|
HC COLPOSCOPY BX OF VAG/CERVIX
|
Facility
|
IP
|
$2,796.00
|
|
|
Service Code
|
CPT 57421
|
| Hospital Charge Code |
904057421
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$559.20 |
| Max. Negotiated Rate |
$2,516.40 |
| Rate for Payer: Adventist Health Commercial |
$559.20
|
| Rate for Payer: Cash Price |
$1,258.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,236.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,118.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,118.40
|
| Rate for Payer: Galaxy Health WC |
$2,376.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,677.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,516.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,864.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,065.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,730.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$559.20
|
| Rate for Payer: Multiplan Commercial |
$2,097.00
|
| Rate for Payer: Networks By Design Commercial |
$1,817.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,376.60
|
|
|
HC COLPOSCOPY BX OF VAG/CERVIX
|
Facility
|
OP
|
$2,796.00
|
|
|
Service Code
|
CPT 57421
|
| Hospital Charge Code |
904057421
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$278.18 |
| Max. Negotiated Rate |
$4,460.00 |
| Rate for Payer: Adventist Health Commercial |
$559.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,106.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,659.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,217.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,106.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,353.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,642.09
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,762.79
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$1,258.20
|
| Rate for Payer: Cash Price |
$1,258.20
|
| Rate for Payer: Cash Price |
$1,258.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,236.80
|
| Rate for Payer: Cigna of CA HMO |
$1,789.44
|
| Rate for Payer: Cigna of CA PPO |
$2,069.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,659.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,217.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,106.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,493.59
|
| Rate for Payer: EPIC Health Plan Senior |
$1,106.36
|
| Rate for Payer: Galaxy Health WC |
$2,376.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,677.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,516.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,814.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$278.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,106.36
|
| Rate for Payer: InnovAge PACE Commercial |
$1,659.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,864.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$307.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,106.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$559.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,482.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,482.52
|
| Rate for Payer: Multiplan Commercial |
$2,097.00
|
| Rate for Payer: Multiplan WC |
$1,762.79
|
| Rate for Payer: Networks By Design Commercial |
$1,817.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,106.36
|
| Rate for Payer: Preferred Health Network WC |
$1,798.77
|
| Rate for Payer: Prime Health Services Commercial |
$2,376.60
|
| Rate for Payer: Prime Health Services Medicare |
$1,172.74
|
| Rate for Payer: Prime Health Services WC |
$1,744.81
|
| Rate for Payer: Riverside University Health System MISP |
$1,217.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,677.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,106.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,659.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,217.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,106.36
|
|
|
HC COLPOSCOPY CERV INCL UP/ADJ VAGINA W BX CERVIX
|
Facility
|
IP
|
$1,209.00
|
|
|
Service Code
|
CPT 57455
|
| Hospital Charge Code |
904000021
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$241.80 |
| Max. Negotiated Rate |
$1,088.10 |
| Rate for Payer: Adventist Health Commercial |
$241.80
|
| Rate for Payer: Cash Price |
$544.05
|
| Rate for Payer: Central Health Plan Commercial |
$967.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$483.60
|
| Rate for Payer: EPIC Health Plan Senior |
$483.60
|
| Rate for Payer: Galaxy Health WC |
$1,027.65
|
| Rate for Payer: Global Benefits Group Commercial |
$725.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,088.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$806.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$460.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$748.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.80
|
| Rate for Payer: Multiplan Commercial |
$906.75
|
| Rate for Payer: Networks By Design Commercial |
$785.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,027.65
|
|
|
HC COLPOSCOPY CERV INCL UP/ADJ VAGINA W BX CERVIX
|
Facility
|
OP
|
$1,209.00
|
|
|
Service Code
|
CPT 57455
|
| Hospital Charge Code |
904000021
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$241.80 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$241.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$386.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$386.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$585.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$710.05
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$615.83
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$544.05
|
| Rate for Payer: Cash Price |
$544.05
|
| Rate for Payer: Cash Price |
$544.05
|
| Rate for Payer: Central Health Plan Commercial |
$967.20
|
| Rate for Payer: Cigna of CA HMO |
$773.76
|
| Rate for Payer: Cigna of CA PPO |
$894.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$579.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$425.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$386.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$521.77
