|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
OP
|
$2,110.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
906749080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$422.00 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,132.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,266.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,132.59
|
| Rate for Payer: Cash Price |
$949.50
|
| Rate for Payer: Cash Price |
$949.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,688.00
|
| Rate for Payer: Cigna of CA PPO |
$1,561.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$1,793.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,266.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,899.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,582.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,868.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: InnovAge PACE Commercial |
$1,698.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,407.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$526.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$422.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,517.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$1,582.50
|
| Rate for Payer: Networks By Design Commercial |
$1,371.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,793.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,200.55
|
| Rate for Payer: Riverside University Health System MISP |
$1,245.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,266.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
OP
|
$2,110.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
901200097
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$422.00 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,132.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,266.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,132.59
|
| Rate for Payer: Cash Price |
$949.50
|
| Rate for Payer: Cash Price |
$949.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,688.00
|
| Rate for Payer: Cigna of CA PPO |
$1,561.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$1,793.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,266.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,899.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,582.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,868.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: InnovAge PACE Commercial |
$1,698.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,407.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$526.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$422.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,517.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$1,582.50
|
| Rate for Payer: Networks By Design Commercial |
$1,371.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,793.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,200.55
|
| Rate for Payer: Riverside University Health System MISP |
$1,245.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,266.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
OP
|
$2,110.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
906749080
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,266.00
|
| Rate for Payer: Caremore Medicare Advantage |
$1,132.59
|
| Rate for Payer: Cash Price |
$949.50
|
| Rate for Payer: Cash Price |
$949.50
|
| Rate for Payer: Cash Price |
$949.50
|
| Rate for Payer: Cash Price |
$949.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,688.00
|
| Rate for Payer: Cigna of CA PPO |
$1,561.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$1,793.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,266.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,899.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,582.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: InnovAge PACE Commercial |
$1,698.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,407.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$526.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$422.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,517.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$1,582.50
|
| Rate for Payer: Networks By Design Commercial |
$1,371.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,793.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,200.55
|
| Rate for Payer: Riverside University Health System MISP |
$1,245.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,266.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,055.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,055.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,055.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,055.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
IP
|
$2,110.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
906749080
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$422.00 |
| Max. Negotiated Rate |
$1,899.00 |
| Rate for Payer: Cash Price |
$949.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,688.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$844.00
|
| Rate for Payer: Galaxy Health WC |
$1,793.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,266.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,899.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,407.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$803.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$422.00
|
| Rate for Payer: Multiplan Commercial |
$1,582.50
|
| Rate for Payer: Networks By Design Commercial |
$1,371.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,793.50
|
|
|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
IP
|
$2,110.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
906749080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$422.00 |
| Max. Negotiated Rate |
$1,899.00 |
| Rate for Payer: Cash Price |
$949.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,688.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$844.00
|
| Rate for Payer: Galaxy Health WC |
$1,793.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,266.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,899.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,407.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$803.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$422.00
|
| Rate for Payer: Multiplan Commercial |
$1,582.50
|
| Rate for Payer: Networks By Design Commercial |
$1,371.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,793.50
|
|
|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
IP
|
$2,110.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
901200097
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$422.00 |
| Max. Negotiated Rate |
$1,899.00 |
| Rate for Payer: Cash Price |
$949.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,688.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$844.00
|
| Rate for Payer: Galaxy Health WC |
$1,793.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,266.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,899.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,407.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$803.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$422.00
|
| Rate for Payer: Multiplan Commercial |
$1,582.50
|
| Rate for Payer: Networks By Design Commercial |
$1,371.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,793.50
|
|
|
HC ABD PARACENTESIS W IMAGE GUID
|
Facility
|
IP
|
$2,110.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
906749080
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$422.00 |
| Max. Negotiated Rate |
$1,899.00 |
| Rate for Payer: Cash Price |
$949.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,688.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$844.00
