|
HC ASPARAGUS IGE
|
Facility
|
IP
|
$64.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913632
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$57.60 |
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Central Health Plan Commercial |
$51.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.80
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
|
|
HC ASPARAGUS IGE
|
Facility
|
OP
|
$64.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913632
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$140.27 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$140.27
|
| Rate for Payer: Blue Distinction Transplant |
$38.40
|
| Rate for Payer: Blue Shield of California Commercial |
$39.55
|
| Rate for Payer: Blue Shield of California EPN |
$31.10
|
| Rate for Payer: Caremore Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Central Health Plan Commercial |
$51.20
|
| Rate for Payer: Cigna of CA HMO |
$40.96
|
| Rate for Payer: Cigna of CA PPO |
$47.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Media |
$5.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$48.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: InnovAge PACE Commercial |
$7.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
| Rate for Payer: Prime Health Services Medicare |
$5.53
|
| Rate for Payer: Riverside University Health System MISP |
$5.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC ASPIRATION/BLADDER BY NEEDLE
|
Facility
|
IP
|
$2,029.00
|
|
|
Service Code
|
CPT 51100
|
| Hospital Charge Code |
900501596
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$405.80 |
| Max. Negotiated Rate |
$1,826.10 |
| Rate for Payer: Cash Price |
$913.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,623.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$811.60
|
| Rate for Payer: Galaxy Health WC |
$1,724.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,217.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,826.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,353.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$773.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$405.80
|
| Rate for Payer: Multiplan Commercial |
$1,521.75
|
| Rate for Payer: Networks By Design Commercial |
$1,318.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,724.65
|
|
|
HC ASPIRATION/BLADDER BY NEEDLE
|
Facility
|
OP
|
$2,029.00
|
|
|
Service Code
|
CPT 51100
|
| Hospital Charge Code |
900501596
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$99.03 |
| 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 |
$463.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$339.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$308.79
|
| 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 |
$1,217.40
|
| Rate for Payer: Caremore Medicare Advantage |
$308.79
|
| Rate for Payer: Cash Price |
$913.05
|
| Rate for Payer: Cash Price |
$913.05
|
| Rate for Payer: Cash Price |
$913.05
|
| Rate for Payer: Cash Price |
$913.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,623.20
|
| Rate for Payer: Cigna of CA PPO |
$1,501.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$463.18
|
| Rate for Payer: Dignity Health Media |
$308.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$339.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$416.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$308.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$308.79
|
| Rate for Payer: Galaxy Health WC |
$1,724.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,217.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,826.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,521.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$506.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$308.79
|
| Rate for Payer: InnovAge PACE Commercial |
$463.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,353.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$99.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$308.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$405.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$413.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$413.78
|
| Rate for Payer: Multiplan Commercial |
$1,521.75
|
| Rate for Payer: Networks By Design Commercial |
$1,318.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,724.65
|
| Rate for Payer: Prime Health Services Medicare |
$327.32
|
| Rate for Payer: Riverside University Health System MISP |
$339.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,217.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,014.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,014.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,014.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,014.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$463.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$339.67
|
| Rate for Payer: Vantage Medical Group Senior |
$308.79
|
|
|
HC ASPIRATION/BLADDER BY NEEDLE
|
Facility
|
IP
|
$2,029.00
|
|
|
Service Code
|
CPT 51100
|
| Hospital Charge Code |
900501596
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$405.80 |
| Max. Negotiated Rate |
$1,826.10 |
| Rate for Payer: Cash Price |
$913.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,623.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$811.60
|
| Rate for Payer: Galaxy Health WC |
$1,724.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,217.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,826.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,353.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$773.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$405.80
|
| Rate for Payer: Multiplan Commercial |
$1,521.75
|
| Rate for Payer: Networks By Design Commercial |
$1,318.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,724.65
|
|
|
HC ASPIRATION/BLADDER BY NEEDLE
|
Facility
|
OP
|
$2,029.00
|
|
|
Service Code
|
CPT 51100
|
| Hospital Charge Code |
900501596
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$99.03 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$308.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$463.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$339.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$308.79
