|
HC ANGIO LV/OR LA
|
Facility
|
IP
|
$2,194.00
|
|
|
Service Code
|
CPT 93565
|
| Hospital Charge Code |
906820071
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$438.80 |
| Max. Negotiated Rate |
$1,974.60 |
| Rate for Payer: Cash Price |
$987.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,755.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$877.60
|
| Rate for Payer: Galaxy Health WC |
$1,864.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,316.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,974.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,463.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$835.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$438.80
|
| Rate for Payer: Multiplan Commercial |
$1,645.50
|
| Rate for Payer: Networks By Design Commercial |
$1,426.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,864.90
|
|
|
HC ANGIOPLASTY/ENDEAVOR
|
Facility
|
IP
|
$1,530.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081807
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$306.00 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Blue Shield of California EPN |
$817.02
|
| Rate for Payer: Cash Price |
$688.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,224.00
|
| Rate for Payer: Cigna of CA HMO |
$1,071.00
|
| Rate for Payer: Cigna of CA PPO |
$1,071.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$612.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$612.00
|
| Rate for Payer: Galaxy Health WC |
$1,300.50
|
| Rate for Payer: Global Benefits Group Commercial |
$918.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,377.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,020.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$582.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$306.00
|
| Rate for Payer: Multiplan Commercial |
$1,147.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,300.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$577.73
|
| Rate for Payer: United Healthcare All Other HMO |
$564.26
|
| Rate for Payer: United Healthcare HMO Rider |
$552.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$504.90
|
|
|
HC ANGIOPLASTY/ENDEAVOR
|
Facility
|
OP
|
$1,530.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081807
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$306.00 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,300.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$841.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$841.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$698.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$852.21
|
| Rate for Payer: Blue Distinction Transplant |
$918.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,147.50
|
| Rate for Payer: Blue Shield of California EPN |
$832.32
|
| Rate for Payer: Cash Price |
$688.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,224.00
|
| Rate for Payer: Cigna of CA HMO |
$1,071.00
|
| Rate for Payer: Cigna of CA PPO |
$1,071.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,300.50
|
| Rate for Payer: Dignity Health Media |
$1,300.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,300.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$612.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$612.00
|
| Rate for Payer: Galaxy Health WC |
$1,300.50
|
| Rate for Payer: Global Benefits Group Commercial |
$918.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,377.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,147.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$535.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,020.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$582.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$306.00
|
| Rate for Payer: Multiplan Commercial |
$1,147.50
|
| Rate for Payer: Networks By Design Commercial |
$765.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,300.50
|
| Rate for Payer: Riverside University Health System MISP |
$612.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$918.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$918.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$765.00
|
| Rate for Payer: United Healthcare All Other HMO |
$765.00
|
| Rate for Payer: United Healthcare HMO Rider |
$765.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$765.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,300.50
|
| Rate for Payer: Vantage Medical Group Senior |
$1,300.50
|
|
|
HC ANGIOPLASTY INTRACRANIAL
|
Facility
|
OP
|
$7,865.00
|
|
|
Service Code
|
CPT 61630
|
| Hospital Charge Code |
909081013
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,573.00 |
| Max. Negotiated Rate |
$7,830.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6,669.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,685.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,325.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,325.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,719.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$3,539.25
|
| Rate for Payer: Cash Price |
$3,539.25
|
| Rate for Payer: Cash Price |
$3,539.25
|
| Rate for Payer: Central Health Plan Commercial |
$6,292.00
|
| Rate for Payer: Cigna of CA PPO |
$5,820.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,685.25
|
| Rate for Payer: Dignity Health Media |
$6,685.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,685.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,146.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,146.00
|
| Rate for Payer: Galaxy Health WC |
$6,685.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,719.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,078.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,898.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,752.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,245.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,573.00
|
| Rate for Payer: Multiplan Commercial |
$5,898.75
|
| Rate for Payer: Networks By Design Commercial |
$5,112.25
|
| Rate for Payer: Prime Health Services Commercial |
$6,685.25
|
| Rate for Payer: Riverside University Health System MISP |
$3,146.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,719.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,685.25
|
| Rate for Payer: Vantage Medical Group Senior |
$6,685.25
