|
HC ENDOSCOPIC STUDY SWALLOW FUNCT
|
Facility
|
IP
|
$1,177.00
|
|
|
Service Code
|
CPT 92612
|
| Hospital Charge Code |
905601751
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$235.40 |
| Max. Negotiated Rate |
$1,059.30 |
| Rate for Payer: Adventist Health Commercial |
$235.40
|
| Rate for Payer: Cash Price |
$529.65
|
| Rate for Payer: Central Health Plan Commercial |
$941.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$823.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$470.80
|
| Rate for Payer: EPIC Health Plan Senior |
$470.80
|
| Rate for Payer: Galaxy Health WC |
$1,000.45
|
| Rate for Payer: Global Benefits Group Commercial |
$706.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,059.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$747.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$694.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$235.40
|
| Rate for Payer: Multiplan Commercial |
$882.75
|
| Rate for Payer: Networks By Design Commercial |
$765.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,000.45
|
|
|
HC ENDOSCOPIC STUDY SWALLOW FUNCT MCAL
|
Facility
|
IP
|
$1,177.00
|
|
|
Service Code
|
CPT 92612
|
| Hospital Charge Code |
907000015
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$235.40 |
| Max. Negotiated Rate |
$1,059.30 |
| Rate for Payer: Adventist Health Commercial |
$235.40
|
| Rate for Payer: Cash Price |
$529.65
|
| Rate for Payer: Central Health Plan Commercial |
$941.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$823.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$470.80
|
| Rate for Payer: EPIC Health Plan Senior |
$470.80
|
| Rate for Payer: Galaxy Health WC |
$1,000.45
|
| Rate for Payer: Global Benefits Group Commercial |
$706.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,059.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$747.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$694.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$235.40
|
| Rate for Payer: Multiplan Commercial |
$882.75
|
| Rate for Payer: Networks By Design Commercial |
$765.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,000.45
|
|
|
HC ENDOSCOPIC STUDY SWALLOW FUNCT MCAL
|
Facility
|
OP
|
$1,177.00
|
|
|
Service Code
|
CPT 92612
|
| Hospital Charge Code |
907000015
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$197.66 |
| Max. Negotiated Rate |
$1,059.30 |
| Rate for Payer: Adventist Health Commercial |
$482.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$394.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,000.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$647.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$882.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$529.65
|
| Rate for Payer: Cash Price |
$529.65
|
| Rate for Payer: Cash Price |
$529.65
|
| Rate for Payer: Central Health Plan Commercial |
$941.60
|
| Rate for Payer: Cigna of CA HMO |
$753.28
|
| Rate for Payer: Cigna of CA PPO |
$870.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,000.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,000.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,000.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$823.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$470.80
|
| Rate for Payer: EPIC Health Plan Senior |
$470.80
|
| Rate for Payer: Galaxy Health WC |
$1,000.45
|
| Rate for Payer: Global Benefits Group Commercial |
$706.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,059.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$197.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$747.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$218.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$694.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$482.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$823.90
|
| Rate for Payer: Multiplan Commercial |
$882.75
|
| Rate for Payer: Networks By Design Commercial |
$765.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,000.45
|
| Rate for Payer: Riverside University Health System MISP |
$470.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$706.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$706.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,000.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,000.45
|
| Rate for Payer: Vantage Medical Group Senior |
$1,000.45
|
|
|
HC ENDOSCOPIC US EXAM
|
Facility
|
OP
|
$2,830.00
|
|
|
Service Code
|
CPT 43237
|
| Hospital Charge Code |
906743237
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$215.15 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$566.00
|
| Rate for Payer: Adventist Health Commercial |
$302.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,468.04
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,468.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,273.50
|
| Rate for Payer: Cash Price |
$1,273.50
|
| Rate for Payer: Cash Price |
$680.40
|
| Rate for Payer: Cash Price |
$1,273.50
|
| Rate for Payer: Cash Price |
$680.40
|
| Rate for Payer: Cash Price |
$680.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,209.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,264.00
|
| Rate for Payer: Cigna of CA HMO |
$967.68
|
| Rate for Payer: Cigna of CA HMO |
$1,811.20
|
| Rate for Payer: Cigna of CA PPO |
$2,094.20
|
| Rate for Payer: Cigna of CA PPO |
$1,118.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,058.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,981.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$2,405.50
|
| Rate for Payer: Galaxy Health WC |
$1,285.20
|
| Rate for Payer: Global Benefits Group Commercial |
$907.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,698.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,360.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,547.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$215.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$215.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$960.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,797.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$237.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$237.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$566.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$2,122.50
|
| Rate for Payer: Multiplan Commercial |
$1,134.00
|
| Rate for Payer: Networks By Design Commercial |
$1,839.50
|
| Rate for Payer: Networks By Design Commercial |
$982.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Prime Health Services Commercial |
$1,285.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,405.50
