|
HC ESOPH DIAG FLEX TRANS W ENDO MUC
|
Facility
|
OP
|
$2,232.00
|
|
|
Service Code
|
CPT 43211
|
| Hospital Charge Code |
906743211
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$363.07 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$446.40
|
| Rate for Payer: Adventist Health Commercial |
$298.40
|
| 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| 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 |
$1,004.40
|
| Rate for Payer: Cash Price |
$1,004.40
|
| Rate for Payer: Cash Price |
$671.40
|
| Rate for Payer: Cash Price |
$1,004.40
|
| Rate for Payer: Cash Price |
$671.40
|
| Rate for Payer: Cash Price |
$671.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,193.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,785.60
|
| Rate for Payer: Cigna of CA HMO |
$954.88
|
| Rate for Payer: Cigna of CA HMO |
$1,428.48
|
| Rate for Payer: Cigna of CA PPO |
$1,651.68
|
| Rate for Payer: Cigna of CA PPO |
$1,104.08
|
| 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 |
$1,044.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,562.40
|
| 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 |
$1,897.20
|
| Rate for Payer: Galaxy Health WC |
$1,268.20
|
| Rate for Payer: Global Benefits Group Commercial |
$895.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,339.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,342.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,008.80
|
| 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 |
$363.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$363.07
|
| 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 |
$947.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,417.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$401.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$401.07
|
| 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 |
$446.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$298.40
|
| 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 |
$1,674.00
|
| Rate for Payer: Multiplan Commercial |
$1,119.00
|
| Rate for Payer: Networks By Design Commercial |
$1,450.80
|
| Rate for Payer: Networks By Design Commercial |
$969.80
|
| 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 |
$1,268.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,897.20
|
| 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 |
$895.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,339.20
|
| 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 |
$1,116.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$746.00
|
| 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 ESOPH DIAG RIGID TRANSORAL
|
Facility
|
IP
|
$2,791.00
|
|
|
Service Code
|
CPT 43191
|
| Hospital Charge Code |
906743191
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$558.20 |
| Max. Negotiated Rate |
$2,511.90 |
| Rate for Payer: Adventist Health Commercial |
$558.20
|
| Rate for Payer: Cash Price |
$1,255.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,232.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,953.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,116.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,116.40
|
| Rate for Payer: Galaxy Health WC |
$2,372.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,674.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,511.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,772.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,646.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$558.20
|
| Rate for Payer: Multiplan Commercial |
$2,093.25
|
| Rate for Payer: Networks By Design Commercial |
$1,814.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,372.35
|
|
|
HC ESOPH DIAG RIGID TRANSORAL
|
Facility
|
OP
|
$2,791.00
|
|
|
Service Code
|
CPT 43191
|
| Hospital Charge Code |
906743191
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$190.18 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$558.20
|
| Rate for Payer: Adventist Health Commercial |
$298.40
|
| 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| 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 |
$1,255.95
|
| Rate for Payer: Cash Price |
$1,255.95
|
| Rate for Payer: Cash Price |
$671.40
|
| Rate for Payer: Cash Price |
$1,255.95
|
| Rate for Payer: Cash Price |
$671.40
|
| Rate for Payer: Cash Price |
$671.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,193.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,232.80
|
| Rate for Payer: Cigna of CA HMO |
$954.88
|
| Rate for Payer: Cigna of CA HMO |
$1,786.24
|
| Rate for Payer: Cigna of CA PPO |
$2,065.34
|
| Rate for Payer: Cigna of CA PPO |
$1,104.08
|
| 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 |
$1,044.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,953.70
|
| 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 |
$2,372.35
|
| Rate for Payer: Galaxy Health WC |
$1,268.20
|
| Rate for Payer: Global Benefits Group Commercial |
$895.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,674.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,342.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,511.90
|
| 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 |
$190.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$190.18
|
| 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 |
$947.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,772.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.08
|
| 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 |
$558.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$298.40
|
| 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 |
$2,093.25
|
| Rate for Payer: Multiplan Commercial |
$1,119.00
|
| Rate for Payer: Networks By Design Commercial |
$1,814.15
|
| Rate for Payer: Networks By Design Commercial |
$969.80
|
| 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 |
$1,268.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,372.35
|
| 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 |
$895.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,674.60
