|
HC DIAB OP SELF MGMT-GRP 30 MIN
|
Facility
|
IP
|
$136.00
|
|
|
Service Code
|
CPT G0109
|
| Hospital Charge Code |
902501101
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$122.40 |
| Rate for Payer: Adventist Health Commercial |
$27.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Central Health Plan Commercial |
$108.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$95.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.40
|
| Rate for Payer: EPIC Health Plan Senior |
$54.40
|
| Rate for Payer: Galaxy Health WC |
$115.60
|
| Rate for Payer: Global Benefits Group Commercial |
$81.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$122.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$86.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$80.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.20
|
| Rate for Payer: Multiplan Commercial |
$102.00
|
| Rate for Payer: Networks By Design Commercial |
$88.40
|
| Rate for Payer: Prime Health Services Commercial |
$115.60
|
|
|
HC DIAB OP SELF MGMT-GRP 30 MIN
|
Facility
|
OP
|
$136.00
|
|
|
Service Code
|
CPT G0109
|
| Hospital Charge Code |
902501101
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$24.32 |
| Max. Negotiated Rate |
$824.00 |
| Rate for Payer: Adventist Health Commercial |
$55.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$103.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$115.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$74.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$102.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$65.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.11
|
| Rate for Payer: Blue Shield of California Commercial |
$86.22
|
| Rate for Payer: Blue Shield of California EPN |
$54.26
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Central Health Plan Commercial |
$108.80
|
| Rate for Payer: Cigna of CA HMO |
$87.04
|
| Rate for Payer: Cigna of CA PPO |
$100.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$115.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$115.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$115.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$95.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.40
|
| Rate for Payer: EPIC Health Plan Senior |
$54.40
|
| Rate for Payer: Galaxy Health WC |
$115.60
|
| Rate for Payer: Global Benefits Group Commercial |
$81.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$122.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$24.32
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$86.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$26.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$80.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$95.20
|
| Rate for Payer: Multiplan Commercial |
$102.00
|
| Rate for Payer: Networks By Design Commercial |
$88.40
|
| Rate for Payer: Prime Health Services Commercial |
$115.60
|
| Rate for Payer: Riverside University Health System MISP |
$54.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$81.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$81.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$634.00
|
| Rate for Payer: United Healthcare All Other HMO |
$824.00
|
| Rate for Payer: United Healthcare HMO Rider |
$623.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$570.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$115.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$115.60
|
| Rate for Payer: Vantage Medical Group Senior |
$115.60
|
|
|
HC DIAB OP SELF MGMT-INDIV 30 MIN
|
Facility
|
OP
|
$311.00
|
|
|
Service Code
|
CPT G0108
|
| Hospital Charge Code |
902501100
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$62.20 |
| Max. Negotiated Rate |
$824.00 |
| Rate for Payer: Adventist Health Commercial |
$127.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$296.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$264.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$171.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$233.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$150.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$180.91
|
| Rate for Payer: Blue Shield of California Commercial |
$197.17
|
| Rate for Payer: Blue Shield of California EPN |
$124.09
|
| Rate for Payer: Cash Price |
$139.95
|
| Rate for Payer: Cash Price |
$139.95
|
| Rate for Payer: Cash Price |
$139.95
|
| Rate for Payer: Central Health Plan Commercial |
$248.80
|
| Rate for Payer: Cigna of CA HMO |
$199.04
|
| Rate for Payer: Cigna of CA PPO |
$230.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$264.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$264.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$264.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$217.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$124.40
|
| Rate for Payer: EPIC Health Plan Senior |
$124.40
|
| Rate for Payer: Galaxy Health WC |
$264.35
|
| Rate for Payer: Global Benefits Group Commercial |
$186.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$279.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$78.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$197.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$86.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$183.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$217.70
|
| Rate for Payer: Multiplan Commercial |
$233.25
|
| Rate for Payer: Networks By Design Commercial |
$202.15
|