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$907.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,698.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,415.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$756.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ENDOSCOPIC US EXAM
|
Facility
|
IP
|
$2,830.00
|
|
|
Service Code
|
CPT 43237
|
| Hospital Charge Code |
906743237
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$566.00 |
| Max. Negotiated Rate |
$2,547.00 |
| Rate for Payer: Adventist Health Commercial |
$566.00
|
| Rate for Payer: Cash Price |
$1,273.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,264.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,981.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,132.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,132.00
|
| Rate for Payer: Galaxy Health WC |
$2,405.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,698.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,547.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,797.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,669.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$566.00
|
| Rate for Payer: Multiplan Commercial |
$2,122.50
|
| Rate for Payer: Networks By Design Commercial |
$1,839.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,405.50
|
|
|
HC ENDO SM INT CNTRL BLEEDING
|
Facility
|
IP
|
$6,991.00
|
|
|
Service Code
|
CPT 44366
|
| Hospital Charge Code |
906744366
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,398.20 |
| Max. Negotiated Rate |
$6,291.90 |
| Rate for Payer: Adventist Health Commercial |
$1,398.20
|
| Rate for Payer: Cash Price |
$3,145.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,592.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,893.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,796.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,796.40
|
| Rate for Payer: Galaxy Health WC |
$5,942.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,194.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,291.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,439.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,124.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,398.20
|
| Rate for Payer: Multiplan Commercial |
$5,243.25
|
| Rate for Payer: Networks By Design Commercial |
$4,544.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,942.35
|
|
|
HC ENDO SM INT CNTRL BLEEDING
|
Facility
|
OP
|
$6,991.00
|
|
|
Service Code
|
CPT 44366
|
| Hospital Charge Code |
906744366
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$404.06 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,398.20
|
| Rate for Payer: Adventist Health Commercial |
$617.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,468.04
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,468.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$3,145.95
|
| Rate for Payer: Cash Price |
$3,145.95
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$3,145.95
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,470.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,592.80
|
| Rate for Payer: Cigna of CA HMO |
$1,976.32
|
| Rate for Payer: Cigna of CA HMO |
$4,474.24
|
| Rate for Payer: Cigna of CA PPO |
$5,173.34
|
| Rate for Payer: Cigna of CA PPO |
$2,285.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,161.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,893.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$5,942.35
|
| Rate for Payer: Galaxy Health WC |
$2,624.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,852.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,194.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,779.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,291.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$404.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$404.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,960.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,439.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$446.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$446.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,398.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$617.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$5,243.25
|
| Rate for Payer: Multiplan Commercial |
$2,316.00
|
| Rate for Payer: Networks By Design Commercial |
$4,544.15
|
| Rate for Payer: Networks By Design Commercial |
$2,007.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Prime Health Services Commercial |
$2,624.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,942.35
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,852.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,194.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,495.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,544.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ENDO SM INTEST ENDO W/BX SNGL OR MUL
|
Facility
|
OP
|
$9,790.00
|
|
|
Service Code
|
CPT 44361
|
| Hospital Charge Code |
906744361
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$307.36 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,958.00
|
| Rate for Payer: Adventist Health Commercial |
$1,073.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,468.04
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,468.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$4,405.50
|
| Rate for Payer: Cash Price |
$4,405.50
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Cash Price |
$4,405.50
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Central Health Plan Commercial |
$4,294.40
|
| Rate for Payer: Central Health Plan Commercial |
$7,832.00
|
| Rate for Payer: Cigna of CA HMO |
$3,435.52
|
| Rate for Payer: Cigna of CA HMO |
$6,265.60
|
| Rate for Payer: Cigna of CA PPO |
$7,244.60
|
| Rate for Payer: Cigna of CA PPO |
$3,972.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,757.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,853.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$8,321.50
|
| Rate for Payer: Galaxy Health WC |
$4,562.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,220.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5,874.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,831.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,811.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$307.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$307.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,408.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,216.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$339.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$339.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,958.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,073.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$7,342.50
