|
HC EGD W/DILATION OF GASTRIC OUTL
|
Facility
|
OP
|
$3,708.00
|
|
|
Service Code
|
CPT 43245
|
| Hospital Charge Code |
906743245
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$416.24 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$741.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,410.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,410.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$2,039.40
|
| Rate for Payer: Cash Price |
$2,039.40
|
| Rate for Payer: Cash Price |
$2,039.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,966.40
|
| Rate for Payer: Cigna of CA HMO |
$2,373.12
|
| Rate for Payer: Cigna of CA PPO |
$2,743.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,651.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,410.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,253.93
|
| Rate for Payer: EPIC Health Plan Senior |
$2,410.32
|
| Rate for Payer: Galaxy Health WC |
$3,151.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,224.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,337.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,952.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$416.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,410.32
|
| Rate for Payer: InnovAge PACE Commercial |
$3,615.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,473.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$459.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,410.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$741.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,229.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,229.83
|
| Rate for Payer: Multiplan Commercial |
$2,781.00
|
| Rate for Payer: Networks By Design Commercial |
$2,410.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Prime Health Services Commercial |
$3,151.80
|
| Rate for Payer: Prime Health Services Medicare |
$2,554.94
|
| Rate for Payer: Riverside University Health System MISP |
$2,651.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,224.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,892.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,410.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,410.32
|
|
|
HC EGD W/DILATION OF GASTRIC OUTL
|
Facility
|
IP
|
$3,708.00
|
|
|
Service Code
|
CPT 43245
|
| Hospital Charge Code |
906743245
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$741.60 |
| Max. Negotiated Rate |
$3,337.20 |
| Rate for Payer: Adventist Health Commercial |
$741.60
|
| Rate for Payer: Cash Price |
$2,039.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,966.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,483.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,483.20
|
| Rate for Payer: Galaxy Health WC |
$3,151.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,224.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,337.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,473.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,412.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,295.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$741.60
|
| Rate for Payer: Multiplan Commercial |
$2,781.00
|
| Rate for Payer: Networks By Design Commercial |
$2,410.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,151.80
|
|
|
HC EGD W/DRCTD PLCMT PERCUT GAST
|
Facility
|
OP
|
$2,785.00
|
|
|
Service Code
|
CPT 43246
|
| Hospital Charge Code |
906743246
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$416.24 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$557.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,410.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,410.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$1,531.75
|
| Rate for Payer: Cash Price |
$1,531.75
|
| Rate for Payer: Cash Price |
$1,531.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,228.00
|
| Rate for Payer: Cigna of CA HMO |
$1,782.40
|
| Rate for Payer: Cigna of CA PPO |
$2,060.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,651.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,410.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,253.93
|
| Rate for Payer: EPIC Health Plan Senior |
$2,410.32
|
| Rate for Payer: Galaxy Health WC |
$2,367.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,671.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,506.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,952.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$416.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,410.32
|
| Rate for Payer: InnovAge PACE Commercial |
$3,615.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,857.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$459.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,410.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,229.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,229.83
|
| Rate for Payer: Multiplan Commercial |
$2,088.75
|
| Rate for Payer: Networks By Design Commercial |
$1,810.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Prime Health Services Commercial |
$2,367.25
|
| Rate for Payer: Prime Health Services Medicare |
$2,554.94
|
| Rate for Payer: Riverside University Health System MISP |
$2,651.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,671.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,892.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,410.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,410.32
|
|
|
HC EGD W/DRCTD PLCMT PERCUT GAST
|
Facility
|
IP
|
$2,785.00
|
|
|
Service Code
|
CPT 43246
|
| Hospital Charge Code |
906743246
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$557.00 |
| Max. Negotiated Rate |
$2,506.50 |
| Rate for Payer: Adventist Health Commercial |
$557.00
|
| Rate for Payer: Cash Price |
$1,531.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,228.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,114.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,114.00
|
| Rate for Payer: Galaxy Health WC |
