|
HC BRONCHIAL THERMOPLASTY 2+ LOBES
|
Facility
|
OP
|
$13,743.00
|
|
|
Service Code
|
CPT 31661
|
| Hospital Charge Code |
900831661
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$338.10 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$2,748.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$8,795.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,193.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,675.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,795.69
|
| 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 |
$14,014.35
|
| 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 |
$7,558.65
|
| Rate for Payer: Cash Price |
$7,558.65
|
| Rate for Payer: Cash Price |
$7,558.65
|
| Rate for Payer: Central Health Plan Commercial |
$10,994.40
|
| Rate for Payer: Cigna of CA HMO |
$8,795.52
|
| Rate for Payer: Cigna of CA PPO |
$10,169.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,193.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,675.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,795.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,874.18
|
| Rate for Payer: EPIC Health Plan Senior |
$8,795.69
|
| Rate for Payer: Galaxy Health WC |
$11,681.55
|
| Rate for Payer: Global Benefits Group Commercial |
$8,245.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,368.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14,424.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$338.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,795.69
|
| Rate for Payer: InnovAge PACE Commercial |
$13,193.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,166.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$373.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,795.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,748.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,786.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,786.22
|
| Rate for Payer: Multiplan Commercial |
$10,307.25
|
| Rate for Payer: Multiplan WC |
$14,014.35
|
| Rate for Payer: Networks By Design Commercial |
$8,932.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8,795.69
|
| Rate for Payer: Preferred Health Network WC |
$14,300.36
|
| Rate for Payer: Prime Health Services Commercial |
$11,681.55
|
| Rate for Payer: Prime Health Services Medicare |
$9,323.43
|
| Rate for Payer: Prime Health Services WC |
$13,871.35
|
| Rate for Payer: Riverside University Health System MISP |
$9,675.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,245.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$8,795.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,193.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,675.26
|
| Rate for Payer: Vantage Medical Group Senior |
$8,795.69
|
|
|
HC BRONCHIAL THERMOPLASTY 2+ LOBES
|
Facility
|
IP
|
$13,743.00
|
|
|
Service Code
|
CPT 31661
|
| Hospital Charge Code |
900831661
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,748.60 |
| Max. Negotiated Rate |
$12,368.70 |
| Rate for Payer: Adventist Health Commercial |
$2,748.60
|
| Rate for Payer: Cash Price |
$7,558.65
|
| Rate for Payer: Central Health Plan Commercial |
$10,994.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,497.20
|
| Rate for Payer: EPIC Health Plan Senior |
$5,497.20
|
| Rate for Payer: Galaxy Health WC |
$11,681.55
|
| Rate for Payer: Global Benefits Group Commercial |
$8,245.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,368.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,166.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,236.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,506.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,748.60
|
| Rate for Payer: Multiplan Commercial |
$10,307.25
|
| Rate for Payer: Networks By Design Commercial |
$8,932.95
|
| Rate for Payer: Prime Health Services Commercial |
$11,681.55
|
|
|
HC BRONCHOGRAM BILAT
|
Facility
|
IP
|
$782.00
|
|
|
Service Code
|
CPT 71060
|
| Hospital Charge Code |
909001451
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$156.40 |
| Max. Negotiated Rate |
$703.80 |
| Rate for Payer: Adventist Health Commercial |
$156.40
|
| Rate for Payer: Cash Price |
$430.10
|
| Rate for Payer: Central Health Plan Commercial |
$625.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$312.80
|
| Rate for Payer: EPIC Health Plan Senior |
$312.80
|
| Rate for Payer: Galaxy Health WC |
$664.70
|
| Rate for Payer: Global Benefits Group Commercial |
$469.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$703.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$521.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$297.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$484.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$156.40
|
| Rate for Payer: Multiplan Commercial |
$586.50
|
| Rate for Payer: Networks By Design Commercial |
$508.30
|
| Rate for Payer: Prime Health Services Commercial |
$664.70
|
|
|
HC BRONCHOGRAM BILAT
|
Facility
|
OP
|
$782.00
|
|
|
Service Code
|
CPT 71060
|
| Hospital Charge Code |
909001451
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$156.40 |
| Max. Negotiated Rate |
$703.80 |
| Rate for Payer: Adventist Health Commercial |
$156.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$474.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$664.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$430.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$586.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$378.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$459.27
|
| Rate for Payer: Blue Shield of California Commercial |
$474.67
|
| Rate for Payer: Blue Shield of California EPN |
$310.45
|
| Rate for Payer: Cash Price |
$430.10
|
| Rate for Payer: Central Health Plan Commercial |
$625.60
|
| Rate for Payer: Cigna of CA HMO |
$500.48
|
| Rate for Payer: Cigna of CA PPO |