|
|
|
HC ANGIOPLASTY INTRACRANIAL
|
Facility
|
IP
|
$7,865.00
|
|
|
Service Code
|
CPT 61630
|
| Hospital Charge Code |
909081013
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,573.00 |
| Max. Negotiated Rate |
$7,078.50 |
| Rate for Payer: Cash Price |
$3,539.25
|
| Rate for Payer: Central Health Plan Commercial |
$6,292.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,146.00
|
| Rate for Payer: Galaxy Health WC |
$6,685.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,719.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,078.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,245.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,996.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,573.00
|
| Rate for Payer: Multiplan Commercial |
$5,898.75
|
| Rate for Payer: Networks By Design Commercial |
$5,112.25
|
| Rate for Payer: Prime Health Services Commercial |
$6,685.25
|
|
|
HC ANGIO RV/OR RA
|
Facility
|
OP
|
$1,956.00
|
|
|
Service Code
|
CPT 93566
|
| Hospital Charge Code |
906811415
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$293.91 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,247.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,662.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,075.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,075.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,173.60
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$880.20
|
| Rate for Payer: Cash Price |
$880.20
|
| Rate for Payer: Cash Price |
$880.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,564.80
|
| Rate for Payer: Cigna of CA PPO |
$1,447.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,662.60
|
| Rate for Payer: Dignity Health Media |
$1,662.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,662.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$782.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$782.40
|
| Rate for Payer: Galaxy Health WC |
$1,662.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,173.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,760.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,467.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$684.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,304.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$293.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$391.20
|
| Rate for Payer: Multiplan Commercial |
$1,467.00
|
| Rate for Payer: Networks By Design Commercial |
$1,271.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,662.60
|
| Rate for Payer: Riverside University Health System MISP |
$782.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,173.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,173.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,662.60
|
| Rate for Payer: Vantage Medical Group Senior |
$1,662.60
|
|
|
HC ANGIO RV/OR RA
|
Facility
|
IP
|
$1,956.00
|
|
|
Service Code
|
CPT 93566
|
| Hospital Charge Code |
906811415
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$391.20 |
| Max. Negotiated Rate |
$1,760.40 |
| Rate for Payer: Cash Price |
$880.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,564.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$782.40
|
| Rate for Payer: Galaxy Health WC |
$1,662.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,173.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,760.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,304.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$745.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$391.20
|
| Rate for Payer: Multiplan Commercial |
$1,467.00
|
| Rate for Payer: Networks By Design Commercial |
$1,271.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,662.60
|
|
|
HC ANGIO RV/OR RA
|
Facility
|
IP
|
$1,956.00
|
|
|
Service Code
|
CPT 93566
|
| Hospital Charge Code |
906820072
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$391.20 |
| Max. Negotiated Rate |
$1,760.40 |
| Rate for Payer: Cash Price |
$880.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,564.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$782.40
|
| Rate for Payer: Galaxy Health WC |
$1,662.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,173.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,760.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,304.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$745.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$391.20
|
| Rate for Payer: Multiplan Commercial |
$1,467.00
|
| Rate for Payer: Networks By Design Commercial |
$1,271.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,662.60
|
|
|
HC ANGIO RV/OR RA
|
Facility
|
OP
|
$1,956.00
|
|
|
Service Code
|
CPT 93566
|
| Hospital Charge Code |
906820072
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$293.91 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,247.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,662.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,075.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,075.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,173.60
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$880.20
|
| Rate for Payer: Cash Price |
$880.20
|
| Rate for Payer: Cash Price |
$880.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,564.80
|
| Rate for Payer: Cigna of CA PPO |
$1,447.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,662.60
|
| Rate for Payer: Dignity Health Media |
$1,662.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,662.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$782.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$782.40
|
| Rate for Payer: Galaxy Health WC |
$1,662.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,173.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,760.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,467.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$684.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,304.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$293.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$391.20
|
| Rate for Payer: Multiplan Commercial |
$1,467.00
|
| Rate for Payer: Networks By Design Commercial |
$1,271.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,662.60
|
| Rate for Payer: Riverside University Health System MISP |
