|
HC BRONCH FOREIGN BODY REMOVAL
|
Facility
|
IP
|
$6,384.00
|
|
|
Service Code
|
CPT 31635
|
| Hospital Charge Code |
900803505
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,276.80 |
| Max. Negotiated Rate |
$5,745.60 |
| Rate for Payer: Cash Price |
$2,872.80
|
| Rate for Payer: Central Health Plan Commercial |
$5,107.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,553.60
|
| Rate for Payer: Galaxy Health WC |
$5,426.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,830.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,745.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,258.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,432.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,276.80
|
| Rate for Payer: Multiplan Commercial |
$4,788.00
|
| Rate for Payer: Networks By Design Commercial |
$4,149.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,426.40
|
|
|
HC BRONCH FOREIGN BODY REMOVAL
|
Facility
|
OP
|
$6,384.00
|
|
|
Service Code
|
CPT 31635
|
| Hospital Charge Code |
900803505
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$396.13 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,120.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,830.40
|
| Rate for Payer: Blue Shield of California Commercial |
$4,015.54
|
| Rate for Payer: Blue Shield of California EPN |
$3,121.78
|
| Rate for Payer: Caremore Medicare Advantage |
$2,120.62
|
| Rate for Payer: Cash Price |
$2,872.80
|
| Rate for Payer: Cash Price |
$2,872.80
|
| Rate for Payer: Central Health Plan Commercial |
$5,107.20
|
| Rate for Payer: Cigna of CA HMO |
$4,085.76
|
| Rate for Payer: Cigna of CA PPO |
$4,724.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Dignity Health Media |
$2,120.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,332.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,862.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,120.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,120.62
|
| Rate for Payer: Galaxy Health WC |
$5,426.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,830.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,745.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,788.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,477.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,499.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,120.62
|
| Rate for Payer: InnovAge PACE Commercial |
$3,180.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,258.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$396.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,120.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,276.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,841.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,841.63
|
| Rate for Payer: Multiplan Commercial |
$4,788.00
|
| Rate for Payer: Networks By Design Commercial |
$4,149.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,426.40
|
| Rate for Payer: Prime Health Services Medicare |
$2,247.86
|
| Rate for Payer: Riverside University Health System MISP |
$2,332.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,830.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,830.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,192.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,192.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,192.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,120.62
|
|
|
HC BRONCHIAL THERMOPLASTY 1 LOBE
|
Facility
|
IP
|
$11,669.00
|
|
|
Service Code
|
CPT 31660
|
| Hospital Charge Code |
900831660
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,333.80 |
| Max. Negotiated Rate |
$10,502.10 |
| Rate for Payer: Cash Price |
$5,251.05
|
| Rate for Payer: Central Health Plan Commercial |
$9,335.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,667.60
|
| Rate for Payer: Galaxy Health WC |
$9,918.65
|
| Rate for Payer: Global Benefits Group Commercial |
$7,001.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,502.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,783.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,445.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,333.80
|
| Rate for Payer: Multiplan Commercial |
$8,751.75
|
| Rate for Payer: Networks By Design Commercial |
$7,584.85
|
| Rate for Payer: Prime Health Services Commercial |
$9,918.65
|
|
|
HC BRONCHIAL THERMOPLASTY 1 LOBE
|
Facility
|
OP
|
$11,669.00
|
|
|
Service Code
|
CPT 31660
|
| Hospital Charge Code |
900831660
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$354.39 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$8,551.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,406.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,551.50
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$11,691.12
|
| Rate for Payer: Blue Distinction Transplant |
$7,001.40
|
| 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 |
$8,551.50
|
| Rate for Payer: Cash Price |
$5,251.05
|
| Rate for Payer: Cash Price |
$5,251.05
|
| Rate for Payer: Central Health Plan Commercial |
$9,335.20
|
| Rate for Payer: Cigna of CA PPO |
$8,635.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Dignity Health Media |
$8,551.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,406.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,544.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,551.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,551.50
|
| Rate for Payer: Galaxy Health WC |
$9,918.65
|
| Rate for Payer: Global Benefits Group Commercial |