$578.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$664.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$664.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$664.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$312.80
|
| Rate for Payer: EPIC Health Plan Senior |
$312.80
|
| Rate for Payer: Galaxy Health WC |
$664.70
|
| Rate for Payer: Global Benefits Group Commercial |
$469.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$703.80
|
| Rate for Payer: InnovAge PACE Commercial |
$391.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$521.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$297.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$484.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$156.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$547.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$547.40
|
| Rate for Payer: Multiplan Commercial |
$586.50
|
| Rate for Payer: Networks By Design Commercial |
$508.30
|
| Rate for Payer: Prime Health Services Commercial |
$664.70
|
| Rate for Payer: Riverside University Health System MISP |
$312.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$469.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$469.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$391.00
|
| Rate for Payer: United Healthcare All Other HMO |
$391.00
|
| Rate for Payer: United Healthcare HMO Rider |
$391.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$391.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$664.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$664.70
|
| Rate for Payer: Vantage Medical Group Senior |
$664.70
|
|
|
HC BRONCHOGRAM UNILAT
|
Facility
|
OP
|
$782.00
|
|
|
Service Code
|
CPT 71040
|
| Hospital Charge Code |
909001477
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$156.40 |
| Max. Negotiated Rate |
$703.80 |
| Rate for Payer: Adventist Health Commercial |
$156.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$474.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$664.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$430.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$586.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$378.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$459.27
|
| Rate for Payer: Blue Shield of California Commercial |
$474.67
|
| Rate for Payer: Blue Shield of California EPN |
$310.45
|
| Rate for Payer: Cash Price |
$430.10
|
| Rate for Payer: Central Health Plan Commercial |
$625.60
|
| Rate for Payer: Cigna of CA HMO |
$500.48
|
| Rate for Payer: Cigna of CA PPO |
$578.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$664.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$664.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$664.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$312.80
|
| Rate for Payer: EPIC Health Plan Senior |
$312.80
|
| Rate for Payer: Galaxy Health WC |
$664.70
|
| Rate for Payer: Global Benefits Group Commercial |
$469.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$703.80
|
| Rate for Payer: InnovAge PACE Commercial |
$391.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$521.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$297.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$484.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$156.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$547.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$547.40
|
| Rate for Payer: Multiplan Commercial |
$586.50
|
| Rate for Payer: Networks By Design Commercial |
$508.30
|
| Rate for Payer: Prime Health Services Commercial |
$664.70
|
| Rate for Payer: Riverside University Health System MISP |
$312.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$469.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$469.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$391.00
|
| Rate for Payer: United Healthcare All Other HMO |
$391.00
|
| Rate for Payer: United Healthcare HMO Rider |
$391.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$391.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$664.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$664.70
|
| Rate for Payer: Vantage Medical Group Senior |
$664.70
|
|
|
HC BRONCHOGRAM UNILAT
|
Facility
|
IP
|
$782.00
|
|
|
Service Code
|
CPT 71040
|
| Hospital Charge Code |
909001477
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$156.40 |
| Max. Negotiated Rate |
$703.80 |
| Rate for Payer: Adventist Health Commercial |
$156.40
|
| Rate for Payer: Cash Price |
$430.10
|
| Rate for Payer: Central Health Plan Commercial |
$625.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$312.80
|
| Rate for Payer: EPIC Health Plan Senior |
$312.80
|
| Rate for Payer: Galaxy Health WC |
$664.70
|
| Rate for Payer: Global Benefits Group Commercial |
$469.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$703.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$521.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$297.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$484.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$156.40
|
| Rate for Payer: Multiplan Commercial |
$586.50
|
| Rate for Payer: Networks By Design Commercial |
$508.30
|
| Rate for Payer: Prime Health Services Commercial |
$664.70
|
|
|
HC BRONCHOSCOPY W BRONCH ALVEOLAR
|
Facility
|
IP
|
$9,338.00
|
|
|
Service Code
|
CPT 31624
|
| Hospital Charge Code |
900803502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,867.60 |
| Max. Negotiated Rate |
$8,404.20 |
| Rate for Payer: Adventist Health Commercial |
$1,867.60
|
| Rate for Payer: Cash Price |
$5,135.90
|
| Rate for Payer: Central Health Plan Commercial |
$7,470.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,735.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,735.20
|
| Rate for Payer: Galaxy Health WC |
