|
HC COLPOSCOPY/ECC
|
Facility
|
IP
|
$1,209.00
|
|
|
Service Code
|
CPT 57456
|
| Hospital Charge Code |
904000024
|
|
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/ECC
|
Facility
|
OP
|
$1,209.00
|
|
|
Service Code
|
CPT 57456
|
| Hospital Charge Code |
904000024
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$128.98 |
| 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 |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| 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 |
$128.98
|
| 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 |
$142.48
|
| 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
|
|
|
HC COLPOSCOPY VAG W CRVIX
|
Facility
|
OP
|
$961.00
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
906757420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$192.20 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$192.20
|
| Rate for Payer: Adventist Health Commercial |
$363.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$391.93
|
| Rate for Payer: Adventist Health Medi-Cal |
$391.93
|
| 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 |
$587.89
|
| 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 Medi-Cal |
$431.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$391.93
|
| 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 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: Anthem Blue Cross of CA Workers' Comp |
$615.83
|
| 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 Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$816.75
|
| Rate for Payer: Cash Price |
$816.75
|
| Rate for Payer: Cash Price |
$816.75
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Central Health Plan Commercial |
$768.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,452.00
|
| Rate for Payer: Cigna of CA HMO |
$1,161.60
|
| Rate for Payer: Cigna of CA HMO |
$615.04
|
| Rate for Payer: Cigna of CA PPO |
$711.14
|
| Rate for Payer: Cigna of CA PPO |
$1,343.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,270.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$672.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.68
|
| Rate for Payer: EPIC Health Plan Senior |
$431.12
|
| Rate for Payer: EPIC Health Plan Senior |
$431.12
|
| Rate for Payer: Galaxy Health WC |
$816.85
|
| Rate for Payer: Galaxy Health WC |
$1,542.75
|
| Rate for Payer: Global Benefits Group Commercial |
$576.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,089.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,633.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$864.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$642.77
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$642.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$234.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$234.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$610.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,152.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$258.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$258.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$548.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$548.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$363.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$525.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$525.19
|
| Rate for Payer: Multiplan Commercial |
$720.75
|
| Rate for Payer: Multiplan Commercial |
$1,361.25
|
| Rate for Payer: Multiplan WC |
$615.83
|
| Rate for Payer: Multiplan WC |
$615.83
|
| Rate for Payer: Networks By Design Commercial |
$1,179.75
|
| Rate for Payer: Networks By Design Commercial |
$624.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$391.93
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$391.93
|
| Rate for Payer: Preferred Health Network WC |
$628.40
|
| Rate for Payer: Preferred Health Network WC |
$628.40
|
| Rate for Payer: Prime Health Services Commercial |
$816.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,542.75
|
| Rate for Payer: Prime Health Services Medicare |
$415.45
|
| Rate for Payer: Prime Health Services Medicare |
$415.45
|
| Rate for Payer: Prime Health Services WC |
$609.55
|
| Rate for Payer: Prime Health Services WC |
$609.55
|
| Rate for Payer: Riverside University Health System MISP |
$431.12
|
| Rate for Payer: Riverside University Health System MISP |
$431.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$576.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,089.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$907.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$480.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$391.93
|
| 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 Commercial/Exchange |
$587.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Vantage Medical Group Senior |
$391.93
|
| Rate for Payer: Vantage Medical Group Senior |
$391.93
|
|
|
HC COLPOSCOPY VAG W CRVIX
|
Facility
|
OP
|
$961.00
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
906757420
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$192.20 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$192.20
|
| Rate for Payer: Adventist Health Commercial |
$363.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$587.89
|
| 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 Medi-Cal |
$431.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$391.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$391.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| 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 HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$615.83
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$615.83
|
| Rate for Payer: Cash Price |
$816.75
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cash Price |
$816.75
|
| Rate for Payer: Cash Price |
$816.75
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cash Price |
$816.75
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Central Health Plan Commercial |