|
| 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 |
$1,395.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$746.00
|
| 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 ESOPH DIAG RIGID W BLLN DILATION
|
Facility
|
OP
|
$4,217.00
|
|
|
Service Code
|
CPT 43195
|
| Hospital Charge Code |
906743195
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$269.59 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$843.40
|
| Rate for Payer: Adventist Health Commercial |
$450.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,958.78
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,958.78
|
| 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 |
$7,438.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,958.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,958.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| 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 |
$1,897.65
|
| Rate for Payer: Cash Price |
$1,897.65
|
| Rate for Payer: Cash Price |
$1,013.85
|
| Rate for Payer: Cash Price |
$1,897.65
|
| Rate for Payer: Cash Price |
$1,013.85
|
| Rate for Payer: Cash Price |
$1,013.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,802.40
|
| Rate for Payer: Central Health Plan Commercial |
$3,373.60
|
| Rate for Payer: Cigna of CA HMO |
$1,441.92
|
| Rate for Payer: Cigna of CA HMO |
$2,698.88
|
| Rate for Payer: Cigna of CA PPO |
$3,120.58
|
| Rate for Payer: Cigna of CA PPO |
$1,667.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,454.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,454.66
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,958.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,958.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,577.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,951.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,181.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,181.99
|
| Rate for Payer: EPIC Health Plan Senior |
$5,454.66
|
| Rate for Payer: EPIC Health Plan Senior |
$5,454.66
|
| Rate for Payer: Galaxy Health WC |
$3,584.45
|
| Rate for Payer: Galaxy Health WC |
$1,915.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,351.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,530.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,027.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,795.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,132.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,132.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$269.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$269.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,958.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,958.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,430.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,677.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$297.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$297.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,942.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,942.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$843.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$450.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,644.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,644.77
|
| Rate for Payer: Multiplan Commercial |
$3,162.75
|
| Rate for Payer: Multiplan Commercial |
$1,689.75
|
| Rate for Payer: Networks By Design Commercial |
$2,741.05
|
| Rate for Payer: Networks By Design Commercial |
$1,464.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,958.78
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,958.78
|
| Rate for Payer: Prime Health Services Commercial |
$1,915.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,584.45
|
| Rate for Payer: Prime Health Services Medicare |
$5,256.31
|
| Rate for Payer: Prime Health Services Medicare |
$5,256.31
|
| Rate for Payer: Riverside University Health System MISP |
$5,454.66
|
| Rate for Payer: Riverside University Health System MISP |
$5,454.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,351.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,530.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,950.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,950.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,108.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,126.50
|
| 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 |
$4,958.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,958.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,438.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,454.66
|
| Rate for Payer: Vantage Medical Group Senior |
$4,958.78
|
| Rate for Payer: Vantage Medical Group Senior |
$4,958.78
|
|
|
HC ESOPH DIAG RIGID W BLLN DILATION
|
Facility
|
IP
|
$4,217.00
|
|
|
Service Code
|
CPT 43195
|
| Hospital Charge Code |
906743195
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$843.40 |
| Max. Negotiated Rate |
$3,795.30 |
| Rate for Payer: Adventist Health Commercial |
$843.40
|
| Rate for Payer: Cash Price |
$1,897.65
|
| Rate for Payer: Central Health Plan Commercial |
$3,373.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,951.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,686.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,686.80
|
| Rate for Payer: Galaxy Health WC |
$3,584.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,530.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,795.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,677.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,488.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$843.40
|
| Rate for Payer: Multiplan Commercial |
$3,162.75
|
| Rate for Payer: Networks By Design Commercial |
$2,741.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,584.45
|
|
|
HC ESOPH DIAG RIG TRANSO BIOPSY
|
Facility
|
IP
|
$3,373.00
|
|
|
Service Code
|
CPT 43193
|
| Hospital Charge Code |
906743193
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$674.60 |
