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,702.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$577.20
|
| Rate for Payer: Multiplan Commercial |
$2,164.50
|
| Rate for Payer: Networks By Design Commercial |
$1,875.90
|
| Rate for Payer: Prime Health Services Commercial |
$2,453.10
|
|
|
HC ABD/PEL/LE ART, 1ST ORDR CA
|
Facility
|
OP
|
$2,201.00
|
|
|
Service Code
|
CPT 36245
|
| Hospital Charge Code |
909081315
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$348.99 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$440.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,870.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,210.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,650.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$990.45
|
| Rate for Payer: Cash Price |
$990.45
|
| Rate for Payer: Cash Price |
$990.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,760.80
|
| Rate for Payer: Cigna of CA HMO |
$1,408.64
|
| Rate for Payer: Cigna of CA PPO |
$1,628.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,870.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,870.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,870.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,540.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$880.40
|
| Rate for Payer: EPIC Health Plan Senior |
$880.40
|
| Rate for Payer: Galaxy Health WC |
$1,870.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,320.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,980.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$348.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,397.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$385.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,298.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$440.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,540.70
|
| Rate for Payer: Multiplan Commercial |
$1,650.75
|
| Rate for Payer: Networks By Design Commercial |
$1,430.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,870.85
|
| Rate for Payer: Riverside University Health System MISP |
$880.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,320.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,100.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,870.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,870.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,870.85
|
|
|
HC ABD/PEL/LE ART, 1ST ORDR CA
|
Facility
|
IP
|
$2,201.00
|
|
|
Service Code
|
CPT 36245
|
| Hospital Charge Code |
909081315
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$440.20 |
| Max. Negotiated Rate |
$1,980.90 |
| Rate for Payer: Adventist Health Commercial |
$440.20
|
| Rate for Payer: Cash Price |
$990.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,760.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,540.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$880.40
|
| Rate for Payer: EPIC Health Plan Senior |
$880.40
|
| Rate for Payer: Galaxy Health WC |
$1,870.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,320.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,980.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,397.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,298.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$440.20
|
| Rate for Payer: Multiplan Commercial |
$1,650.75
|
| Rate for Payer: Networks By Design Commercial |
$1,430.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,870.85
|
|
|
HC ABD/PEL/LE ART, 2ND ORDR CA
|
Facility
|
IP
|
$787.00
|
|
|
Service Code
|
CPT 36246
|
| Hospital Charge Code |
909081324
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$157.40 |
| Max. Negotiated Rate |
$708.30 |
| Rate for Payer: Adventist Health Commercial |
$157.40
|
| Rate for Payer: Cash Price |
$354.15
|
| Rate for Payer: Central Health Plan Commercial |
$629.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$550.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$314.80
|
| Rate for Payer: EPIC Health Plan Senior |
$314.80
|
| Rate for Payer: Galaxy Health WC |
$668.95
|
| Rate for Payer: Global Benefits Group Commercial |
$472.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$708.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$499.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$464.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$157.40
|
| Rate for Payer: Multiplan Commercial |
$590.25
|
| Rate for Payer: Networks By Design Commercial |
$511.55
|
| Rate for Payer: Prime Health Services Commercial |
$668.95
|
|
|
HC ABD/PEL/LE ART, 2ND ORDR CA
|
Facility
|
OP
|
$787.00
|
|
|
Service Code
|
CPT 36246
|
| Hospital Charge Code |
909081324
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$157.40 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$157.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$668.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$432.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$590.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$354.15
|
| Rate for Payer: Cash Price |
$354.15
|
| Rate for Payer: Cash Price |
$354.15
|
| Rate for Payer: Central Health Plan Commercial |
$629.60
|
| Rate for Payer: Cigna of CA HMO |
$503.68
|
| Rate for Payer: Cigna of CA PPO |
$582.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$668.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$668.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$668.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$550.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$314.80
|
| Rate for Payer: EPIC Health Plan Senior |
$314.80
|
| Rate for Payer: Galaxy Health WC |
$668.95
|
| Rate for Payer: Global Benefits Group Commercial |
$472.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$708.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$418.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$499.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$462.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$464.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$157.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$550.90
|
| Rate for Payer: Multiplan Commercial |
$590.25
|