$7,001.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,502.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,751.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14,024.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14,109.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,551.50
|
| Rate for Payer: InnovAge PACE Commercial |
$12,827.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,783.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$354.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,551.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,333.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,459.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,459.01
|
| Rate for Payer: Multiplan Commercial |
$8,751.75
|
| Rate for Payer: Multiplan WC |
$11,691.12
|
| Rate for Payer: Networks By Design Commercial |
$7,584.85
|
| Rate for Payer: Preferred Health Network WC |
$11,929.71
|
| Rate for Payer: Prime Health Services Commercial |
$9,918.65
|
| Rate for Payer: Prime Health Services Medicare |
$9,064.59
|
| Rate for Payer: Prime Health Services WC |
$11,571.82
|
| Rate for Payer: Riverside University Health System MISP |
$9,406.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,001.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,406.65
|
| Rate for Payer: Vantage Medical Group Senior |
$8,551.50
|
|
|
HC BRONCHIAL THERMOPLASTY 2+ LOBES
|
Facility
|
IP
|
$11,669.00
|
|
|
Service Code
|
CPT 31661
|
| Hospital Charge Code |
900831661
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,333.80 |
| Max. Negotiated Rate |
$10,502.10 |
| Rate for Payer: Cash Price |
$5,251.05
|
| Rate for Payer: Central Health Plan Commercial |
$9,335.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,667.60
|
| Rate for Payer: Galaxy Health WC |
$9,918.65
|
| Rate for Payer: Global Benefits Group Commercial |
$7,001.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,502.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,783.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,445.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,333.80
|
| Rate for Payer: Multiplan Commercial |
$8,751.75
|
| Rate for Payer: Networks By Design Commercial |
$7,584.85
|
| Rate for Payer: Prime Health Services Commercial |
$9,918.65
|
|
|
HC BRONCHIAL THERMOPLASTY 2+ LOBES
|
Facility
|
OP
|
$11,669.00
|
|
|
Service Code
|
CPT 31661
|
| Hospital Charge Code |
900831661
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$373.48 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$8,551.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,406.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,551.50
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$11,691.12
|
| Rate for Payer: Blue Distinction Transplant |
$7,001.40
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Caremore Medicare Advantage |
$8,551.50
|
| Rate for Payer: Cash Price |
$5,251.05
|
| Rate for Payer: Cash Price |
$5,251.05
|
| Rate for Payer: Central Health Plan Commercial |
$9,335.20
|
| Rate for Payer: Cigna of CA PPO |
$8,635.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Dignity Health Media |
$8,551.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,406.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,544.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,551.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,551.50
|
| Rate for Payer: Galaxy Health WC |
$9,918.65
|
| Rate for Payer: Global Benefits Group Commercial |
$7,001.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,502.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,751.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14,024.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14,109.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,551.50
|
| Rate for Payer: InnovAge PACE Commercial |
$12,827.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,783.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$373.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,551.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,333.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,459.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,459.01
|
| Rate for Payer: Multiplan Commercial |
$8,751.75
|
| Rate for Payer: Multiplan WC |
$11,691.12
|
| Rate for Payer: Networks By Design Commercial |
$7,584.85
|
| Rate for Payer: Preferred Health Network WC |
$11,929.71
|
| Rate for Payer: Prime Health Services Commercial |
$9,918.65
|
| Rate for Payer: Prime Health Services Medicare |
$9,064.59
|
| Rate for Payer: Prime Health Services WC |
$11,571.82
|
| Rate for Payer: Riverside University Health System MISP |
$9,406.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,001.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,406.65
|
| Rate for Payer: Vantage Medical Group Senior |
$8,551.50
|
|
|
HC BRONCHOGRAM BILAT
|
Facility
|
IP
|
$800.00
|
|
|
Service Code
|
CPT 71060
|
| Hospital Charge Code |
909001451
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$160.00 |
| Max. Negotiated Rate |
$720.00 |
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Central Health Plan Commercial |
$640.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$320.00
|
| Rate for Payer: Galaxy Health WC |
$680.00
|
| Rate for Payer: Global Benefits Group Commercial |
$480.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$720.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$533.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$304.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$160.00
|
| Rate for Payer: Multiplan Commercial |