| Max. Negotiated Rate |
$3,035.70 |
| Rate for Payer: Adventist Health Commercial |
$674.60
|
| Rate for Payer: Cash Price |
$1,517.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,698.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,361.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,349.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,349.20
|
| Rate for Payer: Galaxy Health WC |
$2,867.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,023.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,035.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,141.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,990.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$674.60
|
| Rate for Payer: Multiplan Commercial |
$2,529.75
|
| Rate for Payer: Networks By Design Commercial |
$2,192.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,867.05
|
|
|
HC ESOPH DIAG RIG TRANSO BIOPSY
|
Facility
|
OP
|
$3,373.00
|
|
|
Service Code
|
CPT 43193
|
| Hospital Charge Code |
906743193
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$268.96 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$674.60
|
| Rate for Payer: Adventist Health Commercial |
$450.60
|
| 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| 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 |
$1,517.85
|
| Rate for Payer: Cash Price |
$1,517.85
|
| Rate for Payer: Cash Price |
$1,013.85
|
| Rate for Payer: Cash Price |
$1,517.85
|
| Rate for Payer: Cash Price |
$1,013.85
|
| Rate for Payer: Cash Price |
$1,013.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,802.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,698.40
|
| Rate for Payer: Cigna of CA HMO |
$1,441.92
|
| Rate for Payer: Cigna of CA HMO |
$2,158.72
|
| Rate for Payer: Cigna of CA PPO |
$2,496.02
|
| Rate for Payer: Cigna of CA PPO |
$1,667.22
|
| 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 |
$1,577.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,361.10
|
| 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 |
$2,867.05
|
| Rate for Payer: Galaxy Health WC |
$1,915.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,351.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,023.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,027.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,035.70
|
| 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 |
$268.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$268.96
|
| 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 |
$1,430.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,141.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$297.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$297.10
|
| 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 |
$674.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$450.60
|
| 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 |
$2,529.75
|
| Rate for Payer: Multiplan Commercial |
$1,689.75
|
| Rate for Payer: Networks By Design Commercial |
$2,192.45
|
| Rate for Payer: Networks By Design Commercial |
$1,464.45
|
| 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 |
$1,915.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,867.05
|
| 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 |
$1,351.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,023.80
|
| 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 |
$1,686.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,126.50
|
| 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 ESOPH DIAG RIG TRANSO INJECT
|
Facility
|
IP
|
$4,217.00
|
|
|
Service Code
|
CPT 43192
|
| Hospital Charge Code |
906743192
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$843.40 |
| Max. Negotiated Rate |
$3,795.30 |
| Rate for Payer: Adventist Health Commercial |
$843.40
|
| Rate for Payer: Cash Price |
$1,897.65
|
| Rate for Payer: Central Health Plan Commercial |
$3,373.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,951.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,686.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,686.80
|
| Rate for Payer: Galaxy Health WC |
$3,584.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,530.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,795.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,677.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,488.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$843.40
|
| Rate for Payer: Multiplan Commercial |
$3,162.75
|
| Rate for Payer: Networks By Design Commercial |
$2,741.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,584.45
|
|
|
HC ESOPH DIAG RIG TRANSO INJECT
|
Facility
|
OP
|
$4,217.00
|
|
|
Service Code
|
CPT 43192
|
| Hospital Charge Code |
906743192
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$226.04 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$843.40
|
| Rate for Payer: Adventist Health Commercial |
$450.60
|
| 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| 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 |
$1,897.65
|
| Rate for Payer: Cash Price |
$1,897.65
|
| Rate for Payer: Cash Price |
$1,013.85
|
| Rate for Payer: Cash Price |
$1,897.65
|
| Rate for Payer: Cash Price |
$1,013.85
|
| Rate for Payer: Cash Price |
$1,013.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,802.40
|
| Rate for Payer: Central Health Plan Commercial |
$3,373.60
|
| Rate for Payer: Cigna of CA HMO |
$1,441.92
|
| Rate for Payer: Cigna of CA HMO |
$2,698.88
|
| Rate for Payer: Cigna of CA PPO |
$3,120.58
|
| Rate for Payer: Cigna of CA PPO |
$1,667.22
|
| 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 |
$1,577.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,951.90
|
| 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 |
$3,584.45
|
| Rate for Payer: Galaxy Health WC |
$1,915.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,351.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,530.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,027.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,795.30