| Rate for Payer: Networks By Design Commercial |
$511.55
|
| Rate for Payer: Prime Health Services Commercial |
$668.95
|
| Rate for Payer: Riverside University Health System MISP |
$314.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$472.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$393.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$668.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$668.95
|
| Rate for Payer: Vantage Medical Group Senior |
$668.95
|
|
|
HC ABD/PEL/LE ART, 3RD ORDR CA
|
Facility
|
OP
|
$787.00
|
|
|
Service Code
|
CPT 36247
|
| Hospital Charge Code |
909081325
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$157.40 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$157.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$668.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$432.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$590.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$354.15
|
| Rate for Payer: Cash Price |
$354.15
|
| Rate for Payer: Cash Price |
$354.15
|
| Rate for Payer: Central Health Plan Commercial |
$629.60
|
| Rate for Payer: Cigna of CA HMO |
$503.68
|
| Rate for Payer: Cigna of CA PPO |
$582.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$668.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$668.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$668.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$550.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$314.80
|
| Rate for Payer: EPIC Health Plan Senior |
$314.80
|
| Rate for Payer: Galaxy Health WC |
$668.95
|
| Rate for Payer: Global Benefits Group Commercial |
$472.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$708.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$498.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$499.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$550.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$464.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$157.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$550.90
|
| Rate for Payer: Multiplan Commercial |
$590.25
|
| Rate for Payer: Networks By Design Commercial |
$511.55
|
| Rate for Payer: Prime Health Services Commercial |
$668.95
|
| Rate for Payer: Riverside University Health System MISP |
$314.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$472.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$393.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$668.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$668.95
|
| Rate for Payer: Vantage Medical Group Senior |
$668.95
|
|
|
HC ABD/PEL/LE ART, 3RD ORDR CA
|
Facility
|
IP
|
$787.00
|
|
|
Service Code
|
CPT 36247
|
| Hospital Charge Code |
909081325
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$157.40 |
| Max. Negotiated Rate |
$708.30 |
| Rate for Payer: Adventist Health Commercial |
$157.40
|
| Rate for Payer: Cash Price |
$354.15
|
| Rate for Payer: Central Health Plan Commercial |
$629.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$550.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$314.80
|
| Rate for Payer: EPIC Health Plan Senior |
$314.80
|
| Rate for Payer: Galaxy Health WC |
$668.95
|
| Rate for Payer: Global Benefits Group Commercial |
$472.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$708.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$499.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$464.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$157.40
|
| Rate for Payer: Multiplan Commercial |
$590.25
|
| Rate for Payer: Networks By Design Commercial |
$511.55
|
| Rate for Payer: Prime Health Services Commercial |
$668.95
|
|
|
HC ABD/PEL/LE ART, ADDL 2ND/3R
|
Facility
|
IP
|
$650.00
|
|
|
Service Code
|
CPT 36248
|
| Hospital Charge Code |
909081326
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$130.00 |
| Max. Negotiated Rate |
$585.00 |
| Rate for Payer: Adventist Health Commercial |
$130.00
|
| Rate for Payer: Cash Price |
$292.50
|
| Rate for Payer: Central Health Plan Commercial |
$520.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$455.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$260.00
|
| Rate for Payer: EPIC Health Plan Senior |
$260.00
|
| Rate for Payer: Galaxy Health WC |
$552.50
|
| Rate for Payer: Global Benefits Group Commercial |
$390.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$585.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$412.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$383.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$130.00
|
| Rate for Payer: Multiplan Commercial |
$487.50
|
| Rate for Payer: Networks By Design Commercial |
$422.50
|
| Rate for Payer: Prime Health Services Commercial |
$552.50
|
|
|
HC ABD/PEL/LE ART, ADDL 2ND/3R
|
Facility
|
OP
|
$650.00
|
|
|
Service Code
|
CPT 36248
|
| Hospital Charge Code |
909081326
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$79.41 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$130.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$552.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$357.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$487.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$292.50
|
| Rate for Payer: Cash Price |
$292.50
|
| Rate for Payer: Cash Price |
$292.50
|
| Rate for Payer: Central Health Plan Commercial |
$520.00
|
| Rate for Payer: Cigna of CA HMO |
$416.00
|
| Rate for Payer: Cigna of CA PPO |
$481.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$552.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$552.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$552.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$455.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$260.00
|
| Rate for Payer: EPIC Health Plan Senior |
$260.00
|
| Rate for Payer: Galaxy Health WC |
$552.50
|
| Rate for Payer: Global Benefits Group Commercial |
$390.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$585.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$79.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$412.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$87.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$383.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$130.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$455.00