$2,367.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,671.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,506.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,857.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,061.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,723.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.00
|
| Rate for Payer: Multiplan Commercial |
$2,088.75
|
| Rate for Payer: Networks By Design Commercial |
$1,810.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,367.25
|
|
|
HC EGD W ENDO MUCOSAL RESECTION
|
Facility
|
IP
|
$1,492.00
|
|
|
Service Code
|
CPT 43254
|
| Hospital Charge Code |
906743254
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$298.40 |
| Max. Negotiated Rate |
$1,342.80 |
| Rate for Payer: Adventist Health Commercial |
$298.40
|
| Rate for Payer: Cash Price |
$820.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,193.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$596.80
|
| Rate for Payer: EPIC Health Plan Senior |
$596.80
|
| Rate for Payer: Galaxy Health WC |
$1,268.20
|
| Rate for Payer: Global Benefits Group Commercial |
$895.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,342.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$995.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$568.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$923.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$298.40
|
| Rate for Payer: Multiplan Commercial |
$1,119.00
|
| Rate for Payer: Networks By Design Commercial |
$969.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,268.20
|
|
|
HC EGD W ENDO MUCOSAL RESECTION
|
Facility
|
OP
|
$1,492.00
|
|
|
Service Code
|
CPT 43254
|
| Hospital Charge Code |
906743254
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$298.40 |
| Max. Negotiated Rate |
$8,114.00 |
| Rate for Payer: Adventist Health Commercial |
$298.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,410.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,410.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$820.60
|
| Rate for Payer: Cash Price |
$820.60
|
| Rate for Payer: Cash Price |
$820.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,193.60
|
| Rate for Payer: Cigna of CA HMO |
$954.88
|
| Rate for Payer: Cigna of CA PPO |
$1,104.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,651.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,410.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,253.93
|
| Rate for Payer: EPIC Health Plan Senior |
$2,410.32
|
| Rate for Payer: Galaxy Health WC |
$1,268.20
|
| Rate for Payer: Global Benefits Group Commercial |
$895.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,342.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,952.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$416.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,410.32
|
| Rate for Payer: InnovAge PACE Commercial |
$3,615.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$995.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$459.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,410.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$298.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,229.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,229.83
|
| Rate for Payer: Multiplan Commercial |
$1,119.00
|
| Rate for Payer: Networks By Design Commercial |
$969.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Prime Health Services Commercial |
$1,268.20
|
| Rate for Payer: Prime Health Services Medicare |
$2,554.94
|
| Rate for Payer: Riverside University Health System MISP |
$2,651.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$895.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,892.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,410.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,410.32
|
|
|
HC EGD W/ENDO US EXAM
|
Facility
|
IP
|
$3,438.00
|
|
|
Service Code
|
CPT 43259
|
| Hospital Charge Code |
906743259
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$687.60 |
| Max. Negotiated Rate |
$3,094.20 |
| Rate for Payer: Adventist Health Commercial |
$687.60
|
| Rate for Payer: Cash Price |
$1,890.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,750.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,375.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,375.20
|
| Rate for Payer: Galaxy Health WC |
$2,922.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,062.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,094.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,293.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,309.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,128.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$687.60
|
| Rate for Payer: Multiplan Commercial |
$2,578.50
|
| Rate for Payer: Networks By Design Commercial |
$2,234.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,922.30
|
|
|
HC EGD W/ENDO US EXAM
|
Facility
|
OP
|
$3,438.00
|
|
|
Service Code
|
CPT 43259
|
| Hospital Charge Code |
906743259
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$357.31 |
| Max. Negotiated Rate |
$8,114.00 |
| Rate for Payer: Adventist Health Commercial |
$687.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,410.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,410.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,764.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,851.77
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$1,890.90
|
| Rate for Payer: Cash Price |
$1,890.90
|
| Rate for Payer: Cash Price |
$1,890.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,750.40
|
| Rate for Payer: Cigna of CA HMO |
$2,200.32
|
| Rate for Payer: Cigna of CA PPO |
$2,544.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,651.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,410.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,253.93
|
| Rate for Payer: EPIC Health Plan Senior |
$2,410.32
|
| Rate for Payer: Galaxy Health WC |
$2,922.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,062.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,094.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,952.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$357.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,410.32