$7,937.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,602.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,404.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,228.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,557.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,780.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,867.60
|
| Rate for Payer: Multiplan Commercial |
$7,003.50
|
| Rate for Payer: Networks By Design Commercial |
$6,069.70
|
| Rate for Payer: Prime Health Services Commercial |
$7,937.30
|
|
|
HC BRONCHOSCOPY W BRONCH ALVEOLAR
|
Facility
|
OP
|
$9,338.00
|
|
|
Service Code
|
CPT 31624
|
| Hospital Charge Code |
900803502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$366.93 |
| Max. Negotiated Rate |
$8,404.20 |
| Rate for Payer: Adventist Health Commercial |
$1,867.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,191.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,410.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,191.11
|
| 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 |
$3,491.15
|
| 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 |
$5,135.90
|
| Rate for Payer: Cash Price |
$5,135.90
|
| Rate for Payer: Cash Price |
$5,135.90
|
| Rate for Payer: Central Health Plan Commercial |
$7,470.40
|
| Rate for Payer: Cigna of CA HMO |
$5,976.32
|
| Rate for Payer: Cigna of CA PPO |
$6,910.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,410.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,191.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,958.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,191.11
|
| Rate for Payer: Galaxy Health WC |
$7,937.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,602.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,404.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,593.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$366.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,191.11
|
| Rate for Payer: InnovAge PACE Commercial |
$3,286.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,228.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$405.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,191.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,867.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,936.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,936.09
|
| Rate for Payer: Multiplan Commercial |
$7,003.50
|
| Rate for Payer: Multiplan WC |
$3,491.15
|
| Rate for Payer: Networks By Design Commercial |
$6,069.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,191.11
|
| Rate for Payer: Preferred Health Network WC |
$3,562.40
|
| Rate for Payer: Prime Health Services Commercial |
$7,937.30
|
| Rate for Payer: Prime Health Services Medicare |
$2,322.58
|
| Rate for Payer: Prime Health Services WC |
$3,455.53
|
| Rate for Payer: Riverside University Health System MISP |
$2,410.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,602.80
|
| 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 |
$2,191.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,410.22
|
| Rate for Payer: Vantage Medical Group Senior |
$2,191.11
|
|
|
HC BRONCHOSCOPY W/RMVL OF F.B.
|
Facility
|
OP
|
$7,519.00
|
|
|
Service Code
|
CPT 31635
|
| Hospital Charge Code |
900501509
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$396.13 |
| Max. Negotiated Rate |
$6,767.10 |
| Rate for Payer: Adventist Health Commercial |
$1,503.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,410.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,191.11
|
| 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 |
$3,491.15
|
| Rate for Payer: Cash Price |
$4,135.45
|
| Rate for Payer: Cash Price |
$4,135.45
|
| Rate for Payer: Cash Price |
$4,135.45
|
| Rate for Payer: Cash Price |
$4,135.45
|
| Rate for Payer: Central Health Plan Commercial |
$6,015.20
|
| Rate for Payer: Cigna of CA HMO |
$4,812.16
|
| Rate for Payer: Cigna of CA PPO |
$5,564.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,410.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,191.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,958.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,191.11
|
| Rate for Payer: Galaxy Health WC |
$6,391.15
|
| Rate for Payer: Global Benefits Group Commercial |
$4,511.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,767.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,593.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,191.11
|
| Rate for Payer: InnovAge PACE Commercial |
$3,286.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,015.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$396.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,191.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,503.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,936.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,936.09
|
| Rate for Payer: Multiplan Commercial |
$5,639.25
|
| Rate for Payer: Multiplan WC |
$3,491.15
|
| Rate for Payer: Networks By Design Commercial |
$4,887.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,191.11
|
| Rate for Payer: Preferred Health Network WC |
$3,562.40
|
| Rate for Payer: Prime Health Services Commercial |
$6,391.15
|
| Rate for Payer: Prime Health Services Medicare |
$2,322.58
|
| Rate for Payer: Prime Health Services WC |
$3,455.53
|
| Rate for Payer: Riverside University Health System MISP |
$2,410.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,511.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,759.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,759.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,759.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,759.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,191.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,410.22
|
| Rate for Payer: Vantage Medical Group Senior |
$2,191.11
|
|
|
HC BRONCHOSCOPY W/RMVL OF F.B.
