|
HC BILATERAL LSHO-CUSTOM FIT ABD
|
Facility
OP
|
$3,039.00
|
|
|
Service Code
|
CPT L1690
|
| Hospital Charge Code |
905351690
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,063.65 |
| Max. Negotiated Rate |
$7,670.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,670.05
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,583.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,671.45
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,671.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,471.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,795.44
|
| Rate for Payer: BCBS Transplant Transplant |
$1,823.40
|
| Rate for Payer: Blue Shield of California Commercial |
$2,279.25
|
| Rate for Payer: Blue Shield of California EPN |
$1,653.22
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,431.20
|
| Rate for Payer: Cigna of CA HMO |
$2,127.30
|
| Rate for Payer: Cigna of CA PPO |
$2,127.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,583.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,215.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,215.60
|
| Rate for Payer: Galaxy Health WC |
$2,583.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,823.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,735.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,279.25
|
| Rate for Payer: IEHP medi-cal |
$1,063.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,027.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,245.99
|
| Rate for Payer: Multiplan Commercial |
$2,279.25
|
| Rate for Payer: Networks By Design Commercial |
$1,519.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,583.15
|
| Rate for Payer: Riverside University Health MISP |
$1,215.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,823.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,823.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,519.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,519.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,519.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,519.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,583.15
|
| Rate for Payer: Vantage Medical Group Senior |
$2,583.15
|
|
|
HC BILATERAL LSHO-CUSTOM FIT ABD
|
Facility
IP
|
$3,039.00
|
|
|
Service Code
|
CPT L1690
|
| Hospital Charge Code |
905351690
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$607.80 |
| Max. Negotiated Rate |
$2,735.10 |
| Rate for Payer: Blue Shield of California EPN |
$1,622.83
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,431.20
|
| Rate for Payer: Cigna of CA HMO |
$2,127.30
|
| Rate for Payer: Cigna of CA PPO |
$2,127.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,215.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,215.60
|
| Rate for Payer: Galaxy Health WC |
$2,583.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,823.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,735.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,027.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$607.80
|
| Rate for Payer: Multiplan Commercial |
$2,279.25
|
| Rate for Payer: Networks By Design Commercial |
$1,519.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,583.15
|
|
|
HC BIL CATH CONV EXT TO INT/EXT
|
Facility
IP
|
$11,134.00
|
|
|
Service Code
|
CPT 47535
|
| Hospital Charge Code |
909047535
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,226.80 |
| Max. Negotiated Rate |
$10,020.60 |
| Rate for Payer: Cash Price |
$5,010.30
|
| Rate for Payer: Central Health Plan Commercial |
$8,907.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,453.60
|
| Rate for Payer: Galaxy Health WC |
$9,463.90
|
| Rate for Payer: Global Benefits Group Commercial |
$6,680.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,020.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,426.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,226.80
|
| Rate for Payer: Multiplan Commercial |
$8,350.50
|
| Rate for Payer: Networks By Design Commercial |
$7,237.10
|
| Rate for Payer: Prime Health Services Commercial |
$9,463.90
|
|
|
HC BIL CATH CONV EXT TO INT/EXT
|
Facility
OP
|
$11,134.00
|
|
|
Service Code
|
CPT 47535
|
| Hospital Charge Code |
909047535
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,226.80 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,322.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,483.93
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,754.88
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,322.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$6,680.40
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Caremore Medicare Advantage |
$4,322.62
|
| Rate for Payer: Cash Price |
$5,010.30
|
| Rate for Payer: Cash Price |
$5,010.30
|
| Rate for Payer: Cash Price |
$5,010.30
|
| Rate for Payer: Central Health Plan Commercial |
$8,907.20
|
| Rate for Payer: Cigna of CA PPO |
$8,239.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,483.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,835.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,322.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,322.62
|
| Rate for Payer: Galaxy Health WC |
$9,463.90
|
| Rate for Payer: Global Benefits Group Commercial |
$6,680.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,020.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8,350.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,089.10