|
| 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 |
$226.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$226.04
|
| 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 |
$1,430.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,677.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$249.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$249.70
|
| 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 |
$843.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$450.60
|
| 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 |
$3,162.75
|
| Rate for Payer: Multiplan Commercial |
$1,689.75
|
| Rate for Payer: Networks By Design Commercial |
$2,741.05
|
| Rate for Payer: Networks By Design Commercial |
$1,464.45
|
| 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 |
$1,915.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,584.45
|
| 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 |
$1,351.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,530.20
|
| 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 |
$2,108.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,126.50
|
| 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 ESOPH DIAG RIG TRANSO RMVL FB
|
Facility
|
OP
|
$4,217.00
|
|
|
Service Code
|
CPT 43194
|
| Hospital Charge Code |
906743194
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$241.42 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$843.40
|
| Rate for Payer: Adventist Health Commercial |
$450.60
|
| 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| 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 |
$1,897.65
|
| Rate for Payer: Cash Price |
$1,897.65
|
| Rate for Payer: Cash Price |
$1,013.85
|
| Rate for Payer: Cash Price |
$1,897.65
|
| Rate for Payer: Cash Price |
$1,013.85
|
| Rate for Payer: Cash Price |
$1,013.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,802.40
|
| Rate for Payer: Central Health Plan Commercial |
$3,373.60
|
| Rate for Payer: Cigna of CA HMO |
$1,441.92
|
| Rate for Payer: Cigna of CA HMO |
$2,698.88
|
| Rate for Payer: Cigna of CA PPO |
$3,120.58
|
| Rate for Payer: Cigna of CA PPO |
$1,667.22
|
| 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 |
$1,577.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,951.90
|
| 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 |
$3,584.45
|
| Rate for Payer: Galaxy Health WC |
$1,915.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,351.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,530.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,027.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,795.30
|
| 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 |
$241.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$241.42
|
| 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 |
$1,430.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,677.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$266.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$266.68
|
| 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 |
$843.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$450.60
|
| 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 |
$3,162.75
|
| Rate for Payer: Multiplan Commercial |
$1,689.75
|
| Rate for Payer: Networks By Design Commercial |
$2,741.05
|
| Rate for Payer: Networks By Design Commercial |
$1,464.45
|
| 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 |
$1,915.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,584.45
|
| 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 |
$1,351.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,530.20
|
| 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 |
$2,108.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,126.50
|
| 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 ESOPH DIAG RIG TRANSO RMVL FB
|
Facility
|
IP
|
$4,217.00
|
|
|
Service Code
|
CPT 43194
|
| Hospital Charge Code |
906743194
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$843.40 |
| Max. Negotiated Rate |
$3,795.30 |
| Rate for Payer: Adventist Health Commercial |
$843.40
|
| Rate for Payer: Cash Price |
$1,897.65
|
| Rate for Payer: Central Health Plan Commercial |
$3,373.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,951.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,686.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,686.80
|
| Rate for Payer: Galaxy Health WC |
$3,584.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,530.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,795.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,677.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,488.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$843.40
|
| Rate for Payer: Multiplan Commercial |
$3,162.75
|
| Rate for Payer: Networks By Design Commercial |
$2,741.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,584.45
|
|
|
HC ESOPH DIAG RIG W INSRT GW DILA
|
Facility
|
IP
|
$3,373.00
|
|
|
Service Code
|
CPT 43196
|
| Hospital Charge Code |
906743196
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$674.60 |
| Max. Negotiated Rate |
$3,035.70 |
| Rate for Payer: Adventist Health Commercial |
$674.60
|
| Rate for Payer: Cash Price |
$1,517.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,698.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,361.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,349.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,349.20
|
| Rate for Payer: Galaxy Health WC |
$2,867.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,023.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,035.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,141.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,990.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$674.60
|
| Rate for Payer: Multiplan Commercial |
$2,529.75
|
| Rate for Payer: Networks By Design Commercial |
$2,192.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,867.05
|
|
|
HC ESOPH DIAG RIG W INSRT GW DILA
|
Facility