$600.00
|
| Rate for Payer: Networks By Design Commercial |
$520.00
|
| Rate for Payer: Prime Health Services Commercial |
$680.00
|
|
|
HC BRONCHOGRAM BILAT
|
Facility
|
OP
|
$800.00
|
|
|
Service Code
|
CPT 71060
|
| Hospital Charge Code |
909001451
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$160.00 |
| Max. Negotiated Rate |
$720.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$485.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$680.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$440.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$440.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$387.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$472.64
|
| Rate for Payer: Blue Distinction Transplant |
$480.00
|
| Rate for Payer: Blue Shield of California Commercial |
$494.40
|
| Rate for Payer: Blue Shield of California EPN |
$388.80
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Central Health Plan Commercial |
$640.00
|
| Rate for Payer: Cigna of CA HMO |
$512.00
|
| Rate for Payer: Cigna of CA PPO |
$592.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$680.00
|
| Rate for Payer: Dignity Health Media |
$680.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$680.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$320.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$320.00
|
| Rate for Payer: Galaxy Health WC |
$680.00
|
| Rate for Payer: Global Benefits Group Commercial |
$480.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$720.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$600.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$280.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$533.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$304.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$160.00
|
| Rate for Payer: Multiplan Commercial |
$600.00
|
| Rate for Payer: Networks By Design Commercial |
$520.00
|
| Rate for Payer: Prime Health Services Commercial |
$680.00
|
| Rate for Payer: Riverside University Health System MISP |
$320.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$480.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$480.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$400.00
|
| Rate for Payer: United Healthcare All Other HMO |
$400.00
|
| Rate for Payer: United Healthcare HMO Rider |
$400.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$400.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$680.00
|
| Rate for Payer: Vantage Medical Group Senior |
$680.00
|
|
|
HC BRONCHOGRAM UNILAT
|
Facility
|
IP
|
$800.00
|
|
|
Service Code
|
CPT 71040
|
| Hospital Charge Code |
909001477
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$160.00 |
| Max. Negotiated Rate |
$720.00 |
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Central Health Plan Commercial |
$640.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$320.00
|
| Rate for Payer: Galaxy Health WC |
$680.00
|
| Rate for Payer: Global Benefits Group Commercial |
$480.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$720.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$533.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$304.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$160.00
|
| Rate for Payer: Multiplan Commercial |
$600.00
|
| Rate for Payer: Networks By Design Commercial |
$520.00
|
| Rate for Payer: Prime Health Services Commercial |
$680.00
|
|
|
HC BRONCHOGRAM UNILAT
|
Facility
|
OP
|
$800.00
|
|
|
Service Code
|
CPT 71040
|
| Hospital Charge Code |
909001477
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$160.00 |
| Max. Negotiated Rate |
$720.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$485.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$680.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$440.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$440.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$387.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$472.64
|
| Rate for Payer: Blue Distinction Transplant |
$480.00
|
| Rate for Payer: Blue Shield of California Commercial |
$494.40
|
| Rate for Payer: Blue Shield of California EPN |
$388.80
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Central Health Plan Commercial |
$640.00
|
| Rate for Payer: Cigna of CA HMO |
$512.00
|
| Rate for Payer: Cigna of CA PPO |
$592.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$680.00
|
| Rate for Payer: Dignity Health Media |
$680.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$680.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$320.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$320.00
|
| Rate for Payer: Galaxy Health WC |
$680.00
|
| Rate for Payer: Global Benefits Group Commercial |
$480.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$720.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$600.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$280.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$533.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$304.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$160.00
|
| Rate for Payer: Multiplan Commercial |
$600.00
|
| Rate for Payer: Networks By Design Commercial |
$520.00
|
| Rate for Payer: Prime Health Services Commercial |
$680.00
|
| Rate for Payer: Riverside University Health System MISP |
$320.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$480.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$480.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$400.00
|
| Rate for Payer: United Healthcare All Other HMO |
$400.00
|