|
| Rate for Payer: IEHP medi-cal |
$7,132.32
|
| Rate for Payer: IEHP Medicare Advantage |
$4,322.62
|
| Rate for Payer: Innovage PACE Commercial |
$6,483.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,426.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,322.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,226.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,792.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,792.31
|
| Rate for Payer: Multiplan Commercial |
$8,350.50
|
| Rate for Payer: Networks By Design Commercial |
$7,237.10
|
| Rate for Payer: Prime Health Services Commercial |
$9,463.90
|
| Rate for Payer: Prime Health Services Medicare |
$4,581.98
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6,680.40
|
| Rate for Payer: Riverside University Health MISP |
$4,754.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,680.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,754.88
|
| Rate for Payer: Vantage Medical Group Senior |
$4,322.62
|
|
|
HC BILIARY BRUSH/BIOPSY
|
Facility
IP
|
$9,646.00
|
|
|
Service Code
|
CPT 47553
|
| Hospital Charge Code |
909000148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,929.20 |
| Max. Negotiated Rate |
$8,681.40 |
| 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: 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: 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 BILIARY BRUSH/BIOPSY
|
Facility
OP
|
$9,646.00
|
|
|
Service Code
|
CPT 47553
|
| Hospital Charge Code |
909000148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,929.20 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$9,452.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$14,179.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10,397.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9,452.68
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$12,923.16
|
| Rate for Payer: BCBS Transplant Transplant |
$5,787.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Caremore Medicare Advantage |
$9,452.68
|
| Rate for Payer: Cash Price |
$4,340.70
|
| Rate for Payer: Cash Price |
$4,340.70
|
| Rate for Payer: Central Health Plan Commercial |
$7,716.80
|
| Rate for Payer: Cigna of CA PPO |
$7,138.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14,179.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,761.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9,452.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$9,452.68
|
| 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: Health Plan of Nevada - Sierra Transplant Other |
$7,234.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15,502.40
|
| Rate for Payer: IEHP medi-cal |
$15,596.92
|
| Rate for Payer: IEHP Medicare Advantage |
$9,452.68
|
| Rate for Payer: Innovage PACE Commercial |
$14,179.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,433.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,452.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,929.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,666.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,666.59
|
| Rate for Payer: Multiplan Commercial |
$7,234.50
|
| Rate for Payer: Multiplan WC |
$12,923.16
|
| Rate for Payer: Networks By Design Commercial |
$6,269.90
|
| Rate for Payer: Preferred Health Network WC |
$13,186.90
|
| Rate for Payer: Prime Health Services Commercial |
$8,199.10
|
| Rate for Payer: Prime Health Services Medicare |
$10,019.84
|
| Rate for Payer: Prime Health Services WC |
$12,791.29
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,787.60
|
| Rate for Payer: Riverside University Health MISP |
$10,397.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,787.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14,179.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,397.95
|
| Rate for Payer: Vantage Medical Group Senior |
$9,452.68
|
|
|
HC BILIARY CATH RMVL W FLUORO
|
Facility
IP
|
$2,469.00
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
909047537
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$493.80 |
| Max. Negotiated Rate |
$2,222.10 |
| Rate for Payer: Cash Price |
$1,111.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,975.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$987.60
|
| Rate for Payer: Galaxy Health WC |
$2,098.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,481.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,222.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,646.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$493.80
|
| Rate for Payer: Multiplan Commercial |
$1,851.75
|
| Rate for Payer: Networks By Design Commercial |
$1,604.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,098.65
|
|
|
HC BILIARY CATH RMVL W FLUORO
|
Facility
OP
|
$2,469.00
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
909047537
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$493.80 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,132.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,481.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,132.59
|
| Rate for Payer: Cash Price |
$1,111.05
|
| Rate for Payer: Cash Price |
$1,111.05
|
| Rate for Payer: Cash Price |
$1,111.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,975.20
|
| Rate for Payer: Cigna of CA PPO |