$768.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,452.00
|
| Rate for Payer: Cigna of CA HMO |
$1,161.60
|
| Rate for Payer: Cigna of CA HMO |
$615.04
|
| Rate for Payer: Cigna of CA PPO |
$711.14
|
| Rate for Payer: Cigna of CA PPO |
$1,343.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$672.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,270.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.68
|
| Rate for Payer: EPIC Health Plan Senior |
$431.12
|
| Rate for Payer: EPIC Health Plan Senior |
$431.12
|
| Rate for Payer: Galaxy Health WC |
$1,542.75
|
| Rate for Payer: Galaxy Health WC |
$816.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,089.00
|
| Rate for Payer: Global Benefits Group Commercial |
$576.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$864.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,633.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$642.77
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$642.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,152.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$610.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$258.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$258.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$421.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$421.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$363.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$525.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$525.19
|
| Rate for Payer: Multiplan Commercial |
$1,361.25
|
| Rate for Payer: Multiplan Commercial |
$720.75
|
| Rate for Payer: Multiplan WC |
$615.83
|
| Rate for Payer: Multiplan WC |
$615.83
|
| Rate for Payer: Networks By Design Commercial |
$1,179.75
|
| Rate for Payer: Networks By Design Commercial |
$624.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$391.93
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$391.93
|
| Rate for Payer: Preferred Health Network WC |
$628.40
|
| Rate for Payer: Preferred Health Network WC |
$628.40
|
| Rate for Payer: Prime Health Services Commercial |
$816.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,542.75
|
| Rate for Payer: Prime Health Services Medicare |
$415.45
|
| Rate for Payer: Prime Health Services Medicare |
$415.45
|
| Rate for Payer: Prime Health Services WC |
$609.55
|
| Rate for Payer: Prime Health Services WC |
$609.55
|
| Rate for Payer: Riverside University Health System MISP |
$431.12
|
| Rate for Payer: Riverside University Health System MISP |
$431.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$576.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,089.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$907.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$480.50
|
| Rate for Payer: United Healthcare All Other HMO |
$480.50
|
| Rate for Payer: United Healthcare All Other HMO |
$907.50
|
| Rate for Payer: United Healthcare HMO Rider |
$907.50
|
| Rate for Payer: United Healthcare HMO Rider |
$480.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$480.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$907.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$391.93
|
| 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 Commercial/Exchange |
$587.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Vantage Medical Group Senior |
$391.93
|
| Rate for Payer: Vantage Medical Group Senior |
$391.93
|
|
|
HC COLPOSCOPY VAG W CRVIX
|
Facility
|
IP
|
$1,815.00
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
906757420
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$363.00 |
| Max. Negotiated Rate |
$1,633.50 |
| Rate for Payer: Adventist Health Commercial |
$363.00
|
| Rate for Payer: Cash Price |
$816.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,452.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,270.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$726.00
|
| Rate for Payer: EPIC Health Plan Senior |
$726.00
|
| Rate for Payer: Galaxy Health WC |
$1,542.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,089.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,633.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,152.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,070.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$363.00
|
| Rate for Payer: Multiplan Commercial |
$1,361.25
|
| Rate for Payer: Networks By Design Commercial |
$1,179.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,542.75
|
|
|
HC COLPOSCOPY VAG W CRVIX
|
Facility
|
IP
|
$1,815.00
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
906757420
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$363.00 |
| Max. Negotiated Rate |
$1,633.50 |
| Rate for Payer: Adventist Health Commercial |
$363.00
|
| Rate for Payer: Cash Price |
$816.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,452.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,270.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$726.00
|
| Rate for Payer: EPIC Health Plan Senior |
$726.00
|
| Rate for Payer: Galaxy Health WC |
$1,542.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,089.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,633.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,152.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,070.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$363.00
|
| Rate for Payer: Multiplan Commercial |
$1,361.25
|
| Rate for Payer: Networks By Design Commercial |
$1,179.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,542.75
|
|
|
HC COLPOSCOPY VAG W CRVIX
|
Facility
|
IP
|
$1,815.00
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
906757420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$363.00 |
| Max. Negotiated Rate |
$1,633.50 |
| Rate for Payer: Adventist Health Commercial |
$363.00
|
| Rate for Payer: Cash Price |
$816.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,452.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,270.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$726.00
