|
HC BIOPSY ANORECTAL WALL
|
Facility
IP
|
$10,450.00
|
|
|
Service Code
|
CPT 45100
|
| Hospital Charge Code |
906745100
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,090.00 |
| Max. Negotiated Rate |
$9,405.00 |
| Rate for Payer: Cash Price |
$4,702.50
|
| Rate for Payer: Central Health Plan Commercial |
$8,360.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,180.00
|
| Rate for Payer: Galaxy Health WC |
$8,882.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6,270.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,405.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,970.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,090.00
|
| Rate for Payer: Multiplan Commercial |
$7,837.50
|
| Rate for Payer: Networks By Design Commercial |
$6,792.50
|
| Rate for Payer: Prime Health Services Commercial |
$8,882.50
|
|
|
HC BIOPSY ARM/ELBOW SOFT TISSUE.
|
Facility
OP
|
$6,105.00
|
|
|
Service Code
|
CPT 24066
|
| Hospital Charge Code |
904000004
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,221.00 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,550.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,325.39
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,905.29
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,550.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,663.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$3,550.26
|
| Rate for Payer: Cash Price |
$2,747.25
|
| Rate for Payer: Cash Price |
$2,747.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,884.00
|
| Rate for Payer: Cigna of CA PPO |
$4,517.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,325.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,792.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,550.26
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,550.26
|
| Rate for Payer: Galaxy Health WC |
$5,189.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,663.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,494.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,578.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,822.43
|
| Rate for Payer: IEHP medi-cal |
$5,857.93
|
| Rate for Payer: IEHP Medicare Advantage |
$3,550.26
|
| Rate for Payer: Innovage PACE Commercial |
$5,325.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,072.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,550.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,221.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,757.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,757.35
|
| Rate for Payer: Multiplan Commercial |
$4,578.75
|
| Rate for Payer: Networks By Design Commercial |
$3,968.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,189.25
|
| Rate for Payer: Prime Health Services Medicare |
$3,763.28
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,663.00
|
| Rate for Payer: Riverside University Health MISP |
$3,905.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,663.00
|
| 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 |
$5,325.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,905.29
|
| Rate for Payer: Vantage Medical Group Senior |
$3,550.26
|
|
|
HC BIOPSY ARM/ELBOW SOFT TISSUE.
|
Facility
IP
|
$6,105.00
|
|
|
Service Code
|
CPT 24066
|
| Hospital Charge Code |
904000004
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,221.00 |
| Max. Negotiated Rate |
$5,494.50 |
| Rate for Payer: Cash Price |
$2,747.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,884.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,442.00
|
| Rate for Payer: Galaxy Health WC |
$5,189.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,663.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,494.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,072.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,221.00
|
| Rate for Payer: Multiplan Commercial |
$4,578.75
|
| Rate for Payer: Networks By Design Commercial |
$3,968.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,189.25
|
|
|
HC BIOPSY EXTERNAL EAR
|
Facility
IP
|
$1,452.00
|
|
|
Service Code
|
CPT 69100
|
| Hospital Charge Code |
900501504
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$290.40 |
| Max. Negotiated Rate |
$1,306.80 |
| Rate for Payer: Cash Price |
$653.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,161.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$580.80
|
| Rate for Payer: Galaxy Health WC |
$1,234.20
|
| Rate for Payer: Global Benefits Group Commercial |
$871.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,306.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$968.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$290.40
|
| Rate for Payer: Multiplan Commercial |
$1,089.00
|
| Rate for Payer: Networks By Design Commercial |
$943.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,234.20
|
|
|
HC BIOPSY EXTERNAL EAR
|
Facility
OP
|
$1,452.00
|
|
|
Service Code
|
CPT 69100
|
| Hospital Charge Code |
900501504
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$290.40 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$305.19
|
| 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 |
$871.20
|
| Rate for Payer: Caremore Medicare Advantage |
$305.19
|
| Rate for Payer: Cash Price |
$653.40
|
| Rate for Payer: Cash Price |
$653.40
|
| Rate for Payer: Cash Price |
$653.40
|
| Rate for Payer: Cash Price |
$653.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,161.60
|
| Rate for Payer: Cigna of CA PPO |
$1,074.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$1,234.20
|
| Rate for Payer: Global Benefits Group Commercial |
$871.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,306.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,089.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$500.51
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$305.19
|
| Rate for Payer: Innovage PACE Commercial |
$457.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$968.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$290.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$1,089.00
|
| Rate for Payer: Networks By Design Commercial |
$943.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,234.20
|
| Rate for Payer: Prime Health Services Medicare |
$323.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$871.20
|
| Rate for Payer: Riverside University Health MISP |
$335.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$871.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$726.00
