|
HC COLONOSCOPY W POLYPECTOMY
|
Facility
|
OP
|
$4,474.00
|
|
|
Service Code
|
CPT 45384
|
| Hospital Charge Code |
906745384
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$644.85 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$894.80
|
| Rate for Payer: Adventist Health Commercial |
$516.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$2,013.30
|
| Rate for Payer: Cash Price |
$2,013.30
|
| Rate for Payer: Cash Price |
$1,161.45
|
| Rate for Payer: Cash Price |
$2,013.30
|
| Rate for Payer: Cash Price |
$1,161.45
|
| Rate for Payer: Cash Price |
$1,161.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,064.80
|
| Rate for Payer: Central Health Plan Commercial |
$3,579.20
|
| Rate for Payer: Cigna of CA HMO |
$1,651.84
|
| Rate for Payer: Cigna of CA HMO |
$2,863.36
|
| Rate for Payer: Cigna of CA PPO |
$3,310.76
|
| Rate for Payer: Cigna of CA PPO |
$1,909.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,806.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,131.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$3,802.90
|
| Rate for Payer: Galaxy Health WC |
$2,193.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,548.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,684.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,322.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,026.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$644.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$644.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,638.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,840.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$712.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$712.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$894.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$516.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$3,355.50
|
| Rate for Payer: Multiplan Commercial |
$1,935.75
|
| Rate for Payer: Networks By Design Commercial |
$2,908.10
|
| Rate for Payer: Networks By Design Commercial |
$1,677.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Prime Health Services Commercial |
$2,193.85
|
| Rate for Payer: Prime Health Services Commercial |
$3,802.90
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,548.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,684.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,237.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,290.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| 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 HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC COLONOSCOPY W RESECTION
|
Facility
|
OP
|
$2,394.00
|
|
|
Service Code
|
CPT 44403
|
| Hospital Charge Code |
906744403
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$478.80 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$478.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,077.30
|
| Rate for Payer: Cash Price |
$1,077.30
|
| Rate for Payer: Cash Price |
$1,077.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,915.20
|
| Rate for Payer: Cigna of CA HMO |
$1,532.16
|
| Rate for Payer: Cigna of CA PPO |
$1,771.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,675.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$2,034.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,436.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,154.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,520.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$478.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$1,795.50
|
| Rate for Payer: Networks By Design Commercial |
$1,556.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Prime Health Services Commercial |
$2,034.90
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,436.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,197.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC COLONOSCOPY W RESECTION
|
Facility
|
IP
|
$2,394.00
|
|
|
Service Code
|
CPT 44403
|
| Hospital Charge Code |
906744403
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$478.80 |
| Max. Negotiated Rate |
$2,154.60 |
| Rate for Payer: Adventist Health Commercial |
$478.80
|
| Rate for Payer: Cash Price |
$1,077.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,915.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,675.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$957.60
|
| Rate for Payer: EPIC Health Plan Senior |
$957.60
|
| Rate for Payer: Galaxy Health WC |
$2,034.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,436.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,154.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,520.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,412.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$478.80
|
| Rate for Payer: Multiplan Commercial |
$1,795.50
|
| Rate for Payer: Networks By Design Commercial |
$1,556.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,034.90
|
|
|
HC COLONOSCOPY W STENT PLCMNT
|
Facility
|
IP
|
$6,781.00
|
|
|
Service Code
|
CPT 45389
|
| Hospital Charge Code |
906745389
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,356.20 |
| Max. Negotiated Rate |
$6,102.90 |
| Rate for Payer: Adventist Health Commercial |
$1,356.20
|
| Rate for Payer: Cash Price |
$3,051.45
|
| Rate for Payer: Central Health Plan Commercial |
$5,424.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,746.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,712.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,712.40
|
| Rate for Payer: Galaxy Health WC |
$5,763.85
|
| Rate for Payer: Global Benefits Group Commercial |
$4,068.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,102.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,305.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,000.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,356.20
|
| Rate for Payer: Multiplan Commercial |
$5,085.75
|
| Rate for Payer: Networks By Design Commercial |
$4,407.65
|
| Rate for Payer: Prime Health Services Commercial |
$5,763.85
|
|
|
HC COLONOSCOPY W STENT PLCMNT
|
Facility
|
OP
|
$6,781.00
|
|
|
Service Code
|