|
| Rate for Payer: EPIC Health Plan Senior |
$726.00
|
| Rate for Payer: Galaxy Health WC |
$1,542.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,089.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,633.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,152.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,070.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$363.00
|
| Rate for Payer: Multiplan Commercial |
$1,361.25
|
| Rate for Payer: Networks By Design Commercial |
$1,179.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,542.75
|
|
|
HC COLPOSCOPY VAG W CRVIX
|
Facility
|
OP
|
$961.00
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
906757420
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$192.20 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$192.20
|
| Rate for Payer: Adventist Health Commercial |
$363.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$391.93
|
| Rate for Payer: Adventist Health Medi-Cal |
$391.93
|
| 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 |
$587.89
|
| 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 Medi-Cal |
$431.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$391.93
|
| 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 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 |
$1,017.03
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cash Price |
$816.75
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cash Price |
$816.75
|
| Rate for Payer: Cash Price |
$816.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,452.00
|
| Rate for Payer: Central Health Plan Commercial |
$768.80
|
| Rate for Payer: Cigna of CA HMO |
$1,161.60
|
| Rate for Payer: Cigna of CA HMO |
$615.04
|
| Rate for Payer: Cigna of CA PPO |
$711.14
|
| Rate for Payer: Cigna of CA PPO |
$1,343.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,270.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$672.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.68
|
| Rate for Payer: EPIC Health Plan Senior |
$431.12
|
| Rate for Payer: EPIC Health Plan Senior |
$431.12
|
| Rate for Payer: Galaxy Health WC |
$816.85
|
| Rate for Payer: Galaxy Health WC |
$1,542.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,089.00
|
| Rate for Payer: Global Benefits Group Commercial |
$576.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,633.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$864.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$642.77
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$642.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$234.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$234.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,152.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$610.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$258.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$258.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$548.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$548.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$363.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$525.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$525.19
|
| Rate for Payer: Multiplan Commercial |
$720.75
|
| Rate for Payer: Multiplan Commercial |
$1,361.25
|
| Rate for Payer: Networks By Design Commercial |
$624.65
|
| Rate for Payer: Networks By Design Commercial |
$1,179.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$391.93
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$391.93
|
| Rate for Payer: Prime Health Services Commercial |
$1,542.75
|
| Rate for Payer: Prime Health Services Commercial |
$816.85
|
| Rate for Payer: Prime Health Services Medicare |
$415.45
|
| Rate for Payer: Prime Health Services Medicare |
$415.45
|
| Rate for Payer: Riverside University Health System MISP |
$431.12
|
| Rate for Payer: Riverside University Health System MISP |
$431.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,089.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$576.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$470.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$470.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$480.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$907.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$391.93
|
| 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 Commercial/Exchange |
$587.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Vantage Medical Group Senior |
$391.93
|
| Rate for Payer: Vantage Medical Group Senior |
$391.93
|
|
|
HC COLPOSCOPY VULVA W BIOPSY
|
Facility
|
IP
|
$641.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
904000023
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$128.20 |
| Max. Negotiated Rate |
$576.90 |
| Rate for Payer: Adventist Health Commercial |
$128.20
|
| Rate for Payer: Cash Price |
$288.45
|
| Rate for Payer: Central Health Plan Commercial |
$512.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$448.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$256.40
|
| Rate for Payer: EPIC Health Plan Senior |
$256.40
|
| Rate for Payer: Galaxy Health WC |
$544.85
|
| Rate for Payer: Global Benefits Group Commercial |
$384.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$576.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$407.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$378.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$128.20
|
| Rate for Payer: Multiplan Commercial |
$480.75
|
| Rate for Payer: Networks By Design Commercial |
$416.65
|
| Rate for Payer: Prime Health Services Commercial |
$544.85
|
|
|
HC COLPOSCOPY VULVA W BIOPSY
|
Facility
|
OP
|
$641.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
904000023
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$128.20 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$128.20
|
| 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 |
$288.45
|
| Rate for Payer: Cash Price |
$288.45
|
| Rate for Payer: Cash Price |