|
| 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 |
$1,217.40
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$308.79
|
| Rate for Payer: Cash Price |
$913.05
|
| Rate for Payer: Cash Price |
$913.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,623.20
|
| Rate for Payer: Cigna of CA PPO |
$1,501.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$463.18
|
| Rate for Payer: Dignity Health Media |
$308.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$339.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$416.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$308.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$308.79
|
| Rate for Payer: Galaxy Health WC |
$1,724.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,217.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,826.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,521.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$506.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$509.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$308.79
|
| Rate for Payer: InnovAge PACE Commercial |
$463.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,353.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$99.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$308.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$405.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$413.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$413.78
|
| Rate for Payer: Multiplan Commercial |
$1,521.75
|
| Rate for Payer: Networks By Design Commercial |
$1,318.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,724.65
|
| Rate for Payer: Prime Health Services Medicare |
$327.32
|
| Rate for Payer: Riverside University Health System MISP |
$339.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,217.40
|
| 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 |
$463.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$339.67
|
| Rate for Payer: Vantage Medical Group Senior |
$308.79
|
|
|
HC ASPIRATION INJECTION INTERM JONT W US GUID
|
Facility
|
IP
|
$1,126.00
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
906620606
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$225.20 |
| Max. Negotiated Rate |
$1,013.40 |
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Central Health Plan Commercial |
$900.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$450.40
|
| Rate for Payer: Galaxy Health WC |
$957.10
|
| Rate for Payer: Global Benefits Group Commercial |
$675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,013.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$751.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$429.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.20
|
| Rate for Payer: Multiplan Commercial |
$844.50
|
| Rate for Payer: Networks By Design Commercial |
$731.90
|
| Rate for Payer: Prime Health Services Commercial |
$957.10
|
|
|
HC ASPIRATION INJECTION INTERM JONT W US GUID
|
Facility
|
OP
|
$1,126.00
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
906620606
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$155.65 |
| Max. Negotiated Rate |
$5,779.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$864.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$864.04
|
| 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 |
$675.60
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$864.04
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Central Health Plan Commercial |
$900.80
|
| Rate for Payer: Cigna of CA PPO |
$833.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Dignity Health Media |
$864.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$950.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,166.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$864.04
|
| Rate for Payer: EPIC Health Plan Transplant |
$864.04
|
| Rate for Payer: Galaxy Health WC |
$957.10
|
| Rate for Payer: Global Benefits Group Commercial |
$675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,013.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$844.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,417.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,425.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$864.04
|
| Rate for Payer: InnovAge PACE Commercial |
$1,296.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$751.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$864.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,157.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,157.81
|
| Rate for Payer: Multiplan Commercial |
$844.50
|
| Rate for Payer: Networks By Design Commercial |
$731.90
|
| Rate for Payer: Prime Health Services Commercial |
$957.10
|
| Rate for Payer: Prime Health Services Medicare |
$915.88
|
| Rate for Payer: Riverside University Health System MISP |
$950.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$675.60
|
| 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 Commercial/Exchange |
$1,296.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$950.44
|
| Rate for Payer: Vantage Medical Group Senior |
$864.04
|
|
|
HC ASPIRATION INJECTION MAJOR JONT W US GUID
|
Facility
|
IP
|
$1,126.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
906620611
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$225.20 |
| Max. Negotiated Rate |
$1,013.40 |
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Central Health Plan Commercial |
$900.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$450.40
|
| Rate for Payer: Galaxy Health WC |
$957.10
|
| Rate for Payer: Global Benefits Group Commercial |
$675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,013.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$751.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$429.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.20
|
| Rate for Payer: Multiplan Commercial |
$844.50
|
| Rate for Payer: Networks By Design Commercial |
$731.90
|
| Rate for Payer: Prime Health Services Commercial |
$957.10
|
|
|
HC ASPIRATION INJECTION MAJOR JONT W US GUID
|
Facility
|
OP
|
$1,126.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
906620611
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$173.38 |