|
Facility
|
IP
|
$7,519.00
|
|
|
Service Code
|
CPT 31635
|
| Hospital Charge Code |
900501509
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,503.80 |
| Max. Negotiated Rate |
$6,767.10 |
| Rate for Payer: Adventist Health Commercial |
$1,503.80
|
| Rate for Payer: Cash Price |
$4,135.45
|
| Rate for Payer: Central Health Plan Commercial |
$6,015.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,007.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,007.60
|
| Rate for Payer: Galaxy Health WC |
$6,391.15
|
| Rate for Payer: Global Benefits Group Commercial |
$4,511.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,767.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,015.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,864.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,654.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,503.80
|
| Rate for Payer: Multiplan Commercial |
$5,639.25
|
| Rate for Payer: Networks By Design Commercial |
$4,887.35
|
| Rate for Payer: Prime Health Services Commercial |
$6,391.15
|
|
|
HC BRONCH-RADIOELEMENT PLACEMENT
|
Facility
|
OP
|
$5,620.00
|
|
|
Service Code
|
CPT 31643
|
| Hospital Charge Code |
900803506
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$309.29 |
| Max. Negotiated Rate |
$6,333.00 |
| Rate for Payer: Adventist Health Commercial |
$1,124.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,191.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,410.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,191.11
|
| 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: Blue Shield of California Commercial |
$3,433.82
|
| Rate for Payer: Blue Shield of California EPN |
$2,242.38
|
| Rate for Payer: Cash Price |
$3,091.00
|
| Rate for Payer: Cash Price |
$3,091.00
|
| Rate for Payer: Cash Price |
$3,091.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,496.00
|
| Rate for Payer: Cigna of CA HMO |
$3,596.80
|
| Rate for Payer: Cigna of CA PPO |
$4,158.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,410.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,191.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,958.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,191.11
|
| Rate for Payer: Galaxy Health WC |
$4,777.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,372.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,058.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,593.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$309.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,191.11
|
| Rate for Payer: InnovAge PACE Commercial |
$3,286.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,748.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$341.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,191.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,124.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,936.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,936.09
|
| Rate for Payer: Multiplan Commercial |
$4,215.00
|
| Rate for Payer: Networks By Design Commercial |
$3,653.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,191.11
|
| Rate for Payer: Prime Health Services Commercial |
$4,777.00
|
| Rate for Payer: Prime Health Services Medicare |
$2,322.58
|
| Rate for Payer: Riverside University Health System MISP |
$2,410.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,372.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,372.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,810.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,810.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,810.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,810.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,191.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,286.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,410.22
|
| Rate for Payer: Vantage Medical Group Senior |
$2,191.11
|
|
|
HC BRONCH-RADIOELEMENT PLACEMENT
|
Facility
|
IP
|
$5,620.00
|
|
|
Service Code
|
CPT 31643
|
| Hospital Charge Code |
900803506
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,124.00 |
| Max. Negotiated Rate |
$5,058.00 |
| Rate for Payer: Adventist Health Commercial |
$1,124.00
|
| Rate for Payer: Cash Price |
$3,091.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,496.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,248.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,248.00
|
| Rate for Payer: Galaxy Health WC |
$4,777.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,372.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,058.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,748.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,141.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,478.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,124.00
|
| Rate for Payer: Multiplan Commercial |
$4,215.00
|
| Rate for Payer: Networks By Design Commercial |
$3,653.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,777.00
|
|
|
HC BRONCH W BLLN OCC ADD LOBES
|
Facility
|
OP
|
$6,130.00
|
|
|
Service Code
|
CPT 31651
|
| Hospital Charge Code |
900831651
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$112.69 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$1,226.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,210.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,371.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,597.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,968.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,600.15
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,371.50