$288.45
|
| Rate for Payer: Central Health Plan Commercial |
$512.80
|
| Rate for Payer: Cigna of CA HMO |
$410.24
|
| Rate for Payer: Cigna of CA PPO |
$474.34
|
| 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 |
$448.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.68
|
| Rate for Payer: EPIC Health Plan Senior |
$431.12
|
| Rate for Payer: Galaxy Health WC |
$544.85
|
| Rate for Payer: Global Benefits Group Commercial |
$384.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$576.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$642.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$279.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$407.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$309.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$548.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$128.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$525.19
|
| Rate for Payer: Multiplan Commercial |
$480.75
|
| Rate for Payer: Multiplan WC |
$615.83
|
| Rate for Payer: Networks By Design Commercial |
$416.65
|
| 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 |
$544.85
|
| 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 |
$384.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$320.50
|
| 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
|
|
|
HC COLPOSCOPY W/BIOPSY CERVIX
|
Facility
|
OP
|
$1,607.00
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
902890150
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$163.67 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$658.87
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$837.15
|
| 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 |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$615.83
|
| Rate for Payer: Cash Price |
$723.15
|
| Rate for Payer: Cash Price |
$723.15
|
| Rate for Payer: Cash Price |
$723.15
|
| Rate for Payer: Cash Price |
$723.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,285.60
|
| Rate for Payer: Cigna of CA HMO |
$1,028.48
|
| Rate for Payer: Cigna of CA PPO |
$1,189.18
|
| 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 |
$1,124.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.68
|
| Rate for Payer: EPIC Health Plan Senior |
$431.12
|
| Rate for Payer: Galaxy Health WC |
$1,365.95
|
| Rate for Payer: Global Benefits Group Commercial |
$964.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,446.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$642.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,020.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$163.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$421.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$525.19
|
| Rate for Payer: Multiplan Commercial |
$1,205.25
|
| Rate for Payer: Multiplan WC |
$615.83
|
| Rate for Payer: Networks By Design Commercial |
$1,044.55
|
| 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 |
$1,365.95
|
| 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 |
$964.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$964.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$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
|
|
|
HC COLPOSCOPY W/BIOPSY CERVIX
|
Facility
|
IP
|
$1,607.00
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
902890150
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$321.40 |
| Max. Negotiated Rate |
$1,446.30 |
| Rate for Payer: Adventist Health Commercial |
$321.40
|
| Rate for Payer: Cash Price |
$723.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,285.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,124.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$642.80
|
| Rate for Payer: EPIC Health Plan Senior |
$642.80
|
| Rate for Payer: Galaxy Health WC |
$1,365.95
|
| Rate for Payer: Global Benefits Group Commercial |
$964.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,446.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,020.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$948.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.40
|
| Rate for Payer: Multiplan Commercial |
$1,205.25
|
| Rate for Payer: Networks By Design Commercial |
$1,044.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,365.95
|
|
|
HC COLPOSCOPY W/BIOPSY CERVIX
|
Facility
|
OP
|
$1,607.00
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
902890150
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$148.16 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$321.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$391.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$837.15
|
| 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 |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,018.84
|
| Rate for Payer: Blue Shield of California EPN |
$641.19
|
| Rate for Payer: Cash Price |
$723.15
|
| Rate for Payer: Cash Price |
$723.15
|
| Rate for Payer: Cash Price |
$723.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,285.60
|
| Rate for Payer: Cigna of CA HMO |
$1,028.48
|
| Rate for Payer: Cigna of CA PPO |
$1,189.18
|
| 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 |
$1,124.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.68
|
| Rate for Payer: EPIC Health Plan Senior |
$431.12
|
| Rate for Payer: Galaxy Health WC |
$1,365.95
|
| Rate for Payer: Global Benefits Group Commercial |
$964.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,446.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$642.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$148.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,020.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$163.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$548.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$525.19
|
| Rate for Payer: Multiplan Commercial |
$1,205.25
|
| Rate for Payer: Networks By Design Commercial |
$1,044.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$391.93
|
| Rate for Payer: Prime Health Services Commercial |
$1,365.95
|
