|
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 |
$1,648.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,397.60
|
| 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 Permanente of CA Commercial/Self Funded |
$1,999.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,141.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,855.14
|
| 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
|
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 |
$1,648.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,397.60
|
| 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 Permanente of CA Commercial/Self Funded |
$1,999.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,141.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,855.14
|
| 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 |
$3,203.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,659.20
|
| 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 Permanente of CA Commercial/Self Funded |
$3,884.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,218.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,605.06
|
| 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 |
$5,241.60 |
| 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 |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| 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 |
$3,280.13
|
| Rate for Payer: Cash Price |
$3,203.20
|
| Rate for Payer: Cash Price |
$3,203.20
|
| Rate for Payer: Cash Price |
$3,203.20
|
| Rate for Payer: Cash Price |
$3,203.20
|
| 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 |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,779.22
|
| Rate for Payer: EPIC Health Plan Senior |
$2,058.68
|
| 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 |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: InnovAge PACE Commercial |
$3,088.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,884.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$184.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,164.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,758.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,758.63
|
| 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 |
$2,058.68
|
| 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 |
$2,182.20
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,264.55
|
| 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 |
$2,058.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
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 |
$16,122.00 |
| Rate for Payer: Adventist Health Commercial |
$2,083.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,033.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,033.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,764.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,851.77
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$5,728.80
|
| Rate for Payer: Cash Price |
$5,728.80
|
| Rate for Payer: Cash Price |
$5,728.80
|
| 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 |
$3,050.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,236.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,033.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,745.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,033.48
|
| 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 |
$3,334.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$179.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,033.48
|
| Rate for Payer: InnovAge PACE Commercial |
$3,050.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,947.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$198.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,033.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,083.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,724.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,724.86
|
| 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 |
$2,033.48
|
| 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 |
$2,155.49
|
| Rate for Payer: Prime Health Services WC |
$3,206.94
|
| Rate for Payer: Riverside University Health System MISP |
$2,236.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,249.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,984.00
|
| 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 |
$2,033.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Vantage Medical Group Senior |
$2,033.48
|
|
|
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 |
$5,728.80
|
| Rate for Payer: Central Health Plan Commercial |
$8,332.80
|
| 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 Permanente of CA Commercial/Self Funded |
$6,947.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,968.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,447.50
|
| 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 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 |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$1,334.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,058.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| 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 |
$3,280.13
|
| 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 |
$3,669.05
|
| Rate for Payer: Cash Price |
$3,669.05
|
| Rate for Payer: Cash Price |
$3,669.05
|
| 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 |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,779.22
|
| Rate for Payer: EPIC Health Plan Senior |
$2,058.68
|
| 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 |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$128.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: InnovAge PACE Commercial |
$3,088.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,449.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$141.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,334.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,758.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,758.63
|
| 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 |
$2,058.68
|
| 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 |
$2,182.20
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,264.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,002.60
|
| 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 |
$2,058.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
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 |
$3,669.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,336.80
|
| 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 Permanente of CA Commercial/Self Funded |
$4,449.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,541.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,129.35
|
| 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
|
OP
|
$3,473.00
|
|
|
Service Code
|
CPT 27040
|
| Hospital Charge Code |
904000006
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$694.60 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$694.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,058.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| 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 |
$3,280.13
|
| 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 |
$1,910.15
|
| Rate for Payer: Cash Price |
$1,910.15
|
| Rate for Payer: Cash Price |
$1,910.15
|
| 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 |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,779.22
|
| Rate for Payer: EPIC Health Plan Senior |
$2,058.68
|
| 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 |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: InnovAge PACE Commercial |
$3,088.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,316.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$694.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,758.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,758.63
|
| 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 |
$2,058.68
|
| 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 |
$2,182.20
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,264.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,083.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| 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 |
$2,058.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
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 |
$1,910.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,778.40
|
| 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 Permanente of CA Commercial/Self Funded |
$2,316.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,323.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,149.79
|
| 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 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 |
$1,143.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,663.20
|
| 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 Permanente of CA Commercial/Self Funded |
$1,386.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$792.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,286.90
|
| 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
|
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 |
$2,901.00 |