$1,827.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$2,098.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,481.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,222.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,851.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,857.45
|
| Rate for Payer: IEHP medi-cal |
$1,868.77
|
| Rate for Payer: IEHP Medicare Advantage |
$1,132.59
|
| Rate for Payer: Innovage PACE Commercial |
$1,698.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,646.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$493.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,517.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$1,851.75
|
| Rate for Payer: Networks By Design Commercial |
$1,604.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,098.65
|
| Rate for Payer: Prime Health Services Medicare |
$1,200.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,481.40
|
| Rate for Payer: Riverside University Health MISP |
$1,245.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,481.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC BILIARY CATH RMVL W FLUORO
|
Facility
IP
|
$2,469.00
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
909047537
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$493.80 |
| Max. Negotiated Rate |
$2,222.10 |
| Rate for Payer: Cash Price |
$1,111.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,975.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$987.60
|
| Rate for Payer: Galaxy Health WC |
$2,098.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,481.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,222.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,646.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$493.80
|
| Rate for Payer: Multiplan Commercial |
$1,851.75
|
| Rate for Payer: Networks By Design Commercial |
$1,604.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,098.65
|
|
|
HC BILIARY CATH RMVL W FLUORO
|
Facility
OP
|
$2,469.00
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
909047537
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$493.80 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,132.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,481.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,132.59
|
| Rate for Payer: Cash Price |
$1,111.05
|
| Rate for Payer: Cash Price |
$1,111.05
|
| Rate for Payer: Cash Price |
$1,111.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,975.20
|
| Rate for Payer: Cigna of CA PPO |
$1,827.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$2,098.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,481.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,222.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,851.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,857.45
|
| Rate for Payer: IEHP medi-cal |
$1,868.77
|
| Rate for Payer: IEHP Medicare Advantage |
$1,132.59
|
| Rate for Payer: Innovage PACE Commercial |
$1,698.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,646.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$493.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,517.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$1,851.75
|
| Rate for Payer: Networks By Design Commercial |
$1,604.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,098.65
|
| Rate for Payer: Prime Health Services Medicare |
$1,200.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,245.85
|
| Rate for Payer: Riverside University Health MISP |
$1,245.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,481.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,359.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC BILIARY COPE LOOP CATH
|
Facility
OP
|
$418.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909001069
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$83.60 |
| Max. Negotiated Rate |
$376.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$312.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$355.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$229.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$229.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$190.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$232.83
|
| Rate for Payer: BCBS Transplant Transplant |
$250.80
|
| Rate for Payer: Blue Shield of California Commercial |
$313.50
|
| Rate for Payer: Blue Shield of California EPN |
$227.39
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Central Health Plan Commercial |
$334.40
|
| Rate for Payer: Cigna of CA HMO |
$292.60
|
| Rate for Payer: Cigna of CA PPO |
$292.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$355.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$167.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$167.20
|
| Rate for Payer: Galaxy Health WC |
$355.30
|
| Rate for Payer: Global Benefits Group Commercial |
$250.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$376.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$313.50
|
| Rate for Payer: IEHP medi-cal |
$146.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$278.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$83.60
|
| Rate for Payer: Multiplan Commercial |
$313.50
|
| Rate for Payer: Networks By Design Commercial |
$209.00
|
| Rate for Payer: Prime Health Services Commercial |
$355.30
|
| Rate for Payer: Riverside University Health MISP |
$167.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$250.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$250.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$209.00