CPT 45389
|
| Hospital Charge Code |
906745389
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,356.20 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,356.20
|
| Rate for Payer: Adventist Health Commercial |
$861.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,808.19
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,808.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,808.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,808.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$3,051.45
|
| Rate for Payer: Cash Price |
$1,937.70
|
| Rate for Payer: Cash Price |
$1,937.70
|
| Rate for Payer: Cash Price |
$1,937.70
|
| Rate for Payer: Cash Price |
$3,051.45
|
| Rate for Payer: Cash Price |
$3,051.45
|
| Rate for Payer: Central Health Plan Commercial |
$3,444.80
|
| Rate for Payer: Central Health Plan Commercial |
$5,424.80
|
| Rate for Payer: Cigna of CA HMO |
$4,339.84
|
| Rate for Payer: Cigna of CA HMO |
$2,755.84
|
| Rate for Payer: Cigna of CA PPO |
$5,017.94
|
| Rate for Payer: Cigna of CA PPO |
$3,186.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,589.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,589.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,808.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,808.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,746.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,014.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,883.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,883.51
|
| Rate for Payer: EPIC Health Plan Senior |
$8,589.01
|
| Rate for Payer: EPIC Health Plan Senior |
$8,589.01
|
| Rate for Payer: Galaxy Health WC |
$5,763.85
|
| Rate for Payer: Galaxy Health WC |
$3,660.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4,068.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,583.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,875.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,102.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,805.43
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,805.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,808.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,808.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,305.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,734.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,931.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,931.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$861.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,356.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10,462.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10,462.97
|
| Rate for Payer: Multiplan Commercial |
$3,229.50
|
| Rate for Payer: Multiplan Commercial |
$5,085.75
|
| Rate for Payer: Networks By Design Commercial |
$4,407.65
|
| Rate for Payer: Networks By Design Commercial |
$2,798.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,808.19
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,808.19
|
| Rate for Payer: Prime Health Services Commercial |
$5,763.85
|
| Rate for Payer: Prime Health Services Commercial |
$3,660.10
|
| Rate for Payer: Prime Health Services Medicare |
$8,276.68
|
| Rate for Payer: Prime Health Services Medicare |
$8,276.68
|
| Rate for Payer: Riverside University Health System MISP |
$8,589.01
|
| Rate for Payer: Riverside University Health System MISP |
$8,589.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,583.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,068.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,369.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,369.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,390.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,153.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| 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 HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,808.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,808.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Vantage Medical Group Senior |
$7,808.19
|
| Rate for Payer: Vantage Medical Group Senior |
$7,808.19
|
|
|
HC COLONOSCOPY W SUBMUCOSAL INJ
|
Facility
|
IP
|
$6,112.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
906745381
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,222.40 |
| Max. Negotiated Rate |
$5,500.80 |
| Rate for Payer: Adventist Health Commercial |
$1,222.40
|
| Rate for Payer: Cash Price |
$2,750.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,889.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,278.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,444.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,444.80
|
| Rate for Payer: Galaxy Health WC |
$5,195.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,667.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,500.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,881.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,606.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,222.40
|
| Rate for Payer: Multiplan Commercial |
$4,584.00
|
| Rate for Payer: Networks By Design Commercial |
$3,972.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,195.20
|
|
|
HC COLONOSCOPY W SUBMUCOSAL INJ
|
Facility
|
OP
|
$6,112.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
906745381
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$710.15 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,222.40
|
| Rate for Payer: Adventist Health Commercial |
$776.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$2,750.40
|
| Rate for Payer: Cash Price |
$2,750.40
|
| Rate for Payer: Cash Price |
$1,746.90
|
| Rate for Payer: Cash Price |
$2,750.40
|
| Rate for Payer: Cash Price |
$1,746.90
|
| Rate for Payer: Cash Price |
$1,746.90
|
| Rate for Payer: Central Health Plan Commercial |
$3,105.60
|
| Rate for Payer: Central Health Plan Commercial |
$4,889.60
|
| Rate for Payer: Cigna of CA HMO |
$2,484.48
|
| Rate for Payer: Cigna of CA HMO |
$3,911.68
|
| Rate for Payer: Cigna of CA PPO |
$4,522.88
|
| Rate for Payer: Cigna of CA PPO |