$782.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,173.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,173.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,662.60
|
| Rate for Payer: Vantage Medical Group Senior |
$1,662.60
|
|
|
HC ANKLE ARTHROGRAPHY INJECTION
|
Facility
|
OP
|
$455.00
|
|
|
Service Code
|
CPT 27648
|
| Hospital Charge Code |
909000118
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$91.00 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$386.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$250.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$250.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$273.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$204.75
|
| Rate for Payer: Cash Price |
$204.75
|
| Rate for Payer: Cash Price |
$204.75
|
| Rate for Payer: Central Health Plan Commercial |
$364.00
|
| Rate for Payer: Cigna of CA PPO |
$336.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$386.75
|
| Rate for Payer: Dignity Health Media |
$386.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$386.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$182.00
|
| Rate for Payer: Galaxy Health WC |
$386.75
|
| Rate for Payer: Global Benefits Group Commercial |
$273.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$409.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$341.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$159.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$303.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$304.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.00
|
| Rate for Payer: Multiplan Commercial |
$341.25
|
| Rate for Payer: Networks By Design Commercial |
$295.75
|
| Rate for Payer: Prime Health Services Commercial |
$386.75
|
| Rate for Payer: Riverside University Health System MISP |
$182.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$273.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$386.75
|
| Rate for Payer: Vantage Medical Group Senior |
$386.75
|
|
|
HC ANKLE ARTHROGRAPHY INJECTION
|
Facility
|
IP
|
$455.00
|
|
|
Service Code
|
CPT 27648
|
| Hospital Charge Code |
909000118
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$91.00 |
| Max. Negotiated Rate |
$409.50 |
| Rate for Payer: Blue Shield of California Commercial |
$341.25
|
| Rate for Payer: Cash Price |
$204.75
|
| Rate for Payer: Central Health Plan Commercial |
$364.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.00
|
| Rate for Payer: Galaxy Health WC |
$386.75
|
| Rate for Payer: Global Benefits Group Commercial |
$273.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$409.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$303.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$173.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.00
|
| Rate for Payer: Multiplan Commercial |
$341.25
|
| Rate for Payer: Networks By Design Commercial |
$295.75
|
| Rate for Payer: Prime Health Services Commercial |
$386.75
|
|
|
HC ANKLE COMPLETE
|
Facility
|
IP
|
$1,012.00
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
909001648
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$202.40 |
| Max. Negotiated Rate |
$910.80 |
| Rate for Payer: Cash Price |
$455.40
|
| Rate for Payer: Central Health Plan Commercial |
$809.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$404.80
|
| Rate for Payer: Galaxy Health WC |
$860.20
|
| Rate for Payer: Global Benefits Group Commercial |
$607.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$910.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$675.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$385.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.40
|
| Rate for Payer: Multiplan Commercial |
$759.00
|
| Rate for Payer: Networks By Design Commercial |
$657.80
|
| Rate for Payer: Prime Health Services Commercial |
$860.20
|
|
|
HC ANKLE COMPLETE
|
Facility
|
OP
|
$1,012.00
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
909001648
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$47.77 |
| Max. Negotiated Rate |
$910.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$113.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$134.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$113.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$110.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134.65
|
| Rate for Payer: Blue Distinction Transplant |
$607.20
|
| Rate for Payer: Blue Shield of California Commercial |
$625.42
|
| Rate for Payer: Blue Shield of California EPN |
$491.83
|
| Rate for Payer: Caremore Medicare Advantage |
$113.54
|
| Rate for Payer: Cash Price |
$455.40
|
| Rate for Payer: Cash Price |
$455.40
|
| Rate for Payer: Central Health Plan Commercial |
$809.60
|
| Rate for Payer: Cigna of CA HMO |
$647.68
|
| Rate for Payer: Cigna of CA PPO |
$748.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$170.31
|
| Rate for Payer: Dignity Health Media |
$113.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$124.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$153.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$113.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$113.54
|
| Rate for Payer: Galaxy Health WC |
$860.20
|
| Rate for Payer: Global Benefits Group Commercial |
$607.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$910.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$759.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$186.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$187.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$113.54
|
| Rate for Payer: InnovAge PACE Commercial |
$170.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$675.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$113.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$152.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$152.14
|
| Rate for Payer: Multiplan Commercial |
$759.00
|
| Rate for Payer: Networks By Design Commercial |
$657.80
|
| Rate for Payer: Prime Health Services Commercial |
$860.20
|
| Rate for Payer: Prime Health Services Medicare |
$120.35
|
| Rate for Payer: Riverside University Health System MISP |
$124.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$607.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$607.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Vantage Medical Group Senior |