|
| Rate for Payer: EPIC Health Plan Senior |
$386.50
|
| Rate for Payer: Galaxy Health WC |
$1,027.65
|
| Rate for Payer: Global Benefits Group Commercial |
$725.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,088.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$633.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$253.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$386.50
|
| Rate for Payer: InnovAge PACE Commercial |
$579.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$806.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$279.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$386.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$517.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$517.91
|
| Rate for Payer: Multiplan Commercial |
$906.75
|
| Rate for Payer: Multiplan WC |
$615.83
|
| Rate for Payer: Networks By Design Commercial |
$785.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$386.50
|
| Rate for Payer: Preferred Health Network WC |
$628.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,027.65
|
| Rate for Payer: Prime Health Services Medicare |
$409.69
|
| Rate for Payer: Prime Health Services WC |
$609.55
|
| Rate for Payer: Riverside University Health System MISP |
$425.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$725.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$386.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Vantage Medical Group Senior |
$386.50
|
|
|
HC COLPOSCOPY/ECC
|
Facility
|
IP
|
$1,209.00
|
|
|
Service Code
|
CPT 57456
|
| Hospital Charge Code |
904000024
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$241.80 |
| Max. Negotiated Rate |
$1,088.10 |
| Rate for Payer: Adventist Health Commercial |
$241.80
|
| Rate for Payer: Cash Price |
$544.05
|
| Rate for Payer: Central Health Plan Commercial |
$967.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$483.60
|
| Rate for Payer: EPIC Health Plan Senior |
$483.60
|
| Rate for Payer: Galaxy Health WC |
$1,027.65
|
| Rate for Payer: Global Benefits Group Commercial |
$725.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,088.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$806.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$460.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$748.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.80
|
| Rate for Payer: Multiplan Commercial |
$906.75
|
| Rate for Payer: Networks By Design Commercial |
$785.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,027.65
|
|
|
HC COLPOSCOPY/ECC
|
Facility
|
OP
|
$1,209.00
|
|
|
Service Code
|
CPT 57456
|
| Hospital Charge Code |
904000024
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$128.98 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$241.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$386.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$386.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$615.83
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$544.05
|
| Rate for Payer: Cash Price |
$544.05
|
| Rate for Payer: Cash Price |
$544.05
|
| Rate for Payer: Central Health Plan Commercial |
$967.20
|
| Rate for Payer: Cigna of CA HMO |
$773.76
|
| Rate for Payer: Cigna of CA PPO |
$894.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$579.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$425.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$386.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$521.77
|
| Rate for Payer: EPIC Health Plan Senior |
$386.50
|
| Rate for Payer: Galaxy Health WC |
$1,027.65
|
| Rate for Payer: Global Benefits Group Commercial |
$725.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,088.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$633.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$128.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$386.50
|
| Rate for Payer: InnovAge PACE Commercial |
$579.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$806.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$386.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$517.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$517.91
|
| Rate for Payer: Multiplan Commercial |
$906.75
|
| Rate for Payer: Multiplan WC |
$615.83
|
| Rate for Payer: Networks By Design Commercial |
$785.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$386.50
|
| Rate for Payer: Preferred Health Network WC |
$628.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,027.65
|
| Rate for Payer: Prime Health Services Medicare |
$409.69
|
| Rate for Payer: Prime Health Services WC |
$609.55
|
| Rate for Payer: Riverside University Health System MISP |
$425.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$725.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$386.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Vantage Medical Group Senior |
$386.50
|
|
|
HC COLPOSCOPY VAG W CRVIX
|
Facility
|
IP
|
$1,815.00
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
906757420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$363.00 |
| Max. Negotiated Rate |
$1,633.50 |
| Rate for Payer: Adventist Health Commercial |
$363.00
|
| Rate for Payer: Cash Price |
$816.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,452.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$726.00
|
| Rate for Payer: EPIC Health Plan Senior |
$726.00
|
| Rate for Payer: Galaxy Health WC |
$1,542.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,089.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,633.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,210.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$691.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,123.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$363.00
|
| Rate for Payer: Multiplan Commercial |
$1,361.25
|
| Rate for Payer: Networks By Design Commercial |
$1,179.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,542.75
|
|
|
HC COLPOSCOPY VAG W CRVIX
|
Facility
|
OP
|
$961.00
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
906757420
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$192.20 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$192.20