|
| Rate for Payer: United Healthcare All Other HMO |
$209.00
|
| Rate for Payer: United Healthcare HMO Rider |
$209.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$209.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$355.30
|
| Rate for Payer: Vantage Medical Group Senior |
$355.30
|
|
|
HC BILIARY COPE LOOP CATH
|
Facility
IP
|
$418.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909001069
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$83.60 |
| Max. Negotiated Rate |
$376.20 |
| Rate for Payer: Blue Shield of California EPN |
$223.21
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Central Health Plan Commercial |
$334.40
|
| Rate for Payer: Cigna of CA HMO |
$292.60
|
| Rate for Payer: Cigna of CA PPO |
$292.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$167.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$167.20
|
| Rate for Payer: Galaxy Health WC |
$355.30
|
| Rate for Payer: Global Benefits Group Commercial |
$250.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$376.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$278.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$83.60
|
| Rate for Payer: Multiplan Commercial |
$313.50
|
| Rate for Payer: Prime Health Services Commercial |
$355.30
|
|
|
HC BILIARY DILATION WITH STENT
|
Facility
OP
|
$18,618.00
|
|
|
Service Code
|
CPT 47556
|
| Hospital Charge Code |
909000150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,723.60 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$12,861.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12,861.31
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$17,583.26
|
| Rate for Payer: BCBS Transplant Transplant |
$11,170.80
|
| Rate for Payer: Blue Shield of California Commercial |
$12,373.72
|
| Rate for Payer: Blue Shield of California EPN |
$8,887.36
|
| Rate for Payer: Caremore Medicare Advantage |
$12,861.31
|
| Rate for Payer: Cash Price |
$8,378.10
|
| Rate for Payer: Cash Price |
$8,378.10
|
| Rate for Payer: Central Health Plan Commercial |
$14,894.40
|
| Rate for Payer: Cigna of CA PPO |
$13,777.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,291.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,362.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,861.31
|
| Rate for Payer: EPIC Health Plan Transplant |
$12,861.31
|
| Rate for Payer: Galaxy Health WC |
$15,825.30
|
| Rate for Payer: Global Benefits Group Commercial |
$11,170.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,756.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13,963.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21,092.55
|
| Rate for Payer: IEHP medi-cal |
$21,221.16
|
| Rate for Payer: IEHP Medicare Advantage |
$12,861.31
|
| Rate for Payer: Innovage PACE Commercial |
$19,291.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,418.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,861.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,723.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,234.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,234.16
|
| Rate for Payer: Multiplan Commercial |
$13,963.50
|
| Rate for Payer: Multiplan WC |
$17,583.26
|
| Rate for Payer: Networks By Design Commercial |
$12,101.70
|
| Rate for Payer: Preferred Health Network WC |
$17,942.10
|
| Rate for Payer: Prime Health Services Commercial |
$15,825.30
|
| Rate for Payer: Prime Health Services Medicare |
$13,632.99
|
| Rate for Payer: Prime Health Services WC |
$17,403.84
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11,170.80
|
| Rate for Payer: Riverside University Health MISP |
$14,147.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,170.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: Vantage Medical Group Senior |
$12,861.31
|
|
|
HC BILIARY DILATION WITH STENT
|
Facility
IP
|
$18,618.00
|
|
|
Service Code
|
CPT 47556
|
| Hospital Charge Code |
909000150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,723.60 |
| Max. Negotiated Rate |
$16,756.20 |
| Rate for Payer: Cash Price |
$8,378.10
|
| Rate for Payer: Central Health Plan Commercial |
$14,894.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,447.20
|
| Rate for Payer: Galaxy Health WC |
$15,825.30
|
| Rate for Payer: Global Benefits Group Commercial |
$11,170.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,756.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,418.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,723.60
|
| Rate for Payer: Multiplan Commercial |
$13,963.50
|
| Rate for Payer: Networks By Design Commercial |
$12,101.70
|
| Rate for Payer: Prime Health Services Commercial |
$15,825.30
|
|
|
HC BILIARY DILATION W/O STENT
|
Facility
IP
|
$10,154.00
|
|
|
Service Code
|
CPT 47555
|
| Hospital Charge Code |
909000149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,030.80 |
| Max. Negotiated Rate |
$9,138.60 |
| Rate for Payer: Cash Price |
$4,569.30
|
| Rate for Payer: Central Health Plan Commercial |
$8,123.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,061.60
|
| Rate for Payer: Galaxy Health WC |
$8,630.90
|
| Rate for Payer: Global Benefits Group Commercial |
$6,092.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,138.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,772.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,030.80
|