| Rate for Payer: United Healthcare HMO Rider |
$400.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$400.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$680.00
|
| Rate for Payer: Vantage Medical Group Senior |
$680.00
|
|
|
HC BRONCHOSCOPY W BRONCH ALVEOLAR
|
Facility
|
IP
|
$7,929.00
|
|
|
Service Code
|
CPT 31624
|
| Hospital Charge Code |
900803502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,585.80 |
| Max. Negotiated Rate |
$7,136.10 |
| Rate for Payer: Cash Price |
$3,568.05
|
| Rate for Payer: Central Health Plan Commercial |
$6,343.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,171.60
|
| Rate for Payer: Galaxy Health WC |
$6,739.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,757.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,136.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,288.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,020.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,585.80
|
| Rate for Payer: Multiplan Commercial |
$5,946.75
|
| Rate for Payer: Networks By Design Commercial |
$5,153.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,739.65
|
|
|
HC BRONCHOSCOPY W BRONCH ALVEOLAR
|
Facility
|
OP
|
$7,929.00
|
|
|
Service Code
|
CPT 31624
|
| Hospital Charge Code |
900803502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$405.33 |
| Max. Negotiated Rate |
$7,136.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,120.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,757.40
|
| 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 |
$2,120.62
|
| Rate for Payer: Cash Price |
$3,568.05
|
| Rate for Payer: Cash Price |
$3,568.05
|
| Rate for Payer: Central Health Plan Commercial |
$6,343.20
|
| Rate for Payer: Cigna of CA PPO |
$5,867.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Dignity Health Media |
$2,120.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,332.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,862.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,120.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,120.62
|
| Rate for Payer: Galaxy Health WC |
$6,739.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,757.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,136.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,946.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,477.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,499.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,120.62
|
| Rate for Payer: InnovAge PACE Commercial |
$3,180.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,288.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$405.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,120.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,585.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,841.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,841.63
|
| Rate for Payer: Multiplan Commercial |
$5,946.75
|
| Rate for Payer: Networks By Design Commercial |
$5,153.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,739.65
|
| Rate for Payer: Prime Health Services Medicare |
$2,247.86
|
| Rate for Payer: Riverside University Health System MISP |
$2,332.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,757.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,120.62
|
|
|
HC BRONCHOSCOPY W/RMVL OF F.B.
|
Facility
|
OP
|
$6,384.00
|
|
|
Service Code
|
CPT 31635
|
| Hospital Charge Code |
900501509
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$396.13 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,830.40
|
| Rate for Payer: Caremore Medicare Advantage |
$2,120.62
|
| Rate for Payer: Cash Price |
$2,872.80
|
| Rate for Payer: Cash Price |
$2,872.80
|
| Rate for Payer: Cash Price |
$2,872.80
|
| Rate for Payer: Cash Price |
$2,872.80
|
| Rate for Payer: Central Health Plan Commercial |
$5,107.20
|
| Rate for Payer: Cigna of CA PPO |
$4,724.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Dignity Health Media |
$2,120.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,332.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,862.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,120.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,120.62
|
| Rate for Payer: Galaxy Health WC |
$5,426.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,830.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,745.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,788.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,477.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,120.62
|
| Rate for Payer: InnovAge PACE Commercial |
$3,180.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,258.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$396.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,120.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,276.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,841.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,841.63
|
| Rate for Payer: Multiplan Commercial |
$4,788.00
|
| Rate for Payer: Networks By Design Commercial |
$4,149.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,426.40
|
| Rate for Payer: Prime Health Services Medicare |
$2,247.86
|
| Rate for Payer: Riverside University Health System MISP |
$2,332.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,830.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,192.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,192.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,192.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,120.62
|
|
|
HC BRONCHOSCOPY W/RMVL OF F.B.
