|
HC BIOPSY OF CERVIX
|
Facility
|
OP
|
$2,997.00
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
900501433
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$77.03 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,228.77
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$468.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,303.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,184.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,762.79
|
| Rate for Payer: Cash Price |
$1,348.65
|
| Rate for Payer: Cash Price |
$1,348.65
|
| Rate for Payer: Cash Price |
$1,348.65
|
| Rate for Payer: Cash Price |
$1,348.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,397.60
|
| Rate for Payer: Cigna of CA HMO |
$1,918.08
|
| Rate for Payer: Cigna of CA PPO |
$2,217.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,303.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,184.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,097.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,954.62
|
| Rate for Payer: EPIC Health Plan Senior |
$1,303.08
|
| Rate for Payer: Galaxy Health WC |
$2,547.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,798.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,697.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,942.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,184.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,903.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$77.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,273.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$599.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,587.39
|
| Rate for Payer: Multiplan Commercial |
$2,247.75
|
| Rate for Payer: Multiplan WC |
$1,762.79
|
| Rate for Payer: Networks By Design Commercial |
$1,948.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,184.62
|
| Rate for Payer: Preferred Health Network WC |
$1,798.77
|
| Rate for Payer: Prime Health Services Commercial |
$2,547.45
|
| Rate for Payer: Prime Health Services Medicare |
$1,255.70
|
| Rate for Payer: Prime Health Services WC |
$1,744.81
|
| Rate for Payer: Riverside University Health System MISP |
$1,303.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,798.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,798.20
|
| 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 |
$1,184.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,303.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,184.62
|
|
|
HC BIOPSY OF CERVIX
|
Facility
|
IP
|
$2,997.00
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
900501433
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$599.40 |
| Max. Negotiated Rate |
$2,697.30 |
| Rate for Payer: Adventist Health Commercial |
$599.40
|
| Rate for Payer: Cash Price |
$1,348.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,397.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,097.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,198.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,198.80
|
| Rate for Payer: Galaxy Health WC |
$2,547.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,798.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,697.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,903.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,768.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$599.40
|
| Rate for Payer: Multiplan Commercial |
$2,247.75
|
| Rate for Payer: Networks By Design Commercial |
$1,948.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,547.45
|
|
|
HC BIOPSY OF CERVIX
|
Facility
|
IP
|
$2,997.00
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
900501433
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$599.40 |
| Max. Negotiated Rate |
$2,697.30 |
| Rate for Payer: Adventist Health Commercial |
$599.40
|
| Rate for Payer: Cash Price |
$1,348.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,397.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,097.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,198.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,198.80
|
| Rate for Payer: Galaxy Health WC |
$2,547.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,798.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,697.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,903.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,768.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$599.40
|
| Rate for Payer: Multiplan Commercial |
$2,247.75
|
| Rate for Payer: Networks By Design Commercial |
$1,948.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,547.45
|
|
|
HC BIOPSY OF CERVIX
|
Facility
|
OP
|
$2,997.00
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
900501433
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$77.03 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$599.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,303.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,184.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,762.79
|
| Rate for Payer: Cash Price |
$1,348.65
|
| Rate for Payer: Cash Price |
$1,348.65
|
| Rate for Payer: Cash Price |
$1,348.65
|
| Rate for Payer: Cash Price |
$1,348.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,397.60
|
| Rate for Payer: Cigna of CA HMO |
$1,918.08
|
| Rate for Payer: Cigna of CA PPO |
$2,217.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,303.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,184.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,097.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,954.62
|
| Rate for Payer: EPIC Health Plan Senior |
$1,303.08
|
| Rate for Payer: Galaxy Health WC |
$2,547.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,798.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,697.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,942.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,184.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,903.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$77.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,273.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$599.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,587.39
