|
HC ENDLMNL BX RNL PLVS AND OR URE
|
Facility
|
OP
|
$6,462.00
|
|
|
Service Code
|
CPT 50606
|
| Hospital Charge Code |
909050606
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$826.70 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$1,292.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,492.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,554.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,846.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,128.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,795.13
|
| 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 |
$3,554.10
|
| Rate for Payer: Cash Price |
$3,554.10
|
| Rate for Payer: Cash Price |
$3,554.10
|
| Rate for Payer: Central Health Plan Commercial |
$5,169.60
|
| Rate for Payer: Cigna of CA HMO |
$4,135.68
|
| Rate for Payer: Cigna of CA PPO |
$4,781.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,492.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,492.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,492.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,584.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,584.80
|
| Rate for Payer: Galaxy Health WC |
$5,492.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,877.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,815.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$826.70
|
| Rate for Payer: InnovAge PACE Commercial |
$3,231.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,310.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$913.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,292.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,523.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,523.40
|
| Rate for Payer: Multiplan Commercial |
$4,846.50
|
| Rate for Payer: Networks By Design Commercial |
$4,200.30
|
| Rate for Payer: Prime Health Services Commercial |
$5,492.70
|
| Rate for Payer: Riverside University Health System MISP |
$2,584.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,877.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,492.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,492.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5,492.70
|
|
|
HC ENDLMNL BX RNL PLVS AND OR URE
|
Facility
|
IP
|
$6,462.00
|
|
|
Service Code
|
CPT 50606
|
| Hospital Charge Code |
909050606
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,292.40 |
| Max. Negotiated Rate |
$5,815.80 |
| Rate for Payer: Adventist Health Commercial |
$1,292.40
|
| Rate for Payer: Cash Price |
$3,554.10
|
| Rate for Payer: Central Health Plan Commercial |
$5,169.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,584.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,584.80
|
| Rate for Payer: Galaxy Health WC |
$5,492.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,877.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,815.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,310.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,462.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,292.40
|
| Rate for Payer: Multiplan Commercial |
$4,846.50
|
| Rate for Payer: Networks By Design Commercial |
$4,200.30
|
| Rate for Payer: Prime Health Services Commercial |
$5,492.70
|
|
|
HC ENDOCERVICAL CURETTAGE
|
Facility
|
IP
|
$3,291.00
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
900501170
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$658.20 |
| Max. Negotiated Rate |
$2,961.90 |
| Rate for Payer: Adventist Health Commercial |
$658.20
|
| Rate for Payer: Cash Price |
$1,810.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,632.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,316.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,316.40
|
| Rate for Payer: Galaxy Health WC |
$2,797.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,974.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,961.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,195.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,253.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,037.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$658.20
|
| Rate for Payer: Multiplan Commercial |
$2,468.25
|
| Rate for Payer: Networks By Design Commercial |
$2,139.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,797.35
|
|
|
HC ENDOCERVICAL CURETTAGE
|
Facility
|
OP
|
$3,291.00
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
900501170
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$249.73 |
| Max. Negotiated Rate |
$2,961.90 |
| Rate for Payer: Adventist Health Commercial |
$658.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,106.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,659.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,217.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,106.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,593.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,932.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,010.80
|
| Rate for Payer: Blue Shield of California EPN |
$1,313.11
|
| Rate for Payer: Cash Price |
$1,810.05
|
| Rate for Payer: Cash Price |
$1,810.05
|
| Rate for Payer: Cash Price |
$1,810.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,632.80
|
| Rate for Payer: Cigna of CA HMO |
$2,106.24
|
| Rate for Payer: Cigna of CA PPO |
$2,435.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,659.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,217.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,106.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,493.59
|
| Rate for Payer: EPIC Health Plan Senior |
$1,106.36
|
| Rate for Payer: Galaxy Health WC |
$2,797.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,974.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,961.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,814.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$249.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,106.36
|
| Rate for Payer: InnovAge PACE Commercial |
$1,659.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,195.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$275.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,106.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$658.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,482.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,482.52
|
| Rate for Payer: Multiplan Commercial |
$2,468.25
|
| Rate for Payer: Networks By Design Commercial |
$2,139.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,106.36
|
| Rate for Payer: Prime Health Services Commercial |
$2,797.35
|
| Rate for Payer: Prime Health Services Medicare |
$1,172.74
|
| Rate for Payer: Riverside University Health System MISP |
$1,217.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,974.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,974.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,645.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,645.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,645.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,645.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,106.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,659.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,217.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,106.36