|
OP
|
$3,373.00
|
|
|
Service Code
|
CPT 43196
|
| Hospital Charge Code |
906743196
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$293.93 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$674.60
|
| Rate for Payer: Adventist Health Commercial |
$450.60
|
| 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| 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 |
$1,517.85
|
| Rate for Payer: Cash Price |
$1,517.85
|
| Rate for Payer: Cash Price |
$1,013.85
|
| Rate for Payer: Cash Price |
$1,517.85
|
| Rate for Payer: Cash Price |
$1,013.85
|
| Rate for Payer: Cash Price |
$1,013.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,802.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,698.40
|
| Rate for Payer: Cigna of CA HMO |
$1,441.92
|
| Rate for Payer: Cigna of CA HMO |
$2,158.72
|
| Rate for Payer: Cigna of CA PPO |
$2,496.02
|
| Rate for Payer: Cigna of CA PPO |
$1,667.22
|
| 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 |
$1,577.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,361.10
|
| 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 |
$2,867.05
|
| Rate for Payer: Galaxy Health WC |
$1,915.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,351.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,023.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,027.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,035.70
|
| 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 |
$293.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$293.93
|
| 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 |
$1,430.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,141.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$324.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$324.69
|
| 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 |
$674.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$450.60
|
| 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 |
$2,529.75
|
| Rate for Payer: Multiplan Commercial |
$1,689.75
|
| Rate for Payer: Networks By Design Commercial |
$2,192.45
|
| Rate for Payer: Networks By Design Commercial |
$1,464.45
|
| 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 |
$1,915.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,867.05
|
| 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 |
$1,351.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,023.80
|
| 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 |
$1,686.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,126.50
|
| 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 ESOPH DIAG W/BAND LIGATION
|
Facility
|
IP
|
$5,336.00
|
|
|
Service Code
|
CPT 43205
|
| Hospital Charge Code |
900501692
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,067.20 |
| Max. Negotiated Rate |
$4,802.40 |
| Rate for Payer: Adventist Health Commercial |
$1,067.20
|
| Rate for Payer: Cash Price |
$2,401.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,268.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,735.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,134.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,134.40
|
| Rate for Payer: Galaxy Health WC |
$4,535.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,201.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,802.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,388.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,148.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,067.20
|
| Rate for Payer: Multiplan Commercial |
$4,002.00
|
| Rate for Payer: Networks By Design Commercial |
$3,468.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,535.60
|
|
|
HC ESOPH DIAG W/BAND LIGATION
|
Facility
|
OP
|
$5,336.00
|
|
|
Service Code
|
CPT 43205
|
| Hospital Charge Code |
900501692
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$336.70 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$1,067.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| 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: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,840.40
|
| Rate for Payer: Cash Price |
$2,401.20
|
| Rate for Payer: Cash Price |
$2,401.20
|
| Rate for Payer: Cash Price |
$2,401.20
|
| Rate for Payer: Cash Price |
$2,401.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,268.80
|
| Rate for Payer: Cigna of CA HMO |
$3,415.04
|
| Rate for Payer: Cigna of CA PPO |
$3,948.64
|
| 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 Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,735.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$4,535.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,201.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,802.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,388.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$336.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,653.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,067.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$4,002.00
|
| Rate for Payer: Multiplan WC |
$3,840.40
|
| Rate for Payer: Networks By Design Commercial |
$3,468.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Preferred Health Network WC |
$3,918.78
|
| Rate for Payer: Prime Health Services Commercial |
$4,535.60
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Prime Health Services WC |
$3,801.22
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,201.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,668.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,668.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,668.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,668.00
|
| 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 Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ESOPH DIAG W/BAND LIGATION
|
Facility
|
OP
|
$5,336.00
|
|
|
Service Code
|
CPT 43205
|
| Hospital Charge Code |
906743205
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$304.80 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,067.20
|
| Rate for Payer: Adventist Health Commercial |