|
| Rate for Payer: Multiplan Commercial |
$2,247.75
|
| Rate for Payer: Multiplan WC |
$1,762.79
|
| Rate for Payer: Networks By Design Commercial |
$1,948.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,184.62
|
| Rate for Payer: Preferred Health Network WC |
$1,798.77
|
| Rate for Payer: Prime Health Services Commercial |
$2,547.45
|
| Rate for Payer: Prime Health Services Medicare |
$1,255.70
|
| Rate for Payer: Prime Health Services WC |
$1,744.81
|
| Rate for Payer: Riverside University Health System MISP |
$1,303.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,798.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,498.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,498.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,498.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,498.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,184.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,303.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,184.62
|
|
|
HC BIOPSY OF CERVIX
|
Facility
|
IP
|
$2,997.00
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
900501433
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$599.40 |
| Max. Negotiated Rate |
$2,697.30 |
| Rate for Payer: Adventist Health Commercial |
$599.40
|
| Rate for Payer: Cash Price |
$1,348.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,397.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,097.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,198.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,198.80
|
| Rate for Payer: Galaxy Health WC |
$2,547.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,798.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,697.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,903.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,768.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$599.40
|
| Rate for Payer: Multiplan Commercial |
$2,247.75
|
| Rate for Payer: Networks By Design Commercial |
$1,948.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,547.45
|
|
|
HC BIOPSY OF FLOOR OF MOUTH
|
Facility
|
IP
|
$5,824.00
|
|
|
Service Code
|
CPT 41108
|
| Hospital Charge Code |
900501208
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,164.80 |
| Max. Negotiated Rate |
$5,241.60 |
| Rate for Payer: Adventist Health Commercial |
$1,164.80
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,659.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,076.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,329.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,329.60
|
| Rate for Payer: Galaxy Health WC |
$4,950.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,494.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,241.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,698.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,436.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,164.80
|
| Rate for Payer: Multiplan Commercial |
$4,368.00
|
| Rate for Payer: Networks By Design Commercial |
$3,785.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,950.40
|
|
|
HC BIOPSY OF FLOOR OF MOUTH
|
Facility
|
OP
|
$5,824.00
|
|
|
Service Code
|
CPT 41108
|
| Hospital Charge Code |
900501208
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$184.62 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,164.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,659.20
|
| Rate for Payer: Cigna of CA HMO |
$3,727.36
|
| Rate for Payer: Cigna of CA PPO |
$4,309.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,076.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Galaxy Health WC |
$4,950.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,494.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,241.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,698.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$184.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,283.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,164.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$4,368.00
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$3,785.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$4,950.40
|
| Rate for Payer: Prime Health Services Medicare |
$2,251.68
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,336.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,494.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,912.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,912.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,912.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,912.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
|
HC BIOPSY OF HIP JOINT
|
Facility
|
IP
|
$10,416.00
|
|
|
Service Code
|
CPT 27052
|
| Hospital Charge Code |
909020043
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,083.20 |
| Max. Negotiated Rate |
$9,374.40 |
| Rate for Payer: Adventist Health Commercial |
$2,083.20
|
| Rate for Payer: Cash Price |
$4,687.20
|
| Rate for Payer: Central Health Plan Commercial |
$8,332.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,291.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,166.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,166.40
|
| Rate for Payer: Galaxy Health WC |
$8,853.60
|
| Rate for Payer: Global Benefits Group Commercial |
$6,249.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,374.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,614.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,145.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,083.20
|
| Rate for Payer: Multiplan Commercial |
$7,812.00
|
| Rate for Payer: Networks By Design Commercial |
$6,770.40
|