|
| Rate for Payer: Multiplan Commercial |
$4,026.00
|
| Rate for Payer: Networks By Design Commercial |
$6,363.50
|
| Rate for Payer: Networks By Design Commercial |
$3,489.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Prime Health Services Commercial |
$4,562.80
|
| Rate for Payer: Prime Health Services Commercial |
$8,321.50
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,220.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,874.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,895.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,684.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ENDO SM INTEST ENDO W/BX SNGL OR MUL
|
Facility
|
IP
|
$9,790.00
|
|
|
Service Code
|
CPT 44361
|
| Hospital Charge Code |
906744361
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,958.00 |
| Max. Negotiated Rate |
$8,811.00 |
| Rate for Payer: Adventist Health Commercial |
$1,958.00
|
| Rate for Payer: Cash Price |
$4,405.50
|
| Rate for Payer: Central Health Plan Commercial |
$7,832.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,853.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,916.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,916.00
|
| Rate for Payer: Galaxy Health WC |
$8,321.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,874.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,811.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,216.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,776.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,958.00
|
| Rate for Payer: Multiplan Commercial |
$7,342.50
|
| Rate for Payer: Networks By Design Commercial |
$6,363.50
|
| Rate for Payer: Prime Health Services Commercial |
$8,321.50
|
|
|
HC ENDO SM INTEST W WO CO
|
Facility
|
IP
|
$9,722.00
|
|
|
Service Code
|
CPT 44360
|
| Hospital Charge Code |
906744360
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,944.40 |
| Max. Negotiated Rate |
$8,749.80 |
| Rate for Payer: Adventist Health Commercial |
$1,944.40
|
| Rate for Payer: Cash Price |
$4,374.90
|
| Rate for Payer: Central Health Plan Commercial |
$7,777.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,805.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,888.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,888.80
|
| Rate for Payer: Galaxy Health WC |
$8,263.70
|
| Rate for Payer: Global Benefits Group Commercial |
$5,833.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,749.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,173.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,735.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,944.40
|
| Rate for Payer: Multiplan Commercial |
$7,291.50
|
| Rate for Payer: Networks By Design Commercial |
$6,319.30
|
| Rate for Payer: Prime Health Services Commercial |
$8,263.70
|
|
|
HC ENDO SM INTEST W WO CO
|
Facility
|
OP
|
$9,722.00
|
|
|
Service Code
|
CPT 44360
|
| Hospital Charge Code |
906744360
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$261.90 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,944.40
|
| Rate for Payer: Adventist Health Commercial |
$1,073.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,468.04
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,468.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$4,374.90
|
| Rate for Payer: Cash Price |
$4,374.90
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Cash Price |
$4,374.90
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Central Health Plan Commercial |
$4,294.40
|
| Rate for Payer: Central Health Plan Commercial |
$7,777.60
|
| Rate for Payer: Cigna of CA HMO |
$3,435.52
|
| Rate for Payer: Cigna of CA HMO |
$6,222.08
|
| Rate for Payer: Cigna of CA PPO |
$7,194.28
|
| Rate for Payer: Cigna of CA PPO |
$3,972.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,757.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,805.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$8,263.70
|
| Rate for Payer: Galaxy Health WC |
$4,562.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,220.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5,833.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,831.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,749.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$261.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$261.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,408.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,173.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$289.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$289.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,944.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,073.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$7,291.50
|
| Rate for Payer: Multiplan Commercial |
$4,026.00
|
| Rate for Payer: Networks By Design Commercial |
$6,319.30
|
| Rate for Payer: Networks By Design Commercial |
$3,489.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Prime Health Services Commercial |
$4,562.80
|
| Rate for Payer: Prime Health Services Commercial |
$8,263.70
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,220.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,833.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,861.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,684.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ENDO SM INT ILEUM DIAG
|
Facility
|
IP
|
$10,751.00
|
|
|
Service Code
|
CPT 44376
|
| Hospital Charge Code |
906744376
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,150.20 |
| Max. Negotiated Rate |
$9,675.90 |
| Rate for Payer: Adventist Health Commercial |
$2,150.20
|
| Rate for Payer: Cash Price |
$4,837.95
|
| Rate for Payer: Central Health Plan Commercial |
$8,600.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,525.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,300.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,300.40
|
| Rate for Payer: Galaxy Health WC |
$9,138.35
|
| Rate for Payer: Global Benefits Group Commercial |
$6,450.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,675.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,826.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,343.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,150.20
|
| Rate for Payer: Multiplan Commercial |