$113.54
|
|
|
HC ANKLE-FOOT SYS DORS-PLANT FLEX
|
Facility
|
OP
|
$48,612.58
|
|
|
Service Code
|
CPT L5973
|
| Hospital Charge Code |
905355973
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$17,014.40 |
| Max. Negotiated Rate |
$43,751.32 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$41,320.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26,736.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26,736.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23,538.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28,720.31
|
| Rate for Payer: Blue Distinction Transplant |
$29,167.55
|
| Rate for Payer: Blue Shield of California Commercial |
$36,459.44
|
| Rate for Payer: Blue Shield of California EPN |
$26,445.24
|
| Rate for Payer: Cash Price |
$21,875.66
|
| Rate for Payer: Central Health Plan Commercial |
$38,890.06
|
| Rate for Payer: Cigna of CA HMO |
$34,028.81
|
| Rate for Payer: Cigna of CA PPO |
$34,028.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$41,320.69
|
| Rate for Payer: Dignity Health Media |
$41,320.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$41,320.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,445.03
|
| Rate for Payer: EPIC Health Plan Transplant |
$19,445.03
|
| Rate for Payer: Galaxy Health WC |
$41,320.69
|
| Rate for Payer: Global Benefits Group Commercial |
$29,167.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$43,751.32
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$36,459.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17,014.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32,424.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,931.16
|
| Rate for Payer: Multiplan Commercial |
$36,459.44
|
| Rate for Payer: Networks By Design Commercial |
$24,306.29
|
| Rate for Payer: Prime Health Services Commercial |
$41,320.69
|
| Rate for Payer: Riverside University Health System MISP |
$19,445.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29,167.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29,167.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$24,306.29
|
| Rate for Payer: United Healthcare All Other HMO |
$24,306.29
|
| Rate for Payer: United Healthcare HMO Rider |
$24,306.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$24,306.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$41,320.69
|
| Rate for Payer: Vantage Medical Group Senior |
$41,320.69
|
|
|
HC ANKLE-FOOT SYS DORS-PLANT FLEX
|
Facility
|
IP
|
$48,612.58
|
|
|
Service Code
|
CPT L5973
|
| Hospital Charge Code |
905355973
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$9,722.52 |
| Max. Negotiated Rate |
$43,751.32 |
| Rate for Payer: Blue Shield of California EPN |
$25,959.12
|
| Rate for Payer: Cash Price |
$21,875.66
|
| Rate for Payer: Central Health Plan Commercial |
$38,890.06
|
| Rate for Payer: Cigna of CA HMO |
$34,028.81
|
| Rate for Payer: Cigna of CA PPO |
$34,028.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,445.03
|
| Rate for Payer: EPIC Health Plan Transplant |
$19,445.03
|
| Rate for Payer: Galaxy Health WC |
$41,320.69
|
| Rate for Payer: Global Benefits Group Commercial |
$29,167.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$43,751.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32,424.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18,521.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,722.52
|
| Rate for Payer: Multiplan Commercial |
$36,459.44
|
| Rate for Payer: Networks By Design Commercial |
$24,306.29
|
| Rate for Payer: Prime Health Services Commercial |
$41,320.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$18,356.11
|
| Rate for Payer: United Healthcare All Other HMO |
$17,928.32
|
| Rate for Payer: United Healthcare HMO Rider |
$17,539.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,042.15
|
|
|
HC ANKLE LIMITED
|
Facility
|
OP
|
$864.00
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
909001642
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$36.14 |
| Max. Negotiated Rate |
$777.60 |
| Rate for Payer: Adventist Health Medi-Cal |
$113.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$113.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$113.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$102.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$125.22
|
| Rate for Payer: Blue Distinction Transplant |
$518.40
|
| Rate for Payer: Blue Shield of California Commercial |
$533.95
|
| Rate for Payer: Blue Shield of California EPN |
$419.90
|
| Rate for Payer: Caremore Medicare Advantage |
$113.54
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Central Health Plan Commercial |
$691.20
|
| Rate for Payer: Cigna of CA HMO |
$552.96
|
| Rate for Payer: Cigna of CA PPO |
$639.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$170.31
|
| Rate for Payer: Dignity Health Media |
$113.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$124.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$153.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$113.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$113.54
|
| Rate for Payer: Galaxy Health WC |
$734.40
|
| Rate for Payer: Global Benefits Group Commercial |
$518.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$777.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$648.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$186.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$187.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$113.54
|
| Rate for Payer: InnovAge PACE Commercial |
$170.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$576.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$113.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$152.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$152.14
|
| Rate for Payer: Multiplan Commercial |
$648.00
|
| Rate for Payer: Networks By Design Commercial |
$561.60
|
| Rate for Payer: Prime Health Services Commercial |
$734.40
|
| Rate for Payer: Prime Health Services Medicare |
$120.35
|
| Rate for Payer: Riverside University Health System MISP |
$124.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$518.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$518.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Vantage Medical Group Senior |
$113.54
|
|
|
HC ANKLE LIMITED
|
Facility
|
IP