|
| Rate for Payer: United Healthcare All Other HMO |
$726.00
|
| Rate for Payer: United Healthcare HMO Rider |
$726.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$726.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC BIOPSY OF CERVIX
|
Facility
OP
|
$2,266.00
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
900501433
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$453.20 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,004.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,506.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,104.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,004.43
|
| 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 |
$1,359.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1,425.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,108.07
|
| Rate for Payer: Caremore Medicare Advantage |
$1,004.43
|
| Rate for Payer: Cash Price |
$1,019.70
|
| Rate for Payer: Cash Price |
$1,019.70
|
| Rate for Payer: Cash Price |
$1,019.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,812.80
|
| Rate for Payer: Cigna of CA HMO |
$1,450.24
|
| Rate for Payer: Cigna of CA PPO |
$1,676.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,506.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,355.98
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,004.43
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,004.43
|
| Rate for Payer: Galaxy Health WC |
$1,926.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,359.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,039.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,699.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,647.27
|
| Rate for Payer: IEHP medi-cal |
$1,657.31
|
| Rate for Payer: IEHP Medicare Advantage |
$1,004.43
|
| Rate for Payer: Innovage PACE Commercial |
$1,506.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,511.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,004.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$453.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,345.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,345.94
|
| Rate for Payer: Multiplan Commercial |
$1,699.50
|
| Rate for Payer: Networks By Design Commercial |
$1,472.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,926.10
|
| Rate for Payer: Prime Health Services Medicare |
$1,064.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,359.60
|
| Rate for Payer: Riverside University Health MISP |
$1,104.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,359.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,359.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,133.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,133.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,133.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,133.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,506.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.87
|
| Rate for Payer: Vantage Medical Group Senior |
$1,004.43
|
|
|
HC BIOPSY OF CERVIX
|
Facility
IP
|
$2,266.00
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
900501433
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$453.20 |
| Max. Negotiated Rate |
$2,039.40 |
| Rate for Payer: Cash Price |
$1,019.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,812.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$906.40
|
| Rate for Payer: Galaxy Health WC |
$1,926.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,359.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,039.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,511.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$453.20
|
| Rate for Payer: Multiplan Commercial |
$1,699.50
|
| Rate for Payer: Networks By Design Commercial |
$1,472.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,926.10
|
|
|
HC BIOPSY OF CERVIX
|
Facility
OP
|
$2,266.00
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
900501433
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$453.20 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,004.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,506.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,104.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,004.43
|
| 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 |
$1,359.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1,425.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,108.07
|
| Rate for Payer: Caremore Medicare Advantage |
$1,004.43
|
| Rate for Payer: Cash Price |
$1,019.70
|
| Rate for Payer: Cash Price |
$1,019.70
|
| Rate for Payer: Cash Price |
$1,019.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,812.80
|
| Rate for Payer: Cigna of CA HMO |
$1,450.24
|
| Rate for Payer: Cigna of CA PPO |
$1,676.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,506.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,355.98
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,004.43
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,004.43
|
| Rate for Payer: Galaxy Health WC |
$1,926.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,359.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,039.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,699.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,647.27
|
| Rate for Payer: IEHP medi-cal |
$1,657.31
|
| Rate for Payer: IEHP Medicare Advantage |
$1,004.43
|
| Rate for Payer: Innovage PACE Commercial |
$1,506.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,511.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,004.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$453.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,345.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,345.94
|
| Rate for Payer: Multiplan Commercial |
$1,699.50
|
| Rate for Payer: Networks By Design Commercial |
$1,472.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,926.10
|
| Rate for Payer: Prime Health Services Medicare |
$1,064.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,359.60
|
| Rate for Payer: Riverside University Health MISP |
$1,104.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,359.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,359.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,133.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,133.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,133.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,133.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,506.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.87