|
| Rate for Payer: Galaxy Health WC |
$1,793.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,266.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,899.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,407.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$803.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$422.00
|
| Rate for Payer: Multiplan Commercial |
$1,582.50
|
| Rate for Payer: Networks By Design Commercial |
$1,371.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,793.50
|
|
|
HC ABD PARACENTESIS W IMAG GUID
|
Facility
|
IP
|
$1,789.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
901249083
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$357.80 |
| Max. Negotiated Rate |
$1,610.10 |
| Rate for Payer: Cash Price |
$805.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,431.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$715.60
|
| Rate for Payer: Galaxy Health WC |
$1,520.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,073.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,610.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,193.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$681.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$357.80
|
| Rate for Payer: Multiplan Commercial |
$1,341.75
|
| Rate for Payer: Networks By Design Commercial |
$1,162.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,520.65
|
|
|
HC ABD PARACENTESIS W IMAG GUID
|
Facility
|
OP
|
$1,789.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
901249083
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$357.80 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,132.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,073.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,132.59
|
| Rate for Payer: Cash Price |
$805.05
|
| Rate for Payer: Cash Price |
$805.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,431.20
|
| Rate for Payer: Cigna of CA PPO |
$1,323.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$1,520.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,073.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,610.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,341.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,868.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: InnovAge PACE Commercial |
$1,698.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,193.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$526.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$357.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,517.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$1,341.75
|
| Rate for Payer: Networks By Design Commercial |
$1,162.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,520.65
|
| Rate for Payer: Prime Health Services Medicare |
$1,200.55
|
| Rate for Payer: Riverside University Health System MISP |
$1,245.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,073.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,359.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC ABD PARACENTESIS W IMAG GUID
|
Facility
|
IP
|
$1,789.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
901249083
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$357.80 |
| Max. Negotiated Rate |
$1,610.10 |
| Rate for Payer: Cash Price |
$805.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,431.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$715.60
|
| Rate for Payer: Galaxy Health WC |
$1,520.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,073.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,610.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,193.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$681.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$357.80
|
| Rate for Payer: Multiplan Commercial |
$1,341.75
|
| Rate for Payer: Networks By Design Commercial |
$1,162.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,520.65
|
|
|
HC ABD PARACENTESIS W IMAG GUID
|
Facility
|
OP
|
$1,789.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
901249083
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$357.80 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,132.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,073.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,125.28
|
| Rate for Payer: Blue Shield of California EPN |
$874.82
|
| Rate for Payer: Caremore Medicare Advantage |
$1,132.59
|
| Rate for Payer: Cash Price |
$805.05
|
| Rate for Payer: Cash Price |
$805.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,431.20
|
| Rate for Payer: Cigna of CA HMO |
$1,144.96
|
| Rate for Payer: Cigna of CA PPO |
$1,323.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$1,520.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,073.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,610.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,341.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,868.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: InnovAge PACE Commercial |
$1,698.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,193.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$526.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$357.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,517.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$1,341.75
|
| Rate for Payer: Networks By Design Commercial |
$1,162.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,520.65
|
| Rate for Payer: Prime Health Services Medicare |
$1,200.55
|
| Rate for Payer: Riverside University Health System MISP |
$1,245.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,073.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,073.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$894.50
|
| Rate for Payer: United Healthcare All Other HMO |
$894.50
|
| Rate for Payer: United Healthcare HMO Rider |
$894.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$894.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC ABD PARACENTESIS WO IMAGE GUID
|
Facility
|
IP
|
$2,183.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
901200098
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$436.60 |
| Max. Negotiated Rate |
$1,964.70 |
| Rate for Payer: Cash Price |
$982.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,746.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$873.20
|
| Rate for Payer: Galaxy Health WC |
$1,855.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,309.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,964.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,456.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$831.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$436.60
|
| Rate for Payer: Multiplan Commercial |
$1,637.25
|
| Rate for Payer: Networks By Design Commercial |
$1,418.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,855.55
|
|
|
HC ABD PARACENTESIS WO IMAGE GUID
|
Facility
|
OP
|
$2,183.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
906749081
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$111.28 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,132.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,309.80
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$1,132.59
|
| Rate for Payer: Cash Price |
$982.35
|
| Rate for Payer: Cash Price |
$982.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,746.40
|
| Rate for Payer: Cigna of CA PPO |
$1,615.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$1,855.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,309.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,964.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,637.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,868.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: InnovAge PACE Commercial |