|
| Rate for Payer: InnovAge PACE Commercial |
$3,615.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,293.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$394.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,410.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$687.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,229.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,229.83
|
| Rate for Payer: Multiplan Commercial |
$2,578.50
|
| Rate for Payer: Networks By Design Commercial |
$2,234.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Prime Health Services Commercial |
$2,922.30
|
| Rate for Payer: Prime Health Services Medicare |
$2,554.94
|
| Rate for Payer: Riverside University Health System MISP |
$2,651.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,062.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,892.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,410.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,410.32
|
|
|
HC EGD W ESPHGSTRC FNDOPLSTY
|
Facility
|
OP
|
$16,070.00
|
|
|
Service Code
|
CPT 43210
|
| Hospital Charge Code |
906743210
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$640.99 |
| Max. Negotiated Rate |
$21,694.74 |
| Rate for Payer: Adventist Health Commercial |
$3,214.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$13,228.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,842.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,551.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,228.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$8,838.50
|
| Rate for Payer: Cash Price |
$8,838.50
|
| Rate for Payer: Cash Price |
$8,838.50
|
| Rate for Payer: Central Health Plan Commercial |
$12,856.00
|
| Rate for Payer: Cigna of CA HMO |
$10,284.80
|
| Rate for Payer: Cigna of CA PPO |
$11,891.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,842.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,551.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,228.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,858.47
|
| Rate for Payer: EPIC Health Plan Senior |
$13,228.50
|
| Rate for Payer: Galaxy Health WC |
$13,659.50
|
| Rate for Payer: Global Benefits Group Commercial |
$9,642.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,463.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21,694.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$640.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,228.50
|
| Rate for Payer: InnovAge PACE Commercial |
$19,842.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,718.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$708.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,228.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,214.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,726.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,726.19
|
| Rate for Payer: Multiplan Commercial |
$12,052.50
|
| Rate for Payer: Networks By Design Commercial |
$10,445.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,228.50
|
| Rate for Payer: Prime Health Services Commercial |
$13,659.50
|
| Rate for Payer: Prime Health Services Medicare |
$14,022.21
|
| Rate for Payer: Riverside University Health System MISP |
$14,551.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,642.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15,874.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$13,228.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,842.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,551.35
|
| Rate for Payer: Vantage Medical Group Senior |
$13,228.50
|
|
|
HC EGD W ESPHGSTRC FNDOPLSTY
|
Facility
|
IP
|
$16,070.00
|
|
|
Service Code
|
CPT 43210
|
| Hospital Charge Code |
906743210
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$3,214.00 |
| Max. Negotiated Rate |
$14,463.00 |
| Rate for Payer: Adventist Health Commercial |
$3,214.00
|
| Rate for Payer: Cash Price |
$8,838.50
|
| Rate for Payer: Central Health Plan Commercial |
$12,856.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,428.00
|
| Rate for Payer: EPIC Health Plan Senior |
$6,428.00
|
| Rate for Payer: Galaxy Health WC |
$13,659.50
|
| Rate for Payer: Global Benefits Group Commercial |
$9,642.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,463.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,718.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,122.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,947.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,214.00
|
| Rate for Payer: Multiplan Commercial |
$12,052.50
|
| Rate for Payer: Networks By Design Commercial |
$10,445.50
|
| Rate for Payer: Prime Health Services Commercial |
$13,659.50
|
|
|
HC EGD W INJ SCLER ESO
|
Facility
|
OP
|
$3,127.00
|
|
|
Service Code
|
CPT 43243
|
| Hospital Charge Code |
906743243
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,333.00 |
| Rate for Payer: Adventist Health Commercial |
$625.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,410.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,840.40
|
| Rate for Payer: Cash Price |
$1,719.85
|
| Rate for Payer: Cash Price |
$1,719.85
|
| Rate for Payer: Cash Price |
$1,719.85
|
| Rate for Payer: Cash Price |
$1,719.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,501.60
|
| Rate for Payer: Cigna of CA HMO |
$2,001.28
|
| Rate for Payer: Cigna of CA PPO |
$2,313.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,651.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,410.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,253.93
|
| Rate for Payer: EPIC Health Plan Senior |
$2,410.32
|
| Rate for Payer: Galaxy Health WC |
$2,657.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,876.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,814.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,952.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,410.32
|
| Rate for Payer: InnovAge PACE Commercial |