| Rate for Payer: Prime Health Services Medicare |
$415.45
|
| Rate for Payer: Riverside University Health System MISP |
$431.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$964.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$964.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$803.50
|
| Rate for Payer: United Healthcare All Other HMO |
$803.50
|
| Rate for Payer: United Healthcare HMO Rider |
$803.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$803.50
|
| 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
|
|
|
HC COLPOSCOPY W/BIOPSY CERVIX
|
Facility
|
IP
|
$1,607.00
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
902890150
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$321.40 |
| Max. Negotiated Rate |
$1,446.30 |
| Rate for Payer: Adventist Health Commercial |
$321.40
|
| Rate for Payer: Cash Price |
$723.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,285.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,124.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$642.80
|
| Rate for Payer: EPIC Health Plan Senior |
$642.80
|
| Rate for Payer: Galaxy Health WC |
$1,365.95
|
| Rate for Payer: Global Benefits Group Commercial |
$964.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,446.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,020.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$948.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.40
|
| Rate for Payer: Multiplan Commercial |
$1,205.25
|
| Rate for Payer: Networks By Design Commercial |
$1,044.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,365.95
|
|
|
HC COMMON CAROTID HEAD UNI
|
Facility
|
IP
|
$10,153.00
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
909020146
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,030.60 |
| Max. Negotiated Rate |
$9,137.70 |
| Rate for Payer: Adventist Health Commercial |
$2,030.60
|
| Rate for Payer: Cash Price |
$4,568.85
|
| Rate for Payer: Central Health Plan Commercial |
$8,122.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,107.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,061.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4,061.20
|
| Rate for Payer: Galaxy Health WC |
$8,630.05
|
| Rate for Payer: Global Benefits Group Commercial |
$6,091.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,137.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,447.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,990.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,030.60
|
| Rate for Payer: Multiplan Commercial |
$7,614.75
|
| Rate for Payer: Networks By Design Commercial |
$6,599.45
|
| Rate for Payer: Prime Health Services Commercial |
$8,630.05
|
|
|
HC COMMON CAROTID HEAD UNI
|
Facility
|
OP
|
$10,153.00
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
909020146
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$441.85 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$2,030.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,156.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,156.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$10,943.70
|
| 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 |
$4,568.85
|
| Rate for Payer: Cash Price |
$4,568.85
|
| Rate for Payer: Cash Price |
$4,568.85
|
| Rate for Payer: Central Health Plan Commercial |
$8,122.40
|
| Rate for Payer: Cigna of CA HMO |
$6,497.92
|
| Rate for Payer: Cigna of CA PPO |
$7,513.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,872.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,156.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,107.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,808.82
|
| Rate for Payer: EPIC Health Plan Senior |
$7,872.55
|
| Rate for Payer: Galaxy Health WC |
$8,630.05
|
| Rate for Payer: Global Benefits Group Commercial |
$6,091.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,137.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,737.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$441.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,156.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,447.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$488.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,019.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,030.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,590.19
|
| Rate for Payer: Multiplan Commercial |
$7,614.75
|
| Rate for Payer: Multiplan WC |
$10,943.70
|
| Rate for Payer: Networks By Design Commercial |
$6,599.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,156.86
|
| Rate for Payer: Preferred Health Network WC |
$11,167.04
|
| Rate for Payer: Prime Health Services Commercial |
$8,630.05
|
| Rate for Payer: Prime Health Services Medicare |
$7,586.27
|
| Rate for Payer: Prime Health Services WC |
$10,832.03
|
| Rate for Payer: Riverside University Health System MISP |
$7,872.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,091.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,076.50
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,156.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Vantage Medical Group Senior |
$7,156.86
|
|
|
HC COMMON CAROTID NECK UNI
|
Facility
|
OP
|
$9,646.00
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
909020145
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$409.19 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,929.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,061.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| 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 |
$4,340.70
|
| Rate for Payer: Cash Price |
$4,340.70
|
| Rate for Payer: Cash Price |
$4,340.70
|
| Rate for Payer: Central Health Plan Commercial |
$7,716.80
|
| Rate for Payer: Cigna of CA HMO |
$6,173.44
|
| Rate for Payer: Cigna of CA PPO |