| Rate for Payer: Prime Health Services Commercial |
$264.35
|
| Rate for Payer: Riverside University Health System MISP |
$124.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$186.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$186.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$634.00
|
| Rate for Payer: United Healthcare All Other HMO |
$824.00
|
| Rate for Payer: United Healthcare HMO Rider |
$623.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$570.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$264.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$264.35
|
| Rate for Payer: Vantage Medical Group Senior |
$264.35
|
|
|
HC DIAB OP SELF MGMT-INDIV 30 MIN
|
Facility
|
IP
|
$311.00
|
|
|
Service Code
|
CPT G0108
|
| Hospital Charge Code |
902501100
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$62.20 |
| Max. Negotiated Rate |
$279.90 |
| Rate for Payer: Adventist Health Commercial |
$62.20
|
| Rate for Payer: Cash Price |
$139.95
|
| Rate for Payer: Central Health Plan Commercial |
$248.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$217.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$124.40
|
| Rate for Payer: EPIC Health Plan Senior |
$124.40
|
| Rate for Payer: Galaxy Health WC |
$264.35
|
| Rate for Payer: Global Benefits Group Commercial |
$186.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$279.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$197.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$183.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.20
|
| Rate for Payer: Multiplan Commercial |
$233.25
|
| Rate for Payer: Networks By Design Commercial |
$202.15
|
| Rate for Payer: Prime Health Services Commercial |
$264.35
|
|
|
HC DIAG GASTRO INTUB W ASP SPECS
|
Facility
|
IP
|
$629.00
|
|
|
Service Code
|
CPT 43755
|
| Hospital Charge Code |
906743755
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$125.80 |
| Max. Negotiated Rate |
$566.10 |
| Rate for Payer: Adventist Health Commercial |
$125.80
|
| Rate for Payer: Cash Price |
$283.05
|
| Rate for Payer: Central Health Plan Commercial |
$503.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$440.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$251.60
|
| Rate for Payer: EPIC Health Plan Senior |
$251.60
|
| Rate for Payer: Galaxy Health WC |
$534.65
|
| Rate for Payer: Global Benefits Group Commercial |
$377.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$566.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$399.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$371.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$125.80
|
| Rate for Payer: Multiplan Commercial |
$471.75
|
| Rate for Payer: Networks By Design Commercial |
$408.85
|
| Rate for Payer: Prime Health Services Commercial |
$534.65
|
|
|
HC DIAG GASTRO INTUB W ASP SPECS
|
Facility
|
OP
|
$629.00
|
|
|
Service Code
|
CPT 43755
|
| Hospital Charge Code |
906743755
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$85.17 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$125.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$165.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$283.05
|
| Rate for Payer: Cash Price |
$283.05
|
| Rate for Payer: Cash Price |
$283.05
|
| Rate for Payer: Central Health Plan Commercial |
$503.20
|
| Rate for Payer: Cigna of CA HMO |
$402.56
|
| Rate for Payer: Cigna of CA PPO |
$465.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$248.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$165.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$440.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.06
|
| Rate for Payer: EPIC Health Plan Senior |
$182.04
|
| Rate for Payer: Galaxy Health WC |
$534.65
|
| Rate for Payer: Global Benefits Group Commercial |
$377.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$566.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$271.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$85.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$165.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$399.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$94.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$231.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$125.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$221.76
|
| Rate for Payer: Multiplan Commercial |
$471.75
|
| Rate for Payer: Networks By Design Commercial |
$408.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$165.49
|
| Rate for Payer: Prime Health Services Commercial |
$534.65
|
| Rate for Payer: Prime Health Services Medicare |
$175.42
|
| Rate for Payer: Riverside University Health System MISP |
$182.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$377.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$198.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$314.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$165.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Vantage Medical Group Senior |
$165.49
|
|
|
HC DIAGNOSTIC BRONCH
|
Facility
|
OP
|
$8,386.00
|
|
|
Service Code
|
CPT 31622
|
| Hospital Charge Code |
900501418
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$313.37 |
| Max. Negotiated Rate |
$7,547.40 |
| Rate for Payer: Adventist Health Commercial |
$1,677.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,289.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,491.15
|
| Rate for Payer: Cash Price |
$3,773.70
|
| Rate for Payer: Cash Price |
$3,773.70
|