|
Facility
|
IP
|
$6,384.00
|
|
|
Service Code
|
CPT 31635
|
| Hospital Charge Code |
900501509
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,276.80 |
| Max. Negotiated Rate |
$5,745.60 |
| Rate for Payer: Cash Price |
$2,872.80
|
| Rate for Payer: Central Health Plan Commercial |
$5,107.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,553.60
|
| Rate for Payer: Galaxy Health WC |
$5,426.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,830.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,745.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,258.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,432.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,276.80
|
| Rate for Payer: Multiplan Commercial |
$4,788.00
|
| Rate for Payer: Networks By Design Commercial |
$4,149.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,426.40
|
|
|
HC BRONCH-RADIOELEMENT PLACEMENT
|
Facility
|
IP
|
$4,772.00
|
|
|
Service Code
|
CPT 31643
|
| Hospital Charge Code |
900803506
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$954.40 |
| Max. Negotiated Rate |
$4,294.80 |
| Rate for Payer: Cash Price |
$2,147.40
|
| Rate for Payer: Central Health Plan Commercial |
$3,817.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,908.80
|
| Rate for Payer: Galaxy Health WC |
$4,056.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,863.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,294.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,182.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,818.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$954.40
|
| Rate for Payer: Multiplan Commercial |
$3,579.00
|
| Rate for Payer: Networks By Design Commercial |
$3,101.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,056.20
|
|
|
HC BRONCH-RADIOELEMENT PLACEMENT
|
Facility
|
OP
|
$4,772.00
|
|
|
Service Code
|
CPT 31643
|
| Hospital Charge Code |
900803506
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$341.66 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,120.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,863.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,001.59
|
| Rate for Payer: Blue Shield of California EPN |
$2,333.51
|
| Rate for Payer: Caremore Medicare Advantage |
$2,120.62
|
| Rate for Payer: Cash Price |
$2,147.40
|
| Rate for Payer: Cash Price |
$2,147.40
|
| Rate for Payer: Central Health Plan Commercial |
$3,817.60
|
| Rate for Payer: Cigna of CA HMO |
$3,054.08
|
| Rate for Payer: Cigna of CA PPO |
$3,531.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Dignity Health Media |
$2,120.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,332.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,862.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,120.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,120.62
|
| Rate for Payer: Galaxy Health WC |
$4,056.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,863.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,294.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,579.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,477.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,499.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,120.62
|
| Rate for Payer: InnovAge PACE Commercial |
$3,180.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,182.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$341.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,120.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$954.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,841.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,841.63
|
| Rate for Payer: Multiplan Commercial |
$3,579.00
|
| Rate for Payer: Networks By Design Commercial |
$3,101.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,056.20
|
| Rate for Payer: Prime Health Services Medicare |
$2,247.86
|
| Rate for Payer: Riverside University Health System MISP |
$2,332.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,863.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,863.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,386.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,386.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,386.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,386.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,120.62
|
|
|
HC BRONCH W BLLN OCC ADD LOBES
|
Facility
|
OP
|
$5,205.00
|
|
|
Service Code
|
CPT 31651
|
| Hospital Charge Code |
900831651
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$124.49 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,424.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,862.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,862.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,123.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$2,342.25
|
| Rate for Payer: Cash Price |
$2,342.25
|
| Rate for Payer: Cash Price |
$2,342.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,164.00
|
| Rate for Payer: Cigna of CA PPO |
$3,851.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,424.25
|
| Rate for Payer: Dignity Health Media |
$4,424.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,424.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,082.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,082.00
|
| Rate for Payer: Galaxy Health WC |
$4,424.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,123.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,684.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,903.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,821.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,471.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$124.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,041.00
|
| Rate for Payer: Multiplan Commercial |
$3,903.75
|
| Rate for Payer: Networks By Design Commercial |
$3,383.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,424.25
|
| Rate for Payer: Riverside University Health System MISP |
$2,082.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,123.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,424.25
|
| Rate for Payer: Vantage Medical Group Senior |
$4,424.25
|
|
|