$8,063.25
|
| Rate for Payer: Networks By Design Commercial |
$6,988.15
|
| Rate for Payer: Prime Health Services Commercial |
$9,138.35
|
|
|
HC ENDO SM INT ILEUM DIAG
|
Facility
|
OP
|
$5,589.00
|
|
|
Service Code
|
CPT 44376
|
| Hospital Charge Code |
906744376
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$434.16 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,117.80
|
| Rate for Payer: Adventist Health Commercial |
$2,150.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,468.04
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,468.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$2,515.05
|
| Rate for Payer: Cash Price |
$2,515.05
|
| Rate for Payer: Cash Price |
$4,837.95
|
| Rate for Payer: Cash Price |
$2,515.05
|
| Rate for Payer: Cash Price |
$4,837.95
|
| Rate for Payer: Cash Price |
$4,837.95
|
| Rate for Payer: Central Health Plan Commercial |
$8,600.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,471.20
|
| Rate for Payer: Cigna of CA HMO |
$6,880.64
|
| Rate for Payer: Cigna of CA HMO |
$3,576.96
|
| Rate for Payer: Cigna of CA PPO |
$4,135.86
|
| Rate for Payer: Cigna of CA PPO |
$7,955.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,525.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,912.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$4,750.65
|
| Rate for Payer: Galaxy Health WC |
$9,138.35
|
| Rate for Payer: Global Benefits Group Commercial |
$6,450.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,353.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,675.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,030.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$434.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$434.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,826.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,549.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$479.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$479.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,117.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,150.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$4,191.75
|
| Rate for Payer: Multiplan Commercial |
$8,063.25
|
| Rate for Payer: Networks By Design Commercial |
$3,632.85
|
| Rate for Payer: Networks By Design Commercial |
$6,988.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Prime Health Services Commercial |
$9,138.35
|
| Rate for Payer: Prime Health Services Commercial |
$4,750.65
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,450.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,353.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,794.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,375.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ENDO SM INT ILEUM W BX
|
Facility
|
OP
|
$6,991.00
|
|
|
Service Code
|
CPT 44377
|
| Hospital Charge Code |
906744377
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$459.14 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,398.20
|
| Rate for Payer: Adventist Health Commercial |
$617.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,468.04
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,468.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$3,145.95
|
| Rate for Payer: Cash Price |
$3,145.95
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$3,145.95
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,470.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,592.80
|
| Rate for Payer: Cigna of CA HMO |
$1,976.32
|
| Rate for Payer: Cigna of CA HMO |
$4,474.24
|
| Rate for Payer: Cigna of CA PPO |
$5,173.34
|
| Rate for Payer: Cigna of CA PPO |
$2,285.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,161.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,893.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$5,942.35
|
| Rate for Payer: Galaxy Health WC |
$2,624.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,852.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,194.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,779.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,291.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$459.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$459.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,960.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,439.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$507.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$507.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,398.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$617.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$5,243.25
|
| Rate for Payer: Multiplan Commercial |
$2,316.00
|
| Rate for Payer: Networks By Design Commercial |
$4,544.15
|
| Rate for Payer: Networks By Design Commercial |
$2,007.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Prime Health Services Commercial |
$2,624.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,942.35
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,852.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,194.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,495.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,544.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ENDO SM INT ILEUM W BX
|
Facility
|
IP
|
$6,991.00
|
|
|
Service Code
|
CPT 44377
|
| Hospital Charge Code |
906744377
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,398.20 |
| Max. Negotiated Rate |
$6,291.90 |
| Rate for Payer: Adventist Health Commercial |
$1,398.20
|
| Rate for Payer: Cash Price |
$3,145.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,592.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,893.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,796.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,796.40
|
| Rate for Payer: Galaxy Health WC |
$5,942.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,194.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,291.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,439.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,124.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,398.20
|
| Rate for Payer: Multiplan Commercial |
$5,243.25
|
| Rate for Payer: Networks By Design Commercial |
$4,544.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,942.35
|
|
|
HC ENDO SM INT ILEUM W CNTRL BLEEDING
|
Facility
|
OP
|
$6,991.00
|
|
|
Service Code
|
CPT 44378
|
| Hospital Charge Code |
906744378
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$598.73 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,398.20
|