$1,698.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,456.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$436.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,517.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$1,637.25
|
| Rate for Payer: Networks By Design Commercial |
$1,418.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,855.55
|
| Rate for Payer: Prime Health Services Medicare |
$1,200.55
|
| Rate for Payer: Riverside University Health System MISP |
$1,245.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,309.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC ABD PARACENTESIS WO IMAGE GUID
|
Facility
|
IP
|
$2,183.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
906749081
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$436.60 |
| Max. Negotiated Rate |
$1,964.70 |
| Rate for Payer: Cash Price |
$982.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,746.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$873.20
|
| Rate for Payer: Galaxy Health WC |
$1,855.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,309.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,964.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,456.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$831.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$436.60
|
| Rate for Payer: Multiplan Commercial |
$1,637.25
|
| Rate for Payer: Networks By Design Commercial |
$1,418.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,855.55
|
|
|
HC ABD PARACENTESIS WO IMAGE GUID
|
Facility
|
OP
|
$2,183.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
901200098
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$111.28 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,132.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,309.80
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$1,132.59
|
| Rate for Payer: Cash Price |
$982.35
|
| Rate for Payer: Cash Price |
$982.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,746.40
|
| Rate for Payer: Cigna of CA PPO |
$1,615.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$1,855.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,309.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,964.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,637.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,868.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: InnovAge PACE Commercial |
$1,698.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,456.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$436.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,517.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$1,637.25
|
| Rate for Payer: Networks By Design Commercial |
$1,418.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,855.55
|
| Rate for Payer: Prime Health Services Medicare |
$1,200.55
|
| Rate for Payer: Riverside University Health System MISP |
$1,245.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,309.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC ABD PARACENTESIS WO IMAGE GUIDE
|
Facility
|
OP
|
$2,183.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
901249082
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$111.28 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,132.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,309.80
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$1,132.59
|
| Rate for Payer: Cash Price |
$982.35
|
| Rate for Payer: Cash Price |
$982.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,746.40
|
| Rate for Payer: Cigna of CA PPO |
$1,615.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$1,855.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,309.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,964.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,637.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,868.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: InnovAge PACE Commercial |
$1,698.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,456.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$436.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,517.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$1,637.25
|
| Rate for Payer: Networks By Design Commercial |
$1,418.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,855.55
|
| Rate for Payer: Prime Health Services Medicare |
$1,200.55
|
| Rate for Payer: Riverside University Health System MISP |
$1,245.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,309.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,359.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC ABD PARACENTESIS WO IMAGE GUIDE
|
Facility
|
IP
|
$2,183.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
901249082
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$436.60 |
| Max. Negotiated Rate |
$1,964.70 |
| Rate for Payer: Cash Price |
$982.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,746.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$873.20
|
| Rate for Payer: Galaxy Health WC |
$1,855.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,309.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,964.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,456.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$831.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$436.60
|
| Rate for Payer: Multiplan Commercial |
$1,637.25
|
| Rate for Payer: Networks By Design Commercial |
$1,418.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,855.55
|
|
|
HC ABD PARACENTESIS WO IMAGE GUIDE
|
Facility
|
OP
|
$2,183.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
901249082
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$111.28 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,132.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,309.80
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$1,132.59
|
| Rate for Payer: Cash Price |
$982.35
|
| Rate for Payer: Cash Price |
$982.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,746.40
|
| Rate for Payer: Cigna of CA PPO |
$1,615.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$1,855.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,309.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,964.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,637.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,868.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: InnovAge PACE Commercial |
$1,698.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,456.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$436.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,517.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$1,637.25
|
| Rate for Payer: Networks By Design Commercial |
$1,418.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,855.55
|
| Rate for Payer: Prime Health Services Medicare |
$1,200.55
|
| Rate for Payer: Riverside University Health System MISP |
$1,245.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,309.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC ABD PARACENTESIS WO IMAGE GUIDE
|
Facility
|
IP
|
$2,183.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
901249082
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$436.60 |
| Max. Negotiated Rate |
$1,964.70 |
| Rate for Payer: Cash Price |
$982.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,746.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$873.20
|
| Rate for Payer: Galaxy Health WC |
$1,855.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,309.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,964.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,456.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$831.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$436.60
|
| Rate for Payer: Multiplan Commercial |
$1,637.25
|