HC BRONCH W BLLN OCC ADD LOBES
|
Facility
|
IP
|
$5,205.00
|
|
|
Service Code
|
CPT 31651
|
| Hospital Charge Code |
900831651
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,041.00 |
| Max. Negotiated Rate |
$4,684.50 |
| Rate for Payer: Cash Price |
$2,342.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,164.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,082.00
|
| Rate for Payer: Galaxy Health WC |
$4,424.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,123.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,684.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,471.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,983.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,041.00
|
| Rate for Payer: Multiplan Commercial |
$3,903.75
|
| Rate for Payer: Networks By Design Commercial |
$3,383.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,424.25
|
|
|
HC BRONCH W/BLLN OCCLUSION
|
Facility
|
IP
|
$5,106.00
|
|
|
Service Code
|
CPT 31634
|
| Hospital Charge Code |
900803513
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,021.20 |
| Max. Negotiated Rate |
$4,595.40 |
| Rate for Payer: Cash Price |
$2,297.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,084.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,042.40
|
| Rate for Payer: Galaxy Health WC |
$4,340.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,063.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,595.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,405.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,945.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,021.20
|
| Rate for Payer: Multiplan Commercial |
$3,829.50
|
| Rate for Payer: Networks By Design Commercial |
$3,318.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,340.10
|
|
|
HC BRONCH W/BLLN OCCLUSION
|
Facility
|
OP
|
$5,106.00
|
|
|
Service Code
|
CPT 31634
|
| Hospital Charge Code |
900803513
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$330.12 |
| Max. Negotiated Rate |
$14,109.98 |
| Rate for Payer: Adventist Health Medi-Cal |
$8,551.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,406.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,551.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,063.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,211.67
|
| Rate for Payer: Blue Shield of California EPN |
$2,496.83
|
| Rate for Payer: Caremore Medicare Advantage |
$8,551.50
|
| Rate for Payer: Cash Price |
$2,297.70
|
| Rate for Payer: Cash Price |
$2,297.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,084.80
|
| Rate for Payer: Cigna of CA HMO |
$3,267.84
|
| Rate for Payer: Cigna of CA PPO |
$3,778.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Dignity Health Media |
$8,551.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,406.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,544.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,551.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,551.50
|
| Rate for Payer: Galaxy Health WC |
$4,340.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,063.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,595.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,829.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14,024.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14,109.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,551.50
|
| Rate for Payer: InnovAge PACE Commercial |
$12,827.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,405.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$330.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,551.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,021.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,459.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,459.01
|
| Rate for Payer: Multiplan Commercial |
$3,829.50
|
| Rate for Payer: Networks By Design Commercial |
$3,318.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,340.10
|
| Rate for Payer: Prime Health Services Medicare |
$9,064.59
|
| Rate for Payer: Riverside University Health System MISP |
$9,406.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,063.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,063.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,553.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,553.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,553.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,553.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,406.65
|
| Rate for Payer: Vantage Medical Group Senior |
$8,551.50
|
|
|
HC BRONCH W PLCMNT FIDUCIAL MRK
|
Facility
|
OP
|
$13,894.00
|
|
|
Service Code
|
CPT 31626
|
| Hospital Charge Code |
900531626
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$713.03 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$8,551.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,406.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,551.50
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$11,691.12
|
| Rate for Payer: Blue Distinction Transplant |
$8,336.40
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Caremore Medicare Advantage |
$8,551.50
|
| Rate for Payer: Cash Price |
$6,252.30
|
| Rate for Payer: Cash Price |
$6,252.30
|
| Rate for Payer: Central Health Plan Commercial |
$11,115.20
|
| Rate for Payer: Cigna of CA PPO |
$10,281.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Dignity Health Media |
$8,551.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,406.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,544.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,551.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,551.50
|
| Rate for Payer: Galaxy Health WC |
$11,809.90
|
| Rate for Payer: Global Benefits Group Commercial |
$8,336.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,504.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$10,420.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14,024.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14,109.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,551.50
|
| Rate for Payer: InnovAge PACE Commercial |