$3,615.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,085.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$580.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,410.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$625.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,229.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,229.83
|
| Rate for Payer: Multiplan Commercial |
$2,345.25
|
| Rate for Payer: Multiplan WC |
$3,840.40
|
| Rate for Payer: Networks By Design Commercial |
$2,032.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Preferred Health Network WC |
$3,918.78
|
| Rate for Payer: Prime Health Services Commercial |
$2,657.95
|
| Rate for Payer: Prime Health Services Medicare |
$2,554.94
|
| Rate for Payer: Prime Health Services WC |
$3,801.22
|
| Rate for Payer: Riverside University Health System MISP |
$2,651.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,876.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,563.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,563.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,563.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,563.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,410.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,410.32
|
|
|
HC EGD W INJ SCLER ESO
|
Facility
|
IP
|
$3,127.00
|
|
|
Service Code
|
CPT 43243
|
| Hospital Charge Code |
906743243
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$625.40 |
| Max. Negotiated Rate |
$2,814.30 |
| Rate for Payer: Adventist Health Commercial |
$625.40
|
| Rate for Payer: Cash Price |
$1,719.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,501.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,250.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,250.80
|
| Rate for Payer: Galaxy Health WC |
$2,657.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,876.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,814.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,085.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,191.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,935.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$625.40
|
| Rate for Payer: Multiplan Commercial |
$2,345.25
|
| Rate for Payer: Networks By Design Commercial |
$2,032.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,657.95
|
|
|
HC EGD W INJ SCLER ESO
|
Facility
|
OP
|
$3,127.00
|
|
|
Service Code
|
CPT 43243
|
| Hospital Charge Code |
906743243
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$525.10 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$625.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,410.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,410.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$1,719.85
|
| Rate for Payer: Cash Price |
$1,719.85
|
| Rate for Payer: Cash Price |
$1,719.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,501.60
|
| Rate for Payer: Cigna of CA HMO |
$2,001.28
|
| Rate for Payer: Cigna of CA PPO |
$2,313.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,651.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,410.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,253.93
|
| Rate for Payer: EPIC Health Plan Senior |
$2,410.32
|
| Rate for Payer: Galaxy Health WC |
$2,657.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,876.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,814.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,952.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$525.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,410.32
|
| Rate for Payer: InnovAge PACE Commercial |
$3,615.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,085.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$580.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,410.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$625.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,229.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,229.83
|
| Rate for Payer: Multiplan Commercial |
$2,345.25
|
| Rate for Payer: Networks By Design Commercial |
$2,032.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Prime Health Services Commercial |
$2,657.95
|
| Rate for Payer: Prime Health Services Medicare |
$2,554.94
|
| Rate for Payer: Riverside University Health System MISP |
$2,651.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,876.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,892.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,410.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,410.32
|
|
|
HC EGD W INJ SCLER ESO
|
Facility
|
IP
|
$3,127.00
|
|
|
Service Code
|
CPT 43243
|
| Hospital Charge Code |
906743243
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$625.40 |
| Max. Negotiated Rate |
$2,814.30 |
| Rate for Payer: Adventist Health Commercial |
$625.40
|
| Rate for Payer: Cash Price |
$1,719.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,501.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,250.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,250.80
|
| Rate for Payer: Galaxy Health WC |
$2,657.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,876.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,814.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,085.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,191.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,935.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$625.40
|
| Rate for Payer: Multiplan Commercial |
$2,345.25
|
| Rate for Payer: Networks By Design Commercial |
$2,032.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,657.95
|
|
|
HC EGD W/INSRT GIDE WIRE
|
Facility
|
OP
|
$2,644.00
|
|
|
Service Code
|
CPT 43248
|
| Hospital Charge Code |
906743248
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$254.22 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$528.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,191.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$1,454.20
|
| Rate for Payer: Cash Price |
$1,454.20
|
| Rate for Payer: Cash Price |