$2,872.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,717.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,278.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$5,195.20
|
| Rate for Payer: Galaxy Health WC |
$3,299.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,329.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,667.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,493.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,500.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$710.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$710.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,465.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,881.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$784.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$784.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,222.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$776.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$4,584.00
|
| Rate for Payer: Multiplan Commercial |
$2,911.50
|
| Rate for Payer: Networks By Design Commercial |
$3,972.80
|
| Rate for Payer: Networks By Design Commercial |
$2,523.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Prime Health Services Commercial |
$3,299.70
|
| Rate for Payer: Prime Health Services Commercial |
$5,195.20
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,329.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,667.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,056.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,941.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| 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 HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC COLONOSCOPY W/TUMOR SNARE RMVL
|
Facility
|
IP
|
$6,112.00
|
|
|
Service Code
|
CPT 45385
|
| Hospital Charge Code |
906745385
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,222.40 |
| Max. Negotiated Rate |
$5,500.80 |
| Rate for Payer: Adventist Health Commercial |
$1,222.40
|
| Rate for Payer: Cash Price |
$2,750.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,889.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,278.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,444.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,444.80
|
| Rate for Payer: Galaxy Health WC |
$5,195.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,667.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,500.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,881.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,606.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,222.40
|
| Rate for Payer: Multiplan Commercial |
$4,584.00
|
| Rate for Payer: Networks By Design Commercial |
$3,972.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,195.20
|
|
|
HC COLONOSCOPY W/TUMOR SNARE RMVL
|
Facility
|
OP
|
$6,112.00
|
|
|
Service Code
|
CPT 45385
|
| Hospital Charge Code |
906745385
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$688.38 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,222.40
|
| Rate for Payer: Adventist Health Commercial |
$776.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$2,750.40
|
| Rate for Payer: Cash Price |
$2,750.40
|
| Rate for Payer: Cash Price |
$1,746.90
|
| Rate for Payer: Cash Price |
$2,750.40
|
| Rate for Payer: Cash Price |
$1,746.90
|
| Rate for Payer: Cash Price |
$1,746.90
|
| Rate for Payer: Central Health Plan Commercial |
$3,105.60
|
| Rate for Payer: Central Health Plan Commercial |
$4,889.60
|
| Rate for Payer: Cigna of CA HMO |
$2,484.48
|
| Rate for Payer: Cigna of CA HMO |
$3,911.68
|
| Rate for Payer: Cigna of CA PPO |
$4,522.88
|
| Rate for Payer: Cigna of CA PPO |
$2,872.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,717.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,278.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$5,195.20
|
| Rate for Payer: Galaxy Health WC |
$3,299.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,329.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,667.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,493.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,500.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$688.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$688.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,465.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,881.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$760.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$760.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,222.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$776.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$4,584.00
|
| Rate for Payer: Multiplan Commercial |
$2,911.50
|
| Rate for Payer: Networks By Design Commercial |
$3,972.80
|
| Rate for Payer: Networks By Design Commercial |
$2,523.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Prime Health Services Commercial |
$3,299.70
|
| Rate for Payer: Prime Health Services Commercial |
$5,195.20
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,329.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,667.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,056.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,941.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| 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 HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC COLONSCOPY STOMA W RMVL
|
Facility
|
IP
|
$5,076.00
|
|
|
Service Code
|
CPT 44394
|
| Hospital Charge Code |
906744394
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,015.20 |
| Max. Negotiated Rate |
$4,568.40 |
| Rate for Payer: Adventist Health Commercial |
$1,015.20
|
| Rate for Payer: Cash Price |
$2,284.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,060.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,553.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,030.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,030.40
|
| Rate for Payer: Galaxy Health WC |
$4,314.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,045.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,568.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,223.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,994.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,015.20