|
| Rate for Payer: Cash Price |
$3,371.50
|
| Rate for Payer: Cash Price |
$3,371.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,904.00
|
| Rate for Payer: Cigna of CA HMO |
$3,923.20
|
| Rate for Payer: Cigna of CA PPO |
$4,536.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,210.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,210.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,210.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,452.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,452.00
|
| Rate for Payer: Galaxy Health WC |
$5,210.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,678.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,517.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$112.69
|
| Rate for Payer: InnovAge PACE Commercial |
$3,065.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,088.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$124.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,794.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,226.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,291.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,291.00
|
| Rate for Payer: Multiplan Commercial |
$4,597.50
|
| Rate for Payer: Networks By Design Commercial |
$3,984.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,210.50
|
| Rate for Payer: Riverside University Health System MISP |
$2,452.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,678.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,210.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,210.50
|
| Rate for Payer: Vantage Medical Group Senior |
$5,210.50
|
|
|
HC BRONCH W BLLN OCC ADD LOBES
|
Facility
|
IP
|
$6,130.00
|
|
|
Service Code
|
CPT 31651
|
| Hospital Charge Code |
900831651
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,226.00 |
| Max. Negotiated Rate |
$5,517.00 |
| Rate for Payer: Adventist Health Commercial |
$1,226.00
|
| Rate for Payer: Cash Price |
$3,371.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,904.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,452.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,452.00
|
| Rate for Payer: Galaxy Health WC |
$5,210.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,678.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,517.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,088.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,335.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,794.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,226.00
|
| Rate for Payer: Multiplan Commercial |
$4,597.50
|
| Rate for Payer: Networks By Design Commercial |
$3,984.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,210.50
|
|
|
HC BRONCH W/BLLN OCCLUSION
|
Facility
|
OP
|
$6,014.00
|
|
|
Service Code
|
CPT 31634
|
| Hospital Charge Code |
900803513
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$299.04 |
| Max. Negotiated Rate |
$14,424.93 |
| Rate for Payer: Adventist Health Commercial |
$1,202.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$8,795.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,193.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,675.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,795.69
|
| 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: Blue Shield of California Commercial |
$3,674.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,399.59
|
| Rate for Payer: Cash Price |
$3,307.70
|
| Rate for Payer: Cash Price |
$3,307.70
|
| Rate for Payer: Cash Price |
$3,307.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,811.20
|
| Rate for Payer: Cigna of CA HMO |
$3,848.96
|
| Rate for Payer: Cigna of CA PPO |
$4,450.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,193.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,675.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,795.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,874.18
|
| Rate for Payer: EPIC Health Plan Senior |
$8,795.69
|
| Rate for Payer: Galaxy Health WC |
$5,111.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,608.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,412.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14,424.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$299.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,795.69
|
| Rate for Payer: InnovAge PACE Commercial |
$13,193.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,011.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$330.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,795.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,202.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,786.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,786.22
|
| Rate for Payer: Multiplan Commercial |
$4,510.50
|
| Rate for Payer: Networks By Design Commercial |
$3,909.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8,795.69
|
| Rate for Payer: Prime Health Services Commercial |
$5,111.90
|
| Rate for Payer: Prime Health Services Medicare |
$9,323.43
|
| Rate for Payer: Riverside University Health System MISP |
$9,675.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,608.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,608.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,007.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,007.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,007.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,007.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$8,795.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,193.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,675.26