$713.20
|
| 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 |
$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 |
$2,401.20
|
| Rate for Payer: Cash Price |
$2,401.20
|
| Rate for Payer: Cash Price |
$1,604.70
|
| Rate for Payer: Cash Price |
$2,401.20
|
| Rate for Payer: Cash Price |
$1,604.70
|
| Rate for Payer: Cash Price |
$1,604.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,852.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,268.80
|
| Rate for Payer: Cigna of CA HMO |
$2,282.24
|
| Rate for Payer: Cigna of CA HMO |
$3,415.04
|
| Rate for Payer: Cigna of CA PPO |
$3,948.64
|
| Rate for Payer: Cigna of CA PPO |
$2,638.84
|
| 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 |
$2,496.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,735.20
|
| 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 |
$4,535.60
|
| Rate for Payer: Galaxy Health WC |
$3,031.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,139.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,201.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,209.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,802.40
|
| 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 |
$304.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$304.80
|
| 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 |
$2,264.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,388.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$336.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$336.70
|
| 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 |
$1,067.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$713.20
|
| 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 |
$4,002.00
|
| Rate for Payer: Multiplan Commercial |
$2,674.50
|
| Rate for Payer: Networks By Design Commercial |
$3,468.40
|
| Rate for Payer: Networks By Design Commercial |
$2,317.90
|
| 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 |
$3,031.10
|
| Rate for Payer: Prime Health Services Commercial |
$4,535.60
|
| 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 |
$2,139.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,201.60
|
| 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 |
$2,668.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,783.00
|
| 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 ESOPH DIAG W/BAND LIGATION
|
Facility
|
IP
|
$5,336.00
|
|
|
Service Code
|
CPT 43205
|
| Hospital Charge Code |
906743205
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,067.20 |
| Max. Negotiated Rate |
$4,802.40 |
| Rate for Payer: Adventist Health Commercial |
$1,067.20
|
| Rate for Payer: Cash Price |
$2,401.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,268.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,735.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,134.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,134.40
|
| Rate for Payer: Galaxy Health WC |
$4,535.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,201.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,802.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,388.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,148.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,067.20
|
| Rate for Payer: Multiplan Commercial |
$4,002.00
|
| Rate for Payer: Networks By Design Commercial |
$3,468.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,535.60
|
|
|
HC ESOPH DIAG W/BLLN DILATION
|
Facility
|
IP
|
$4,574.00
|
|
|
Service Code
|
CPT 43220
|
| Hospital Charge Code |
906743220
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$914.80 |
| Max. Negotiated Rate |
$4,116.60 |
| Rate for Payer: Adventist Health Commercial |
$914.80
|
| Rate for Payer: Cash Price |
$2,058.30
|
| Rate for Payer: Central Health Plan Commercial |
$3,659.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,201.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,829.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,829.60
|
| Rate for Payer: Galaxy Health WC |
$3,887.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,744.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,116.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,904.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,698.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$914.80
|
| Rate for Payer: Multiplan Commercial |
$3,430.50
|
| Rate for Payer: Networks By Design Commercial |
$2,973.10
|
| Rate for Payer: Prime Health Services Commercial |
$3,887.90
|
|
|
HC ESOPH DIAG W/BLLN DILATION
|
Facility
|
OP
|
$4,574.00
|
|
|
Service Code
|
CPT 43220
|
| Hospital Charge Code |
906743220
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$307.36 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$914.80
|
| Rate for Payer: Adventist Health Commercial |
$611.40
|
| 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| 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 |
$2,058.30
|
| Rate for Payer: Cash Price |
$2,058.30
|
| Rate for Payer: Cash Price |
$1,375.65
|
| Rate for Payer: Cash Price |
$2,058.30
|
| Rate for Payer: Cash Price |
$1,375.65
|
| Rate for Payer: Cash Price |
$1,375.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,445.60
|
| Rate for Payer: Central Health Plan Commercial |
$3,659.20
|
| Rate for Payer: Cigna of CA HMO |
$1,956.48
|
| Rate for Payer: Cigna of CA HMO |
$2,927.36
|
| Rate for Payer: Cigna of CA PPO |
$3,384.76
|
| Rate for Payer: Cigna of CA PPO |
$2,262.18
|
| 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 |
$2,139.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,201.80
|
| 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 |
$3,887.90
|
| Rate for Payer: Galaxy Health WC |
$2,598.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,834.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,744.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,751.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,116.60
|
| 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 |
$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 |