| Max. Negotiated Rate |
$7,084.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$370.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$370.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$675.60
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$370.06
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Central Health Plan Commercial |
$900.80
|
| Rate for Payer: Cigna of CA PPO |
$833.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$555.09
|
| Rate for Payer: Dignity Health Media |
$370.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$407.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$370.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$370.06
|
| Rate for Payer: Galaxy Health WC |
$957.10
|
| Rate for Payer: Global Benefits Group Commercial |
$675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,013.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$844.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$606.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$610.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$370.06
|
| Rate for Payer: InnovAge PACE Commercial |
$555.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$751.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$173.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$495.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$495.88
|
| Rate for Payer: Multiplan Commercial |
$844.50
|
| Rate for Payer: Networks By Design Commercial |
$731.90
|
| Rate for Payer: Prime Health Services Commercial |
$957.10
|
| Rate for Payer: Prime Health Services Medicare |
$392.26
|
| Rate for Payer: Riverside University Health System MISP |
$407.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$675.60
|
| 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 |
$555.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Vantage Medical Group Senior |
$370.06
|
|
|
HC ASPIRATION INJECTION SM JONT W US GUID
|
Facility
|
OP
|
$1,126.00
|
|
|
Service Code
|
CPT 20604
|
| Hospital Charge Code |
906620604
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$143.81 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$370.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$370.06
|
| 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 |
$675.60
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$370.06
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Central Health Plan Commercial |
$900.80
|
| Rate for Payer: Cigna of CA PPO |
$833.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$555.09
|
| Rate for Payer: Dignity Health Media |
$370.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$407.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$370.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$370.06
|
| Rate for Payer: Galaxy Health WC |
$957.10
|
| Rate for Payer: Global Benefits Group Commercial |
$675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,013.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$844.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$606.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$610.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$370.06
|
| Rate for Payer: InnovAge PACE Commercial |
$555.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$751.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$495.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$495.88
|
| Rate for Payer: Multiplan Commercial |
$844.50
|
| Rate for Payer: Networks By Design Commercial |
$731.90
|
| Rate for Payer: Prime Health Services Commercial |
$957.10
|
| Rate for Payer: Prime Health Services Medicare |
$392.26
|
| Rate for Payer: Riverside University Health System MISP |
$407.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$675.60
|
| 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 |
$555.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Vantage Medical Group Senior |
$370.06
|
|
|
HC ASPIRATION INJECTION SM JONT W US GUID
|
Facility
|
IP
|
$1,126.00
|
|
|
Service Code
|
CPT 20604
|
| Hospital Charge Code |
906620604
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$225.20 |
| Max. Negotiated Rate |
$1,013.40 |
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Central Health Plan Commercial |
$900.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$450.40
|
| Rate for Payer: Galaxy Health WC |
$957.10
|
| Rate for Payer: Global Benefits Group Commercial |
$675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,013.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$751.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$429.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.20
|
| Rate for Payer: Multiplan Commercial |
$844.50
|
| Rate for Payer: Networks By Design Commercial |
$731.90
|
| Rate for Payer: Prime Health Services Commercial |
$957.10
|
|
|
HC ASPIRATION/INJ GANGLION CYSTS
|
Facility
|
IP
|
$1,267.00
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
909020036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$253.40 |
| Max. Negotiated Rate |
$1,140.30 |
| Rate for Payer: Cash Price |
$570.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,013.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.80
|
| Rate for Payer: Galaxy Health WC |
$1,076.95
|
| Rate for Payer: Global Benefits Group Commercial |
$760.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,140.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$845.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$482.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.40
|
| Rate for Payer: Multiplan Commercial |
$950.25
|
| Rate for Payer: Networks By Design Commercial |
$823.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,076.95
|
|
|
HC ASPIRATION/INJ GANGLION CYSTS
|
Facility
|
OP
|
$1,267.00
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
909020036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$103.28 |
| Max. Negotiated Rate |
$5,779.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$370.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$370.06
|
| 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 |
$760.20
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$370.06
|
| Rate for Payer: Cash Price |
$570.15
|