|
| Rate for Payer: Vantage Medical Group Senior |
$1,004.43
|
|
|
HC BIOPSY OF CERVIX
|
Facility
IP
|
$2,266.00
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
900501433
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$453.20 |
| Max. Negotiated Rate |
$2,039.40 |
| Rate for Payer: Cash Price |
$1,019.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,812.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$906.40
|
| Rate for Payer: Galaxy Health WC |
$1,926.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,359.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,039.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,511.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$453.20
|
| Rate for Payer: Multiplan Commercial |
$1,699.50
|
| Rate for Payer: Networks By Design Commercial |
$1,472.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,926.10
|
|
|
HC BIOPSY OF CERVIX
|
Facility
IP
|
$2,266.00
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
900501433
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$453.20 |
| Max. Negotiated Rate |
$2,039.40 |
| Rate for Payer: Cash Price |
$1,019.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,812.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$906.40
|
| Rate for Payer: Galaxy Health WC |
$1,926.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,359.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,039.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,511.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$453.20
|
| Rate for Payer: Multiplan Commercial |
$1,699.50
|
| Rate for Payer: Networks By Design Commercial |
$1,472.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,926.10
|
|
|
HC BIOPSY OF CERVIX
|
Facility
OP
|
$2,266.00
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
900501433
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,506.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,104.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,004.43
|
| 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 |
$1,359.60
|
| Rate for Payer: Caremore Medicare Advantage |
$1,004.43
|
| Rate for Payer: Cash Price |
$1,019.70
|
| Rate for Payer: Cash Price |
$1,019.70
|
| Rate for Payer: Cash Price |
$1,019.70
|
| Rate for Payer: Cash Price |
$1,019.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,812.80
|
| Rate for Payer: Cigna of CA PPO |
$1,676.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,506.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,355.98
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,004.43
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,004.43
|
| Rate for Payer: Galaxy Health WC |
$1,926.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,359.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,039.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,699.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,647.27
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$1,004.43
|
| Rate for Payer: Innovage PACE Commercial |
$1,506.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,511.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,004.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$453.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,345.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,345.94
|
| Rate for Payer: Multiplan Commercial |
$1,699.50
|
| Rate for Payer: Networks By Design Commercial |
$1,472.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,926.10
|
| Rate for Payer: Prime Health Services Medicare |
$1,064.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,359.60
|
| Rate for Payer: Riverside University Health MISP |
$1,104.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,359.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,133.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,133.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,133.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,133.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,506.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.87
|
| Rate for Payer: Vantage Medical Group Senior |
$1,004.43
|
|
|
HC BIOPSY OF HIP JOINT
|
Facility
IP
|
$7,876.00
|
|
|
Service Code
|
CPT 27052
|
| Hospital Charge Code |
909020043
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,575.20 |
| Max. Negotiated Rate |
$7,088.40 |
| Rate for Payer: Cash Price |
$3,544.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,300.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,150.40
|
| Rate for Payer: Galaxy Health WC |
$6,694.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,725.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,088.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,253.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,575.20
|
| Rate for Payer: Multiplan Commercial |
$5,907.00
|
| Rate for Payer: Networks By Design Commercial |
$5,119.40
|
| Rate for Payer: Prime Health Services Commercial |
$6,694.60
|
|
|
HC BIOPSY OF HIP JOINT
|
Facility
OP
|
$7,876.00
|
|
|
Service Code
|
CPT 27052
|
| Hospital Charge Code |
909020043
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,575.20 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,008.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| 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 |
$4,725.60
|
| 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 |
$2,008.09
|
| Rate for Payer: Cash Price |
$3,544.20
|
| Rate for Payer: Cash Price |
$3,544.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,300.80
|
| Rate for Payer: Cigna of CA PPO |
$5,828.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,710.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,008.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,008.09
|
| Rate for Payer: Galaxy Health WC |
$6,694.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,725.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,088.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,907.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,293.27
|
| Rate for Payer: IEHP medi-cal |
$3,313.35
|
| Rate for Payer: IEHP Medicare Advantage |
$2,008.09
|
| Rate for Payer: Innovage PACE Commercial |