$7,138.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,752.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$8,199.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,787.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,681.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$409.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,125.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$452.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,929.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$7,234.50
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$6,269.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$8,199.10
|
| Rate for Payer: Prime Health Services Medicare |
$4,304.71
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,467.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,787.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,823.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC COMMON CAROTID NECK UNI
|
Facility
|
IP
|
$9,646.00
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
909020145
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,929.20 |
| Max. Negotiated Rate |
$8,681.40 |
| Rate for Payer: Adventist Health Commercial |
$1,929.20
|
| Rate for Payer: Cash Price |
$4,340.70
|
| Rate for Payer: Central Health Plan Commercial |
$7,716.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,752.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,858.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,858.40
|
| Rate for Payer: Galaxy Health WC |
$8,199.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,787.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,681.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,125.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,691.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,929.20
|
| Rate for Payer: Multiplan Commercial |
$7,234.50
|
| Rate for Payer: Networks By Design Commercial |
$6,269.90
|
| Rate for Payer: Prime Health Services Commercial |
$8,199.10
|
|
|
HC COMM/WORK REINTEGRATION 15 MIN MCAL
|
Facility
|
OP
|
$213.00
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
901300068
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$77.32 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$87.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$125.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$181.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$117.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Central Health Plan Commercial |
$170.40
|
| Rate for Payer: Cigna of CA HMO |
$136.32
|
| Rate for Payer: Cigna of CA PPO |
$157.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$181.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$181.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$181.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$149.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.20
|
| Rate for Payer: EPIC Health Plan Senior |
$85.20
|
| Rate for Payer: Galaxy Health WC |
$181.05
|
| Rate for Payer: Global Benefits Group Commercial |
$127.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$135.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$77.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$125.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$149.10
|
| Rate for Payer: Multiplan Commercial |
$159.75
|
| Rate for Payer: Networks By Design Commercial |
$138.45
|
| Rate for Payer: Prime Health Services Commercial |
$181.05
|
| Rate for Payer: Riverside University Health System MISP |
$85.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$127.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$127.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$181.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$181.05
|
| Rate for Payer: Vantage Medical Group Senior |
$181.05
|
|
|
HC COMM/WORK REINTEGRATION 15 MIN MCAL
|
Facility
|
IP
|
$213.00
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
901300068
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$191.70 |
| Rate for Payer: Adventist Health Commercial |
$42.60
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Central Health Plan Commercial |
$170.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$149.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.20
|
| Rate for Payer: EPIC Health Plan Senior |
$85.20
|
| Rate for Payer: Galaxy Health WC |
$181.05
|
| Rate for Payer: Global Benefits Group Commercial |
$127.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$135.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$125.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.60
|
| Rate for Payer: Multiplan Commercial |
$159.75
|
| Rate for Payer: Networks By Design Commercial |
$138.45
|
| Rate for Payer: Prime Health Services Commercial |
$181.05
|
|
|
HC COMM/WORK REINTEGRATION 15 MIN OT
|
Facility
|
OP
|
$213.00
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
905104153
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$77.32 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$87.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$125.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$181.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$117.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Central Health Plan Commercial |
$170.40
|
| Rate for Payer: Cigna of CA HMO |
$136.32
|
| Rate for Payer: Cigna of CA PPO |
$157.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$181.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$181.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$181.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$149.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.20
|
| Rate for Payer: EPIC Health Plan Senior |
$85.20
|
| Rate for Payer: Galaxy Health WC |
$181.05
|
| Rate for Payer: Global Benefits Group Commercial |
$127.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$135.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$77.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$125.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$149.10
|
| Rate for Payer: Multiplan Commercial |
$159.75
|
| Rate for Payer: Networks By Design Commercial |
$138.45
|
