|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
IP
|
$2,790.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
901200037
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$558.00 |
| Max. Negotiated Rate |
$2,511.00 |
| Rate for Payer: Adventist Health Commercial |
$558.00
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,232.00
|
| 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 Permanente of CA Commercial/Self Funded |
$1,860.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,062.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,727.01
|
| 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 IMAGE GUID
|
Facility
|
OP
|
$2,790.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
901200097
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$476.25 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$558.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,191.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,898.06
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Cash Price |
$1,534.50
|
| 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 |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,608.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,191.26
|
| 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 |
$1,953.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$476.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: InnovAge PACE Commercial |
$1,786.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,860.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$526.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,191.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$558.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,596.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,596.29
|
| 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 |
$1,191.26
|
| 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 |
$1,262.74
|
| Rate for Payer: Prime Health Services WC |
$1,878.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,310.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,674.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,191.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
OP
|
$2,790.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
906749080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$476.25 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$558.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,191.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,898.06
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Cash Price |
$1,534.50
|
| 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 |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,608.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,191.26
|
| 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 |
$1,953.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$476.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: InnovAge PACE Commercial |
$1,786.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,860.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$526.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,191.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$558.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,596.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,596.29
|
| 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 |
$1,191.26
|
| 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 |
$1,262.74
|
| Rate for Payer: Prime Health Services WC |
$1,878.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,310.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,674.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,191.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
IP
|
$2,790.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
901200097
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$558.00 |
| Max. Negotiated Rate |
$2,511.00 |
| Rate for Payer: Adventist Health Commercial |
$558.00
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,232.00
|
| 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 Permanente of CA Commercial/Self Funded |
$1,860.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,062.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,727.01
|
| 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 IMAGE GUID
|
Facility
|
OP
|
$2,790.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
906749080
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Commercial |
$558.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,898.06
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Cash Price |
$1,534.50
|
| 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 |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,608.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,191.26
|
| 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 |
$1,953.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: InnovAge PACE Commercial |
$1,786.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,860.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$526.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,191.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$558.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,596.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,596.29
|
| 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 |
$1,191.26
|
| 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 |
$1,262.74
|
| Rate for Payer: Prime Health Services WC |
$1,878.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,310.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,674.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,395.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,395.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,395.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,395.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,191.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
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 |
$6,248.00 |
| 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 |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,898.06
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Cash Price |
$1,534.50
|
| 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 |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,608.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,191.26
|
| 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 |
$1,953.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: InnovAge PACE Commercial |
$1,786.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,860.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$526.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,191.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$558.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,596.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,596.29
|
| 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 |
$1,191.26
|
| 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 |
$1,262.74
|
| Rate for Payer: Prime Health Services WC |
$1,878.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,310.39
|
| 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 |
$1,191.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
IP
|
$2,790.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
906749080
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$558.00 |
| Max. Negotiated Rate |
$2,511.00 |
| Rate for Payer: Adventist Health Commercial |
$558.00
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,232.00
|
| 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 Permanente of CA Commercial/Self Funded |
$1,860.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,062.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,727.01
|
| 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
|
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 |
$1,177.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,712.00
|
| 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 Permanente of CA Commercial/Self Funded |
$1,427.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$815.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,324.66
|
| 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
|
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 |
$1,177.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,712.00
|
| 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 Permanente of CA Commercial/Self Funded |
$1,427.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$815.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,324.66
|
| 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 |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$428.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,191.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,177.00
|
| Rate for Payer: Cash Price |
$1,177.00
|
| Rate for Payer: Cash Price |
$1,177.00
|
| 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 |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,608.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,191.26
|
| 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 |
$1,953.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$476.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: InnovAge PACE Commercial |