|
| Rate for Payer: Multiplan Commercial |
$487.50
|
| Rate for Payer: Networks By Design Commercial |
$422.50
|
| Rate for Payer: Prime Health Services Commercial |
$552.50
|
| Rate for Payer: Riverside University Health System MISP |
$260.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$390.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$325.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$552.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$552.50
|
| Rate for Payer: Vantage Medical Group Senior |
$552.50
|
|
|
HC ABDUCTION BAR ADDITION LE
|
Facility
|
OP
|
$782.00
|
|
|
Service Code
|
CPT L2300
|
| Hospital Charge Code |
915352300
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$256.11 |
| Max. Negotiated Rate |
$703.80 |
| Rate for Payer: Adventist Health Commercial |
$320.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$664.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$430.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$586.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$454.89
|
| Rate for Payer: Blue Shield of California Commercial |
$627.16
|
| Rate for Payer: Blue Shield of California EPN |
$394.13
|
| Rate for Payer: Cash Price |
$351.90
|
| Rate for Payer: Cash Price |
$351.90
|
| Rate for Payer: Central Health Plan Commercial |
$625.60
|
| Rate for Payer: Cigna of CA HMO |
$547.40
|
| Rate for Payer: Cigna of CA PPO |
$547.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$664.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$664.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$664.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$547.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$312.80
|
| Rate for Payer: EPIC Health Plan Senior |
$312.80
|
| Rate for Payer: Galaxy Health WC |
$664.70
|
| Rate for Payer: Global Benefits Group Commercial |
$469.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$703.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$371.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$496.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$410.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$461.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$320.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$547.40
|
| Rate for Payer: Multiplan Commercial |
$586.50
|
| Rate for Payer: Networks By Design Commercial |
$391.00
|
| Rate for Payer: Prime Health Services Commercial |
$664.70
|
| Rate for Payer: Riverside University Health System MISP |
$312.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$469.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$469.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$293.48
|
| Rate for Payer: United Healthcare All Other HMO |
$285.66
|
| Rate for Payer: United Healthcare HMO Rider |
$279.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$256.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$664.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$664.70
|
| Rate for Payer: Vantage Medical Group Senior |
$664.70
|
|
|
HC ABDUCTION BAR ADDITION LE
|
Facility
|
IP
|
$782.00
|
|
|
Service Code
|
CPT L2300
|
| Hospital Charge Code |
905352300
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$156.40 |
| Max. Negotiated Rate |
$703.80 |
| Rate for Payer: Adventist Health Commercial |
$156.40
|
| Rate for Payer: Blue Shield of California Commercial |
$627.16
|
| Rate for Payer: Blue Shield of California EPN |
$394.13
|
| Rate for Payer: Cash Price |
$351.90
|
| Rate for Payer: Central Health Plan Commercial |
$625.60
|
| Rate for Payer: Cigna of CA HMO |
$547.40
|
| Rate for Payer: Cigna of CA PPO |
$547.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$547.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$312.80
|
| Rate for Payer: EPIC Health Plan Senior |
$312.80
|
| Rate for Payer: Galaxy Health WC |
$664.70
|
| Rate for Payer: Global Benefits Group Commercial |
$469.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$703.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$496.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$461.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$156.40
|
| Rate for Payer: Multiplan Commercial |
$586.50
|
| Rate for Payer: Networks By Design Commercial |
$508.30
|
| Rate for Payer: Prime Health Services Commercial |
$664.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$293.48
|
| Rate for Payer: United Healthcare All Other HMO |
$285.66
|
| Rate for Payer: United Healthcare HMO Rider |
$279.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$256.11
|
|
|
HC ABDUCTION BAR ADDITION LE
|
Facility
|
IP
|
$782.00
|
|
|
Service Code
|
CPT L2300
|
| Hospital Charge Code |
915352300
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$156.40 |
| Max. Negotiated Rate |
$703.80 |
| Rate for Payer: Adventist Health Commercial |
$156.40
|
| Rate for Payer: Blue Shield of California Commercial |
$627.16
|
| Rate for Payer: Blue Shield of California EPN |
$394.13
|
| Rate for Payer: Cash Price |
$351.90
|
| Rate for Payer: Central Health Plan Commercial |
$625.60
|
| Rate for Payer: Cigna of CA HMO |
$547.40
|
| Rate for Payer: Cigna of CA PPO |
$547.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$547.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$312.80
|
| Rate for Payer: EPIC Health Plan Senior |
$312.80
|
| Rate for Payer: Galaxy Health WC |
$664.70
|
| Rate for Payer: Global Benefits Group Commercial |
$469.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$703.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$496.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$461.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$156.40
|
| Rate for Payer: Multiplan Commercial |
$586.50
|
| Rate for Payer: Networks By Design Commercial |
$508.30
|
| Rate for Payer: Prime Health Services Commercial |
$664.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$293.48
|
| Rate for Payer: United Healthcare All Other HMO |
$285.66
|
| Rate for Payer: United Healthcare HMO Rider |
$279.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$256.11
|
|