| Rate for Payer: Prime Health Services Commercial |
$8,853.60
|
|
|
HC BIOPSY OF HIP JOINT
|
Facility
|
OP
|
$10,416.00
|
|
|
Service Code
|
CPT 27052
|
| Hospital Charge Code |
909020043
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$179.29 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,083.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,068.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,068.15
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$3,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,036.70
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$4,687.20
|
| Rate for Payer: Cash Price |
$4,687.20
|
| Rate for Payer: Cash Price |
$4,687.20
|
| Rate for Payer: Central Health Plan Commercial |
$8,332.80
|
| Rate for Payer: Cigna of CA HMO |
$6,666.24
|
| Rate for Payer: Cigna of CA PPO |
$7,707.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,274.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,068.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,291.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,412.45
|
| Rate for Payer: EPIC Health Plan Senior |
$2,274.97
|
| Rate for Payer: Galaxy Health WC |
$8,853.60
|
| Rate for Payer: Global Benefits Group Commercial |
$6,249.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,374.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,391.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$179.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,614.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$198.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,895.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,083.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$7,812.00
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$6,770.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Preferred Health Network WC |
$3,306.12
|
| Rate for Payer: Prime Health Services Commercial |
$8,853.60
|
| Rate for Payer: Prime Health Services Medicare |
$2,192.24
|
| Rate for Payer: Prime Health Services WC |
$3,206.94
|
| Rate for Payer: Riverside University Health System MISP |
$2,274.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,249.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,068.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Vantage Medical Group Senior |
$2,068.15
|
|
|
HC BIOPSY OF NECK/CHEST
|
Facility
|
OP
|
$6,671.00
|
|
|
Service Code
|
CPT 21550
|
| Hospital Charge Code |
904000002
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$128.07 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,334.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,124.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| 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 |
$3,001.95
|
| Rate for Payer: Cash Price |
$3,001.95
|
| Rate for Payer: Cash Price |
$3,001.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,336.80
|
| Rate for Payer: Cigna of CA HMO |
$4,269.44
|
| Rate for Payer: Cigna of CA PPO |
$4,936.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,669.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Galaxy Health WC |
$5,670.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,002.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,003.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$128.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,236.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$141.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,973.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,334.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$5,003.25
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$4,336.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$5,670.35
|
| Rate for Payer: Prime Health Services Medicare |
$2,251.68
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,336.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,002.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,335.50
|
| 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 |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
|
HC BIOPSY OF NECK/CHEST
|
Facility
|
IP
|
$6,671.00
|
|
|
Service Code
|
CPT 21550
|
| Hospital Charge Code |
904000002
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,334.20 |
| Max. Negotiated Rate |
$6,003.90 |
| Rate for Payer: Adventist Health Commercial |
$1,334.20
|
| Rate for Payer: Cash Price |
$3,001.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,336.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,669.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,668.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,668.40
|
| Rate for Payer: Galaxy Health WC |
$5,670.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,002.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,003.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,236.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,935.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,334.20
|
| Rate for Payer: Multiplan Commercial |
$5,003.25
|
| Rate for Payer: Networks By Design Commercial |
$4,336.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,670.35
|
|
|
HC BIOPSY OF SOFT TISSUE PELVIS/HIP
|
Facility
|
IP
|
$3,473.00
|
|
|
Service Code
|
CPT 27040
|
| Hospital Charge Code |
904000006
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$694.60 |
| Max. Negotiated Rate |
$3,125.70 |
| Rate for Payer: Adventist Health Commercial |
$694.60
|
| Rate for Payer: Cash Price |
$1,562.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,778.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,431.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,389.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,389.20
|
| Rate for Payer: Galaxy Health WC |
$2,952.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,083.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,125.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,205.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,049.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$694.60