| Rate for Payer: Cash Price |
$3,773.70
|
| Rate for Payer: Cash Price |
$3,773.70
|
| Rate for Payer: Central Health Plan Commercial |
$6,708.80
|
| Rate for Payer: Cigna of CA HMO |
$5,367.04
|
| Rate for Payer: Cigna of CA PPO |
$6,205.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,518.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,289.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,870.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,777.26
|
| Rate for Payer: EPIC Health Plan Senior |
$2,518.18
|
| Rate for Payer: Galaxy Health WC |
$7,128.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,031.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,547.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,754.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,289.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,325.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$313.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,460.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,677.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,067.59
|
| Rate for Payer: Multiplan Commercial |
$6,289.50
|
| Rate for Payer: Multiplan WC |
$3,491.15
|
| Rate for Payer: Networks By Design Commercial |
$5,450.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,289.25
|
| Rate for Payer: Preferred Health Network WC |
$3,562.40
|
| Rate for Payer: Prime Health Services Commercial |
$7,128.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,426.61
|
| Rate for Payer: Prime Health Services WC |
$3,455.53
|
| Rate for Payer: Riverside University Health System MISP |
$2,518.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,031.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,193.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,193.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,193.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,193.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,289.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Vantage Medical Group Senior |
$2,289.25
|
|
|
HC DIAGNOSTIC BRONCH
|
Facility
|
IP
|
$8,386.00
|
|
|
Service Code
|
CPT 31622
|
| Hospital Charge Code |
900501418
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,677.20 |
| Max. Negotiated Rate |
$7,547.40 |
| Rate for Payer: Adventist Health Commercial |
$1,677.20
|
| Rate for Payer: Cash Price |
$3,773.70
|
| Rate for Payer: Central Health Plan Commercial |
$6,708.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,870.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,354.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,354.40
|
| Rate for Payer: Galaxy Health WC |
$7,128.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,031.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,547.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,325.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,947.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,677.20
|
| Rate for Payer: Multiplan Commercial |
$6,289.50
|
| Rate for Payer: Networks By Design Commercial |
$5,450.90
|
| Rate for Payer: Prime Health Services Commercial |
$7,128.10
|
|
|
HC DIAGNOSTIC BRONCH
|
Facility
|
IP
|
$8,386.00
|
|
|
Service Code
|
CPT 31622
|
| Hospital Charge Code |
900501418
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,677.20 |
| Max. Negotiated Rate |
$7,547.40 |
| Rate for Payer: Adventist Health Commercial |
$1,677.20
|
| Rate for Payer: Cash Price |
$3,773.70
|
| Rate for Payer: Central Health Plan Commercial |
$6,708.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,870.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,354.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,354.40
|
| Rate for Payer: Galaxy Health WC |
$7,128.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,031.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,547.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,325.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,947.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,677.20
|
| Rate for Payer: Multiplan Commercial |
$6,289.50
|
| Rate for Payer: Networks By Design Commercial |
$5,450.90
|
| Rate for Payer: Prime Health Services Commercial |
$7,128.10
|
|
|
HC DIAGNOSTIC BRONCH
|
Facility
|
OP
|
$8,386.00
|
|
|
Service Code
|
CPT 31622
|
| Hospital Charge Code |
900501418
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$283.68 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,677.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,289.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,289.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,491.15
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$3,773.70
|
| Rate for Payer: Cash Price |
$3,773.70
|
| Rate for Payer: Cash Price |
$3,773.70
|
| Rate for Payer: Central Health Plan Commercial |
$6,708.80
|
| Rate for Payer: Cigna of CA HMO |
$5,367.04
|
| Rate for Payer: Cigna of CA PPO |
$6,205.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,518.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,289.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,870.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,777.26
|
| Rate for Payer: EPIC Health Plan Senior |
$2,518.18
|
| Rate for Payer: Galaxy Health WC |