|
| Rate for Payer: Multiplan Commercial |
$3,807.00
|
| Rate for Payer: Networks By Design Commercial |
$3,299.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,314.60
|
|
|
HC COLONSCOPY STOMA W RMVL
|
Facility
|
OP
|
$5,076.00
|
|
|
Service Code
|
CPT 44394
|
| Hospital Charge Code |
906744394
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$534.06 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,015.20
|
| Rate for Payer: Adventist Health Commercial |
$644.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$2,284.20
|
| Rate for Payer: Cash Price |
$2,284.20
|
| Rate for Payer: Cash Price |
$1,450.80
|
| Rate for Payer: Cash Price |
$2,284.20
|
| Rate for Payer: Cash Price |
$1,450.80
|
| Rate for Payer: Cash Price |
$1,450.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,579.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,060.80
|
| Rate for Payer: Cigna of CA HMO |
$2,063.36
|
| Rate for Payer: Cigna of CA HMO |
$3,248.64
|
| Rate for Payer: Cigna of CA PPO |
$3,756.24
|
| Rate for Payer: Cigna of CA PPO |
$2,385.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,256.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,553.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$4,314.60
|
| Rate for Payer: Galaxy Health WC |
$2,740.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,934.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,045.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,901.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,568.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$534.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$534.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,047.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,223.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$589.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$589.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,015.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$644.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$3,807.00
|
| Rate for Payer: Multiplan Commercial |
$2,418.00
|
| Rate for Payer: Networks By Design Commercial |
$3,299.40
|
| Rate for Payer: Networks By Design Commercial |
$2,095.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Prime Health Services Commercial |
$2,740.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,314.60
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,934.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,045.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,538.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,612.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| 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 HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC COLON VIA STOMA W FB REMOVAL
|
Facility
|
OP
|
$1,889.00
|
|
|
Service Code
|
CPT 44390
|
| Hospital Charge Code |
906744390
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$302.26 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$377.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,196.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$850.05
|
| Rate for Payer: Cash Price |
$850.05
|
| Rate for Payer: Cash Price |
$850.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,511.20
|
| Rate for Payer: Cigna of CA HMO |
$1,208.96
|
| Rate for Payer: Cigna of CA PPO |
$1,397.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,322.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: Galaxy Health WC |
$1,605.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,133.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,700.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$302.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,199.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$333.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$377.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$1,416.75
|
| Rate for Payer: Networks By Design Commercial |
$1,227.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Prime Health Services Commercial |
$1,605.65
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,133.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,435.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$944.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC COLON VIA STOMA W FB REMOVAL
|
Facility
|
IP
|
$1,889.00
|
|
|
Service Code
|
CPT 44390
|
| Hospital Charge Code |
906744390
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$377.80 |
| Max. Negotiated Rate |
$1,700.10 |
| Rate for Payer: Adventist Health Commercial |
$377.80
|
| Rate for Payer: Cash Price |
$850.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,511.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,322.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$755.60
|
| Rate for Payer: EPIC Health Plan Senior |
$755.60
|
| Rate for Payer: Galaxy Health WC |
$1,605.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,133.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,700.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,199.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,114.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$377.80
|
| Rate for Payer: Multiplan Commercial |
$1,416.75
|
| Rate for Payer: Networks By Design Commercial |
$1,227.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,605.65
|
|
|
HC COLON W SNGL CONTRAST ENEMA
|
Facility
|
OP
|
$1,436.00
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
909001806
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$89.29 |
| Max. Negotiated Rate |
$1,292.40 |
| Rate for Payer: Adventist Health Commercial |
$287.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$225.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$552.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$344.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$479.42
|
| Rate for Payer: Blue Shield of California Commercial |
$904.68
|
| Rate for Payer: Blue Shield of California EPN |