$1,454.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,115.20
|
| Rate for Payer: Cigna of CA HMO |
$1,692.16
|
| Rate for Payer: Cigna of CA PPO |
$1,956.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,608.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,191.26
|
| Rate for Payer: Galaxy Health WC |
$2,247.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,586.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,379.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,953.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$254.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: InnovAge PACE Commercial |
$1,786.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,763.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$280.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,191.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$528.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,596.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,596.29
|
| Rate for Payer: Multiplan Commercial |
$1,983.00
|
| Rate for Payer: Networks By Design Commercial |
$1,718.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,191.26
|
| Rate for Payer: Prime Health Services Commercial |
$2,247.40
|
| Rate for Payer: Prime Health Services Medicare |
$1,262.74
|
| Rate for Payer: Riverside University Health System MISP |
$1,310.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,586.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,429.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,191.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
HC EGD W/INSRT GIDE WIRE
|
Facility
|
IP
|
$2,644.00
|
|
|
Service Code
|
CPT 43248
|
| Hospital Charge Code |
906743248
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$528.80 |
| Max. Negotiated Rate |
$2,379.60 |
| Rate for Payer: Adventist Health Commercial |
$528.80
|
| Rate for Payer: Cash Price |
$1,454.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,115.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,057.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,057.60
|
| Rate for Payer: Galaxy Health WC |
$2,247.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,586.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,379.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,763.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,007.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,636.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$528.80
|
| Rate for Payer: Multiplan Commercial |
$1,983.00
|
| Rate for Payer: Networks By Design Commercial |
$1,718.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,247.40
|
|
|
HC EGD W/INSRT STENT
|
Facility
|
IP
|
$4,268.00
|
|
|
Service Code
|
CPT 43256
|
| Hospital Charge Code |
906743256
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$853.60 |
| Max. Negotiated Rate |
$3,841.20 |
| Rate for Payer: Adventist Health Commercial |
$853.60
|
| Rate for Payer: Cash Price |
$2,347.40
|
| Rate for Payer: Central Health Plan Commercial |
$3,414.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,707.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,707.20
|
| Rate for Payer: Galaxy Health WC |
$3,627.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,560.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,841.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,846.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,626.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,641.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$853.60
|
| Rate for Payer: Multiplan Commercial |
$3,201.00
|
| Rate for Payer: Networks By Design Commercial |
$2,774.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,627.80
|
|
|
HC EGD W/INSRT STENT
|
Facility
|
OP
|
$4,268.00
|
|
|
Service Code
|
CPT 43256
|
| Hospital Charge Code |
906743256
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$853.60 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$853.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,627.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,347.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,201.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,066.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,506.60
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$2,347.40
|
| Rate for Payer: Cash Price |
$2,347.40
|
| Rate for Payer: Central Health Plan Commercial |
$3,414.40
|
| Rate for Payer: Cigna of CA HMO |
$2,731.52
|
| Rate for Payer: Cigna of CA PPO |
$3,158.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,627.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,627.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,627.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,707.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,707.20
|
| Rate for Payer: Galaxy Health WC |
$3,627.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,560.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,841.20
|
| Rate for Payer: InnovAge PACE Commercial |
$2,134.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,846.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,626.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,641.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$853.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,987.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,987.60
|
| Rate for Payer: Multiplan Commercial |
$3,201.00
|
| Rate for Payer: Networks By Design Commercial |
$2,774.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,627.80
|
| Rate for Payer: Riverside University Health System MISP |
$1,707.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,560.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,560.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,134.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,134.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,134.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,134.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,627.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,627.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,627.80