| Rate for Payer: Multiplan Commercial |
$7,615.50
|
| Rate for Payer: Networks By Design Commercial |
$6,600.10
|
| Rate for Payer: Prime Health Services Commercial |
$8,630.90
|
|
|
HC BILIARY DILATION W/O STENT
|
Facility
OP
|
$10,154.00
|
|
|
Service Code
|
CPT 47555
|
| Hospital Charge Code |
909000149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,030.80 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,322.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,483.93
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,754.88
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,322.62
|
| 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: BCBS Transplant Transplant |
$6,092.40
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Caremore Medicare Advantage |
$4,322.62
|
| Rate for Payer: Cash Price |
$4,569.30
|
| Rate for Payer: Cash Price |
$4,569.30
|
| Rate for Payer: Central Health Plan Commercial |
$8,123.20
|
| Rate for Payer: Cigna of CA PPO |
$7,513.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,483.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,835.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,322.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,322.62
|
| Rate for Payer: Galaxy Health WC |
$8,630.90
|
| Rate for Payer: Global Benefits Group Commercial |
$6,092.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,138.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7,615.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,089.10
|
| Rate for Payer: IEHP medi-cal |
$7,132.32
|
| Rate for Payer: IEHP Medicare Advantage |
$4,322.62
|
| Rate for Payer: Innovage PACE Commercial |
$6,483.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,772.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,322.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,030.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,792.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,792.31
|
| Rate for Payer: Multiplan Commercial |
$7,615.50
|
| Rate for Payer: Networks By Design Commercial |
$6,600.10
|
| Rate for Payer: Prime Health Services Commercial |
$8,630.90
|
| Rate for Payer: Prime Health Services Medicare |
$4,581.98
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6,092.40
|
| Rate for Payer: Riverside University Health MISP |
$4,754.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,092.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,754.88
|
| Rate for Payer: Vantage Medical Group Senior |
$4,322.62
|
|
|
HC BILIARY DRAINAGE CATH CHANGE
|
Facility
IP
|
$9,924.00
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
909000147
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,984.80 |
| Max. Negotiated Rate |
$8,931.60 |
| Rate for Payer: Cash Price |
$4,465.80
|
| Rate for Payer: Central Health Plan Commercial |
$7,939.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,969.60
|
| Rate for Payer: Galaxy Health WC |
$8,435.40
|
| Rate for Payer: Global Benefits Group Commercial |
$5,954.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,931.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,619.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,984.80
|
| Rate for Payer: Multiplan Commercial |
$7,443.00
|
| Rate for Payer: Networks By Design Commercial |
$6,450.60
|
| Rate for Payer: Prime Health Services Commercial |
$8,435.40
|
|
|
HC BILIARY DRAINAGE CATH CHANGE
|
Facility
OP
|
$9,924.00
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
909000147
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$8,931.60 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,483.93
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,754.88
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,322.62
|
| 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: BCBS Transplant Transplant |
$5,954.40
|
| Rate for Payer: Caremore Medicare Advantage |
$4,322.62
|
| Rate for Payer: Cash Price |
$4,465.80
|
| Rate for Payer: Cash Price |
$4,465.80
|
| Rate for Payer: Cash Price |
$4,465.80
|
| Rate for Payer: Cash Price |
$4,465.80
|
| Rate for Payer: Central Health Plan Commercial |
$7,939.20
|
| Rate for Payer: Cigna of CA PPO |
$7,343.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,483.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,835.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,322.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,322.62
|
| Rate for Payer: Galaxy Health WC |
$8,435.40
|
| Rate for Payer: Global Benefits Group Commercial |
$5,954.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,931.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7,443.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,089.10
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$4,322.62
|
| Rate for Payer: Innovage PACE Commercial |
$6,483.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,619.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,322.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,984.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,792.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,792.31
|
| Rate for Payer: Multiplan Commercial |
$7,443.00
|
| Rate for Payer: Networks By Design Commercial |
$6,450.60
|
| Rate for Payer: Prime Health Services Commercial |
$8,435.40
|
| Rate for Payer: Prime Health Services Medicare |
$4,581.98
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,954.40