$3,012.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,253.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,575.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,690.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,690.84
|
| Rate for Payer: Multiplan Commercial |
$5,907.00
|
| Rate for Payer: Networks By Design Commercial |
$5,119.40
|
| Rate for Payer: Prime Health Services Commercial |
$6,694.60
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,725.60
|
| Rate for Payer: Riverside University Health MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,725.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Vantage Medical Group Senior |
$2,008.09
|
|
|
HC BIOPSY OF NECK/CHEST
|
Facility
IP
|
$5,801.00
|
|
|
Service Code
|
CPT 21550
|
| Hospital Charge Code |
904000002
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,160.20 |
| Max. Negotiated Rate |
$5,220.90 |
| Rate for Payer: Cash Price |
$2,610.45
|
| Rate for Payer: Central Health Plan Commercial |
$4,640.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,320.40
|
| Rate for Payer: Galaxy Health WC |
$4,930.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,480.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,220.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,869.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,160.20
|
| Rate for Payer: Multiplan Commercial |
$4,350.75
|
| Rate for Payer: Networks By Design Commercial |
$3,770.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,930.85
|
|
|
HC BIOPSY OF NECK/CHEST
|
Facility
OP
|
$5,801.00
|
|
|
Service Code
|
CPT 21550
|
| Hospital Charge Code |
904000002
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,160.20 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,025.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| 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 |
$3,480.60
|
| 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 |
$2,025.69
|
| Rate for Payer: Cash Price |
$2,610.45
|
| Rate for Payer: Cash Price |
$2,610.45
|
| Rate for Payer: Cash Price |
$2,610.45
|
| Rate for Payer: Central Health Plan Commercial |
$4,640.80
|
| Rate for Payer: Cigna of CA PPO |
$4,292.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
| Rate for Payer: Galaxy Health WC |
$4,930.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,480.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,220.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,350.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,322.13
|
| Rate for Payer: IEHP medi-cal |
$3,342.39
|
| Rate for Payer: IEHP Medicare Advantage |
$2,025.69
|
| Rate for Payer: Innovage PACE Commercial |
$3,038.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,869.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,160.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,714.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
| Rate for Payer: Multiplan Commercial |
$4,350.75
|
| Rate for Payer: Networks By Design Commercial |
$3,770.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,930.85
|
| Rate for Payer: Prime Health Services Medicare |
$2,147.23
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,480.60
|
| Rate for Payer: Riverside University Health MISP |
$2,228.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,480.60
|
| 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 |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC BIOPSY OF SOFT TISSUE PELVIS/HIP
|
Facility
OP
|
$3,020.00
|
|
|
Service Code
|
CPT 27040
|
| Hospital Charge Code |
904000006
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$604.00 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,025.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| 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 |
$1,812.00
|
| 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 |
$2,025.69
|
| Rate for Payer: Cash Price |
$1,359.00
|
| Rate for Payer: Cash Price |
$1,359.00
|
| Rate for Payer: Cash Price |
$1,359.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,416.00
|
| Rate for Payer: Cigna of CA PPO |
$2,234.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
| Rate for Payer: Galaxy Health WC |
$2,567.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,812.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,718.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,265.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,322.13
|
| Rate for Payer: IEHP medi-cal |
$3,342.39
|
| Rate for Payer: IEHP Medicare Advantage |
$2,025.69
|
| Rate for Payer: Innovage PACE Commercial |
$3,038.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,014.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$604.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,714.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
| Rate for Payer: Multiplan Commercial |
$2,265.00
|
| Rate for Payer: Networks By Design Commercial |
$1,963.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,567.00
|
| Rate for Payer: Prime Health Services Medicare |
$2,147.23
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,812.00
|
| Rate for Payer: Riverside University Health MISP |
$2,228.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,812.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC BIOPSY OF SOFT TISSUE PELVIS/HIP
|
Facility
IP
|
$3,020.00
|
|
|
Service Code
|
CPT 27040
|
| Hospital Charge Code |
904000006
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$604.00 |
| Max. Negotiated Rate |
$2,718.00 |
| Rate for Payer: Cash Price |
$1,359.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,416.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,208.00
|
| Rate for Payer: Galaxy Health WC |
$2,567.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,812.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,718.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,014.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$604.00
|
| Rate for Payer: Multiplan Commercial |
$2,265.00
|
| Rate for Payer: Networks By Design Commercial |
$1,963.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,567.00
|
|
|
HC BIOPSY OF TONGUE
|
Facility
IP
|
$1,903.00
|
|
|
Service Code
|
CPT 41100
|
| Hospital Charge Code |
900541100
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$380.60 |
| Max. Negotiated Rate |
$1,712.70 |
| Rate for Payer: Cash Price |
$856.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,522.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$761.20
|
| Rate for Payer: Galaxy Health WC |