|
| 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 |
$579.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$386.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$615.83
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Central Health Plan Commercial |
$768.80
|
| Rate for Payer: Cigna of CA HMO |
$615.04
|
| Rate for Payer: Cigna of CA PPO |
$711.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$579.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$425.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$386.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$521.77
|
| Rate for Payer: EPIC Health Plan Senior |
$386.50
|
| Rate for Payer: Galaxy Health WC |
$816.85
|
| Rate for Payer: Global Benefits Group Commercial |
$576.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$864.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$633.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$386.50
|
| Rate for Payer: InnovAge PACE Commercial |
$579.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$640.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$258.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$386.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$517.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$517.91
|
| Rate for Payer: Multiplan Commercial |
$720.75
|
| Rate for Payer: Multiplan WC |
$615.83
|
| Rate for Payer: Networks By Design Commercial |
$624.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$386.50
|
| Rate for Payer: Preferred Health Network WC |
$628.40
|
| Rate for Payer: Prime Health Services Commercial |
$816.85
|
| Rate for Payer: Prime Health Services Medicare |
$409.69
|
| Rate for Payer: Prime Health Services WC |
$609.55
|
| Rate for Payer: Riverside University Health System MISP |
$425.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$576.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$480.50
|
| Rate for Payer: United Healthcare All Other HMO |
$480.50
|
| Rate for Payer: United Healthcare HMO Rider |
$480.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$480.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$386.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Vantage Medical Group Senior |
$386.50
|
|
|
HC COLPOSCOPY VAG W CRVIX
|
Facility
|
OP
|
$961.00
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
906757420
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$192.20 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$192.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$386.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$386.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$465.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$564.40
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Central Health Plan Commercial |
$768.80
|
| Rate for Payer: Cigna of CA HMO |
$615.04
|
| Rate for Payer: Cigna of CA PPO |
$711.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$579.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$425.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$386.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$521.77
|
| Rate for Payer: EPIC Health Plan Senior |
$386.50
|
| Rate for Payer: Galaxy Health WC |
$816.85
|
| Rate for Payer: Global Benefits Group Commercial |
$576.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$864.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$633.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$234.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$386.50
|
| Rate for Payer: InnovAge PACE Commercial |
$579.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$640.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$258.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$386.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$517.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$517.91
|
| Rate for Payer: Multiplan Commercial |
$720.75
|
| Rate for Payer: Networks By Design Commercial |
$624.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$386.50
|
| Rate for Payer: Prime Health Services Commercial |
$816.85
|
| Rate for Payer: Prime Health Services Medicare |
$409.69
|
| Rate for Payer: Riverside University Health System MISP |
$425.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$576.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$463.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$386.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Vantage Medical Group Senior |
$386.50
|
|
|
HC COLPOSCOPY VAG W CRVIX
|
Facility
|
IP
|
$1,815.00
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
906757420
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$363.00 |
| Max. Negotiated Rate |
$1,633.50 |
| Rate for Payer: Adventist Health Commercial |
$363.00
|
| Rate for Payer: Cash Price |
$816.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,452.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$726.00
|
| Rate for Payer: EPIC Health Plan Senior |
$726.00
|
| Rate for Payer: Galaxy Health WC |
$1,542.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,089.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,633.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,210.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$691.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,123.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$363.00
|
| Rate for Payer: Multiplan Commercial |
$1,361.25
|
| Rate for Payer: Networks By Design Commercial |
$1,179.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,542.75
|
|
|
HC COLPOSCOPY VAG W CRVIX
|
Facility
|
OP
|
$961.00
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
906757420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$192.20 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$192.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$386.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$386.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$465.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$564.40