|
| Rate for Payer: Riverside University Health MISP |
$4,754.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,954.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,962.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,962.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,962.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,962.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,754.88
|
| Rate for Payer: Vantage Medical Group Senior |
$4,322.62
|
|
|
HC BILIARY DRAINAGE CATH CHANGE
|
Facility
IP
|
$9,924.00
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
909000147
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,984.80 |
| Max. Negotiated Rate |
$8,931.60 |
| Rate for Payer: Cash Price |
$4,465.80
|
| Rate for Payer: Central Health Plan Commercial |
$7,939.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,969.60
|
| Rate for Payer: Galaxy Health WC |
$8,435.40
|
| Rate for Payer: Global Benefits Group Commercial |
$5,954.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,931.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,619.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,984.80
|
| Rate for Payer: Multiplan Commercial |
$7,443.00
|
| Rate for Payer: Networks By Design Commercial |
$6,450.60
|
| Rate for Payer: Prime Health Services Commercial |
$8,435.40
|
|
|
HC BILIARY DRAINAGE CATH CHANGE
|
Facility
OP
|
$9,924.00
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
909000147
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,984.80 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,322.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,483.93
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,754.88
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,322.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$5,954.40
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Caremore Medicare Advantage |
$4,322.62
|
| Rate for Payer: Cash Price |
$4,465.80
|
| Rate for Payer: Cash Price |
$4,465.80
|
| Rate for Payer: Cash Price |
$4,465.80
|
| Rate for Payer: Central Health Plan Commercial |
$7,939.20
|
| Rate for Payer: Cigna of CA PPO |
$7,343.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,483.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,835.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,322.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,322.62
|
| Rate for Payer: Galaxy Health WC |
$8,435.40
|
| Rate for Payer: Global Benefits Group Commercial |
$5,954.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,931.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7,443.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,089.10
|
| Rate for Payer: IEHP medi-cal |
$7,132.32
|
| Rate for Payer: IEHP Medicare Advantage |
$4,322.62
|
| Rate for Payer: Innovage PACE Commercial |
$6,483.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,619.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,322.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,984.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,792.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,792.31
|
| Rate for Payer: Multiplan Commercial |
$7,443.00
|
| Rate for Payer: Networks By Design Commercial |
$6,450.60
|
| Rate for Payer: Prime Health Services Commercial |
$8,435.40
|
| Rate for Payer: Prime Health Services Medicare |
$4,581.98
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,954.40
|
| Rate for Payer: Riverside University Health MISP |
$4,754.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,954.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,754.88
|
| Rate for Payer: Vantage Medical Group Senior |
$4,322.62
|
|
|
HC BILIARY ENDOPROSTHESIS
|
Facility
IP
|
$2,611.00
|
|
|
Service Code
|
CPT C1874
|
| Hospital Charge Code |
909001046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$522.20 |
| Max. Negotiated Rate |
$2,349.90 |
| Rate for Payer: Blue Shield of California EPN |
$1,394.27
|
| Rate for Payer: Cash Price |
$1,174.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,088.80
|
| Rate for Payer: Cigna of CA HMO |
$1,827.70
|
| Rate for Payer: Cigna of CA PPO |
$1,827.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,044.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,044.40
|
| Rate for Payer: Galaxy Health WC |
$2,219.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,566.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,349.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,741.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$522.20
|
| Rate for Payer: Multiplan Commercial |
$1,958.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,219.35
|
|
|
HC BILIARY ENDOPROSTHESIS
|
Facility
OP
|
$2,611.00
|
|
|
Service Code
|
CPT C1874
|
| Hospital Charge Code |
909001046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$522.20 |
| Max. Negotiated Rate |
$17,854.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17,854.40
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,219.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,436.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,436.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,192.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,454.33
|
| Rate for Payer: BCBS Transplant Transplant |
$1,566.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1,958.25
|
| Rate for Payer: Blue Shield of California EPN |