|
|
|
HC EGD W/REMOVAL FOREIGN BODY
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
CPT 43247
|
| Hospital Charge Code |
906743247
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$590.80 |
| Max. Negotiated Rate |
$2,658.60 |
| Rate for Payer: Adventist Health Commercial |
$590.80
|
| Rate for Payer: Cash Price |
$1,624.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,363.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,181.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,181.60
|
| Rate for Payer: Galaxy Health WC |
$2,510.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,772.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,658.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,970.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,125.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,828.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$590.80
|
| Rate for Payer: Multiplan Commercial |
$2,215.50
|
| Rate for Payer: Networks By Design Commercial |
$1,920.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,510.90
|
|
|
HC EGD W/REMOVAL FOREIGN BODY
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
CPT 43247
|
| Hospital Charge Code |
906743247
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$439.29 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$590.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,191.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$1,624.70
|
| Rate for Payer: Cash Price |
$1,624.70
|
| Rate for Payer: Cash Price |
$1,624.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,363.20
|
| Rate for Payer: Cigna of CA HMO |
$1,890.56
|
| Rate for Payer: Cigna of CA PPO |
$2,185.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,608.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,191.26
|
| Rate for Payer: Galaxy Health WC |
$2,510.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,772.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,658.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,953.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$439.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: InnovAge PACE Commercial |
$1,786.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,970.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$485.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,191.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$590.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,596.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,596.29
|
| Rate for Payer: Multiplan Commercial |
$2,215.50
|
| Rate for Payer: Networks By Design Commercial |
$1,920.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,191.26
|
| Rate for Payer: Prime Health Services Commercial |
$2,510.90
|
| Rate for Payer: Prime Health Services Medicare |
$1,262.74
|
| Rate for Payer: Riverside University Health System MISP |
$1,310.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,772.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,429.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,191.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
HC EGD W/REMOV TUMOR/POLYP/LESION
|
Facility
|
OP
|
$1,898.00
|
|
|
Service Code
|
CPT 43251
|
| Hospital Charge Code |
906743251
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$379.60 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$379.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,410.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,410.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$1,043.90
|
| Rate for Payer: Cash Price |
$1,043.90
|
| Rate for Payer: Cash Price |
$1,043.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,518.40
|
| Rate for Payer: Cigna of CA HMO |
$1,214.72
|
| Rate for Payer: Cigna of CA PPO |
$1,404.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,651.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,410.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,253.93
|
| Rate for Payer: EPIC Health Plan Senior |
$2,410.32
|
| Rate for Payer: Galaxy Health WC |
$1,613.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,138.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,708.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,952.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,410.32
|
| Rate for Payer: InnovAge PACE Commercial |
$3,615.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,265.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,410.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$379.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,229.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,229.83
|
| Rate for Payer: Multiplan Commercial |
$1,423.50
|
| Rate for Payer: Networks By Design Commercial |
$1,233.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Prime Health Services Commercial |
$1,613.30
|
| Rate for Payer: Prime Health Services Medicare |
$2,554.94
|
| Rate for Payer: Riverside University Health System MISP |
$2,651.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,138.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,892.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,410.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,410.32
|
|
|
HC EGD W/REMOV TUMOR/POLYP/LESION
|
Facility
|
IP
|
$1,898.00
|
|
|
Service Code
|
CPT 43251
|
| Hospital Charge Code |
906743251
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$379.60 |
| Max. Negotiated Rate |
$1,708.20 |
| Rate for Payer: Adventist Health Commercial |
$379.60
|
| Rate for Payer: Cash Price |
$1,043.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,518.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$759.20
|
| Rate for Payer: EPIC Health Plan Senior |
$759.20
|
| Rate for Payer: Galaxy Health WC |
$1,613.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,138.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,708.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,265.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$723.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,174.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$379.60