|
|
|
HC ENDOCERVICAL CURETTAGE
|
Facility
|
OP
|
$3,291.00
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
900501170
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$275.86 |
| Max. Negotiated Rate |
$2,961.90 |
| Rate for Payer: Adventist Health Commercial |
$658.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,659.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,217.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,106.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,762.79
|
| Rate for Payer: Cash Price |
$1,810.05
|
| Rate for Payer: Cash Price |
$1,810.05
|
| Rate for Payer: Cash Price |
$1,810.05
|
| Rate for Payer: Cash Price |
$1,810.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,632.80
|
| Rate for Payer: Cigna of CA HMO |
$2,106.24
|
| Rate for Payer: Cigna of CA PPO |
$2,435.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,659.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,217.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,106.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,493.59
|
| Rate for Payer: EPIC Health Plan Senior |
$1,106.36
|
| Rate for Payer: Galaxy Health WC |
$2,797.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,974.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,961.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,814.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,106.36
|
| Rate for Payer: InnovAge PACE Commercial |
$1,659.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,195.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$275.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,106.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$658.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,482.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,482.52
|
| Rate for Payer: Multiplan Commercial |
$2,468.25
|
| Rate for Payer: Multiplan WC |
$1,762.79
|
| Rate for Payer: Networks By Design Commercial |
$2,139.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,106.36
|
| Rate for Payer: Preferred Health Network WC |
$1,798.77
|
| Rate for Payer: Prime Health Services Commercial |
$2,797.35
|
| Rate for Payer: Prime Health Services Medicare |
$1,172.74
|
| Rate for Payer: Prime Health Services WC |
$1,744.81
|
| Rate for Payer: Riverside University Health System MISP |
$1,217.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,974.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,645.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,645.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,645.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,645.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,106.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,659.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,217.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,106.36
|
|
|
HC ENDOCERVICAL CURETTAGE
|
Facility
|
IP
|
$3,291.00
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
900501170
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$658.20 |
| Max. Negotiated Rate |
$2,961.90 |
| Rate for Payer: Adventist Health Commercial |
$658.20
|
| Rate for Payer: Cash Price |
$1,810.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,632.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,316.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,316.40
|
| Rate for Payer: Galaxy Health WC |
$2,797.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,974.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,961.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,195.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,253.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,037.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$658.20
|
| Rate for Payer: Multiplan Commercial |
$2,468.25
|
| Rate for Payer: Networks By Design Commercial |
$2,139.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,797.35
|
|
|
HC ENDO EVAL SM INTESTINE W BX
|
Facility
|
IP
|
$2,859.00
|
|
|
Service Code
|
CPT 44386
|
| Hospital Charge Code |
906744386
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$571.80 |
| Max. Negotiated Rate |
$2,573.10 |
| Rate for Payer: Adventist Health Commercial |
$571.80
|
| Rate for Payer: Cash Price |
$1,572.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,287.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,143.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,143.60
|
| Rate for Payer: Galaxy Health WC |
$2,430.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,715.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,573.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,906.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,089.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,769.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$571.80
|
| Rate for Payer: Multiplan Commercial |
$2,144.25
|
| Rate for Payer: Networks By Design Commercial |
$1,858.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,430.15
|
|
|
HC ENDO EVAL SM INTESTINE W BX
|
Facility
|
OP
|
$2,859.00
|
|
|
Service Code
|
CPT 44386
|
| Hospital Charge Code |
906744386
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$209.39 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$571.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,158.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| 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 |
$1,572.45
|
| Rate for Payer: Cash Price |
$1,572.45
|
| Rate for Payer: Cash Price |
$1,572.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,287.20
|
| Rate for Payer: Cigna of CA HMO |
$1,829.76
|
| Rate for Payer: Cigna of CA PPO |
$2,115.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,563.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1,158.42
|
| Rate for Payer: Galaxy Health WC |
$2,430.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,715.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,573.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,899.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$209.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: InnovAge PACE Commercial |
$1,737.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,906.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$231.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,158.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$571.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,552.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,552.28
|
| Rate for Payer: Multiplan Commercial |
$2,144.25
|
| Rate for Payer: Networks By Design Commercial |
$1,858.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Prime Health Services Commercial |
$2,430.15
|
| Rate for Payer: Prime Health Services Medicare |
$1,227.93
|
| Rate for Payer: Riverside University Health System MISP |
$1,274.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,715.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,390.10
|
| 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 |