|
| Rate for Payer: Multiplan Commercial |
$2,604.75
|
| Rate for Payer: Networks By Design Commercial |
$2,257.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,952.05
|
|
|
HC BIOPSY OF SOFT TISSUE PELVIS/HIP
|
Facility
|
OP
|
$3,473.00
|
|
|
Service Code
|
CPT 27040
|
| Hospital Charge Code |
904000006
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$694.60 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$694.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,124.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| 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 |
$1,562.85
|
| Rate for Payer: Cash Price |
$1,562.85
|
| Rate for Payer: Cash Price |
$1,562.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,778.40
|
| Rate for Payer: Cigna of CA HMO |
$2,222.72
|
| Rate for Payer: Cigna of CA PPO |
$2,570.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,431.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Galaxy Health WC |
$2,952.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,083.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,125.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,205.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,973.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$694.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$2,604.75
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$2,257.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$2,952.05
|
| Rate for Payer: Prime Health Services Medicare |
$2,251.68
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,336.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,083.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,736.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
|
HC BIOPSY OF TONGUE
|
Facility
|
OP
|
$2,079.00
|
|
|
Service Code
|
CPT 41100
|
| Hospital Charge Code |
900541100
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$128.74 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$415.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,040.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$763.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$693.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,030.97
|
| Rate for Payer: Cash Price |
$935.55
|
| Rate for Payer: Cash Price |
$935.55
|
| Rate for Payer: Cash Price |
$935.55
|
| Rate for Payer: Cash Price |
$935.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,663.20
|
| Rate for Payer: Cigna of CA HMO |
$1,330.56
|
| Rate for Payer: Cigna of CA PPO |
$1,538.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,040.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$763.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$693.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,455.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,144.56
|
| Rate for Payer: EPIC Health Plan Senior |
$763.04
|
| Rate for Payer: Galaxy Health WC |
$1,767.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,247.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,871.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,137.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$693.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,320.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$128.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$745.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$415.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$929.52
|
| Rate for Payer: Multiplan Commercial |
$1,559.25
|
| Rate for Payer: Multiplan WC |
$1,030.97
|
| Rate for Payer: Networks By Design Commercial |
$1,351.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$693.67
|
| Rate for Payer: Preferred Health Network WC |
$1,052.01
|
| Rate for Payer: Prime Health Services Commercial |
$1,767.15
|
| Rate for Payer: Prime Health Services Medicare |
$735.29
|
| Rate for Payer: Prime Health Services WC |
$1,020.45
|
| Rate for Payer: Riverside University Health System MISP |
$763.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,247.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,039.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,039.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,039.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,039.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$693.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,040.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$763.04
|
| Rate for Payer: Vantage Medical Group Senior |
$693.67
|
|
|
HC BIOPSY OF TONGUE
|
Facility
|
IP
|
$2,079.00
|
|
|
Service Code
|
CPT 41100
|
| Hospital Charge Code |
900541100
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$415.80 |
| Max. Negotiated Rate |
$1,871.10 |
| Rate for Payer: Adventist Health Commercial |
$415.80
|
| Rate for Payer: Cash Price |
$935.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,663.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,455.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$831.60
|
| Rate for Payer: EPIC Health Plan Senior |
$831.60
|
| Rate for Payer: Galaxy Health WC |
$1,767.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,247.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,871.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,320.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,226.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$415.80
|
| Rate for Payer: Multiplan Commercial |
$1,559.25
|
| Rate for Payer: Networks By Design Commercial |
$1,351.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,767.15
|
|
|
HC BIOPSY OF TONGUE; POSTERIOR ONE THIRD
|
Facility
|
IP
|
$11,566.00
|
|
|
Service Code
|
CPT 41105
|
| Hospital Charge Code |
988141105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,313.20 |
| Max. Negotiated Rate |
$10,409.40 |
| Rate for Payer: Adventist Health Commercial |