| Rate for Payer: Cash Price |
$570.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,013.60
|
| Rate for Payer: Cigna of CA PPO |
$937.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$555.09
|
| Rate for Payer: Dignity Health Media |
$370.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$407.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$370.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$370.06
|
| Rate for Payer: Galaxy Health WC |
$1,076.95
|
| Rate for Payer: Global Benefits Group Commercial |
$760.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,140.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$950.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$606.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$610.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$370.06
|
| Rate for Payer: InnovAge PACE Commercial |
$555.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$845.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$103.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$495.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$495.88
|
| Rate for Payer: Multiplan Commercial |
$950.25
|
| Rate for Payer: Networks By Design Commercial |
$823.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,076.95
|
| Rate for Payer: Prime Health Services Medicare |
$392.26
|
| Rate for Payer: Riverside University Health System MISP |
$407.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$760.20
|
| 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 |
$555.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Vantage Medical Group Senior |
$370.06
|
|
|
HC ASPIRATION/INJ GANGLION CYSTS
|
Facility
|
IP
|
$1,267.00
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
909020036
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$253.40 |
| Max. Negotiated Rate |
$1,140.30 |
| Rate for Payer: Cash Price |
$570.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,013.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.80
|
| Rate for Payer: Galaxy Health WC |
$1,076.95
|
| Rate for Payer: Global Benefits Group Commercial |
$760.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,140.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$845.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$482.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.40
|
| Rate for Payer: Multiplan Commercial |
$950.25
|
| Rate for Payer: Networks By Design Commercial |
$823.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,076.95
|
|
|
HC ASPIRATION/INJ GANGLION CYSTS
|
Facility
|
OP
|
$1,267.00
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
909020036
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$103.28 |
| Max. Negotiated Rate |
$5,779.00 |
| 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 |
$555.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$370.06
|
| 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 |
$760.20
|
| Rate for Payer: Caremore Medicare Advantage |
$370.06
|
| Rate for Payer: Cash Price |
$570.15
|
| Rate for Payer: Cash Price |
$570.15
|
| Rate for Payer: Cash Price |
$570.15
|
| Rate for Payer: Cash Price |
$570.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,013.60
|
| Rate for Payer: Cigna of CA PPO |
$937.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$555.09
|
| Rate for Payer: Dignity Health Media |
$370.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$407.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$370.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$370.06
|
| Rate for Payer: Galaxy Health WC |
$1,076.95
|
| Rate for Payer: Global Benefits Group Commercial |
$760.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,140.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$950.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$606.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$370.06
|
| Rate for Payer: InnovAge PACE Commercial |
$555.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$845.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$103.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$495.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$495.88
|
| Rate for Payer: Multiplan Commercial |
$950.25
|
| Rate for Payer: Networks By Design Commercial |
$823.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,076.95
|
| Rate for Payer: Prime Health Services Medicare |
$392.26
|
| Rate for Payer: Riverside University Health System MISP |
$407.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$760.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$633.50
|
| Rate for Payer: United Healthcare All Other HMO |
$633.50
|
| Rate for Payer: United Healthcare HMO Rider |
$633.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$633.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Vantage Medical Group Senior |
$370.06
|
|
|
HC ASPIRATOR MECONIUM
|
Facility
|
OP
|
$717.60
|
|
| Hospital Charge Code |
901602312
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$143.52 |
| Max. Negotiated Rate |
$645.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$435.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$609.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$394.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$394.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$347.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$423.96
|
| Rate for Payer: Blue Distinction Transplant |
$430.56
|
| Rate for Payer: Blue Shield of California Commercial |
$451.37
|
| Rate for Payer: Blue Shield of California EPN |
$350.91
|
| Rate for Payer: Cash Price |
$322.92
|
| Rate for Payer: Central Health Plan Commercial |
$574.08
|
| Rate for Payer: Cigna of CA HMO |
$459.26
|
| Rate for Payer: Cigna of CA PPO |
$531.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$609.96
|
| Rate for Payer: Dignity Health Media |
$609.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$609.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$287.04
|
| Rate for Payer: EPIC Health Plan Transplant |
$287.04
|
| Rate for Payer: Galaxy Health WC |
$609.96
|
| Rate for Payer: Global Benefits Group Commercial |
$430.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$645.84