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$615.83
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Cash Price |
$432.45
|
| Rate for Payer: Central Health Plan Commercial |
$768.80
|
| Rate for Payer: Cigna of CA HMO |
$615.04
|
| Rate for Payer: Cigna of CA PPO |
$711.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$579.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$425.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$386.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$521.77
|
| Rate for Payer: EPIC Health Plan Senior |
$386.50
|
| Rate for Payer: Galaxy Health WC |
$816.85
|
| Rate for Payer: Global Benefits Group Commercial |
$576.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$864.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$633.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$234.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$386.50
|
| Rate for Payer: InnovAge PACE Commercial |
$579.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$640.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$258.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$386.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$517.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$517.91
|
| Rate for Payer: Multiplan Commercial |
$720.75
|
| Rate for Payer: Multiplan WC |
$615.83
|
| Rate for Payer: Networks By Design Commercial |
$624.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$386.50
|
| Rate for Payer: Preferred Health Network WC |
$628.40
|
| Rate for Payer: Prime Health Services Commercial |
$816.85
|
| Rate for Payer: Prime Health Services Medicare |
$409.69
|
| Rate for Payer: Prime Health Services WC |
$609.55
|
| Rate for Payer: Riverside University Health System MISP |
$425.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$576.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$386.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Vantage Medical Group Senior |
$386.50
|
|
|
HC COLPOSCOPY VAG W CRVIX
|
Facility
|
IP
|
$1,815.00
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
906757420
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$363.00 |
| Max. Negotiated Rate |
$1,633.50 |
| Rate for Payer: Adventist Health Commercial |
$363.00
|
| Rate for Payer: Cash Price |
$816.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,452.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$726.00
|
| Rate for Payer: EPIC Health Plan Senior |
$726.00
|
| Rate for Payer: Galaxy Health WC |
$1,542.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,089.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,633.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,210.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$691.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,123.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$363.00
|
| Rate for Payer: Multiplan Commercial |
$1,361.25
|
| Rate for Payer: Networks By Design Commercial |
$1,179.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,542.75
|
|
|
HC COLPOSCOPY VULVA W BIOPSY
|
Facility
|
OP
|
$641.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
904000023
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$128.20 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$128.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$386.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$386.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$310.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$376.46
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$615.83
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$288.45
|
| Rate for Payer: Cash Price |
$288.45
|
| Rate for Payer: Cash Price |
$288.45
|
| Rate for Payer: Central Health Plan Commercial |
$512.80
|
| Rate for Payer: Cigna of CA HMO |
$410.24
|
| Rate for Payer: Cigna of CA PPO |
$474.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$579.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$425.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$386.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$521.77
|
| Rate for Payer: EPIC Health Plan Senior |
$386.50
|
| Rate for Payer: Galaxy Health WC |
$544.85
|
| Rate for Payer: Global Benefits Group Commercial |
$384.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$576.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$633.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$279.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$386.50
|
| Rate for Payer: InnovAge PACE Commercial |
$579.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$427.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$309.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$386.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$128.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$517.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$517.91
|
| Rate for Payer: Multiplan Commercial |
$480.75
|
| Rate for Payer: Multiplan WC |
$615.83
|
| Rate for Payer: Networks By Design Commercial |
$416.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$386.50
|
| Rate for Payer: Preferred Health Network WC |
$628.40
|
| Rate for Payer: Prime Health Services Commercial |
$544.85
|
| Rate for Payer: Prime Health Services Medicare |
$409.69
|
| Rate for Payer: Prime Health Services WC |
$609.55
|
| Rate for Payer: Riverside University Health System MISP |
$425.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$384.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$386.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Vantage Medical Group Senior |
$386.50
|
|
|
HC COLPOSCOPY VULVA W BIOPSY
|
Facility
|
IP
|
$641.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
904000023
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$128.20 |
| Max. Negotiated Rate |
$576.90 |
| Rate for Payer: Adventist Health Commercial |
$128.20
|
| Rate for Payer: Cash Price |
$288.45
|
| Rate for Payer: Central Health Plan Commercial |
$512.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$256.40
|
| Rate for Payer: EPIC Health Plan Senior |
$256.40
|