| Rate for Payer: Adventist Health Commercial |
$617.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,468.04
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,468.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$3,145.95
|
| Rate for Payer: Cash Price |
$3,145.95
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$3,145.95
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,470.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,592.80
|
| Rate for Payer: Cigna of CA HMO |
$1,976.32
|
| Rate for Payer: Cigna of CA HMO |
$4,474.24
|
| Rate for Payer: Cigna of CA PPO |
$5,173.34
|
| Rate for Payer: Cigna of CA PPO |
$2,285.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,161.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,893.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$5,942.35
|
| Rate for Payer: Galaxy Health WC |
$2,624.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,852.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,194.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,779.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,291.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$598.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$598.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,960.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,439.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$661.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$661.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,398.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$617.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$5,243.25
|
| Rate for Payer: Multiplan Commercial |
$2,316.00
|
| Rate for Payer: Networks By Design Commercial |
$4,544.15
|
| Rate for Payer: Networks By Design Commercial |
$2,007.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Prime Health Services Commercial |
$2,624.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,942.35
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,852.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,194.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,495.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,544.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ENDO SM INT ILEUM W CNTRL BLEEDING
|
Facility
|
IP
|
$6,991.00
|
|
|
Service Code
|
CPT 44378
|
| Hospital Charge Code |
906744378
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,398.20 |
| Max. Negotiated Rate |
$6,291.90 |
| Rate for Payer: Adventist Health Commercial |
$1,398.20
|
| Rate for Payer: Cash Price |
$3,145.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,592.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,893.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,796.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,796.40
|
| Rate for Payer: Galaxy Health WC |
$5,942.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,194.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,291.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,439.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,124.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,398.20
|
| Rate for Payer: Multiplan Commercial |
$5,243.25
|
| Rate for Payer: Networks By Design Commercial |
$4,544.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,942.35
|
|
|
HC ENDO SM INT ILEUM W STNT PLCMNT
|
Facility
|
IP
|
$15,342.00
|
|
|
Service Code
|
CPT 44379
|
| Hospital Charge Code |
906744379
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$3,068.40 |
| Max. Negotiated Rate |
$13,807.80 |
| Rate for Payer: Adventist Health Commercial |
$3,068.40
|
| Rate for Payer: Cash Price |
$6,903.90
|
| Rate for Payer: Central Health Plan Commercial |
$12,273.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,739.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,136.80
|
| Rate for Payer: EPIC Health Plan Senior |
$6,136.80
|
| Rate for Payer: Galaxy Health WC |
$13,040.70
|
| Rate for Payer: Global Benefits Group Commercial |
$9,205.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,807.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,742.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,051.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,068.40
|
| Rate for Payer: Multiplan Commercial |
$11,506.50
|
| Rate for Payer: Networks By Design Commercial |
$9,972.30
|
| Rate for Payer: Prime Health Services Commercial |
$13,040.70
|
|
|
HC ENDO SM INT ILEUM W STNT PLCMNT
|
Facility
|
OP
|
$8,470.00
|
|
|
Service Code
|
CPT 44379
|
| Hospital Charge Code |
906744379
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$553.27 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,694.00
|
| Rate for Payer: Adventist Health Commercial |
$3,068.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,808.19
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,808.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,808.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,808.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$13,231.02
|
| Rate for Payer: Blue Shield of California Commercial |
$13,231.02
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$3,811.50
|
| Rate for Payer: Cash Price |
$3,811.50
|
| Rate for Payer: Cash Price |
$6,903.90
|
| Rate for Payer: Cash Price |
$3,811.50
|
| Rate for Payer: Cash Price |
$6,903.90
|
| Rate for Payer: Cash Price |
$6,903.90
|
| Rate for Payer: Central Health Plan Commercial |
$12,273.60
|
| Rate for Payer: Central Health Plan Commercial |
$6,776.00
|
| Rate for Payer: Cigna of CA HMO |
$9,818.88
|
| Rate for Payer: Cigna of CA HMO |
$5,420.80
|
| Rate for Payer: Cigna of CA PPO |
$6,267.80
|
| Rate for Payer: Cigna of CA PPO |
$11,353.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,589.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,589.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,808.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,808.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,739.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,929.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,883.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,883.51
|
| Rate for Payer: EPIC Health Plan Senior |
$8,589.01
|
| Rate for Payer: EPIC Health Plan Senior |
$8,589.01
|
| Rate for Payer: Galaxy Health WC |
$7,199.50
|
| Rate for Payer: Galaxy Health WC |
$13,040.70
|
| Rate for Payer: Global Benefits Group Commercial |
$9,205.20
|
| Rate for Payer: Global Benefits Group Commercial |