$1,786.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,427.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$526.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,191.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$428.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,596.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,596.29
|
| 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 |
$1,191.26
|
| Rate for Payer: Prime Health Services Commercial |
$1,819.00
|
| Rate for Payer: Prime Health Services Medicare |
$1,262.74
|
| Rate for Payer: Riverside University Health System MISP |
$1,310.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,284.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,429.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,191.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
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 |
$6,248.00 |
| Rate for Payer: Adventist Health Commercial |
$428.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,191.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,307.54
|
| Rate for Payer: Blue Shield of California EPN |
$853.86
|
| Rate for Payer: Cash Price |
$1,177.00
|
| Rate for Payer: Cash Price |
$1,177.00
|
| Rate for Payer: Cash Price |
$1,177.00
|
| 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 |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,608.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,191.26
|
| 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 |
$1,953.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$476.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: InnovAge PACE Commercial |
$1,786.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,427.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$526.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,191.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$428.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,596.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,596.29
|
| 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 |
$1,191.26
|
| Rate for Payer: Prime Health Services Commercial |
$1,819.00
|
| Rate for Payer: Prime Health Services Medicare |
$1,262.74
|
| Rate for Payer: Riverside University Health System MISP |
$1,310.39
|
| 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 |
$1,191.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
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 |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$577.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,191.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,397.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,694.95
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,898.06
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$1,587.30
|
| Rate for Payer: Cash Price |
$1,587.30
|
| Rate for Payer: Cash Price |
$1,587.30
|
| 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 |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,608.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,191.26
|
| 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 |
$1,953.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$100.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: InnovAge PACE Commercial |
$1,786.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,924.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,191.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$577.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,596.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,596.29
|
| 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 |
$1,191.26
|
| 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 |
$1,262.74
|
| Rate for Payer: Prime Health Services WC |
$1,878.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,310.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,731.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,191.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
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 |
$1,587.30
|
| Rate for Payer: Central Health Plan Commercial |
$2,308.80
|
| 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 Permanente of CA Commercial/Self Funded |
$1,924.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,099.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,786.43
|
| 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
|
OP
|
$2,886.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
906749081
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$100.53 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$577.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,191.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,397.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,694.95
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,898.06
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$1,587.30
|
| Rate for Payer: Cash Price |
$1,587.30
|
| Rate for Payer: Cash Price |
$1,587.30
|
| 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 |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,608.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,191.26
|
| 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 |
$1,953.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$100.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: InnovAge PACE Commercial |
$1,786.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,924.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,191.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$577.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,596.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,596.29
|
| 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 |
$1,191.26
|
| 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 |
$1,262.74
|
| Rate for Payer: Prime Health Services WC |
$1,878.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,310.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,731.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,191.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
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 |
$1,587.30
|
| Rate for Payer: Central Health Plan Commercial |
$2,308.80
|
| 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 Permanente of CA Commercial/Self Funded |
$1,924.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,099.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,786.43
|
| 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 |
$1,587.30
|
| Rate for Payer: Central Health Plan Commercial |
$2,308.80
|
| 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 Permanente of CA Commercial/Self Funded |
$1,924.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,099.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,786.43
|
| 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 |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$577.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,191.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,397.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,694.95
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,898.06
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$1,587.30
|
| Rate for Payer: Cash Price |
$1,587.30
|
| Rate for Payer: Cash Price |
$1,587.30
|
| 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 |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,608.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,191.26
|
| 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 |
$1,953.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$100.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: InnovAge PACE Commercial |
$1,786.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,924.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,191.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$577.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,596.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,596.29
|
| 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 |
$1,191.26
|
| 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 |
$1,262.74
|
| Rate for Payer: Prime Health Services WC |
$1,878.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,310.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,731.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,191.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
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 |
$1,587.30
|
| Rate for Payer: Central Health Plan Commercial |
$2,308.80
|
| 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 Permanente of CA Commercial/Self Funded |
$1,924.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,099.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,786.43
|
| 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
|
750
|
| Min. Negotiated Rate |
$100.53 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$577.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,191.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,397.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,694.95
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$1,587.30
|
| Rate for Payer: Cash Price |
$1,587.30
|
| Rate for Payer: Cash Price |
$1,587.30
|