|
| Rate for Payer: Vantage Medical Group Senior |
$8,795.69
|
|
|
HC BRONCH W/BLLN OCCLUSION
|
Facility
|
IP
|
$6,014.00
|
|
|
Service Code
|
CPT 31634
|
| Hospital Charge Code |
900803513
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,202.80 |
| Max. Negotiated Rate |
$5,412.60 |
| Rate for Payer: Adventist Health Commercial |
$1,202.80
|
| Rate for Payer: Cash Price |
$3,307.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,811.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,405.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,405.60
|
| Rate for Payer: Galaxy Health WC |
$5,111.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,608.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,412.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,011.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,291.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,722.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,202.80
|
| Rate for Payer: Multiplan Commercial |
$4,510.50
|
| Rate for Payer: Networks By Design Commercial |
$3,909.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,111.90
|
|
|
HC BRONCH W PLCMNT FIDUCIAL MRK
|
Facility
|
IP
|
$16,363.00
|
|
|
Service Code
|
CPT 31626
|
| Hospital Charge Code |
900531626
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,272.60 |
| Max. Negotiated Rate |
$14,726.70 |
| Rate for Payer: Adventist Health Commercial |
$3,272.60
|
| Rate for Payer: Cash Price |
$8,999.65
|
| Rate for Payer: Central Health Plan Commercial |
$13,090.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,545.20
|
| Rate for Payer: EPIC Health Plan Senior |
$6,545.20
|
| Rate for Payer: Galaxy Health WC |
$13,908.55
|
| Rate for Payer: Global Benefits Group Commercial |
$9,817.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,726.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,914.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,234.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,128.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,272.60
|
| Rate for Payer: Multiplan Commercial |
$12,272.25
|
| Rate for Payer: Networks By Design Commercial |
$10,635.95
|
| Rate for Payer: Prime Health Services Commercial |
$13,908.55
|
|
|
HC BRONCH W PLCMNT FIDUCIAL MRK
|
Facility
|
OP
|
$16,363.00
|
|
|
Service Code
|
CPT 31626
|
| Hospital Charge Code |
900531626
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$645.48 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$3,272.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$8,795.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,193.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,675.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,795.69
|
| 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 |
$14,014.35
|
| 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 |
$8,999.65
|
| Rate for Payer: Cash Price |
$8,999.65
|
| Rate for Payer: Cash Price |
$8,999.65
|
| Rate for Payer: Central Health Plan Commercial |
$13,090.40
|
| Rate for Payer: Cigna of CA HMO |
$10,472.32
|
| Rate for Payer: Cigna of CA PPO |
$12,108.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,193.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,675.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,795.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,874.18
|
| Rate for Payer: EPIC Health Plan Senior |
$8,795.69
|
| Rate for Payer: Galaxy Health WC |
$13,908.55
|
| Rate for Payer: Global Benefits Group Commercial |
$9,817.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,726.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14,424.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$645.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,795.69
|
| Rate for Payer: InnovAge PACE Commercial |
$13,193.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,914.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$713.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,795.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,272.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,786.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,786.22
|
| Rate for Payer: Multiplan Commercial |
$12,272.25
|
| Rate for Payer: Multiplan WC |
$14,014.35
|
| Rate for Payer: Networks By Design Commercial |
$10,635.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8,795.69
|
| Rate for Payer: Preferred Health Network WC |
$14,300.36
|
| Rate for Payer: Prime Health Services Commercial |
$13,908.55
|
| Rate for Payer: Prime Health Services Medicare |
$9,323.43
|
| Rate for Payer: Prime Health Services WC |
$13,871.35
|
| Rate for Payer: Riverside University Health System MISP |
$9,675.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,817.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$8,795.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,193.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,675.26
|
| Rate for Payer: Vantage Medical Group Senior |
$8,795.69
|
|
|
HC BRONCH W/TUMOR EXCISION
|
Facility
|
IP
|
$12,599.00
|
|
|
Service Code
|
CPT 31640
|
| Hospital Charge Code |
900803516
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,519.80 |
| Max. Negotiated Rate |
$11,339.10 |
| Rate for Payer: Adventist Health Commercial |
$2,519.80
|
| Rate for Payer: Cash Price |
$6,929.45
|
| Rate for Payer: Central Health Plan Commercial |
$10,079.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,039.60
|
| Rate for Payer: EPIC Health Plan Senior |
$5,039.60
|
| Rate for Payer: Galaxy Health WC |