$2,313.20
|
| Rate for Payer: Cash Price |
$5,204.70
|
| Rate for Payer: Central Health Plan Commercial |
$9,252.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,096.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,626.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,626.40
|
| Rate for Payer: Galaxy Health WC |
$9,831.10
|
| Rate for Payer: Global Benefits Group Commercial |
$6,939.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,409.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,344.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,823.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,313.20
|
| Rate for Payer: Multiplan Commercial |
$8,674.50
|
| Rate for Payer: Networks By Design Commercial |
$7,517.90
|
| Rate for Payer: Prime Health Services Commercial |
$9,831.10
|
|
|
HC BIOPSY OF TONGUE; POSTERIOR ONE THIRD
|
Facility
|
OP
|
$11,566.00
|
|
|
Service Code
|
CPT 41105
|
| Hospital Charge Code |
988141105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$103.73 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,313.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,264.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,690.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,264.23
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$6,565.51
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$5,204.70
|
| Rate for Payer: Cash Price |
$5,204.70
|
| Rate for Payer: Cash Price |
$5,204.70
|
| Rate for Payer: Central Health Plan Commercial |
$9,252.80
|
| Rate for Payer: Cigna of CA HMO |
$7,402.24
|
| Rate for Payer: Cigna of CA PPO |
$8,558.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,690.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,264.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,096.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,035.98
|
| Rate for Payer: EPIC Health Plan Senior |
$4,690.65
|
| Rate for Payer: Galaxy Health WC |
$9,831.10
|
| Rate for Payer: Global Benefits Group Commercial |
$6,939.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,409.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,993.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$103.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,264.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,344.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$114.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,969.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,313.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,714.07
|
| Rate for Payer: Multiplan Commercial |
$8,674.50
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: Networks By Design Commercial |
$7,517.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,264.23
|
| Rate for Payer: Preferred Health Network WC |
$6,699.50
|
| Rate for Payer: Prime Health Services Commercial |
$9,831.10
|
| Rate for Payer: Prime Health Services Medicare |
$4,520.08
|
| Rate for Payer: Prime Health Services WC |
$6,498.52
|
| Rate for Payer: Riverside University Health System MISP |
$4,690.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,939.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,783.00
|
| 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 |
$4,264.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,690.65
|
| Rate for Payer: Vantage Medical Group Senior |
$4,264.23
|
|
|
HC BIOPSY OF VAGINA
|
Facility
|
IP
|
$3,587.00
|
|
|
Service Code
|
CPT 57100
|
| Hospital Charge Code |
904000017
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$717.40 |
| Max. Negotiated Rate |
$3,228.30 |
| Rate for Payer: Adventist Health Commercial |
$717.40
|
| Rate for Payer: Cash Price |
$1,614.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,869.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,510.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,434.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,434.80
|
| Rate for Payer: Galaxy Health WC |
$3,048.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,152.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,228.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,277.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,116.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$717.40
|
| Rate for Payer: Multiplan Commercial |
$2,690.25
|
| Rate for Payer: Networks By Design Commercial |
$2,331.55
|
| Rate for Payer: Prime Health Services Commercial |
$3,048.95
|
|
|
HC BIOPSY OF VAGINA
|
Facility
|
OP
|
$3,587.00
|
|
|
Service Code
|
CPT 57100
|
| Hospital Charge Code |
904000017
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$70.59 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$717.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,184.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,303.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,184.62
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$1,762.79
|
| 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 |
$1,614.15
|
| Rate for Payer: Cash Price |
$1,614.15
|
| Rate for Payer: Cash Price |
$1,614.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,869.60
|
| Rate for Payer: Cigna of CA HMO |
$2,295.68
|
| Rate for Payer: Cigna of CA PPO |
$2,654.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,303.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,184.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,510.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,954.62
|
| Rate for Payer: EPIC Health Plan Senior |
$1,303.08
|
| Rate for Payer: Galaxy Health WC |
$3,048.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,152.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,228.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,942.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$70.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,184.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,277.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$77.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,658.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$717.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,587.39