$1,941.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,904.49
|
| 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 |
$914.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$611.40
|
| 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 |
$3,430.50
|
| Rate for Payer: Multiplan Commercial |
$2,292.75
|
| Rate for Payer: Networks By Design Commercial |
$2,973.10
|
| Rate for Payer: Networks By Design Commercial |
$1,987.05
|
| 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 |
$2,598.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,887.90
|
| 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 |
$1,834.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,744.40
|
| 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 |
$2,287.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,528.50
|
| 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 ESOPH DIAG W/BX SNGL OR MULTI
|
Facility
|
IP
|
$4,733.00
|
|
|
Service Code
|
CPT 43202
|
| Hospital Charge Code |
906743202
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$946.60 |
| Max. Negotiated Rate |
$4,259.70 |
| Rate for Payer: Adventist Health Commercial |
$946.60
|
| Rate for Payer: Cash Price |
$2,129.85
|
| Rate for Payer: Central Health Plan Commercial |
$3,786.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,313.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,893.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,893.20
|
| Rate for Payer: Galaxy Health WC |
$4,023.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,839.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,259.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,005.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,792.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$946.60
|
| Rate for Payer: Multiplan Commercial |
$3,549.75
|
| Rate for Payer: Networks By Design Commercial |
$3,076.45
|
| Rate for Payer: Prime Health Services Commercial |
$4,023.05
|
|
|
HC ESOPH DIAG W/BX SNGL OR MULTI
|
Facility
|
OP
|
$4,733.00
|
|
|
Service Code
|
CPT 43202
|
| Hospital Charge Code |
906743202
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$311.85 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$946.60
|
| Rate for Payer: Adventist Health Commercial |
$632.60
|
| 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| 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 |
$2,129.85
|
| Rate for Payer: Cash Price |
$2,129.85
|
| Rate for Payer: Cash Price |
$1,423.35
|
| Rate for Payer: Cash Price |
$2,129.85
|
| Rate for Payer: Cash Price |
$1,423.35
|
| Rate for Payer: Cash Price |
$1,423.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,530.40
|
| Rate for Payer: Central Health Plan Commercial |
$3,786.40
|
| Rate for Payer: Cigna of CA HMO |
$2,024.32
|
| Rate for Payer: Cigna of CA HMO |
$3,029.12
|
| Rate for Payer: Cigna of CA PPO |
$3,502.42
|
| Rate for Payer: Cigna of CA PPO |
$2,340.62
|
| 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 |
$2,214.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,313.10
|
| 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 |
$4,023.05
|
| Rate for Payer: Galaxy Health WC |
$2,688.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,897.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,839.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,846.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,259.70
|
| 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 |
$311.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$311.85
|
| 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 |
$2,008.51
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,005.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$344.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$344.49
|
| 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 |
$946.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$632.60
|
| 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 |
$3,549.75
|
| Rate for Payer: Multiplan Commercial |
$2,372.25
|
| Rate for Payer: Networks By Design Commercial |
$3,076.45
|
| Rate for Payer: Networks By Design Commercial |
$2,055.95
|
| 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 |
$2,688.55
|
| Rate for Payer: Prime Health Services Commercial |
$4,023.05
|
| 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 |
$1,897.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,839.80
|
| 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 |
$2,366.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,581.50
|
| 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 ESOPH DIAG W/ENDO US
|
Facility
|
IP
|
$6,729.00
|
|
|
Service Code
|
CPT 43232
|
| Hospital Charge Code |
906743232
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,345.80 |
| Max. Negotiated Rate |
$6,056.10 |
| Rate for Payer: Adventist Health Commercial |
$1,345.80
|
| Rate for Payer: Cash Price |
$3,028.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,383.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,710.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,691.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,691.60
|
| Rate for Payer: Galaxy Health WC |
$5,719.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,037.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,056.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,272.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,970.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,345.80
|
| Rate for Payer: Multiplan Commercial |
$5,046.75
|
| Rate for Payer: Networks By Design Commercial |
$4,373.85
|
| Rate for Payer: Prime Health Services Commercial |
$5,719.65
|
|
|
HC ESOPH DIAG W/ENDO US
|
Facility
|
OP
|
$6,729.00
|
|
|
Service Code
|
CPT 43232
|
| Hospital Charge Code |
906743232
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$397.66 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,345.80
|
| Rate for Payer: Adventist Health Commercial |
$899.60
|