$1,617.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,141.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,712.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,269.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$380.60
|
| Rate for Payer: Multiplan Commercial |
$1,427.25
|
| Rate for Payer: Networks By Design Commercial |
$1,236.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,617.55
|
|
|
HC BIOPSY OF TONGUE
|
Facility
OP
|
$1,903.00
|
|
|
Service Code
|
CPT 41100
|
| Hospital Charge Code |
900541100
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$380.60 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,031.16
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$756.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$687.44
|
| 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 |
$1,141.80
|
| Rate for Payer: Caremore Medicare Advantage |
$687.44
|
| Rate for Payer: Cash Price |
$856.35
|
| Rate for Payer: Cash Price |
$856.35
|
| Rate for Payer: Cash Price |
$856.35
|
| Rate for Payer: Cash Price |
$856.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,522.40
|
| Rate for Payer: Cigna of CA PPO |
$1,408.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,031.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$928.04
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$687.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$687.44
|
| Rate for Payer: Galaxy Health WC |
$1,617.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,141.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,712.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,427.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,127.40
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$687.44
|
| Rate for Payer: Innovage PACE Commercial |
$1,031.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,269.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$687.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$380.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$921.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$921.17
|
| Rate for Payer: Multiplan Commercial |
$1,427.25
|
| Rate for Payer: Networks By Design Commercial |
$1,236.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,617.55
|
| Rate for Payer: Prime Health Services Medicare |
$728.69
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,141.80
|
| Rate for Payer: Riverside University Health MISP |
$756.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,141.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$951.50
|
| Rate for Payer: United Healthcare All Other HMO |
$951.50
|
| Rate for Payer: United Healthcare HMO Rider |
$951.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,031.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$756.18
|
| Rate for Payer: Vantage Medical Group Senior |
$687.44
|
|
|
HC BIOPSY OF VAGINA
|
Facility
OP
|
$2,712.00
|
|
|
Service Code
|
CPT 57100
|
| Hospital Charge Code |
904000017
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$542.40 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,004.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,506.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,104.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,004.43
|
| 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 |
$1,627.20
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$1,004.43
|
| Rate for Payer: Cash Price |
$1,220.40
|
| Rate for Payer: Cash Price |
$1,220.40
|
| Rate for Payer: Cash Price |
$1,220.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,169.60
|
| Rate for Payer: Cigna of CA PPO |
$2,006.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,506.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,355.98
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,004.43
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,004.43
|
| Rate for Payer: Galaxy Health WC |
$2,305.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,627.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,440.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,034.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,647.27
|
| Rate for Payer: IEHP medi-cal |
$1,657.31
|
| Rate for Payer: IEHP Medicare Advantage |
$1,004.43
|
| Rate for Payer: Innovage PACE Commercial |
$1,506.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,808.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,004.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$542.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,345.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,345.94
|
| Rate for Payer: Multiplan Commercial |
$2,034.00
|
| Rate for Payer: Networks By Design Commercial |
$1,762.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,305.20
|
| Rate for Payer: Prime Health Services Medicare |
$1,064.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,627.20
|
| Rate for Payer: Riverside University Health MISP |
$1,104.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,627.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,506.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.87
|
| Rate for Payer: Vantage Medical Group Senior |
$1,004.43
|
|
|
HC BIOPSY OF VAGINA
|
Facility
IP
|
$2,712.00
|
|
|
Service Code
|
CPT 57100
|
| Hospital Charge Code |
904000017
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$542.40 |
| Max. Negotiated Rate |
$2,440.80 |
| Rate for Payer: Cash Price |
$1,220.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,169.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,084.80
|
| Rate for Payer: Galaxy Health WC |
$2,305.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,627.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,440.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,808.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$542.40
|
| Rate for Payer: Multiplan Commercial |
$2,034.00
|
| Rate for Payer: Networks By Design Commercial |
$1,762.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,305.20
|
|
|
HC BIOPSY OROPHARYNX
|
Facility
OP
|
$4,047.00
|
|
|
Service Code
|
CPT 42800
|
| Hospital Charge Code |
950442316
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$809.40 |
| Max. Negotiated Rate |
$3,642.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,905.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,858.16
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,095.98