| Rate for Payer: Prime Health Services Commercial |
$181.05
|
| Rate for Payer: Riverside University Health System MISP |
$85.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$127.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$127.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$181.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$181.05
|
| Rate for Payer: Vantage Medical Group Senior |
$181.05
|
|
|
HC COMM/WORK REINTEGRATION 15 MIN OT
|
Facility
|
IP
|
$213.00
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
905104153
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$191.70 |
| Rate for Payer: Adventist Health Commercial |
$42.60
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Central Health Plan Commercial |
$170.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$149.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.20
|
| Rate for Payer: EPIC Health Plan Senior |
$85.20
|
| Rate for Payer: Galaxy Health WC |
$181.05
|
| Rate for Payer: Global Benefits Group Commercial |
$127.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$135.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$125.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.60
|
| Rate for Payer: Multiplan Commercial |
$159.75
|
| Rate for Payer: Networks By Design Commercial |
$138.45
|
| Rate for Payer: Prime Health Services Commercial |
$181.05
|
|
|
HC COMM/WORK REINTEGRATION 15 MIN PT
|
Facility
|
OP
|
$213.00
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
905103153
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$77.32 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$87.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$125.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$181.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$117.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Central Health Plan Commercial |
$170.40
|
| Rate for Payer: Cigna of CA HMO |
$136.32
|
| Rate for Payer: Cigna of CA PPO |
$157.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$181.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$181.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$181.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$149.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.20
|
| Rate for Payer: EPIC Health Plan Senior |
$85.20
|
| Rate for Payer: Galaxy Health WC |
$181.05
|
| Rate for Payer: Global Benefits Group Commercial |
$127.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$135.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$77.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$125.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$149.10
|
| Rate for Payer: Multiplan Commercial |
$159.75
|
| Rate for Payer: Networks By Design Commercial |
$138.45
|
| Rate for Payer: Prime Health Services Commercial |
$181.05
|
| Rate for Payer: Riverside University Health System MISP |
$85.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$127.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$127.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$181.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$181.05
|
| Rate for Payer: Vantage Medical Group Senior |
$181.05
|
|
|
HC COMM/WORK REINTEGRATION 15 MIN PT
|
Facility
|
IP
|
$213.00
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
905103153
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$191.70 |
| Rate for Payer: Adventist Health Commercial |
$42.60
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Central Health Plan Commercial |
$170.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$149.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.20
|
| Rate for Payer: EPIC Health Plan Senior |
$85.20
|
| Rate for Payer: Galaxy Health WC |
$181.05
|
| Rate for Payer: Global Benefits Group Commercial |
$127.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$135.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$125.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.60
|
| Rate for Payer: Multiplan Commercial |
$159.75
|
| Rate for Payer: Networks By Design Commercial |
$138.45
|
| Rate for Payer: Prime Health Services Commercial |
$181.05
|
|
|
HC COMM/WORK REINTEGRATION 15 MIN PT COMM MCARE
|
Facility
|
OP
|
$213.00
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
900417537
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$77.32 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$87.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$125.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$181.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$117.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Central Health Plan Commercial |
$170.40
|
| Rate for Payer: Cigna of CA HMO |
$136.32
|
| Rate for Payer: Cigna of CA PPO |
$157.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$181.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$181.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$181.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$149.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.20
|
| Rate for Payer: EPIC Health Plan Senior |
$85.20
|
| Rate for Payer: Galaxy Health WC |
$181.05
|
| Rate for Payer: Global Benefits Group Commercial |
$127.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$135.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$77.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$125.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$149.10
|
| Rate for Payer: Multiplan Commercial |
$159.75
|
| Rate for Payer: Networks By Design Commercial |
$138.45
|
| Rate for Payer: Prime Health Services Commercial |
$181.05
|
| Rate for Payer: Riverside University Health System MISP |
$85.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$127.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$127.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$181.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$181.05
|
| Rate for Payer: Vantage Medical Group Senior |
$181.05
|
|