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$538.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$251.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$478.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$273.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$143.52
|
| Rate for Payer: Multiplan Commercial |
$538.20
|
| Rate for Payer: Networks By Design Commercial |
$466.44
|
| Rate for Payer: Prime Health Services Commercial |
$609.96
|
| Rate for Payer: Riverside University Health System MISP |
$287.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$430.56
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$430.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$358.80
|
| Rate for Payer: United Healthcare All Other HMO |
$358.80
|
| Rate for Payer: United Healthcare HMO Rider |
$358.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$358.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$609.96
|
| Rate for Payer: Vantage Medical Group Senior |
$609.96
|
|
|
HC ASPIRATOR MECONIUM
|
Facility
|
IP
|
$717.60
|
|
| Hospital Charge Code |
901602312
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$143.52 |
| Max. Negotiated Rate |
$645.84 |
| Rate for Payer: Cash Price |
$322.92
|
| Rate for Payer: Central Health Plan Commercial |
$574.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$287.04
|
| Rate for Payer: Galaxy Health WC |
$609.96
|
| Rate for Payer: Global Benefits Group Commercial |
$430.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$645.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$478.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$273.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$143.52
|
| Rate for Payer: Multiplan Commercial |
$538.20
|
| Rate for Payer: Networks By Design Commercial |
$466.44
|
| Rate for Payer: Prime Health Services Commercial |
$609.96
|
|
|
HC ASPIR INJECT THYROID CYST
|
Facility
|
IP
|
$4,411.00
|
|
|
Service Code
|
CPT 60300
|
| Hospital Charge Code |
909020010
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$882.20 |
| Max. Negotiated Rate |
$3,969.90 |
| Rate for Payer: Cash Price |
$1,984.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,528.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,764.40
|
| Rate for Payer: Galaxy Health WC |
$3,749.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,646.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,969.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,942.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,680.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$882.20
|
| Rate for Payer: Multiplan Commercial |
$3,308.25
|
| Rate for Payer: Networks By Design Commercial |
$2,867.15
|
| Rate for Payer: Prime Health Services Commercial |
$3,749.35
|
|
|
HC ASPIR INJECT THYROID CYST
|
Facility
|
OP
|
$4,411.00
|
|
|
Service Code
|
CPT 60300
|
| Hospital Charge Code |
909020010
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$159.87 |
| Max. Negotiated Rate |
$3,969.90 |
| 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 |
$1,318.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.07
|
| 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 |
$2,646.60
|
| Rate for Payer: Caremore Medicare Advantage |
$879.07
|
| Rate for Payer: Cash Price |
$1,984.95
|
| Rate for Payer: Cash Price |
$1,984.95
|
| Rate for Payer: Cash Price |
$1,984.95
|
| Rate for Payer: Cash Price |
$1,984.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,528.80
|
| Rate for Payer: Cigna of CA PPO |
$3,264.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Dignity Health Media |
$879.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$966.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,186.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.07
|
| Rate for Payer: Galaxy Health WC |
$3,749.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,646.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,969.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,308.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,441.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.07
|
| Rate for Payer: InnovAge PACE Commercial |
$1,318.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,942.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$159.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$882.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,177.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,177.95
|
| Rate for Payer: Multiplan Commercial |
$3,308.25
|
| Rate for Payer: Networks By Design Commercial |
$2,867.15
|
| Rate for Payer: Prime Health Services Commercial |
$3,749.35
|
| Rate for Payer: Prime Health Services Medicare |
$931.81
|
| Rate for Payer: Riverside University Health System MISP |
$966.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,646.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,205.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,205.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,205.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,205.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
|
HC ASPIR INJECT THYROID CYST
|
Facility
|
OP
|
$4,411.00
|
|
|
Service Code
|
CPT 60300
|
| Hospital Charge Code |
909020010
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$159.87 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$879.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.07
|
| 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 |
$2,646.60
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$879.07
|
| Rate for Payer: Cash Price |
$1,984.95
|
| Rate for Payer: Cash Price |
$1,984.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,528.80
|
| Rate for Payer: Cigna of CA PPO |
$3,264.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Dignity Health Media |
$879.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$966.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,186.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.07
|
| Rate for Payer: Galaxy Health WC |
$3,749.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,646.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,969.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,308.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,441.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,450.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.07