|
$864.00
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
909001642
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$172.80 |
| Max. Negotiated Rate |
$777.60 |
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Central Health Plan Commercial |
$691.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$345.60
|
| Rate for Payer: Galaxy Health WC |
$734.40
|
| Rate for Payer: Global Benefits Group Commercial |
$518.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$777.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$576.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$329.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.80
|
| Rate for Payer: Multiplan Commercial |
$648.00
|
| Rate for Payer: Networks By Design Commercial |
$561.60
|
| Rate for Payer: Prime Health Services Commercial |
$734.40
|
|
|
HC ANORECTAL MANOMETRY
|
Facility
|
OP
|
$1,842.00
|
|
|
Service Code
|
CPT 91122
|
| Hospital Charge Code |
906791122
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$114.70 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Adventist Health Medi-Cal |
$392.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$844.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$392.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$217.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,088.25
|
| Rate for Payer: Blue Distinction Transplant |
$1,105.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$392.17
|
| Rate for Payer: Cash Price |
$828.90
|
| Rate for Payer: Cash Price |
$828.90
|
| Rate for Payer: Cash Price |
$828.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,473.60
|
| Rate for Payer: Cigna of CA PPO |
$1,363.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.26
|
| Rate for Payer: Dignity Health Media |
$392.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$529.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$392.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$392.17
|
| Rate for Payer: Galaxy Health WC |
$1,565.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,105.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,657.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,381.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$643.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$647.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$392.17
|
| Rate for Payer: InnovAge PACE Commercial |
$588.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,228.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$114.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$368.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$525.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$525.51
|
| Rate for Payer: Multiplan Commercial |
$1,381.50
|
| Rate for Payer: Networks By Design Commercial |
$1,197.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,565.70
|
| Rate for Payer: Prime Health Services Medicare |
$415.70
|
| Rate for Payer: Riverside University Health System MISP |
$431.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,105.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$470.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Vantage Medical Group Senior |
$392.17
|
|
|
HC ANORECTAL MANOMETRY
|
Facility
|
IP
|
$2,534.00
|
|
|
Service Code
|
CPT 91122
|
| Hospital Charge Code |
906791122
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$506.80 |
| Max. Negotiated Rate |
$2,280.60 |
| Rate for Payer: Cash Price |
$1,140.30
|
| Rate for Payer: Central Health Plan Commercial |
$2,027.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,013.60
|
| Rate for Payer: Galaxy Health WC |
$2,153.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,520.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,280.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,690.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$965.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$506.80
|
| Rate for Payer: Multiplan Commercial |
$1,900.50
|
| Rate for Payer: Networks By Design Commercial |
$1,647.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,153.90
|
|
|
HC ANOSCOPY AND BIOPSY
|
Facility
|
IP
|
$7,535.00
|
|
|
Service Code
|
CPT 46606
|
| Hospital Charge Code |
904000011
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,507.00 |
| Max. Negotiated Rate |
$6,781.50 |
| Rate for Payer: Cash Price |
$3,390.75
|
| Rate for Payer: Central Health Plan Commercial |
$6,028.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,014.00
|
| Rate for Payer: Galaxy Health WC |
$6,404.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,521.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,781.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,025.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,870.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,507.00
|
| Rate for Payer: Multiplan Commercial |
$5,651.25
|
| Rate for Payer: Networks By Design Commercial |
$4,897.75
|
| Rate for Payer: Prime Health Services Commercial |
$6,404.75
|
|
|
HC ANOSCOPY AND BIOPSY
|
Facility
|
OP
|
$7,535.00
|
|
|
Service Code
|
CPT 46606
|
| Hospital Charge Code |
904000011
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$55.18 |
| Max. Negotiated Rate |
$6,781.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,474.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,521.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,739.52
|
| Rate for Payer: Blue Shield of California EPN |
$3,684.62
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$3,390.75
|
| Rate for Payer: Cash Price |
$3,390.75
|
| Rate for Payer: Central Health Plan Commercial |
$6,028.00
|
| Rate for Payer: Cigna of CA HMO |
$4,822.40
|
| Rate for Payer: Cigna of CA PPO |
$5,575.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Dignity Health Media |
$1,474.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,621.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Galaxy Health WC |
$6,404.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,521.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,781.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,651.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,418.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,432.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,474.42
|