| 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| 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 |
$3,028.05
|
| Rate for Payer: Cash Price |
$3,028.05
|
| Rate for Payer: Cash Price |
$2,024.10
|
| Rate for Payer: Cash Price |
$3,028.05
|
| Rate for Payer: Cash Price |
$2,024.10
|
| Rate for Payer: Cash Price |
$2,024.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,598.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,383.20
|
| Rate for Payer: Cigna of CA HMO |
$2,878.72
|
| Rate for Payer: Cigna of CA HMO |
$4,306.56
|
| Rate for Payer: Cigna of CA PPO |
$4,979.46
|
| Rate for Payer: Cigna of CA PPO |
$3,328.52
|
| 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 |
$3,148.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,710.30
|
| 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 |
$5,719.65
|
| Rate for Payer: Galaxy Health WC |
$3,823.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,698.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,037.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,048.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,056.10
|
| 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 |
$397.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$397.66
|
| 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 |
$2,856.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,272.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$439.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$439.28
|
| 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 |
$1,345.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$899.60
|
| 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 |
$5,046.75
|
| Rate for Payer: Multiplan Commercial |
$3,373.50
|
| Rate for Payer: Networks By Design Commercial |
$4,373.85
|
| Rate for Payer: Networks By Design Commercial |
$2,923.70
|
| 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 |
$3,823.30
|
| Rate for Payer: Prime Health Services Commercial |
$5,719.65
|
| 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 |
$2,698.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,037.40
|
| 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 |
$3,364.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,249.00
|
| 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 ESOPH DIAG W/ENDO US EXAM
|
Facility
|
OP
|
$7,778.00
|
|
|
Service Code
|
CPT 43231
|
| Hospital Charge Code |
906743231
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$341.95 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,555.60
|
| Rate for Payer: Adventist Health Commercial |
$897.80
|
| 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| 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 |
$3,500.10
|
| Rate for Payer: Cash Price |
$3,500.10
|
| Rate for Payer: Cash Price |
$2,020.05
|
| Rate for Payer: Cash Price |
$3,500.10
|
| Rate for Payer: Cash Price |
$2,020.05
|
| Rate for Payer: Cash Price |
$2,020.05
|
| Rate for Payer: Central Health Plan Commercial |
$3,591.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,222.40
|
| Rate for Payer: Cigna of CA HMO |
$2,872.96
|
| Rate for Payer: Cigna of CA HMO |
$4,977.92
|
| Rate for Payer: Cigna of CA PPO |
$5,755.72
|
| Rate for Payer: Cigna of CA PPO |
$3,321.86
|
| 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 |
$3,142.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,444.60
|
| 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 |
$6,611.30
|
| Rate for Payer: Galaxy Health WC |
$3,815.65
|
| Rate for Payer: Global Benefits Group Commercial |
$2,693.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,666.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,040.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,000.20
|
| 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 |
$341.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$341.95
|
| 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 |
$2,850.51
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,939.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$377.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$377.74
|
| 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 |
$1,555.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$897.80
|
| 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 |
$5,833.50
|
| Rate for Payer: Multiplan Commercial |
$3,366.75
|
| Rate for Payer: Networks By Design Commercial |
$5,055.70
|
| Rate for Payer: Networks By Design Commercial |
$2,917.85
|
| 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 |
$3,815.65
|
| Rate for Payer: Prime Health Services Commercial |
$6,611.30
|
| 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 |
$2,693.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,666.80
|
| 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 |
$3,889.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,244.50
|
| 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 ESOPH DIAG W/ENDO US EXAM
|
Facility
|
IP
|
$7,778.00
|
|
|
Service Code
|
CPT 43231
|
| Hospital Charge Code |
906743231
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,555.60 |
| Max. Negotiated Rate |
$7,000.20 |
| Rate for Payer: Adventist Health Commercial |
$1,555.60
|
| Rate for Payer: Cash Price |
$3,500.10
|
| Rate for Payer: Central Health Plan Commercial |
$6,222.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,444.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,111.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,111.20
|
| Rate for Payer: Galaxy Health WC |
$6,611.30
|
| Rate for Payer: Global Benefits Group Commercial |
$4,666.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,000.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,939.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,589.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,555.60
|
| Rate for Payer: Multiplan Commercial |
$5,833.50
|
| Rate for Payer: Networks By Design Commercial |
$5,055.70
|
| Rate for Payer: Prime Health Services Commercial |
$6,611.30
|
|