$1,420.38
|
| Rate for Payer: Cash Price |
$1,174.95
|
| Rate for Payer: Cash Price |
$1,174.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,088.80
|
| Rate for Payer: Cigna of CA HMO |
$1,827.70
|
| Rate for Payer: Cigna of CA PPO |
$1,827.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,219.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,044.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,044.40
|
| Rate for Payer: Galaxy Health WC |
$2,219.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,566.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,349.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,958.25
|
| Rate for Payer: IEHP medi-cal |
$913.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,741.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$522.20
|
| Rate for Payer: Multiplan Commercial |
$1,958.25
|
| Rate for Payer: Networks By Design Commercial |
$1,305.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,219.35
|
| Rate for Payer: Riverside University Health MISP |
$1,044.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,566.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,566.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,305.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,305.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,305.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,305.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,219.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,219.35
|
|
|
HC BILIARY ENDOPROTHESIS
|
Facility
IP
|
$455.00
|
|
|
Service Code
|
CPT C1874
|
| Hospital Charge Code |
909001066
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$91.00 |
| Max. Negotiated Rate |
$409.50 |
| Rate for Payer: Blue Shield of California EPN |
$242.97
|
| Rate for Payer: Cash Price |
$204.75
|
| Rate for Payer: Central Health Plan Commercial |
$364.00
|
| Rate for Payer: Cigna of CA HMO |
$318.50
|
| Rate for Payer: Cigna of CA PPO |
$318.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$182.00
|
| Rate for Payer: Galaxy Health WC |
$386.75
|
| Rate for Payer: Global Benefits Group Commercial |
$273.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$409.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$303.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.00
|
| Rate for Payer: Multiplan Commercial |
$341.25
|
| Rate for Payer: Prime Health Services Commercial |
$386.75
|
|
|
HC BILIARY ENDOPROTHESIS
|
Facility
OP
|
$455.00
|
|
|
Service Code
|
CPT C1874
|
| Hospital Charge Code |
909001066
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$91.00 |
| Max. Negotiated Rate |
$17,854.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17,854.40
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$386.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$250.25
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$250.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$207.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$253.44
|
| Rate for Payer: BCBS Transplant Transplant |
$273.00
|
| Rate for Payer: Blue Shield of California Commercial |
$341.25
|
| Rate for Payer: Blue Shield of California EPN |
$247.52
|
| Rate for Payer: Cash Price |
$204.75
|
| Rate for Payer: Cash Price |
$204.75
|
| Rate for Payer: Central Health Plan Commercial |
$364.00
|
| Rate for Payer: Cigna of CA HMO |
$318.50
|
| Rate for Payer: Cigna of CA PPO |
$318.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$386.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$182.00
|
| Rate for Payer: Galaxy Health WC |
$386.75
|
| Rate for Payer: Global Benefits Group Commercial |
$273.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$409.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$341.25
|
| Rate for Payer: IEHP medi-cal |
$159.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$303.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.00
|
| Rate for Payer: Multiplan Commercial |
$341.25
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$386.75
|
| Rate for Payer: Riverside University Health MISP |
$182.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$273.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$273.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$227.50
|
| Rate for Payer: United Healthcare All Other HMO |
$227.50
|
| Rate for Payer: United Healthcare HMO Rider |
$227.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$227.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$386.75
|
| Rate for Payer: Vantage Medical Group Senior |
$386.75
|
|
|
HC BILIARY ENDSCPY, INTRAOP
|
Facility
IP
|
$8,801.00
|
|
|
Service Code
|
CPT 47550
|
| Hospital Charge Code |
909047550
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,760.20 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$3,960.45
|
| Rate for Payer: Cash Price |
$3,960.45
|
| Rate for Payer: Central Health Plan Commercial |
$7,040.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,520.40
|
| Rate for Payer: Galaxy Health WC |
$7,480.85
|
| Rate for Payer: Global Benefits Group Commercial |
$5,280.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,920.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,870.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,760.20
|
| Rate for Payer: Multiplan Commercial |
$6,600.75
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$7,480.85
|
|