$12,827.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,267.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$713.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,551.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,778.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,459.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,459.01
|
| Rate for Payer: Multiplan Commercial |
$10,420.50
|
| Rate for Payer: Multiplan WC |
$11,691.12
|
| Rate for Payer: Networks By Design Commercial |
$9,031.10
|
| Rate for Payer: Preferred Health Network WC |
$11,929.71
|
| Rate for Payer: Prime Health Services Commercial |
$11,809.90
|
| Rate for Payer: Prime Health Services Medicare |
$9,064.59
|
| Rate for Payer: Prime Health Services WC |
$11,571.82
|
| Rate for Payer: Riverside University Health System MISP |
$9,406.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,336.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,406.65
|
| Rate for Payer: Vantage Medical Group Senior |
$8,551.50
|
|
|
HC BRONCH W PLCMNT FIDUCIAL MRK
|
Facility
|
IP
|
$13,894.00
|
|
|
Service Code
|
CPT 31626
|
| Hospital Charge Code |
900531626
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,778.80 |
| Max. Negotiated Rate |
$12,504.60 |
| Rate for Payer: Cash Price |
$6,252.30
|
| Rate for Payer: Central Health Plan Commercial |
$11,115.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,557.60
|
| Rate for Payer: Galaxy Health WC |
$11,809.90
|
| Rate for Payer: Global Benefits Group Commercial |
$8,336.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,504.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,267.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,293.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,778.80
|
| Rate for Payer: Multiplan Commercial |
$10,420.50
|
| Rate for Payer: Networks By Design Commercial |
$9,031.10
|
| Rate for Payer: Prime Health Services Commercial |
$11,809.90
|
|
|
HC BRONCH W/TUMOR EXCISION
|
Facility
|
OP
|
$10,697.00
|
|
|
Service Code
|
CPT 31640
|
| Hospital Charge Code |
900803516
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$400.37 |
| Max. Negotiated Rate |
$9,627.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,678.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,678.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,418.20
|
| Rate for Payer: Blue Shield of California Commercial |
$6,728.41
|
| Rate for Payer: Blue Shield of California EPN |
$5,230.83
|
| Rate for Payer: Caremore Medicare Advantage |
$4,678.93
|
| Rate for Payer: Cash Price |
$4,813.65
|
| Rate for Payer: Cash Price |
$4,813.65
|
| Rate for Payer: Central Health Plan Commercial |
$8,557.60
|
| Rate for Payer: Cigna of CA HMO |
$6,846.08
|
| Rate for Payer: Cigna of CA PPO |
$7,915.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,018.40
|
| Rate for Payer: Dignity Health Media |
$4,678.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,146.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,316.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,678.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,678.93
|
| Rate for Payer: Galaxy Health WC |
$9,092.45
|
| Rate for Payer: Global Benefits Group Commercial |
$6,418.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,627.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,022.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,673.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,720.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,678.93
|
| Rate for Payer: InnovAge PACE Commercial |
$7,018.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,134.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$400.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,678.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,139.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,269.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,269.77
|
| Rate for Payer: Multiplan Commercial |
$8,022.75
|
| Rate for Payer: Networks By Design Commercial |
$6,953.05
|
| Rate for Payer: Prime Health Services Commercial |
$9,092.45
|
| Rate for Payer: Prime Health Services Medicare |
$4,959.67
|
| Rate for Payer: Riverside University Health System MISP |
$5,146.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,418.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,418.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,348.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,348.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,348.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,348.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: Vantage Medical Group Senior |
$4,678.93
|
|
|
HC BRONCH W/TUMOR EXCISION
|
Facility
|
IP
|
$10,697.00
|
|
|
Service Code
|
CPT 31640
|
| Hospital Charge Code |
900803516
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,139.40 |
| Max. Negotiated Rate |
$9,627.30 |
| Rate for Payer: Cash Price |
$4,813.65
|
| Rate for Payer: Central Health Plan Commercial |
$8,557.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,278.80
|
| Rate for Payer: Galaxy Health WC |
$9,092.45
|
| Rate for Payer: Global Benefits Group Commercial |
$6,418.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,627.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,134.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,075.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,139.40
|
| Rate for Payer: Multiplan Commercial |
$8,022.75
|
| Rate for Payer: Networks By Design Commercial |
$6,953.05
|
| Rate for Payer: Prime Health Services Commercial |
$9,092.45
|
|
|
HC BRUKER AER ID
|
Facility
|
IP
|
$29.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900913001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.80 |
| Max. Negotiated Rate |
$26.10 |
| Rate for Payer: Cash Price |
$13.05
|
| Rate for Payer: Central Health Plan Commercial |
$23.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.60
|
| Rate for Payer: Galaxy Health WC |
$24.65
|
| Rate for Payer: Global Benefits Group Commercial |
$17.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.80
|
| Rate for Payer: Multiplan Commercial |
$21.75
|
| Rate for Payer: Networks By Design Commercial |
$18.85
|
| Rate for Payer: Prime Health Services Commercial |
$24.65
|
|