| Rate for Payer: Networks By Design Commercial |
$1,418.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,855.55
|
|
|
HC ABD/PEL/LE ART, 1ST ORDR CA
|
Facility
|
IP
|
$2,251.00
|
|
|
Service Code
|
CPT 36245
|
| Hospital Charge Code |
909081315
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$450.20 |
| Max. Negotiated Rate |
$2,025.90 |
| Rate for Payer: Cash Price |
$1,012.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,800.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$900.40
|
| Rate for Payer: Galaxy Health WC |
$1,913.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,350.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,025.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,501.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$857.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$450.20
|
| Rate for Payer: Multiplan Commercial |
$1,688.25
|
| Rate for Payer: Networks By Design Commercial |
$1,463.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,913.35
|
|
|
HC ABD/PEL/LE ART, 1ST ORDR CA
|
Facility
|
IP
|
$2,251.00
|
|
|
Service Code
|
CPT 36245
|
| Hospital Charge Code |
906820173
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$450.20 |
| Max. Negotiated Rate |
$2,025.90 |
| Rate for Payer: Cash Price |
$1,012.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,800.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$900.40
|
| Rate for Payer: Galaxy Health WC |
$1,913.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,350.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,025.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,501.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$857.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$450.20
|
| Rate for Payer: Multiplan Commercial |
$1,688.25
|
| Rate for Payer: Networks By Design Commercial |
$1,463.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,913.35
|
|
|
HC ABD/PEL/LE ART, 1ST ORDR CA
|
Facility
|
OP
|
$2,251.00
|
|
|
Service Code
|
CPT 36245
|
| Hospital Charge Code |
906820173
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$385.51 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,913.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,238.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,238.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,350.60
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$1,012.95
|
| Rate for Payer: Cash Price |
$1,012.95
|
| Rate for Payer: Cash Price |
$1,012.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,800.80
|
| Rate for Payer: Cigna of CA PPO |
$1,665.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,913.35
|
| Rate for Payer: Dignity Health Media |
$1,913.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,913.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$900.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$900.40
|
| Rate for Payer: Galaxy Health WC |
$1,913.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,350.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,025.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,688.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$787.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,501.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$385.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$450.20
|
| Rate for Payer: Multiplan Commercial |
$1,688.25
|
| Rate for Payer: Networks By Design Commercial |
$1,463.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,913.35
|
| Rate for Payer: Riverside University Health System MISP |
$900.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,350.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,913.35
|
| Rate for Payer: Vantage Medical Group Senior |
$1,913.35
|
|
|
HC ABD/PEL/LE ART, 1ST ORDR CA
|
Facility
|
OP
|
$2,251.00
|
|
|
Service Code
|
CPT 36245
|
| Hospital Charge Code |
909081315
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$385.51 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,913.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,238.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,238.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,350.60
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$1,012.95
|
| Rate for Payer: Cash Price |
$1,012.95
|
| Rate for Payer: Cash Price |
$1,012.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,800.80
|
| Rate for Payer: Cigna of CA PPO |
$1,665.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,913.35
|
| Rate for Payer: Dignity Health Media |
$1,913.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,913.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$900.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$900.40
|
| Rate for Payer: Galaxy Health WC |
$1,913.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,350.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,025.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,688.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$787.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,501.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$385.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$450.20
|
| Rate for Payer: Multiplan Commercial |
$1,688.25
|
| Rate for Payer: Networks By Design Commercial |
$1,463.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,913.35
|
| Rate for Payer: Riverside University Health System MISP |
$900.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,350.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,913.35
|
| Rate for Payer: Vantage Medical Group Senior |
$1,913.35
|
|
|
HC ABD/PEL/LE ART, 2ND ORDR CA
|
Facility
|
IP
|
$805.00
|
|
|
Service Code
|
CPT 36246
|
| Hospital Charge Code |
909081324
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$724.50 |
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Central Health Plan Commercial |
$644.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.00
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$724.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$536.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$306.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.00
|
| Rate for Payer: Multiplan Commercial |
$603.75
|
| Rate for Payer: Networks By Design Commercial |
$523.25
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
|
|
HC ABD/PEL/LE ART, 2ND ORDR CA
|
Facility
|
OP
|
$805.00
|
|
|
Service Code
|
CPT 36246
|
| Hospital Charge Code |
906820180
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$684.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$442.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$442.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$483.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Central Health Plan Commercial |
$644.00
|
| Rate for Payer: Cigna of CA PPO |
$595.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$684.25
|
| Rate for Payer: Dignity Health Media |
$684.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$684.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$322.00
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$724.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$603.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$281.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$536.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$462.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.00
|
| Rate for Payer: Multiplan Commercial |
$603.75
|
| Rate for Payer: Networks By Design Commercial |
$523.25
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
| Rate for Payer: Riverside University Health System MISP |
$322.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$483.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$684.25
|
| Rate for Payer: Vantage Medical Group Senior |
$684.25
|
|