$7,128.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,031.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,547.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,754.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$283.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,289.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,325.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$313.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,204.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,677.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,067.59
|
| Rate for Payer: Multiplan Commercial |
$6,289.50
|
| Rate for Payer: Multiplan WC |
$3,491.15
|
| Rate for Payer: Networks By Design Commercial |
$5,450.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,289.25
|
| Rate for Payer: Preferred Health Network WC |
$3,562.40
|
| Rate for Payer: Prime Health Services Commercial |
$7,128.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,426.61
|
| Rate for Payer: Prime Health Services WC |
$3,455.53
|
| Rate for Payer: Riverside University Health System MISP |
$2,518.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,031.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,193.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,289.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Vantage Medical Group Senior |
$2,289.25
|
|
|
HC DIAGNOSTIC BRONCH W BIOPSY
|
Facility
|
OP
|
$8,074.00
|
|
|
Service Code
|
CPT 31625
|
| Hospital Charge Code |
900803503
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$346.43 |
| Max. Negotiated Rate |
$7,266.60 |
| Rate for Payer: Adventist Health Commercial |
$1,614.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,289.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$931.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,289.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,118.92
|
| Rate for Payer: Blue Shield of California EPN |
$3,221.53
|
| Rate for Payer: Cash Price |
$3,633.30
|
| Rate for Payer: Cash Price |
$3,633.30
|
| Rate for Payer: Cash Price |
$3,633.30
|
| Rate for Payer: Central Health Plan Commercial |
$6,459.20
|
| Rate for Payer: Cigna of CA HMO |
$5,167.36
|
| Rate for Payer: Cigna of CA PPO |
$5,974.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,518.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,289.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,651.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,777.26
|
| Rate for Payer: EPIC Health Plan Senior |
$2,518.18
|
| Rate for Payer: Galaxy Health WC |
$6,862.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,844.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,266.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,754.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$346.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,289.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,126.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$382.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,204.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,614.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,067.59
|
| Rate for Payer: Multiplan Commercial |
$6,055.50
|
| Rate for Payer: Networks By Design Commercial |
$5,248.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,289.25
|
| Rate for Payer: Prime Health Services Commercial |
$6,862.90
|
| Rate for Payer: Prime Health Services Medicare |
$2,426.61
|
| Rate for Payer: Riverside University Health System MISP |
$2,518.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,844.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,844.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,037.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,037.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,037.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,037.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,289.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Vantage Medical Group Senior |
$2,289.25
|
|
|
HC DIAGNOSTIC BRONCH W BIOPSY
|
Facility
|
IP
|
$8,074.00
|
|
|
Service Code
|
CPT 31625
|
| Hospital Charge Code |
900803503
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,614.80 |
| Max. Negotiated Rate |
$7,266.60 |
| Rate for Payer: Adventist Health Commercial |
$1,614.80
|
| Rate for Payer: Cash Price |
$3,633.30
|
| Rate for Payer: Central Health Plan Commercial |
$6,459.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,651.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,229.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,229.60
|
| Rate for Payer: Galaxy Health WC |
$6,862.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,844.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,266.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,126.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,763.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,614.80
|
| Rate for Payer: Multiplan Commercial |
$6,055.50
|
| Rate for Payer: Networks By Design Commercial |
$5,248.10
|
| Rate for Payer: Prime Health Services Commercial |
$6,862.90
|
|
|
HC DIAGNOSTIC BRONCH W/BRUSHING
|
Facility
|
OP
|
$6,376.00
|
|
|
Service Code
|
CPT 31623
|
| Hospital Charge Code |
900803501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$363.73 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,275.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,289.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,289.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,491.15
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$2,869.20
|
| Rate for Payer: Cash Price |
$2,869.20
|