| 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 |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$970.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$711.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$647.05
|
| 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 |
$1,030.97
|
| Rate for Payer: Cash Price |
$1,143.45
|
| Rate for Payer: Cash Price |
$1,143.45
|
| Rate for Payer: Cash Price |
$1,143.45
|
| Rate for Payer: Cash Price |
$1,143.45
|
| 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 |
$970.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$711.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$647.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$873.52
|
| Rate for Payer: EPIC Health Plan Senior |
$647.05
|
| 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 |
$1,061.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$647.05
|
| Rate for Payer: InnovAge PACE Commercial |
$970.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,386.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$128.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$647.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$415.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$867.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$867.05
|
| 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 |
$647.05
|
| 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 |
$685.87
|
| Rate for Payer: Prime Health Services WC |
$1,020.45
|
| Rate for Payer: Riverside University Health System MISP |
$711.75
|
| 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 |
$647.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$970.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$711.75
|
| Rate for Payer: Vantage Medical Group Senior |
$647.05
|
|
|
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 |
$10,409.40 |
| Rate for Payer: Adventist Health Commercial |
$2,313.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,120.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,120.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,565.51
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$6,361.30
|
| Rate for Payer: Cash Price |
$6,361.30
|
| Rate for Payer: Cash Price |
$6,361.30
|
| 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 |
$6,180.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,532.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,120.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,562.86
|
| Rate for Payer: EPIC Health Plan Senior |
$4,120.64
|
| 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 |
$6,757.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$103.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,120.64
|
| Rate for Payer: InnovAge PACE Commercial |
$6,180.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,714.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$114.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,120.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,313.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,521.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,521.66
|
| 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 |
$4,120.64
|
| 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 |
$4,367.88
|
| Rate for Payer: Prime Health Services WC |
$6,498.52
|
| Rate for Payer: Riverside University Health System MISP |
$4,532.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,939.60
|
| 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 |
$4,120.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4,120.64
|
|
|
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 |
$6,361.30
|
| Rate for Payer: Central Health Plan Commercial |
$9,252.80
|
| 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 Permanente of CA Commercial/Self Funded |
$7,714.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,406.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,159.35
|
| 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 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 |
$1,972.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,869.60
|
| 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 Permanente of CA Commercial/Self Funded |
$2,392.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,366.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,220.35
|
| 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 |
$4,460.00 |
| Rate for Payer: Adventist Health Commercial |
$717.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,106.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,659.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,217.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,106.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,736.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,106.65
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,762.79
|
| 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 |
$1,972.85
|
| Rate for Payer: Cash Price |
$1,972.85
|
| Rate for Payer: Cash Price |
$1,972.85
|
| 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 |
$1,659.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,217.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,106.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,493.59
|
| Rate for Payer: EPIC Health Plan Senior |
$1,106.36
|
| 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 |
$1,814.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$70.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,106.36
|
| Rate for Payer: InnovAge PACE Commercial |
$1,659.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,392.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,106.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$717.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,482.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,482.52
|
| 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 |
$1,106.36
|
| 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 |
$1,172.74
|
| Rate for Payer: Prime Health Services WC |
$1,744.81
|
| Rate for Payer: Riverside University Health System MISP |
$1,217.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,152.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| 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 |
$1,106.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,659.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,217.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,106.36
|
|
|
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 |
$2,943.60
|
| Rate for Payer: Central Health Plan Commercial |
$4,281.60
|
| 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 Permanente of CA Commercial/Self Funded |
$3,569.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,039.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,312.89
|
| 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 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 |
$6,333.00 |
| 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 |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,823.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,070.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,882.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$2,998.82
|
| Rate for Payer: Cash Price |
$2,943.60
|
| Rate for Payer: Cash Price |
$2,943.60
|
| Rate for Payer: Cash Price |
$2,943.60
|
| Rate for Payer: Cash Price |
$2,943.60
|
| 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 |
$2,823.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,070.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,882.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,540.85
|
| Rate for Payer: EPIC Health Plan Senior |
$1,882.11
|
| 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 |
$3,086.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,882.11
|
| Rate for Payer: InnovAge PACE Commercial |
$2,823.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,569.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$125.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,882.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,070.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,522.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,522.03
|
| 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 |
$1,882.11
|
| 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 |
$1,995.04
|
| Rate for Payer: Prime Health Services WC |
$2,968.22
|
| Rate for Payer: Riverside University Health System MISP |
$2,070.32
|
| 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 |
$1,882.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,823.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,070.32
|
| Rate for Payer: Vantage Medical Group Senior |
$1,882.11
|
|
|
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 |
$6,265.60
|
| Rate for Payer: Central Health Plan Commercial |
$9,113.60
|
| 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 Permanente of CA Commercial/Self Funded |
$7,598.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,340.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,051.65
|
| 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/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 |
$16,122.00 |
| Rate for Payer: Adventist Health Commercial |