$5,082.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,807.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,623.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,805.43
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,805.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$553.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$553.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,808.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,808.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,742.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,378.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$611.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$611.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,931.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,931.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,694.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,068.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10,462.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10,462.97
|
| Rate for Payer: Multiplan Commercial |
$6,352.50
|
| Rate for Payer: Multiplan Commercial |
$11,506.50
|
| Rate for Payer: Networks By Design Commercial |
$5,505.50
|
| Rate for Payer: Networks By Design Commercial |
$9,972.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,808.19
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,808.19
|
| Rate for Payer: Prime Health Services Commercial |
$13,040.70
|
| Rate for Payer: Prime Health Services Commercial |
$7,199.50
|
| Rate for Payer: Prime Health Services Medicare |
$8,276.68
|
| Rate for Payer: Prime Health Services Medicare |
$8,276.68
|
| Rate for Payer: Riverside University Health System MISP |
$8,589.01
|
| Rate for Payer: Riverside University Health System MISP |
$8,589.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,205.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,082.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,369.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,369.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,235.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,671.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,808.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,808.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Vantage Medical Group Senior |
$7,808.19
|
| Rate for Payer: Vantage Medical Group Senior |
$7,808.19
|
|
|
HC ENDO SM INT W/ABLATION
|
Facility
|
OP
|
$5,594.00
|
|
|
Service Code
|
CPT 44369
|
| Hospital Charge Code |
906744369
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$453.37 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,118.80
|
| Rate for Payer: Adventist Health Commercial |
$617.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,468.04
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,468.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$2,517.30
|
| Rate for Payer: Cash Price |
$2,517.30
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$2,517.30
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,470.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,475.20
|
| Rate for Payer: Cigna of CA HMO |
$1,976.32
|
| Rate for Payer: Cigna of CA HMO |
$3,580.16
|
| Rate for Payer: Cigna of CA PPO |
$4,139.56
|
| Rate for Payer: Cigna of CA PPO |
$2,285.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,161.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,915.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$4,754.90
|
| Rate for Payer: Galaxy Health WC |
$2,624.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,852.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,356.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,779.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,034.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$453.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$453.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,960.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,552.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$500.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$500.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,118.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$617.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$4,195.50
|
| Rate for Payer: Multiplan Commercial |
$2,316.00
|
| Rate for Payer: Networks By Design Commercial |
$3,636.10
|
| Rate for Payer: Networks By Design Commercial |
$2,007.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Prime Health Services Commercial |
$2,624.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,754.90
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,852.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,356.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,797.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,544.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ENDO SM INT W/ABLATION
|
Facility
|
IP
|
$5,594.00
|
|
|
Service Code
|
CPT 44369
|
| Hospital Charge Code |
906744369
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,118.80 |
| Max. Negotiated Rate |
$5,034.60 |
| Rate for Payer: Adventist Health Commercial |
$1,118.80
|
| Rate for Payer: Cash Price |
$2,517.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,475.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,915.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,237.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,237.60
|
| Rate for Payer: Galaxy Health WC |
$4,754.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,356.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,034.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,552.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,300.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,118.80
|
| Rate for Payer: Multiplan Commercial |
$4,195.50
|
| Rate for Payer: Networks By Design Commercial |
$3,636.10
|
| Rate for Payer: Prime Health Services Commercial |
$4,754.90
|
|
|
HC ENDO SM INT W/ CONVERSION
|
Facility
|
OP
|
$9,710.00
|
|
|
Service Code
|
CPT 44373
|
| Hospital Charge Code |
906744373
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$364.36 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,942.00
|
| Rate for Payer: Adventist Health Commercial |
$1,072.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,468.04
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,468.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$4,369.50
|
| Rate for Payer: Cash Price |
$4,369.50
|
| Rate for Payer: Cash Price |
$2,412.00
|
| Rate for Payer: Cash Price |
$4,369.50
|
| Rate for Payer: Cash Price |
$2,412.00
|
| Rate for Payer: Cash Price |