|
| Rate for Payer: InnovAge PACE Commercial |
$1,318.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,942.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$159.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$882.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,177.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,177.95
|
| Rate for Payer: Multiplan Commercial |
$3,308.25
|
| Rate for Payer: Networks By Design Commercial |
$2,867.15
|
| Rate for Payer: Prime Health Services Commercial |
$3,749.35
|
| Rate for Payer: Prime Health Services Medicare |
$931.81
|
| Rate for Payer: Riverside University Health System MISP |
$966.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,646.60
|
| 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 Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
|
HC ASPIR INJECT THYROID CYST
|
Facility
|
IP
|
$4,411.00
|
|
|
Service Code
|
CPT 60300
|
| Hospital Charge Code |
909020010
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$882.20 |
| Max. Negotiated Rate |
$3,969.90 |
| Rate for Payer: Cash Price |
$1,984.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,528.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,764.40
|
| Rate for Payer: Galaxy Health WC |
$3,749.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,646.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,969.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,942.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,680.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$882.20
|
| Rate for Payer: Multiplan Commercial |
$3,308.25
|
| Rate for Payer: Networks By Design Commercial |
$2,867.15
|
| Rate for Payer: Prime Health Services Commercial |
$3,749.35
|
|
|
HC ASPIR/INJ MAJOR JOINT/BURSA
|
Facility
|
IP
|
$1,724.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
900501055
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$344.80 |
| Max. Negotiated Rate |
$1,551.60 |
| Rate for Payer: Cash Price |
$775.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,379.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$689.60
|
| Rate for Payer: Galaxy Health WC |
$1,465.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,034.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,551.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,149.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$656.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$344.80
|
| Rate for Payer: Multiplan Commercial |
$1,293.00
|
| Rate for Payer: Networks By Design Commercial |
$1,120.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,465.40
|
|
|
HC ASPIR/INJ MAJOR JOINT/BURSA
|
Facility
|
OP
|
$1,724.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
900501055
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$87.00 |
| Max. Negotiated Rate |
$7,084.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$370.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$370.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,034.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,084.40
|
| Rate for Payer: Blue Shield of California EPN |
$843.04
|
| Rate for Payer: Caremore Medicare Advantage |
$370.06
|
| Rate for Payer: Cash Price |
$775.80
|
| Rate for Payer: Cash Price |
$775.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,379.20
|
| Rate for Payer: Cigna of CA HMO |
$1,103.36
|
| Rate for Payer: Cigna of CA PPO |
$1,275.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$555.09
|
| Rate for Payer: Dignity Health Media |
$370.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$407.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$370.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$370.06
|
| Rate for Payer: Galaxy Health WC |
$1,465.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,034.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,551.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,293.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$606.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$610.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$370.06
|
| Rate for Payer: InnovAge PACE Commercial |
$555.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,149.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$87.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$344.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$495.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$495.88
|
| Rate for Payer: Multiplan Commercial |
$1,293.00
|
| Rate for Payer: Networks By Design Commercial |
$1,120.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,465.40
|
| Rate for Payer: Prime Health Services Medicare |
$392.26
|
| Rate for Payer: Riverside University Health System MISP |
$407.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,034.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,034.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$862.00
|
| Rate for Payer: United Healthcare All Other HMO |
$862.00
|
| Rate for Payer: United Healthcare HMO Rider |
$862.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$862.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Vantage Medical Group Senior |
$370.06
|
|
|
HC ASPIR/INJ MAJOR JOINT/BURSA
|
Facility
|
IP
|
$920.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
909000111
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$184.00 |
| Max. Negotiated Rate |
$828.00 |
| Rate for Payer: Cash Price |
$414.00
|
| Rate for Payer: Central Health Plan Commercial |
$736.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$368.00
|
| Rate for Payer: Galaxy Health WC |
$782.00
|
| Rate for Payer: Global Benefits Group Commercial |
$552.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$828.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$613.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$350.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$184.00
|
| Rate for Payer: Multiplan Commercial |
$690.00
|
| Rate for Payer: Networks By Design Commercial |
$598.00
|
| Rate for Payer: Prime Health Services Commercial |
$782.00
|
|