|
| Rate for Payer: Multiplan Commercial |
$2,690.25
|
| Rate for Payer: Multiplan WC |
$1,762.79
|
| Rate for Payer: Networks By Design Commercial |
$2,331.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,184.62
|
| Rate for Payer: Preferred Health Network WC |
$1,798.77
|
| Rate for Payer: Prime Health Services Commercial |
$3,048.95
|
| Rate for Payer: Prime Health Services Medicare |
$1,255.70
|
| Rate for Payer: Prime Health Services WC |
$1,744.81
|
| Rate for Payer: Riverside University Health System MISP |
$1,303.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,152.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,793.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,184.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,303.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,184.62
|
|
|
HC BIOPSY OROPHARYNX
|
Facility
|
OP
|
$5,352.00
|
|
|
Service Code
|
CPT 42800
|
| Hospital Charge Code |
950442316
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$125.91 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$2,194.32
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$672.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,993.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,195.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,995.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$2,998.82
|
| Rate for Payer: Cash Price |
$2,408.40
|
| Rate for Payer: Cash Price |
$2,408.40
|
| Rate for Payer: Cash Price |
$2,408.40
|
| Rate for Payer: Cash Price |
$2,408.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,281.60
|
| Rate for Payer: Cigna of CA HMO |
$3,425.28
|
| Rate for Payer: Cigna of CA PPO |
$3,960.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,993.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,195.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,995.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,746.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,292.74
|
| Rate for Payer: EPIC Health Plan Senior |
$2,195.16
|
| Rate for Payer: Galaxy Health WC |
$4,549.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,211.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,816.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,272.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,995.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,398.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$125.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,145.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,070.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,674.10
|
| Rate for Payer: Multiplan Commercial |
$4,014.00
|
| Rate for Payer: Multiplan WC |
$2,998.82
|
| Rate for Payer: Networks By Design Commercial |
$3,478.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,995.60
|
| Rate for Payer: Preferred Health Network WC |
$3,060.02
|
| Rate for Payer: Prime Health Services Commercial |
$4,549.20
|
| Rate for Payer: Prime Health Services Medicare |
$2,115.34
|
| Rate for Payer: Prime Health Services WC |
$2,968.22
|
| Rate for Payer: Riverside University Health System MISP |
$2,195.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,211.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,211.20
|
| 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 |
$1,995.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,993.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,195.16
|
| Rate for Payer: Vantage Medical Group Senior |
$1,995.60
|
|
|
HC BIOPSY OROPHARYNX
|
Facility
|
IP
|
$5,352.00
|
|
|
Service Code
|
CPT 42800
|
| Hospital Charge Code |
950442316
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,070.40 |
| Max. Negotiated Rate |
$4,816.80 |
| Rate for Payer: Adventist Health Commercial |
$1,070.40
|
| Rate for Payer: Cash Price |
$2,408.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,281.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,746.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,140.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,140.80
|
| Rate for Payer: Galaxy Health WC |
$4,549.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,211.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,816.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,398.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,157.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,070.40
|
| Rate for Payer: Multiplan Commercial |
$4,014.00
|
| Rate for Payer: Networks By Design Commercial |
$3,478.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,549.20
|
|
|
HC BIOPSY/REMOVAL LYMPH NODE(S)
|
Facility
|
OP
|
$11,392.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
904000008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$165.21 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,278.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$5,035.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,539.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,035.90
|
| 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 |
$7,752.28
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$5,126.40
|
| Rate for Payer: Cash Price |
$5,126.40
|
| Rate for Payer: Cash Price |
$5,126.40
|
| Rate for Payer: Central Health Plan Commercial |
$9,113.60
|
| Rate for Payer: Cigna of CA HMO |
$7,290.88
|
| Rate for Payer: Cigna of CA PPO |
$8,430.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,539.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,035.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,974.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,309.24
|
| Rate for Payer: EPIC Health Plan Senior |
$5,539.49
|
| Rate for Payer: Galaxy Health WC |
$9,683.20
|