| Rate for Payer: Cash Price |
$2,869.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,100.80
|
| Rate for Payer: Cigna of CA HMO |
$4,080.64
|
| Rate for Payer: Cigna of CA PPO |
$4,718.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,518.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,289.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,463.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,777.26
|
| Rate for Payer: EPIC Health Plan Senior |
$2,518.18
|
| Rate for Payer: Galaxy Health WC |
$5,419.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,825.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,738.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,754.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$363.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,289.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,048.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$401.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,204.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,275.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,067.59
|
| Rate for Payer: Multiplan Commercial |
$4,782.00
|
| Rate for Payer: Multiplan WC |
$3,491.15
|
| Rate for Payer: Networks By Design Commercial |
$4,144.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,289.25
|
| Rate for Payer: Preferred Health Network WC |
$3,562.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,419.60
|
| Rate for Payer: Prime Health Services Medicare |
$2,426.61
|
| Rate for Payer: Prime Health Services WC |
$3,455.53
|
| Rate for Payer: Riverside University Health System MISP |
$2,518.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,825.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,188.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,289.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Vantage Medical Group Senior |
$2,289.25
|
|
|
HC DIAGNOSTIC BRONCH W/BRUSHING
|
Facility
|
IP
|
$6,376.00
|
|
|
Service Code
|
CPT 31623
|
| Hospital Charge Code |
900803501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,275.20 |
| Max. Negotiated Rate |
$5,738.40 |
| Rate for Payer: Adventist Health Commercial |
$1,275.20
|
| Rate for Payer: Cash Price |
$2,869.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,100.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,463.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,550.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,550.40
|
| Rate for Payer: Galaxy Health WC |
$5,419.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,825.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,738.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,048.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,761.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,275.20
|
| Rate for Payer: Multiplan Commercial |
$4,782.00
|
| Rate for Payer: Networks By Design Commercial |
$4,144.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,419.60
|
|
|
HC DIAGNOSTIC LARYNGOSCOPY
|
Facility
|
IP
|
$13,857.00
|
|
|
Service Code
|
CPT 31525
|
| Hospital Charge Code |
900803512
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$2,771.40 |
| Max. Negotiated Rate |
$12,471.30 |
| Rate for Payer: Adventist Health Commercial |
$2,771.40
|
| Rate for Payer: Cash Price |
$6,235.65
|
| Rate for Payer: Central Health Plan Commercial |
$11,085.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,699.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,542.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,542.80
|
| Rate for Payer: Galaxy Health WC |
$11,778.45
|
| Rate for Payer: Global Benefits Group Commercial |
$8,314.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,471.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,799.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,175.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,771.40
|
| Rate for Payer: Multiplan Commercial |
$10,392.75
|
| Rate for Payer: Networks By Design Commercial |
$9,007.05
|
| Rate for Payer: Prime Health Services Commercial |
$11,778.45
|
|
|
HC DIAGNOSTIC LARYNGOSCOPY
|
Facility
|
IP
|
$13,857.00
|
|
|
Service Code
|
CPT 31525
|
| Hospital Charge Code |
900803512
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,771.40 |
| Max. Negotiated Rate |
$12,471.30 |
| Rate for Payer: Adventist Health Commercial |
$2,771.40
|
| Rate for Payer: Cash Price |
$6,235.65
|
| Rate for Payer: Central Health Plan Commercial |
$11,085.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,699.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,542.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,542.80
|
| Rate for Payer: Galaxy Health WC |
$11,778.45
|
| Rate for Payer: Global Benefits Group Commercial |
$8,314.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,471.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,799.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,175.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,771.40
|
| Rate for Payer: Multiplan Commercial |
$10,392.75
|
| Rate for Payer: Networks By Design Commercial |
$9,007.05
|
| Rate for Payer: Prime Health Services Commercial |
$11,778.45
|
|
|
HC DIAGNOSTIC LARYNGOSCOPY
|
Facility
|
OP
|
$13,857.00
|
|
|
Service Code
|
CPT 31525
|
| Hospital Charge Code |
900803512
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$268.00 |
| Max. Negotiated Rate |
$12,471.30 |
| Rate for Payer: Adventist Health Commercial |