| Rate for Payer: InnovAge PACE Commercial |
$2,211.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,025.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,507.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,975.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Multiplan Commercial |
$5,651.25
|
| Rate for Payer: Networks By Design Commercial |
$4,897.75
|
| Rate for Payer: Prime Health Services Commercial |
$6,404.75
|
| Rate for Payer: Prime Health Services Medicare |
$1,562.89
|
| Rate for Payer: Riverside University Health System MISP |
$1,621.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,521.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,521.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,767.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,767.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,767.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,767.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC ANOSCOPY DIAGNOSTIC W WO SPEC COLLECT
|
Facility
|
OP
|
$536.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
900501159
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$41.74 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$321.60
|
| Rate for Payer: Blue Shield of California Commercial |
$337.14
|
| Rate for Payer: Blue Shield of California EPN |
$262.10
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$241.20
|
| Rate for Payer: Cash Price |
$241.20
|
| Rate for Payer: Central Health Plan Commercial |
$428.80
|
| Rate for Payer: Cigna of CA HMO |
$343.04
|
| Rate for Payer: Cigna of CA PPO |
$396.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: Dignity Health Media |
$159.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$455.60
|
| Rate for Payer: Global Benefits Group Commercial |
$321.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$482.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$402.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$263.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$159.60
|
| Rate for Payer: InnovAge PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$357.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$107.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$402.00
|
| Rate for Payer: Networks By Design Commercial |
$348.40
|
| Rate for Payer: Prime Health Services Commercial |
$455.60
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Riverside University Health System MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$321.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$321.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$268.00
|
| Rate for Payer: United Healthcare All Other HMO |
$268.00
|
| Rate for Payer: United Healthcare HMO Rider |
$268.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$268.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC ANOSCOPY DIAGNOSTIC W WO SPEC COLLECT
|
Facility
|
IP
|
$536.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
900501159
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$107.20 |
| Max. Negotiated Rate |
$482.40 |
| Rate for Payer: Cash Price |
$241.20
|
| Rate for Payer: Central Health Plan Commercial |
$428.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$214.40
|
| Rate for Payer: Galaxy Health WC |
$455.60
|
| Rate for Payer: Global Benefits Group Commercial |
$321.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$482.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$357.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$204.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$107.20
|
| Rate for Payer: Multiplan Commercial |
$402.00
|
| Rate for Payer: Networks By Design Commercial |
$348.40
|
| Rate for Payer: Prime Health Services Commercial |
$455.60
|
|
|
HC ANOSCOPY DIAGNOSTIC W WO SPEC COLLECT
|
Facility
|
IP
|
$536.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
900501159
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$107.20 |
| Max. Negotiated Rate |
$482.40 |
| Rate for Payer: Cash Price |
$241.20
|
| Rate for Payer: Central Health Plan Commercial |
$428.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$214.40
|
| Rate for Payer: Galaxy Health WC |
$455.60
|
| Rate for Payer: Global Benefits Group Commercial |
$321.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$482.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$357.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$204.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$107.20
|
| Rate for Payer: Multiplan Commercial |
$402.00
|
| Rate for Payer: Networks By Design Commercial |
$348.40
|
| Rate for Payer: Prime Health Services Commercial |
$455.60
|
|
|
HC ANOSCOPY DIAGNOSTIC W WO SPEC COLLECT
|
Facility
|
OP
|
$536.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
900501159
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$41.74 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$321.60
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$241.20
|
| Rate for Payer: Cash Price |
$241.20
|
| Rate for Payer: Cash Price |
$241.20
|
| Rate for Payer: Cash Price |
$241.20
|
| Rate for Payer: Central Health Plan Commercial |
$428.80
|
| Rate for Payer: Cigna of CA PPO |
$396.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: Dignity Health Media |
$159.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$455.60
|
| Rate for Payer: Global Benefits Group Commercial |
$321.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$482.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$402.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$159.60
|
| Rate for Payer: InnovAge PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$357.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$107.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$402.00
|
| Rate for Payer: Networks By Design Commercial |
$348.40
|
| Rate for Payer: Prime Health Services Commercial |
$455.60
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Riverside University Health System MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$321.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$268.00
|
| Rate for Payer: United Healthcare All Other HMO |
$268.00
|
| Rate for Payer: United Healthcare HMO Rider |
$268.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$268.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