$2,412.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,288.00
|
| Rate for Payer: Central Health Plan Commercial |
$7,768.00
|
| Rate for Payer: Cigna of CA HMO |
$3,430.40
|
| Rate for Payer: Cigna of CA HMO |
$6,214.40
|
| Rate for Payer: Cigna of CA PPO |
$7,185.40
|
| Rate for Payer: Cigna of CA PPO |
$3,966.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,752.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,797.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$8,253.50
|
| Rate for Payer: Galaxy Health WC |
$4,556.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,216.00
|
| Rate for Payer: Global Benefits Group Commercial |
$5,826.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,824.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,739.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$364.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$364.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,403.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,165.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$402.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$402.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,942.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,072.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$7,282.50
|
| Rate for Payer: Multiplan Commercial |
$4,020.00
|
| Rate for Payer: Networks By Design Commercial |
$6,311.50
|
| Rate for Payer: Networks By Design Commercial |
$3,484.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Prime Health Services Commercial |
$4,556.00
|
| Rate for Payer: Prime Health Services Commercial |
$8,253.50
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,216.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,826.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,855.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,680.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ENDO SM INT W/ CONVERSION
|
Facility
|
IP
|
$9,710.00
|
|
|
Service Code
|
CPT 44373
|
| Hospital Charge Code |
906744373
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,942.00 |
| Max. Negotiated Rate |
$8,739.00 |
| Rate for Payer: Adventist Health Commercial |
$1,942.00
|
| Rate for Payer: Cash Price |
$4,369.50
|
| Rate for Payer: Central Health Plan Commercial |
$7,768.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,797.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,884.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,884.00
|
| Rate for Payer: Galaxy Health WC |
$8,253.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,826.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,739.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,165.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,728.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,942.00
|
| Rate for Payer: Multiplan Commercial |
$7,282.50
|
| Rate for Payer: Networks By Design Commercial |
$6,311.50
|
| Rate for Payer: Prime Health Services Commercial |
$8,253.50
|
|
|
HC ENDO SM INT W/FORCEPS
|
Facility
|
IP
|
$5,594.00
|
|
|
Service Code
|
CPT 44365
|
| Hospital Charge Code |
906744365
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,118.80 |
| Max. Negotiated Rate |
$5,034.60 |
| Rate for Payer: Adventist Health Commercial |
$1,118.80
|
| Rate for Payer: Cash Price |
$2,517.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,475.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,915.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,237.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,237.60
|
| Rate for Payer: Galaxy Health WC |
$4,754.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,356.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,034.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,552.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,300.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,118.80
|
| Rate for Payer: Multiplan Commercial |
$4,195.50
|
| Rate for Payer: Networks By Design Commercial |
$3,636.10
|
| Rate for Payer: Prime Health Services Commercial |
$4,754.90
|
|
|
HC ENDO SM INT W/FORCEPS
|
Facility
|
OP
|
$5,594.00
|
|
|
Service Code
|
CPT 44365
|
| Hospital Charge Code |
906744365
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$446.98 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,118.80
|
| Rate for Payer: Adventist Health Commercial |
$617.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,468.04
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,468.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$2,517.30
|
| Rate for Payer: Cash Price |
$2,517.30
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$2,517.30
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,470.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,475.20
|
| Rate for Payer: Cigna of CA HMO |
$1,976.32
|
| Rate for Payer: Cigna of CA HMO |
$3,580.16
|
| Rate for Payer: Cigna of CA PPO |
$4,139.56
|
| Rate for Payer: Cigna of CA PPO |
$2,285.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,161.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,915.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$4,754.90
|
| Rate for Payer: Galaxy Health WC |
$2,624.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,852.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,356.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,779.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,034.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$446.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$446.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,960.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,552.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$493.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$493.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,118.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$617.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$4,195.50
|
| Rate for Payer: Multiplan Commercial |
$2,316.00
|
| Rate for Payer: Networks By Design Commercial |
$3,636.10
|
| Rate for Payer: Networks By Design Commercial |
$2,007.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Prime Health Services Commercial |
$2,624.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,754.90
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,852.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,356.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,797.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,544.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