$2,771.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,289.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$899.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,289.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$6,235.65
|
| Rate for Payer: Cash Price |
$6,235.65
|
| Rate for Payer: Cash Price |
$6,235.65
|
| Rate for Payer: Cash Price |
$6,235.65
|
| Rate for Payer: Central Health Plan Commercial |
$11,085.60
|
| Rate for Payer: Cigna of CA HMO |
$8,868.48
|
| Rate for Payer: Cigna of CA PPO |
$10,254.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,518.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,289.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,699.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,777.26
|
| Rate for Payer: EPIC Health Plan Senior |
$2,518.18
|
| Rate for Payer: Galaxy Health WC |
$11,778.45
|
| Rate for Payer: Global Benefits Group Commercial |
$8,314.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,471.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,754.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$290.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,289.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,799.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$320.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,204.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,771.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,067.59
|
| Rate for Payer: Multiplan Commercial |
$10,392.75
|
| Rate for Payer: Networks By Design Commercial |
$9,007.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,289.25
|
| Rate for Payer: Prime Health Services Commercial |
$11,778.45
|
| Rate for Payer: Prime Health Services Medicare |
$2,426.61
|
| Rate for Payer: Riverside University Health System MISP |
$2,518.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,314.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,314.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$536.00
|
| Rate for Payer: United Healthcare All Other HMO |
$502.00
|
| Rate for Payer: United Healthcare HMO Rider |
$449.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$441.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,289.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Vantage Medical Group Senior |
$2,289.25
|
|
|
HC DIAGNOSTIC LARYNGOSCOPY
|
Facility
|
OP
|
$13,857.00
|
|
|
Service Code
|
CPT 31525
|
| Hospital Charge Code |
900803512
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$320.44 |
| Max. Negotiated Rate |
$12,471.30 |
| Rate for Payer: Adventist Health Commercial |
$2,771.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,289.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,491.15
|
| Rate for Payer: Cash Price |
$6,235.65
|
| Rate for Payer: Cash Price |
$6,235.65
|
| Rate for Payer: Cash Price |
$6,235.65
|
| Rate for Payer: Cash Price |
$6,235.65
|
| Rate for Payer: Central Health Plan Commercial |
$11,085.60
|
| Rate for Payer: Cigna of CA HMO |
$8,868.48
|
| Rate for Payer: Cigna of CA PPO |
$10,254.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,518.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,289.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,699.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,777.26
|
| Rate for Payer: EPIC Health Plan Senior |
$2,518.18
|
| Rate for Payer: Galaxy Health WC |
$11,778.45
|
| Rate for Payer: Global Benefits Group Commercial |
$8,314.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,471.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,754.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,289.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,799.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$320.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,460.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,771.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,067.59
|
| Rate for Payer: Multiplan Commercial |
$10,392.75
|
| Rate for Payer: Multiplan WC |
$3,491.15
|
| Rate for Payer: Networks By Design Commercial |
$9,007.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,289.25
|
| Rate for Payer: Preferred Health Network WC |
$3,562.40
|
| Rate for Payer: Prime Health Services Commercial |
$11,778.45
|
| Rate for Payer: Prime Health Services Medicare |
$2,426.61
|
| Rate for Payer: Prime Health Services WC |
$3,455.53
|
| Rate for Payer: Riverside University Health System MISP |
$2,518.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,314.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,928.50
|
| Rate for Payer: United Healthcare All Other HMO |
$6,928.50
|
| Rate for Payer: United Healthcare HMO Rider |
$6,928.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,928.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,289.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Vantage Medical Group Senior |
$2,289.25
|
|
|
HC DIAGNOSTIC LARYNGOSCOPY W/MICR
|
Facility
|
OP
|
$13,746.00
|
|
|
Service Code
|
CPT 31526
|
| Hospital Charge Code |
900501508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$237.57 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,749.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,289.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,289.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,491.15
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$6,185.70
|
| Rate for Payer: Cash Price |
$6,185.70
|
| Rate for Payer: Cash Price |
$6,185.70
|