| Rate for Payer: Galaxy Health WC |
$544.85
|
| Rate for Payer: Global Benefits Group Commercial |
$384.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$576.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$427.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$244.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$396.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$128.20
|
| Rate for Payer: Multiplan Commercial |
$480.75
|
| Rate for Payer: Networks By Design Commercial |
$416.65
|
| Rate for Payer: Prime Health Services Commercial |
$544.85
|
|
|
HC COLPOSCOPY W/BIOPSY CERVIX
|
Facility
|
OP
|
$1,607.00
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
902890150
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$148.16 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Commercial |
$321.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$386.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$386.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$981.88
|
| Rate for Payer: Blue Shield of California EPN |
$641.19
|
| Rate for Payer: Cash Price |
$723.15
|
| Rate for Payer: Cash Price |
$723.15
|
| Rate for Payer: Cash Price |
$723.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,285.60
|
| Rate for Payer: Cigna of CA HMO |
$1,028.48
|
| Rate for Payer: Cigna of CA PPO |
$1,189.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$579.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$425.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$386.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$521.77
|
| Rate for Payer: EPIC Health Plan Senior |
$386.50
|
| Rate for Payer: Galaxy Health WC |
$1,365.95
|
| Rate for Payer: Global Benefits Group Commercial |
$964.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,446.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$633.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$148.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$386.50
|
| Rate for Payer: InnovAge PACE Commercial |
$579.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,071.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$163.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$386.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$517.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$517.91
|
| Rate for Payer: Multiplan Commercial |
$1,205.25
|
| Rate for Payer: Networks By Design Commercial |
$1,044.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$386.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,365.95
|
| Rate for Payer: Prime Health Services Medicare |
$409.69
|
| Rate for Payer: Riverside University Health System MISP |
$425.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$964.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$964.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$803.50
|
| Rate for Payer: United Healthcare All Other HMO |
$803.50
|
| Rate for Payer: United Healthcare HMO Rider |
$803.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$803.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$386.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Vantage Medical Group Senior |
$386.50
|
|
|
HC COLPOSCOPY W/BIOPSY CERVIX
|
Facility
|
OP
|
$1,607.00
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
902890150
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$163.67 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Commercial |
$658.87
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$386.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$615.83
|
| Rate for Payer: Cash Price |
$723.15
|
| Rate for Payer: Cash Price |
$723.15
|
| Rate for Payer: Cash Price |
$723.15
|
| Rate for Payer: Cash Price |
$723.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,285.60
|
| Rate for Payer: Cigna of CA HMO |
$1,028.48
|
| Rate for Payer: Cigna of CA PPO |
$1,189.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$579.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$425.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$386.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$521.77
|
| Rate for Payer: EPIC Health Plan Senior |
$386.50
|
| Rate for Payer: Galaxy Health WC |
$1,365.95
|
| Rate for Payer: Global Benefits Group Commercial |
$964.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,446.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$633.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$386.50
|
| Rate for Payer: InnovAge PACE Commercial |
$579.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,071.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$163.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$386.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$517.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$517.91
|
| Rate for Payer: Multiplan Commercial |
$1,205.25
|
| Rate for Payer: Multiplan WC |
$615.83
|
| Rate for Payer: Networks By Design Commercial |
$1,044.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$386.50
|
| Rate for Payer: Preferred Health Network WC |
$628.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,365.95
|
| Rate for Payer: Prime Health Services Medicare |
$409.69
|
| Rate for Payer: Prime Health Services WC |
$609.55
|
| Rate for Payer: Riverside University Health System MISP |
$425.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$964.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$964.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$386.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Vantage Medical Group Senior |
$386.50
|
|
|
HC COLPOSCOPY W/BIOPSY CERVIX
|
Facility
|
IP
|
$1,607.00
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
902890150
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$321.40 |
| Max. Negotiated Rate |
$1,446.30 |
| Rate for Payer: Adventist Health Commercial |
$321.40
|
| Rate for Payer: Cash Price |
$723.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,285.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$642.80
|
| Rate for Payer: EPIC Health Plan Senior |
$642.80
|
| Rate for Payer: Galaxy Health WC |