$570.09
|
| Rate for Payer: Cash Price |
$646.20
|
| Rate for Payer: Cash Price |
$646.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,148.80
|
| Rate for Payer: Cigna of CA HMO |
$919.04
|
| Rate for Payer: Cigna of CA PPO |
$1,062.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,005.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: Galaxy Health WC |
$1,220.60
|
| Rate for Payer: Global Benefits Group Commercial |
$861.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,292.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$89.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$911.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$98.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$287.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$302.29
|
| Rate for Payer: Multiplan Commercial |
$1,077.00
|
| Rate for Payer: Networks By Design Commercial |
$933.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$225.59
|
| Rate for Payer: Prime Health Services Commercial |
$1,220.60
|
| Rate for Payer: Prime Health Services Medicare |
$239.13
|
| Rate for Payer: Riverside University Health System MISP |
$248.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$861.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$861.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$219.73
|
| Rate for Payer: United Healthcare All Other HMO |
$219.73
|
| Rate for Payer: United Healthcare HMO Rider |
$219.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$219.73
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
|
|
HC COLON W SNGL CONTRAST ENEMA
|
Facility
|
IP
|
$1,436.00
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
909001806
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$287.20 |
| Max. Negotiated Rate |
$1,292.40 |
| Rate for Payer: Adventist Health Commercial |
$287.20
|
| Rate for Payer: Cash Price |
$646.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,148.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,005.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$574.40
|
| Rate for Payer: EPIC Health Plan Senior |
$574.40
|
| Rate for Payer: Galaxy Health WC |
$1,220.60
|
| Rate for Payer: Global Benefits Group Commercial |
$861.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,292.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$911.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$847.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$287.20
|
| Rate for Payer: Multiplan Commercial |
$1,077.00
|
| Rate for Payer: Networks By Design Commercial |
$933.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,220.60
|
|
|
HC COLORCTL CNCR SCRN NON HGH RSK
|
Facility
|
IP
|
$2,201.00
|
|
|
Service Code
|
CPT G0121
|
| Hospital Charge Code |
900100676
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$440.20 |
| Max. Negotiated Rate |
$1,980.90 |
| Rate for Payer: Adventist Health Commercial |
$440.20
|
| Rate for Payer: Cash Price |
$990.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,760.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,540.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$880.40
|
| Rate for Payer: EPIC Health Plan Senior |
$880.40
|
| Rate for Payer: Galaxy Health WC |
$1,870.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,320.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,980.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,397.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,298.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$440.20
|
| Rate for Payer: Multiplan Commercial |
$1,650.75
|
| Rate for Payer: Networks By Design Commercial |
$1,430.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,870.85
|
|
|
HC COLORCTL CNCR SCRN NON HGH RSK
|
Facility
|
OP
|
$2,201.00
|
|
|
Service Code
|
CPT G0121
|
| Hospital Charge Code |
900100676
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$440.20 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$440.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,196.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$990.45
|
| Rate for Payer: Cash Price |
$990.45
|
| Rate for Payer: Cash Price |
$990.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,760.80
|
| Rate for Payer: Cigna of CA HMO |
$1,408.64
|
| Rate for Payer: Cigna of CA PPO |
$1,628.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,540.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: Galaxy Health WC |
$1,870.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,320.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,980.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,397.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$798.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$440.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$1,650.75
|
| Rate for Payer: Networks By Design Commercial |
$1,430.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Prime Health Services Commercial |
$1,870.85
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,320.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,435.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,100.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC COLORECTAL CANCER SCRN HIGH RISK
|
Facility
|
OP
|
$2,201.00
|
|
|
Service Code
|
CPT G0105
|
| Hospital Charge Code |
900100675
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$440.20 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$440.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,196.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$990.45
|
| Rate for Payer: Cash Price |
$990.45
|
| Rate for Payer: Cash Price |
$990.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,760.80
|
| Rate for Payer: Cigna of CA HMO |
$1,408.64
|
| Rate for Payer: Cigna of CA PPO |
$1,628.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,540.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: Galaxy Health WC |
$1,870.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,320.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,980.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,397.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$798.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$440.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$1,650.75