| Rate for Payer: Central Health Plan Commercial |
$10,996.80
|
| Rate for Payer: Cigna of CA HMO |
$8,797.44
|
| Rate for Payer: Cigna of CA PPO |
$10,172.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,518.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,289.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,622.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,777.26
|
| Rate for Payer: EPIC Health Plan Senior |
$2,518.18
|
| Rate for Payer: Galaxy Health WC |
$11,684.10
|
| Rate for Payer: Global Benefits Group Commercial |
$8,247.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,371.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,754.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$237.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,289.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,728.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$262.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,204.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,749.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,067.59
|
| Rate for Payer: Multiplan Commercial |
$10,309.50
|
| Rate for Payer: Multiplan WC |
$3,491.15
|
| Rate for Payer: Networks By Design Commercial |
$8,934.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,289.25
|
| Rate for Payer: Preferred Health Network WC |
$3,562.40
|
| Rate for Payer: Prime Health Services Commercial |
$11,684.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,426.61
|
| Rate for Payer: Prime Health Services WC |
$3,455.53
|
| Rate for Payer: Riverside University Health System MISP |
$2,518.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,247.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,873.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,289.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Vantage Medical Group Senior |
$2,289.25
|
|
|
HC DIAGNOSTIC LARYNGOSCOPY W/MICR
|
Facility
|
OP
|
$13,746.00
|
|
|
Service Code
|
CPT 31526
|
| Hospital Charge Code |
900501508
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$262.43 |
| Max. Negotiated Rate |
$12,371.40 |
| Rate for Payer: Adventist Health Commercial |
$2,749.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,289.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,491.15
|
| Rate for Payer: Cash Price |
$6,185.70
|
| Rate for Payer: Cash Price |
$6,185.70
|
| Rate for Payer: Cash Price |
$6,185.70
|
| Rate for Payer: Cash Price |
$6,185.70
|
| Rate for Payer: Central Health Plan Commercial |
$10,996.80
|
| Rate for Payer: Cigna of CA HMO |
$8,797.44
|
| Rate for Payer: Cigna of CA PPO |
$10,172.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,518.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,289.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,622.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,777.26
|
| Rate for Payer: EPIC Health Plan Senior |
$2,518.18
|
| Rate for Payer: Galaxy Health WC |
$11,684.10
|
| Rate for Payer: Global Benefits Group Commercial |
$8,247.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,371.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,754.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,289.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,728.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$262.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,460.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,749.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,067.59
|
| Rate for Payer: Multiplan Commercial |
$10,309.50
|
| Rate for Payer: Multiplan WC |
$3,491.15
|
| Rate for Payer: Networks By Design Commercial |
$8,934.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,289.25
|
| Rate for Payer: Preferred Health Network WC |
$3,562.40
|
| Rate for Payer: Prime Health Services Commercial |
$11,684.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,426.61
|
| Rate for Payer: Prime Health Services WC |
$3,455.53
|
| Rate for Payer: Riverside University Health System MISP |
$2,518.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,247.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,873.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6,873.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6,873.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,873.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,289.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Vantage Medical Group Senior |
$2,289.25
|
|
|
HC DIAGNOSTIC LARYNGOSCOPY W/MICR
|
Facility
|
IP
|
$13,746.00
|
|
|
Service Code
|
CPT 31526
|
| Hospital Charge Code |
900501508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,749.20 |
| Max. Negotiated Rate |
$12,371.40 |
| Rate for Payer: Adventist Health Commercial |
$2,749.20
|
| Rate for Payer: Cash Price |
$6,185.70
|
| Rate for Payer: Central Health Plan Commercial |
$10,996.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,622.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,498.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,498.40
|
| Rate for Payer: Galaxy Health WC |
$11,684.10
|
| Rate for Payer: Global Benefits Group Commercial |
$8,247.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,371.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,728.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,110.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,749.20
|
| Rate for Payer: Multiplan Commercial |
$10,309.50
|
| Rate for Payer: Networks By Design Commercial |