$1,365.95
|
| Rate for Payer: Global Benefits Group Commercial |
$964.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,446.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,071.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$612.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$994.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.40
|
| Rate for Payer: Multiplan Commercial |
$1,205.25
|
| Rate for Payer: Networks By Design Commercial |
$1,044.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,365.95
|
|
|
HC COLPOSCOPY W/BIOPSY CERVIX
|
Facility
|
IP
|
$1,607.00
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
902890150
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$321.40 |
| Max. Negotiated Rate |
$1,446.30 |
| Rate for Payer: Adventist Health Commercial |
$321.40
|
| Rate for Payer: Cash Price |
$723.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,285.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$642.80
|
| Rate for Payer: EPIC Health Plan Senior |
$642.80
|
| Rate for Payer: Galaxy Health WC |
$1,365.95
|
| Rate for Payer: Global Benefits Group Commercial |
$964.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,446.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,071.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$612.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$994.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.40
|
| Rate for Payer: Multiplan Commercial |
$1,205.25
|
| Rate for Payer: Networks By Design Commercial |
$1,044.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,365.95
|
|
|
HC COMMON CAROTID HEAD UNI
|
Facility
|
OP
|
$11,945.00
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
906820221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$441.85 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$2,389.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$6,868.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,868.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$10,943.70
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$5,375.25
|
| Rate for Payer: Cash Price |
$5,375.25
|
| Rate for Payer: Cash Price |
$5,375.25
|
| Rate for Payer: Central Health Plan Commercial |
$9,556.00
|
| Rate for Payer: Cigna of CA HMO |
$7,644.80
|
| Rate for Payer: Cigna of CA PPO |
$8,839.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,555.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,868.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,272.45
|
| Rate for Payer: EPIC Health Plan Senior |
$6,868.48
|
| Rate for Payer: Galaxy Health WC |
$10,153.25
|
| Rate for Payer: Global Benefits Group Commercial |
$7,167.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,750.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,264.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$441.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,868.48
|
| Rate for Payer: InnovAge PACE Commercial |
$10,302.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,967.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$488.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,868.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,389.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,203.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,203.76
|
| Rate for Payer: Multiplan Commercial |
$8,958.75
|
| Rate for Payer: Multiplan WC |
$10,943.70
|
| Rate for Payer: Networks By Design Commercial |
$7,764.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6,868.48
|
| Rate for Payer: Preferred Health Network WC |
$11,167.04
|
| Rate for Payer: Prime Health Services Commercial |
$10,153.25
|
| Rate for Payer: Prime Health Services Medicare |
$7,280.59
|
| Rate for Payer: Prime Health Services WC |
$10,832.03
|
| Rate for Payer: Riverside University Health System MISP |
$7,555.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,167.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$6,868.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Vantage Medical Group Senior |
$6,868.48
|
|
|
HC COMMON CAROTID HEAD UNI
|
Facility
|
IP
|
$11,945.00
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
906820221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,389.00 |
| Max. Negotiated Rate |
$10,750.50 |
| Rate for Payer: Adventist Health Commercial |
$2,389.00
|
| Rate for Payer: Cash Price |
$5,375.25
|
| Rate for Payer: Central Health Plan Commercial |
$9,556.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,778.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,778.00
|
| Rate for Payer: Galaxy Health WC |
$10,153.25
|
| Rate for Payer: Global Benefits Group Commercial |
$7,167.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,750.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,967.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,551.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,393.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,389.00
|
| Rate for Payer: Multiplan Commercial |
$8,958.75
|
| Rate for Payer: Networks By Design Commercial |
$7,764.25
|
| Rate for Payer: Prime Health Services Commercial |
$10,153.25
|
|
|
HC COMMON CAROTID HEAD UNI
|
Facility
|
OP
|
$10,153.00
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
909020146
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$441.85 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$2,030.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$6,868.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,868.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$10,943.70
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$4,568.85
|
| Rate for Payer: Cash Price |
$4,568.85
|
| Rate for Payer: Cash Price |
$4,568.85
|
| Rate for Payer: Central Health Plan Commercial |
$8,122.40
|
| Rate for Payer: Cigna of CA HMO |
$6,497.92
|
| Rate for Payer: Cigna of CA PPO |
$7,513.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,555.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,868.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,272.45
|
| Rate for Payer: EPIC Health Plan Senior |