|
| Rate for Payer: Networks By Design Commercial |
$1,430.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Prime Health Services Commercial |
$1,870.85
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,320.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,435.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,100.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC COLORECTAL CANCER SCRN HIGH RISK
|
Facility
|
IP
|
$2,201.00
|
|
|
Service Code
|
CPT G0105
|
| Hospital Charge Code |
900100675
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$440.20 |
| Max. Negotiated Rate |
$1,980.90 |
| Rate for Payer: Adventist Health Commercial |
$440.20
|
| Rate for Payer: Cash Price |
$990.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,760.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,540.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$880.40
|
| Rate for Payer: EPIC Health Plan Senior |
$880.40
|
| Rate for Payer: Galaxy Health WC |
$1,870.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,320.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,980.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,397.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,298.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$440.20
|
| Rate for Payer: Multiplan Commercial |
$1,650.75
|
| Rate for Payer: Networks By Design Commercial |
$1,430.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,870.85
|
|
|
HC COLPORRHAPHY
|
Facility
|
OP
|
$8,771.00
|
|
|
Service Code
|
CPT 57200
|
| Hospital Charge Code |
900501301
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$7,893.90 |
| Rate for Payer: Adventist Health Commercial |
$1,754.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,579.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,163.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,436.87
|
| Rate for Payer: Cash Price |
$3,946.95
|
| Rate for Payer: Cash Price |
$3,946.95
|
| Rate for Payer: Cash Price |
$3,946.95
|
| Rate for Payer: Cash Price |
$3,946.95
|
| Rate for Payer: Central Health Plan Commercial |
$7,016.80
|
| Rate for Payer: Cigna of CA HMO |
$5,613.44
|
| Rate for Payer: Cigna of CA PPO |
$6,490.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,579.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,163.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,139.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,869.74
|
| Rate for Payer: EPIC Health Plan Senior |
$4,579.83
|
| Rate for Payer: Galaxy Health WC |
$7,455.35
|
| Rate for Payer: Global Benefits Group Commercial |
$5,262.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,893.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,828.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,163.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,569.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$571.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,475.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,754.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,579.06
|
| Rate for Payer: Multiplan Commercial |
$6,578.25
|
| Rate for Payer: Multiplan WC |
$6,436.87
|
| Rate for Payer: Networks By Design Commercial |
$5,701.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,163.48
|
| Rate for Payer: Preferred Health Network WC |
$6,568.23
|
| Rate for Payer: Prime Health Services Commercial |
$7,455.35
|
| Rate for Payer: Prime Health Services Medicare |
$4,413.29
|
| Rate for Payer: Prime Health Services WC |
$6,371.18
|
| Rate for Payer: Riverside University Health System MISP |
$4,579.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,262.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,385.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,385.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,385.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,385.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,163.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,579.83
|
| Rate for Payer: Vantage Medical Group Senior |
$4,163.48
|
|
|
HC COLPORRHAPHY
|
Facility
|
IP
|
$8,771.00
|
|
|
Service Code
|
CPT 57200
|
| Hospital Charge Code |
900501301
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,754.20 |
| Max. Negotiated Rate |
$7,893.90 |
| Rate for Payer: Adventist Health Commercial |
$1,754.20
|
| Rate for Payer: Cash Price |
$3,946.95
|
| Rate for Payer: Central Health Plan Commercial |
$7,016.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,139.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,508.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,508.40
|
| Rate for Payer: Galaxy Health WC |
$7,455.35
|
| Rate for Payer: Global Benefits Group Commercial |
$5,262.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,893.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,569.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,174.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,754.20
|
| Rate for Payer: Multiplan Commercial |
$6,578.25
|
| Rate for Payer: Networks By Design Commercial |
$5,701.15
|
| Rate for Payer: Prime Health Services Commercial |
$7,455.35
|
|
|
HC COLPOSCOPY BX OF VAG/CERVIX
|
Facility
|
OP
|
$2,796.00
|
|
|
Service Code
|
CPT 57421
|
| Hospital Charge Code |
904057421
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$278.18 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$559.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,184.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,303.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,184.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,762.79
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$1,258.20
|
| Rate for Payer: Cash Price |
$1,258.20
|
| Rate for Payer: Cash Price |
$1,258.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,236.80
|
| Rate for Payer: Cigna of CA HMO |
$1,789.44
|
| Rate for Payer: Cigna of CA PPO |