$10,709.15
|
| Rate for Payer: Global Benefits Group Commercial |
$7,559.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,339.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,403.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,800.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,798.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,519.80
|
| Rate for Payer: Multiplan Commercial |
$9,449.25
|
| Rate for Payer: Networks By Design Commercial |
$8,189.35
|
| Rate for Payer: Prime Health Services Commercial |
$10,709.15
|
|
|
HC BRONCH W/TUMOR EXCISION
|
Facility
|
OP
|
$12,599.00
|
|
|
Service Code
|
CPT 31640
|
| Hospital Charge Code |
900803516
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$362.44 |
| Max. Negotiated Rate |
$11,339.10 |
| Rate for Payer: Adventist Health Commercial |
$2,519.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,684.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,153.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,684.64
|
| 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: Blue Shield of California Commercial |
$7,697.99
|
| Rate for Payer: Blue Shield of California EPN |
$5,027.00
|
| Rate for Payer: Cash Price |
$6,929.45
|
| Rate for Payer: Cash Price |
$6,929.45
|
| Rate for Payer: Cash Price |
$6,929.45
|
| Rate for Payer: Central Health Plan Commercial |
$10,079.20
|
| Rate for Payer: Cigna of CA HMO |
$8,063.36
|
| Rate for Payer: Cigna of CA PPO |
$9,323.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,153.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,684.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,324.26
|
| Rate for Payer: EPIC Health Plan Senior |
$4,684.64
|
| Rate for Payer: Galaxy Health WC |
$10,709.15
|
| Rate for Payer: Global Benefits Group Commercial |
$7,559.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,339.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,682.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$362.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,684.64
|
| Rate for Payer: InnovAge PACE Commercial |
$7,026.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,403.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$400.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,684.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,519.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,277.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,277.42
|
| Rate for Payer: Multiplan Commercial |
$9,449.25
|
| Rate for Payer: Networks By Design Commercial |
$8,189.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,684.64
|
| Rate for Payer: Prime Health Services Commercial |
$10,709.15
|
| Rate for Payer: Prime Health Services Medicare |
$4,965.72
|
| Rate for Payer: Riverside University Health System MISP |
$5,153.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,559.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,559.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,299.50
|
| Rate for Payer: United Healthcare All Other HMO |
$6,299.50
|
| Rate for Payer: United Healthcare HMO Rider |
$6,299.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,299.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,684.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,153.10
|
| Rate for Payer: Vantage Medical Group Senior |
$4,684.64
|
|
|
HC BRUKER AER ID
|
Facility
|
IP
|
$45.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900913001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Adventist Health Commercial |
$9.00
|
| Rate for Payer: Cash Price |
$24.75
|
| Rate for Payer: Central Health Plan Commercial |
$36.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.00
|
| Rate for Payer: EPIC Health Plan Senior |
$18.00
|
| Rate for Payer: Galaxy Health WC |
$38.25
|
| Rate for Payer: Global Benefits Group Commercial |
$27.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.00
|
| Rate for Payer: Multiplan Commercial |
$33.75
|
| Rate for Payer: Networks By Design Commercial |
$29.25
|
| Rate for Payer: Prime Health Services Commercial |
$38.25
|
|
|
HC BRUKER AER ID
|
Facility
|
OP
|
$45.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900913001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.54 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Commercial |
$9.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$58.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.92
|
| Rate for Payer: Blue Shield of California Commercial |
$27.32
|
| Rate for Payer: Blue Shield of California EPN |
$17.86
|
| Rate for Payer: Cash Price |
$24.75
|
| Rate for Payer: Cash Price |
$24.75
|
| Rate for Payer: Cash Price |
$24.75
|
| Rate for Payer: Central Health Plan Commercial |
$36.00
|
| Rate for Payer: Cigna of CA HMO |
$28.80
|
| Rate for Payer: Cigna of CA PPO |
$33.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.91
|
| Rate for Payer: EPIC Health Plan Senior |
$8.08
|
| Rate for Payer: Galaxy Health WC |
$38.25
|
| Rate for Payer: Global Benefits Group Commercial |
$27.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.08
|
| Rate for Payer: InnovAge PACE Commercial |
$12.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.83
|
| Rate for Payer: Multiplan Commercial |
$33.75
|
| Rate for Payer: Networks By Design Commercial |
$29.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.08
|
| Rate for Payer: Prime Health Services Commercial |
$38.25
|
| Rate for Payer: Prime Health Services Medicare |
$8.56
|
| Rate for Payer: Riverside University Health System MISP |