$6,868.48
|
| Rate for Payer: Galaxy Health WC |
$8,630.05
|
| Rate for Payer: Global Benefits Group Commercial |
$6,091.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,137.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,264.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$441.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,868.48
|
| Rate for Payer: InnovAge PACE Commercial |
$10,302.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,772.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$488.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,868.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,030.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,203.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,203.76
|
| Rate for Payer: Multiplan Commercial |
$7,614.75
|
| Rate for Payer: Multiplan WC |
$10,943.70
|
| Rate for Payer: Networks By Design Commercial |
$6,599.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6,868.48
|
| Rate for Payer: Preferred Health Network WC |
$11,167.04
|
| Rate for Payer: Prime Health Services Commercial |
$8,630.05
|
| Rate for Payer: Prime Health Services Medicare |
$7,280.59
|
| Rate for Payer: Prime Health Services WC |
$10,832.03
|
| Rate for Payer: Riverside University Health System MISP |
$7,555.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,091.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$6,868.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Vantage Medical Group Senior |
$6,868.48
|
|
|
HC COMMON CAROTID HEAD UNI
|
Facility
|
IP
|
$10,153.00
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
909020146
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,030.60 |
| Max. Negotiated Rate |
$9,137.70 |
| Rate for Payer: Adventist Health Commercial |
$2,030.60
|
| Rate for Payer: Cash Price |
$4,568.85
|
| Rate for Payer: Central Health Plan Commercial |
$8,122.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,061.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4,061.20
|
| Rate for Payer: Galaxy Health WC |
$8,630.05
|
| Rate for Payer: Global Benefits Group Commercial |
$6,091.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,137.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,772.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,868.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,284.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,030.60
|
| Rate for Payer: Multiplan Commercial |
$7,614.75
|
| Rate for Payer: Networks By Design Commercial |
$6,599.45
|
| Rate for Payer: Prime Health Services Commercial |
$8,630.05
|
|
|
HC COMMON CAROTID NECK UNI
|
Facility
|
IP
|
$11,348.00
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
906820220
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,269.60 |
| Max. Negotiated Rate |
$10,213.20 |
| Rate for Payer: Adventist Health Commercial |
$2,269.60
|
| Rate for Payer: Cash Price |
$5,106.60
|
| Rate for Payer: Central Health Plan Commercial |
$9,078.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,539.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4,539.20
|
| Rate for Payer: Galaxy Health WC |
$9,645.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,808.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,213.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,569.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,323.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,024.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,269.60
|
| Rate for Payer: Multiplan Commercial |
$8,511.00
|
| Rate for Payer: Networks By Design Commercial |
$7,376.20
|
| Rate for Payer: Prime Health Services Commercial |
$9,645.80
|
|
|
HC COMMON CAROTID NECK UNI
|
Facility
|
IP
|
$9,646.00
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
909020145
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,929.20 |
| Max. Negotiated Rate |
$8,681.40 |
| Rate for Payer: Adventist Health Commercial |
$1,929.20
|
| Rate for Payer: Cash Price |
$4,340.70
|
| Rate for Payer: Central Health Plan Commercial |
$7,716.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,858.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,858.40
|
| Rate for Payer: Galaxy Health WC |
$8,199.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,787.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,681.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,433.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,675.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,970.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,929.20
|
| Rate for Payer: Multiplan Commercial |
$7,234.50
|
| Rate for Payer: Networks By Design Commercial |
$6,269.90
|
| Rate for Payer: Prime Health Services Commercial |
$8,199.10
|
|
|
HC COMMON CAROTID NECK UNI
|
Facility
|
OP
|
$11,348.00
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
906820220
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$409.19 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$2,269.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$5,106.60
|
| Rate for Payer: Cash Price |
$5,106.60
|
| Rate for Payer: Cash Price |
$5,106.60
|
| Rate for Payer: Central Health Plan Commercial |
$9,078.40
|
| Rate for Payer: Cigna of CA HMO |
$7,262.72
|
| Rate for Payer: Cigna of CA PPO |
$8,397.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$9,645.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,808.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,213.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$409.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: InnovAge PACE Commercial |
$5,998.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,569.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$452.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,269.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$8,511.00
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$7,376.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$9,645.80
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,808.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