| 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 |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,608.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,191.26
|
| 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 |
$1,953.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$100.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: InnovAge PACE Commercial |
$1,786.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,924.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,191.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$577.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,596.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,596.29
|
| 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 |
$1,191.26
|
| Rate for Payer: Prime Health Services Commercial |
$2,453.10
|
| Rate for Payer: Prime Health Services Medicare |
$1,262.74
|
| Rate for Payer: Riverside University Health System MISP |
$1,310.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,731.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,429.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,191.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
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 |
$1,210.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,760.80
|
| 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 Permanente of CA Commercial/Self Funded |
$1,468.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$838.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,362.42
|
| 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, 1ST ORDR CA
|
Facility
|
IP
|
$2,589.00
|
|
|
Service Code
|
CPT 36245
|
| Hospital Charge Code |
906820173
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$517.80 |
| Max. Negotiated Rate |
$2,330.10 |
| Rate for Payer: Adventist Health Commercial |
$517.80
|
| Rate for Payer: Cash Price |
$1,423.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,071.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,035.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,035.60
|
| Rate for Payer: Galaxy Health WC |
$2,200.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,553.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,330.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,726.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$986.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,602.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$517.80
|
| Rate for Payer: Multiplan Commercial |
$1,941.75
|
| Rate for Payer: Networks By Design Commercial |
$1,682.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,200.65
|
|
|
HC ABD/PEL/LE ART, 1ST ORDR CA
|
Facility
|
OP
|
$2,589.00
|
|
|
Service Code
|
CPT 36245
|
| Hospital Charge Code |
906820173
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$348.99 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$517.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,200.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,423.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,941.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,253.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,520.52
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$1,423.95
|
| Rate for Payer: Cash Price |
$1,423.95
|
| Rate for Payer: Cash Price |
$1,423.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,071.20
|
| Rate for Payer: Cigna of CA HMO |
$1,656.96
|
| Rate for Payer: Cigna of CA PPO |
$1,915.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,200.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,200.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,200.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,035.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,035.60
|
| Rate for Payer: Galaxy Health WC |
$2,200.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,553.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,330.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$348.99
|
| Rate for Payer: InnovAge PACE Commercial |
$1,294.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,726.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$385.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,602.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$517.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,812.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,812.30
|
| Rate for Payer: Multiplan Commercial |
$1,941.75
|
| Rate for Payer: Networks By Design Commercial |
$1,682.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,200.65
|
| Rate for Payer: Riverside University Health System MISP |
$1,035.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,553.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| 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 |
$2,200.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,200.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,200.65
|
|
|
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 |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$440.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| 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 |
$1,065.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,292.65
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$1,210.55
|
| Rate for Payer: Cash Price |
$1,210.55
|
| Rate for Payer: Cash Price |
$1,210.55
|
| 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: 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: InnovAge PACE Commercial |
$1,100.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,468.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$385.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,362.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$440.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,540.70
|
| Rate for Payer: Molina Healthcare of CA 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 |
$1,932.00
|
| 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 |
$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, 2ND ORDR CA
|
Facility
|
OP
|
$926.00
|
|
|
Service Code
|
CPT 36246
|
| Hospital Charge Code |
906820180
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$185.20 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$185.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$787.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$509.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$694.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$448.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$543.84
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$509.30
|
| Rate for Payer: Cash Price |
$509.30
|
| Rate for Payer: Cash Price |
$509.30
|
| Rate for Payer: Central Health Plan Commercial |
$740.80
|
| Rate for Payer: Cigna of CA HMO |
$592.64
|
| Rate for Payer: Cigna of CA PPO |
$685.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$787.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$787.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$787.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$370.40
|
| Rate for Payer: EPIC Health Plan Senior |
$370.40
|
| Rate for Payer: Galaxy Health WC |
$787.10
|
| Rate for Payer: Global Benefits Group Commercial |
$555.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$833.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$418.79
|
| Rate for Payer: InnovAge PACE Commercial |
$463.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$617.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$462.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$573.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$648.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$648.20
|
| Rate for Payer: Multiplan Commercial |
$694.50
|
| Rate for Payer: Networks By Design Commercial |
$601.90
|
| Rate for Payer: Prime Health Services Commercial |
$787.10
|
| Rate for Payer: Riverside University Health System MISP |
$370.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$555.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| 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 |
$787.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$787.10
|
| Rate for Payer: Vantage Medical Group Senior |
$787.10
|
|
|
HC ABD/PEL/LE ART, 2ND ORDR CA
|
Facility
|
IP
|
$926.00
|
|
|
Service Code
|
CPT 36246
|
| Hospital Charge Code |
906820180
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$185.20 |
| Max. Negotiated Rate |
$833.40 |
| Rate for Payer: Adventist Health Commercial |
$185.20
|
| Rate for Payer: Cash Price |
$509.30
|
| Rate for Payer: Central Health Plan Commercial |
$740.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$370.40
|
| Rate for Payer: EPIC Health Plan Senior |
$370.40
|
| Rate for Payer: Galaxy Health WC |
$787.10
|
| Rate for Payer: Global Benefits Group Commercial |
$555.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$833.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$617.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$352.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$573.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.20
|
| Rate for Payer: Multiplan Commercial |
$694.50
|
| Rate for Payer: Networks By Design Commercial |
$601.90
|
| Rate for Payer: Prime Health Services Commercial |
$787.10
|
|