|
| Rate for Payer: Multiplan Commercial |
$1,423.50
|
| Rate for Payer: Networks By Design Commercial |
$1,233.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,613.30
|
|
|
HC EGD W/TRANSENDO TUBE/CATH PLAC
|
Facility
|
IP
|
$2,869.00
|
|
|
Service Code
|
CPT 43241
|
| Hospital Charge Code |
906743241
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$573.80 |
| Max. Negotiated Rate |
$2,582.10 |
| Rate for Payer: Adventist Health Commercial |
$573.80
|
| Rate for Payer: Cash Price |
$1,577.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,295.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,147.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,147.60
|
| Rate for Payer: Galaxy Health WC |
$2,438.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,721.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,582.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,913.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,093.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,775.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$573.80
|
| Rate for Payer: Multiplan Commercial |
$2,151.75
|
| Rate for Payer: Networks By Design Commercial |
$1,864.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,438.65
|
|
|
HC EGD W/TRANSENDO TUBE/CATH PLAC
|
Facility
|
OP
|
$2,869.00
|
|
|
Service Code
|
CPT 43241
|
| Hospital Charge Code |
906743241
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$573.80 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$573.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,410.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,410.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$1,577.95
|
| Rate for Payer: Cash Price |
$1,577.95
|
| Rate for Payer: Cash Price |
$1,577.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,295.20
|
| Rate for Payer: Cigna of CA HMO |
$1,836.16
|
| Rate for Payer: Cigna of CA PPO |
$2,123.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,651.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,410.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,253.93
|
| Rate for Payer: EPIC Health Plan Senior |
$2,410.32
|
| Rate for Payer: Galaxy Health WC |
$2,438.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,721.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,582.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,952.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,410.32
|
| Rate for Payer: InnovAge PACE Commercial |
$3,615.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,913.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,410.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$573.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,229.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,229.83
|
| Rate for Payer: Multiplan Commercial |
$2,151.75
|
| Rate for Payer: Networks By Design Commercial |
$1,864.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Prime Health Services Commercial |
$2,438.65
|
| Rate for Payer: Prime Health Services Medicare |
$2,554.94
|
| Rate for Payer: Riverside University Health System MISP |
$2,651.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,721.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,892.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,410.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,410.32
|
|
|
HC EGD W/TRNSMRL DRNG/ PSEUDOCYST
|
Facility
|
OP
|
$3,096.00
|
|
|
Service Code
|
CPT 43240
|
| Hospital Charge Code |
906743240
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$601.93 |
| Max. Negotiated Rate |
$16,122.00 |
| Rate for Payer: Adventist Health Commercial |
$619.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,563.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,345.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,320.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,563.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$1,702.80
|
| Rate for Payer: Cash Price |
$1,702.80
|
| Rate for Payer: Cash Price |
$1,702.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,476.80
|
| Rate for Payer: Cigna of CA HMO |
$1,981.44
|
| Rate for Payer: Cigna of CA PPO |
$2,291.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,345.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,320.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,563.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,210.91
|
| Rate for Payer: EPIC Health Plan Senior |
$7,563.64
|
| Rate for Payer: Galaxy Health WC |
$2,631.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,857.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,786.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,404.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$601.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,563.64
|
| Rate for Payer: InnovAge PACE Commercial |
$11,345.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,065.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$664.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,563.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$619.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,135.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,135.28
|
| Rate for Payer: Multiplan Commercial |
$2,322.00
|
| Rate for Payer: Networks By Design Commercial |
$2,012.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,563.64
|
| Rate for Payer: Prime Health Services Commercial |
$2,631.60
|
| Rate for Payer: Prime Health Services Medicare |
$8,017.46
|
| Rate for Payer: Riverside University Health System MISP |
$8,320.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,857.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,076.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,984.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,563.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,345.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,320.00
|
| Rate for Payer: Vantage Medical Group Senior |
$7,563.64
|
|