$1,158.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC ENDO EVAL SM INTESTINE W WO COLLECT
|
Facility
|
IP
|
$2,859.00
|
|
|
Service Code
|
CPT 44385
|
| Hospital Charge Code |
906744385
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$571.80 |
| Max. Negotiated Rate |
$2,573.10 |
| Rate for Payer: Adventist Health Commercial |
$571.80
|
| Rate for Payer: Cash Price |
$1,572.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,287.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,143.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,143.60
|
| Rate for Payer: Galaxy Health WC |
$2,430.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,715.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,573.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,906.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,089.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,769.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$571.80
|
| Rate for Payer: Multiplan Commercial |
$2,144.25
|
| Rate for Payer: Networks By Design Commercial |
$1,858.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,430.15
|
|
|
HC ENDO EVAL SM INTESTINE W WO COLLECT
|
Facility
|
OP
|
$2,859.00
|
|
|
Service Code
|
CPT 44385
|
| Hospital Charge Code |
906744385
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$206.83 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$571.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,158.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| 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 |
$1,572.45
|
| Rate for Payer: Cash Price |
$1,572.45
|
| Rate for Payer: Cash Price |
$1,572.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,287.20
|
| Rate for Payer: Cigna of CA HMO |
$1,829.76
|
| Rate for Payer: Cigna of CA PPO |
$2,115.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,563.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1,158.42
|
| Rate for Payer: Galaxy Health WC |
$2,430.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,715.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,573.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,899.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$206.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: InnovAge PACE Commercial |
$1,737.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,906.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$228.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,158.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$571.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,552.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,552.28
|
| Rate for Payer: Multiplan Commercial |
$2,144.25
|
| Rate for Payer: Networks By Design Commercial |
$1,858.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Prime Health Services Commercial |
$2,430.15
|
| Rate for Payer: Prime Health Services Medicare |
$1,227.93
|
| Rate for Payer: Riverside University Health System MISP |
$1,274.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,715.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,390.10
|
| 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 |
$1,158.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC ENDOLUMINAL BRUSHING
|
Facility
|
IP
|
$1,102.00
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
909081376
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$220.40 |
| Max. Negotiated Rate |
$991.80 |
| Rate for Payer: Adventist Health Commercial |
$220.40
|
| Rate for Payer: Cash Price |
$606.10
|
| Rate for Payer: Central Health Plan Commercial |
$881.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$440.80
|
| Rate for Payer: EPIC Health Plan Senior |
$440.80
|
| Rate for Payer: Galaxy Health WC |
$936.70
|
| Rate for Payer: Global Benefits Group Commercial |
$661.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$991.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$735.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$419.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$682.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$220.40
|
| Rate for Payer: Multiplan Commercial |
$826.50
|
| Rate for Payer: Networks By Design Commercial |
$716.30
|
| Rate for Payer: Prime Health Services Commercial |
$936.70
|
|
|
HC ENDOLUMINAL BRUSHING
|
Facility
|
OP
|
$1,102.00
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
909081376
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$145.36 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$220.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$936.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$606.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$826.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$533.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$647.20
|
| 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 |
$606.10
|
| Rate for Payer: Cash Price |
$606.10
|
| Rate for Payer: Cash Price |
$606.10
|
| Rate for Payer: Central Health Plan Commercial |
$881.60
|
| Rate for Payer: Cigna of CA HMO |
$705.28
|
| Rate for Payer: Cigna of CA PPO |
$815.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$936.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$936.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$936.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$440.80
|
| Rate for Payer: EPIC Health Plan Senior |
$440.80
|
| Rate for Payer: Galaxy Health WC |
$936.70
|
| Rate for Payer: Global Benefits Group Commercial |
$661.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$991.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$145.36
|
| Rate for Payer: InnovAge PACE Commercial |
$551.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$735.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$682.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$220.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$771.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$771.40
|
| Rate for Payer: Multiplan Commercial |
$826.50
|
| Rate for Payer: Networks By Design Commercial |
$716.30
|
| Rate for Payer: Prime Health Services Commercial |
$936.70
|
| Rate for Payer: Riverside University Health System MISP |
$440.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$661.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$936.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$936.70
|
| Rate for Payer: Vantage Medical Group Senior |
$936.70
|
|
|
HC ENDOLUMINAL BRUSHING
|
Facility
|
OP
|
$1,102.00
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
909081376
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$160.57 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$220.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$936.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$606.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$826.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Cash Price |
$606.10
|
| Rate for Payer: Cash Price |
$606.10
|
| Rate for Payer: Cash Price |
$606.10
|
| Rate for Payer: Cash Price |
$606.10
|
| Rate for Payer: Central Health Plan Commercial |
$881.60
|
| Rate for Payer: Cigna of CA HMO |
$705.28
|
| Rate for Payer: Cigna of CA PPO |