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,905.44
|
| 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 |
$2,428.20
|
| Rate for Payer: Blue Shield of California Commercial |
$2,545.56
|
| Rate for Payer: Blue Shield of California EPN |
$1,978.98
|
| Rate for Payer: Caremore Medicare Advantage |
$1,905.44
|
| Rate for Payer: Cash Price |
$1,821.15
|
| Rate for Payer: Cash Price |
$1,821.15
|
| Rate for Payer: Cash Price |
$1,821.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,237.60
|
| Rate for Payer: Cigna of CA HMO |
$2,590.08
|
| Rate for Payer: Cigna of CA PPO |
$2,994.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,858.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,572.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,905.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,905.44
|
| Rate for Payer: Galaxy Health WC |
$3,439.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,428.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,642.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,035.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,124.92
|
| Rate for Payer: IEHP medi-cal |
$3,143.98
|
| Rate for Payer: IEHP Medicare Advantage |
$1,905.44
|
| Rate for Payer: Innovage PACE Commercial |
$2,858.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,699.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,905.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$809.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,553.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,553.29
|
| Rate for Payer: Multiplan Commercial |
$3,035.25
|
| Rate for Payer: Networks By Design Commercial |
$2,630.55
|
| Rate for Payer: Prime Health Services Commercial |
$3,439.95
|
| Rate for Payer: Prime Health Services Medicare |
$2,019.77
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,428.20
|
| Rate for Payer: Riverside University Health MISP |
$2,095.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,428.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,428.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,023.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,023.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,023.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,023.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,858.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,095.98
|
| Rate for Payer: Vantage Medical Group Senior |
$1,905.44
|
|
|
HC BIOPSY OROPHARYNX
|
Facility
IP
|
$4,047.00
|
|
|
Service Code
|
CPT 42800
|
| Hospital Charge Code |
950442316
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$809.40 |
| Max. Negotiated Rate |
$3,642.30 |
| Rate for Payer: Cash Price |
$1,821.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,237.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,618.80
|
| Rate for Payer: Galaxy Health WC |
$3,439.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,428.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,642.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,699.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$809.40
|
| Rate for Payer: Multiplan Commercial |
$3,035.25
|
| Rate for Payer: Networks By Design Commercial |
$2,630.55
|
| Rate for Payer: Prime Health Services Commercial |
$3,439.95
|
|
|
HC BIOPSY/REMOVAL LYMPH NODE(S)
|
Facility
IP
|
$9,906.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
904000008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,981.20 |
| Max. Negotiated Rate |
$8,915.40 |
| Rate for Payer: Cash Price |
$4,457.70
|
| Rate for Payer: Central Health Plan Commercial |
$7,924.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,962.40
|
| Rate for Payer: Galaxy Health WC |
$8,420.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,943.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,915.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,607.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,981.20
|
| Rate for Payer: Multiplan Commercial |
$7,429.50
|
| Rate for Payer: Networks By Design Commercial |
$6,438.90
|
| Rate for Payer: Prime Health Services Commercial |
$8,420.10
|
|
|
HC BIOPSY/REMOVAL LYMPH NODE(S)
|
Facility
OP
|
$9,906.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
904000008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,981.20 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,762.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,143.76
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,238.76
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,762.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$5,943.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$4,762.51
|
| Rate for Payer: Cash Price |
$4,457.70
|
| Rate for Payer: Cash Price |
$4,457.70
|
| Rate for Payer: Central Health Plan Commercial |
$7,924.80
|
| Rate for Payer: Cigna of CA PPO |
$7,330.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,143.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,429.39
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,762.51
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,762.51
|
| Rate for Payer: Galaxy Health WC |
$8,420.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,943.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,915.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7,429.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,810.52
|
| Rate for Payer: IEHP medi-cal |
$7,858.14
|
| Rate for Payer: IEHP Medicare Advantage |
$4,762.51
|
| Rate for Payer: Innovage PACE Commercial |
$7,143.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,607.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,762.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,981.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,381.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,381.76
|
| Rate for Payer: Multiplan Commercial |
$7,429.50
|
| Rate for Payer: Networks By Design Commercial |
$6,438.90
|
| Rate for Payer: Prime Health Services Commercial |
$8,420.10
|
| Rate for Payer: Prime Health Services Medicare |
$5,048.26
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,943.60
|
| Rate for Payer: Riverside University Health MISP |
$5,238.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,943.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,143.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,238.76
|
| Rate for Payer: Vantage Medical Group Senior |
$4,762.51
|
|