$8,934.90
|
| Rate for Payer: Prime Health Services Commercial |
$11,684.10
|
|
|
HC DIAGNOSTIC LARYNGOSCOPY W/MICR
|
Facility
|
IP
|
$13,746.00
|
|
|
Service Code
|
CPT 31526
|
| Hospital Charge Code |
900501508
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,749.20 |
| Max. Negotiated Rate |
$12,371.40 |
| Rate for Payer: Adventist Health Commercial |
$2,749.20
|
| Rate for Payer: Cash Price |
$6,185.70
|
| Rate for Payer: Central Health Plan Commercial |
$10,996.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,622.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,498.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,498.40
|
| Rate for Payer: Galaxy Health WC |
$11,684.10
|
| Rate for Payer: Global Benefits Group Commercial |
$8,247.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,371.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,728.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,110.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,749.20
|
| Rate for Payer: Multiplan Commercial |
$10,309.50
|
| Rate for Payer: Networks By Design Commercial |
$8,934.90
|
| Rate for Payer: Prime Health Services Commercial |
$11,684.10
|
|
|
HC DIALYSIS ACCESS DOPPLER
|
Facility
|
OP
|
$1,445.00
|
|
|
Service Code
|
CPT 93990
|
| Hospital Charge Code |
906601660
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$123.41 |
| Max. Negotiated Rate |
$1,588.00 |
| Rate for Payer: Adventist Health Commercial |
$289.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$134.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$626.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$761.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$840.56
|
| Rate for Payer: Blue Shield of California Commercial |
$910.35
|
| Rate for Payer: Blue Shield of California EPN |
$573.66
|
| Rate for Payer: Cash Price |
$650.25
|
| Rate for Payer: Cash Price |
$650.25
|
| Rate for Payer: Cash Price |
$650.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,156.00
|
| Rate for Payer: Cigna of CA HMO |
$924.80
|
| Rate for Payer: Cigna of CA PPO |
$1,069.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,011.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: Galaxy Health WC |
$1,228.25
|
| Rate for Payer: Global Benefits Group Commercial |
$867.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,300.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$123.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$917.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$136.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$1,083.75
|
| Rate for Payer: Networks By Design Commercial |
$939.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$134.46
|
| Rate for Payer: Prime Health Services Commercial |
$1,228.25
|
| Rate for Payer: Prime Health Services Medicare |
$142.53
|
| Rate for Payer: Riverside University Health System MISP |
$147.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$867.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$867.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,588.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,289.00
|
| Rate for Payer: United Healthcare HMO Rider |
$978.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$895.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC DIALYSIS ACCESS DOPPLER
|
Facility
|
IP
|
$1,445.00
|
|
|
Service Code
|
CPT 93990
|
| Hospital Charge Code |
906601660
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$289.00 |
| Max. Negotiated Rate |
$1,300.50 |
| Rate for Payer: Adventist Health Commercial |
$289.00
|
| Rate for Payer: Cash Price |
$650.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,156.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,011.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$578.00
|
| Rate for Payer: EPIC Health Plan Senior |
$578.00
|
| Rate for Payer: Galaxy Health WC |
$1,228.25
|
| Rate for Payer: Global Benefits Group Commercial |
$867.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,300.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$917.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$852.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.00
|
| Rate for Payer: Multiplan Commercial |
$1,083.75
|
| Rate for Payer: Networks By Design Commercial |
$939.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,228.25
|
|
|
HC DIALYSIS CRCT VASC EMBO OR OCC
|
Facility
|
IP
|
$6,886.00
|
|
|
Service Code
|
CPT 36909
|
| Hospital Charge Code |
909036909
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,377.20 |
| Max. Negotiated Rate |
$6,197.40 |
| Rate for Payer: Adventist Health Commercial |
$1,377.20
|
| Rate for Payer: Cash Price |
$3,098.70
|
| Rate for Payer: Central Health Plan Commercial |
$5,508.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,820.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,754.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,754.40
|
| Rate for Payer: Galaxy Health WC |
$5,853.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4,131.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,197.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,372.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,062.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,377.20
|
| Rate for Payer: Multiplan Commercial |
$5,164.50
|
| Rate for Payer: Networks By Design Commercial |
$4,475.90
|
| Rate for Payer: Prime Health Services Commercial |
$5,853.10
|
|