$2,278.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,865.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,298.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,352.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,865.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$7,752.28
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$6,265.60
|
| Rate for Payer: Cash Price |
$6,265.60
|
| Rate for Payer: Cash Price |
$6,265.60
|
| 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 |
$7,298.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,352.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,865.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,568.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,865.48
|
| 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 |
$7,979.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$165.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,865.48
|
| Rate for Payer: InnovAge PACE Commercial |
$7,298.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,598.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$182.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,865.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,278.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,519.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,519.74
|
| 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 |
$4,865.48
|
| 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 |
$5,157.41
|
| Rate for Payer: Prime Health Services WC |
$7,673.18
|
| Rate for Payer: Riverside University Health System MISP |
$5,352.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,835.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,984.00
|
| 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 |
$4,865.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,298.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,352.03
|
| Rate for Payer: Vantage Medical Group Senior |
$4,865.48
|
|
|
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 |
$6,575.25
|
| Rate for Payer: Central Health Plan Commercial |
$9,564.00
|
| 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 Permanente of CA Commercial/Self Funded |
$7,973.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,554.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,400.15
|
| 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
|
|
|
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 |
$16,122.00 |
| Rate for Payer: Adventist Health Commercial |
$2,391.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,636.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,636.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$5,794.14
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$6,575.25
|
| Rate for Payer: Cash Price |
$6,575.25
|
| Rate for Payer: Cash Price |
$6,575.25
|
| 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 |
$5,454.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,000.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,636.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,909.30
|
| Rate for Payer: EPIC Health Plan Senior |
$3,636.52
|
| 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 |
$5,963.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$320.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,636.52
|
| Rate for Payer: InnovAge PACE Commercial |
$5,454.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,973.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$354.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,636.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,391.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,872.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,872.94
|
| 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 |
$3,636.52
|
| 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 |
$3,854.71
|
| Rate for Payer: Prime Health Services WC |
$5,735.02
|
| Rate for Payer: Riverside University Health System MISP |
$4,000.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,173.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,984.00
|
| 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 |
$3,636.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Vantage Medical Group Senior |
$3,636.52
|
|
|
HC BIOPSY SINONASAL MASS PALAT
|
Facility
|
OP
|
$3,873.00
|
|
|
Service Code
|
CPT 42100
|
| Hospital Charge Code |
900501728
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$111.06 |
| Max. Negotiated Rate |
$3,485.70 |
| Rate for Payer: Adventist Health Commercial |
$774.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,823.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,070.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,882.11
|
| 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 |
$2,998.82
|
| Rate for Payer: Cash Price |
$2,130.15
|
| Rate for Payer: Cash Price |
$2,130.15
|
| Rate for Payer: Cash Price |
$2,130.15
|
| Rate for Payer: Cash Price |
$2,130.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,098.40
|
| Rate for Payer: Cigna of CA HMO |
$2,478.72
|
| Rate for Payer: Cigna of CA PPO |
$2,866.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,823.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,070.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,882.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,540.85
|
| Rate for Payer: EPIC Health Plan Senior |
$1,882.11
|
| Rate for Payer: Galaxy Health WC |
$3,292.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,323.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,485.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,086.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,882.11
|
| Rate for Payer: InnovAge PACE Commercial |
$2,823.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,583.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,882.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$774.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,522.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,522.03
|
| Rate for Payer: Multiplan Commercial |
$2,904.75
|
| Rate for Payer: Multiplan WC |
$2,998.82
|
| Rate for Payer: Networks By Design Commercial |
$2,517.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,882.11
|
| Rate for Payer: Preferred Health Network WC |
$3,060.02
|
| Rate for Payer: Prime Health Services Commercial |
$3,292.05
|
| Rate for Payer: Prime Health Services Medicare |
$1,995.04
|
| Rate for Payer: Prime Health Services WC |
$2,968.22
|
| Rate for Payer: Riverside University Health System MISP |
$2,070.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,323.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,936.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,936.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,936.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,936.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,882.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,823.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,070.32
|
| Rate for Payer: Vantage Medical Group Senior |
$1,882.11
|
|
|
HC BIOPSY SINONASAL MASS PALAT
|
Facility
|
IP
|
$3,873.00
|
|
|
Service Code
|
CPT 42100
|
| Hospital Charge Code |
900501728
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$774.60 |
| Max. Negotiated Rate |
$3,485.70 |
| Rate for Payer: Adventist Health Commercial |
$774.60
|
| Rate for Payer: Cash Price |
$2,130.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,098.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,549.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,549.20
|
| Rate for Payer: Galaxy Health WC |
$3,292.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,323.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,485.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,583.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,475.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,397.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$774.60
|
| Rate for Payer: Multiplan Commercial |
$2,904.75
|
| Rate for Payer: Networks By Design Commercial |
$2,517.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,292.05
|
|
|
HC BIOPSY SKIN EA ADDL LESION
|
Facility
|
IP
|
$693.00
|
|
|
Service Code
|
CPT 11101
|
| Hospital Charge Code |
902890012
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$138.60 |
| Max. Negotiated Rate |
$623.70 |
| Rate for Payer: Adventist Health Commercial |
$138.60
|
| Rate for Payer: Cash Price |
$381.15
|
| Rate for Payer: Central Health Plan Commercial |
$554.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$277.20
|
| Rate for Payer: EPIC Health Plan Senior |
$277.20
|
| Rate for Payer: Galaxy Health WC |
$589.05
|
| Rate for Payer: Global Benefits Group Commercial |
$415.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$623.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$462.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$264.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$428.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.60
|
| Rate for Payer: Multiplan Commercial |
$519.75
|
| Rate for Payer: Networks By Design Commercial |
$450.45
|
| Rate for Payer: Prime Health Services Commercial |
$589.05
|
|