| Rate for Payer: Global Benefits Group Commercial |
$6,835.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,252.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,258.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$165.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5,035.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,233.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$182.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,050.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,278.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,748.11
|
| Rate for Payer: Multiplan Commercial |
$8,544.00
|
| Rate for Payer: Multiplan WC |
$7,752.28
|
| Rate for Payer: Networks By Design Commercial |
$7,404.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5,035.90
|
| Rate for Payer: Preferred Health Network WC |
$7,910.49
|
| Rate for Payer: Prime Health Services Commercial |
$9,683.20
|
| Rate for Payer: Prime Health Services Medicare |
$5,338.05
|
| Rate for Payer: Prime Health Services WC |
$7,673.18
|
| Rate for Payer: Riverside University Health System MISP |
$5,539.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,835.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,696.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$5,035.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,539.49
|
| Rate for Payer: Vantage Medical Group Senior |
$5,035.90
|
|
|
HC BIOPSY/REMOVAL LYMPH NODE(S)
|
Facility
|
IP
|
$11,392.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
904000008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,278.40 |
| Max. Negotiated Rate |
$10,252.80 |
| Rate for Payer: Adventist Health Commercial |
$2,278.40
|
| Rate for Payer: Cash Price |
$5,126.40
|
| Rate for Payer: Central Health Plan Commercial |
$9,113.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,974.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,556.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,556.80
|
| Rate for Payer: Galaxy Health WC |
$9,683.20
|
| Rate for Payer: Global Benefits Group Commercial |
$6,835.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,252.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,233.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,721.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,278.40
|
| Rate for Payer: Multiplan Commercial |
$8,544.00
|
| Rate for Payer: Networks By Design Commercial |
$7,404.80
|
| Rate for Payer: Prime Health Services Commercial |
$9,683.20
|
|
|
HC BIOPSY SHOULDER TISSUES.
|
Facility
|
OP
|
$11,955.00
|
|
|
Service Code
|
CPT 23066
|
| Hospital Charge Code |
904000003
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$320.81 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,391.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,735.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,735.95
|
| 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 |
$5,794.14
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$5,379.75
|
| Rate for Payer: Cash Price |
$5,379.75
|
| Rate for Payer: Cash Price |
$5,379.75
|
| Rate for Payer: Central Health Plan Commercial |
$9,564.00
|
| Rate for Payer: Cigna of CA HMO |
$7,651.20
|
| Rate for Payer: Cigna of CA PPO |
$8,846.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,109.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,735.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,368.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,164.32
|
| Rate for Payer: EPIC Health Plan Senior |
$4,109.55
|
| Rate for Payer: Galaxy Health WC |
$10,161.75
|
| Rate for Payer: Global Benefits Group Commercial |
$7,173.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,759.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,126.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$320.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,591.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$354.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,230.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,391.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,006.17
|
| Rate for Payer: Multiplan Commercial |
$8,966.25
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: Networks By Design Commercial |
$7,770.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Preferred Health Network WC |
$5,912.39
|
| Rate for Payer: Prime Health Services Commercial |
$10,161.75
|
| Rate for Payer: Prime Health Services Medicare |
$3,960.11
|
| Rate for Payer: Prime Health Services WC |
$5,735.02
|
| Rate for Payer: Riverside University Health System MISP |
$4,109.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,173.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,977.50
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,735.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,735.95
|
|
|
HC BIOPSY SHOULDER TISSUES.
|
Facility
|
IP
|
$11,955.00
|
|
|
Service Code
|
CPT 23066
|
| Hospital Charge Code |
904000003
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,391.00 |
| Max. Negotiated Rate |
$10,759.50 |
| Rate for Payer: Adventist Health Commercial |
$2,391.00
|
| Rate for Payer: Cash Price |
$5,379.75
|
| Rate for Payer: Central Health Plan Commercial |
$9,564.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,368.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,782.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,782.00
|
| Rate for Payer: Galaxy Health WC |
$10,161.75
|
| Rate for Payer: Global Benefits Group Commercial |
$7,173.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,759.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,591.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,053.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,391.00
|
| Rate for Payer: Multiplan Commercial |
$8,966.25
|
| Rate for Payer: Networks By Design Commercial |
$7,770.75
|
| Rate for Payer: Prime Health Services Commercial |
$10,161.75
|
|