$8.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.54
|
| Rate for Payer: United Healthcare All Other HMO |
$6.54
|
| Rate for Payer: United Healthcare HMO Rider |
$6.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.54
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Vantage Medical Group Senior |
$8.08
|
|
|
HC BRUKER ANA ID
|
Facility
|
IP
|
$54.98
|
|
|
Service Code
|
CPT 87076
|
| Hospital Charge Code |
900913002
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.00 |
| Max. Negotiated Rate |
$49.48 |
| Rate for Payer: Adventist Health Commercial |
$11.00
|
| Rate for Payer: Cash Price |
$30.24
|
| Rate for Payer: Central Health Plan Commercial |
$43.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.99
|
| Rate for Payer: EPIC Health Plan Senior |
$21.99
|
| Rate for Payer: Galaxy Health WC |
$46.73
|
| Rate for Payer: Global Benefits Group Commercial |
$32.99
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.00
|
| Rate for Payer: Multiplan Commercial |
$41.23
|
| Rate for Payer: Networks By Design Commercial |
$35.74
|
| Rate for Payer: Prime Health Services Commercial |
$46.73
|
|
|
HC BRUKER ANA ID
|
Facility
|
OP
|
$54.98
|
|
|
Service Code
|
CPT 87076
|
| Hospital Charge Code |
900913002
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.54 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Commercial |
$11.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$33.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$91.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.60
|
| Rate for Payer: Blue Shield of California Commercial |
$33.37
|
| Rate for Payer: Blue Shield of California EPN |
$21.83
|
| Rate for Payer: Cash Price |
$30.24
|
| Rate for Payer: Cash Price |
$30.24
|
| Rate for Payer: Cash Price |
$30.24
|
| Rate for Payer: Central Health Plan Commercial |
$43.98
|
| Rate for Payer: Cigna of CA HMO |
$35.19
|
| Rate for Payer: Cigna of CA PPO |
$40.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.91
|
| Rate for Payer: EPIC Health Plan Senior |
$8.08
|
| Rate for Payer: Galaxy Health WC |
$46.73
|
| Rate for Payer: Global Benefits Group Commercial |
$32.99
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.48
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.08
|
| Rate for Payer: InnovAge PACE Commercial |
$12.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.83
|
| Rate for Payer: Multiplan Commercial |
$41.23
|
| Rate for Payer: Networks By Design Commercial |
$35.74
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.08
|
| Rate for Payer: Prime Health Services Commercial |
$46.73
|
| Rate for Payer: Prime Health Services Medicare |
$8.56
|
| Rate for Payer: Riverside University Health System MISP |
$8.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.99
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.54
|
| Rate for Payer: United Healthcare All Other HMO |
$6.54
|
| Rate for Payer: United Healthcare HMO Rider |
$6.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.54
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Vantage Medical Group Senior |
$8.08
|
|
|
HC B/S EMBLEM 3501
|
Facility
|
OP
|
$12,500.00
|
|
|
Service Code
|
CPT C1896
|
| Hospital Charge Code |
906813815
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,500.00 |
| Max. Negotiated Rate |
$11,250.00 |
| Rate for Payer: Adventist Health Commercial |
$2,500.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,625.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,875.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,375.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,052.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,341.25
|
| Rate for Payer: Blue Shield of California Commercial |
$9,662.50
|
| Rate for Payer: Blue Shield of California EPN |
$6,300.00
|
| Rate for Payer: Cash Price |
$6,875.00
|
| Rate for Payer: Central Health Plan Commercial |
$10,000.00
|
| Rate for Payer: Cigna of CA HMO |
$8,750.00
|
| Rate for Payer: Cigna of CA PPO |
$8,750.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,625.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,625.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,625.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,000.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,000.00
|
| Rate for Payer: Galaxy Health WC |
$10,625.00
|
| Rate for Payer: Global Benefits Group Commercial |
$7,500.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,250.00
|
| Rate for Payer: InnovAge PACE Commercial |
$6,250.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,337.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,737.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,500.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,750.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,750.00
|
| Rate for Payer: Multiplan Commercial |
$9,375.00
|
| Rate for Payer: Networks By Design Commercial |
$6,250.00
|
| Rate for Payer: Prime Health Services Commercial |
$10,625.00
|
| Rate for Payer: Riverside University Health System MISP |
$5,000.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,500.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,500.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,691.25
|
| Rate for Payer: United Healthcare All Other HMO |
$4,566.25
|
| Rate for Payer: United Healthcare HMO Rider |
$4,467.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,093.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,625.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,625.00
|
| Rate for Payer: Vantage Medical Group Senior |
$10,625.00
|
|