$2,069.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,303.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,184.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,957.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,954.62
|
| Rate for Payer: EPIC Health Plan Senior |
$1,303.08
|
| Rate for Payer: Galaxy Health WC |
$2,376.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,677.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,516.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,942.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$278.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,184.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,775.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$307.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,658.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$559.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,587.39
|
| Rate for Payer: Multiplan Commercial |
$2,097.00
|
| Rate for Payer: Multiplan WC |
$1,762.79
|
| Rate for Payer: Networks By Design Commercial |
$1,817.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,184.62
|
| Rate for Payer: Preferred Health Network WC |
$1,798.77
|
| Rate for Payer: Prime Health Services Commercial |
$2,376.60
|
| Rate for Payer: Prime Health Services Medicare |
$1,255.70
|
| Rate for Payer: Prime Health Services WC |
$1,744.81
|
| Rate for Payer: Riverside University Health System MISP |
$1,303.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,677.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,398.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,184.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,303.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,184.62
|
|
|
HC COLPOSCOPY BX OF VAG/CERVIX
|
Facility
|
IP
|
$2,796.00
|
|
|
Service Code
|
CPT 57421
|
| Hospital Charge Code |
904057421
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$559.20 |
| Max. Negotiated Rate |
$2,516.40 |
| Rate for Payer: Adventist Health Commercial |
$559.20
|
| Rate for Payer: Cash Price |
$1,258.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,236.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,957.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,118.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,118.40
|
| Rate for Payer: Galaxy Health WC |
$2,376.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,677.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,516.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,775.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,649.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$559.20
|
| Rate for Payer: Multiplan Commercial |
$2,097.00
|
| Rate for Payer: Networks By Design Commercial |
$1,817.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,376.60
|
|
|
HC COLPOSCOPY CERV INCL UP/ADJ VAGINA W BX CERVIX
|
Facility
|
IP
|
$1,209.00
|
|
|
Service Code
|
CPT 57455
|
| Hospital Charge Code |
904000021
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$241.80 |
| Max. Negotiated Rate |
$1,088.10 |
| Rate for Payer: Adventist Health Commercial |
$241.80
|
| Rate for Payer: Cash Price |
$544.05
|
| Rate for Payer: Central Health Plan Commercial |
$967.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$846.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$483.60
|
| Rate for Payer: EPIC Health Plan Senior |
$483.60
|
| Rate for Payer: Galaxy Health WC |
$1,027.65
|
| Rate for Payer: Global Benefits Group Commercial |
$725.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,088.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$767.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$713.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.80
|
| Rate for Payer: Multiplan Commercial |
$906.75
|
| Rate for Payer: Networks By Design Commercial |
$785.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,027.65
|
|
|
HC COLPOSCOPY CERV INCL UP/ADJ VAGINA W BX CERVIX
|
Facility
|
OP
|
$1,209.00
|
|
|
Service Code
|
CPT 57455
|
| Hospital Charge Code |
904000021
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$241.80 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$241.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$391.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$391.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$615.83
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$544.05
|
| Rate for Payer: Cash Price |
$544.05
|
| Rate for Payer: Cash Price |
$544.05
|
| Rate for Payer: Central Health Plan Commercial |
$967.20
|
| Rate for Payer: Cigna of CA HMO |
$773.76
|
| Rate for Payer: Cigna of CA PPO |
$894.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$846.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.68
|
| Rate for Payer: EPIC Health Plan Senior |
$431.12
|
| Rate for Payer: Galaxy Health WC |
$1,027.65
|
| Rate for Payer: Global Benefits Group Commercial |
$725.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,088.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$642.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$253.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$767.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$279.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$548.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$525.19
|
| Rate for Payer: Multiplan Commercial |
$906.75
|
| Rate for Payer: Multiplan WC |
$615.83
|
| Rate for Payer: Networks By Design Commercial |
$785.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$391.93
|
| Rate for Payer: Preferred Health Network WC |
$628.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,027.65
|
| Rate for Payer: Prime Health Services Medicare |
$415.45
|
| Rate for Payer: Prime Health Services WC |
$609.55
|
| Rate for Payer: Riverside University Health System MISP |
$431.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$725.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$604.50
|
| 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: Upland Medical Group Pediatric |
$391.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Vantage Medical Group Senior |
$391.93
|
|