$815.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$936.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$936.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$936.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$440.80
|
| Rate for Payer: EPIC Health Plan Senior |
$440.80
|
| Rate for Payer: Galaxy Health WC |
$936.70
|
| Rate for Payer: Global Benefits Group Commercial |
$661.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$991.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: InnovAge PACE Commercial |
$551.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$735.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$682.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$220.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$771.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$771.40
|
| Rate for Payer: Multiplan Commercial |
$826.50
|
| Rate for Payer: Networks By Design Commercial |
$716.30
|
| Rate for Payer: Prime Health Services Commercial |
$936.70
|
| Rate for Payer: Riverside University Health System MISP |
$440.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$661.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$551.00
|
| Rate for Payer: United Healthcare All Other HMO |
$551.00
|
| Rate for Payer: United Healthcare HMO Rider |
$551.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$551.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$936.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$936.70
|
| Rate for Payer: Vantage Medical Group Senior |
$936.70
|
|
|
HC ENDOLUMINAL BRUSHING
|
Facility
|
IP
|
$1,102.00
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
909081376
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$220.40 |
| Max. Negotiated Rate |
$991.80 |
| Rate for Payer: Adventist Health Commercial |
$220.40
|
| Rate for Payer: Cash Price |
$606.10
|
| Rate for Payer: Central Health Plan Commercial |
$881.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$440.80
|
| Rate for Payer: EPIC Health Plan Senior |
$440.80
|
| Rate for Payer: Galaxy Health WC |
$936.70
|
| Rate for Payer: Global Benefits Group Commercial |
$661.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$991.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$735.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$419.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$682.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$220.40
|
| Rate for Payer: Multiplan Commercial |
$826.50
|
| Rate for Payer: Networks By Design Commercial |
$716.30
|
| Rate for Payer: Prime Health Services Commercial |
$936.70
|
|
|
HC ENDOLUMINAL BX BILIARY TREE
|
Facility
|
OP
|
$1,487.00
|
|
|
Service Code
|
CPT 47543
|
| Hospital Charge Code |
909047543
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$297.40 |
| Max. Negotiated Rate |
$7,764.00 |
| Rate for Payer: Adventist Health Commercial |
$297.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,263.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$817.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,115.25
|
| 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 |
$817.85
|
| Rate for Payer: Cash Price |
$817.85
|
| Rate for Payer: Cash Price |
$817.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,189.60
|
| Rate for Payer: Cigna of CA HMO |
$951.68
|
| Rate for Payer: Cigna of CA PPO |
$1,100.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,263.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,263.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,263.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$594.80
|
| Rate for Payer: EPIC Health Plan Senior |
$594.80
|
| Rate for Payer: Galaxy Health WC |
$1,263.95
|
| Rate for Payer: Global Benefits Group Commercial |
$892.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,338.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,104.85
|
| Rate for Payer: InnovAge PACE Commercial |
$743.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$991.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,325.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$920.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$297.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,040.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,040.90
|
| Rate for Payer: Multiplan Commercial |
$1,115.25
|
| Rate for Payer: Networks By Design Commercial |
$966.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,263.95
|
| Rate for Payer: Riverside University Health System MISP |
$594.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$892.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,263.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,263.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,263.95
|
|
|
HC ENDOLUMINAL BX BILIARY TREE
|
Facility
|
IP
|
$1,487.00
|
|
|
Service Code
|
CPT 47543
|
| Hospital Charge Code |
909047543
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$297.40 |
| Max. Negotiated Rate |
$1,338.30 |
| Rate for Payer: Adventist Health Commercial |
$297.40
|
| Rate for Payer: Cash Price |
$817.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,189.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$594.80
|
| Rate for Payer: EPIC Health Plan Senior |
$594.80
|
| Rate for Payer: Galaxy Health WC |
$1,263.95
|
| Rate for Payer: Global Benefits Group Commercial |
$892.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,338.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$991.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$566.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$920.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$297.40
|
| Rate for Payer: Multiplan Commercial |
$1,115.25
|
| Rate for Payer: Networks By Design Commercial |
$966.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,263.95
|
|
|
HC ENDOMETRIAL BIOPSY
|
Facility
|
IP
|
$905.00
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
900501615
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$181.00 |
| Max. Negotiated Rate |
$814.50 |
| Rate for Payer: Adventist Health Commercial |
$181.00
|
| Rate for Payer: Cash Price |
$497.75
|
| Rate for Payer: Central Health Plan Commercial |
$724.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$362.00
|
| Rate for Payer: EPIC Health Plan Senior |
$362.00
|
| Rate for Payer: Galaxy Health WC |
$769.25
|
| Rate for Payer: Global Benefits Group Commercial |
$543.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$814.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$603.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$344.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$560.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$181.00
|
| Rate for Payer: Multiplan Commercial |
$678.75
|
| Rate for Payer: Networks By Design Commercial |
$588.25
|
| Rate for Payer: Prime Health Services Commercial |
$769.25
|
|
|
HC ENDOMETRIAL BIOPSY
|
Facility
|
IP
|
$905.00
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
900501615
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$181.00 |
| Max. Negotiated Rate |
$814.50 |
| Rate for Payer: Adventist Health Commercial |
$181.00
|
| Rate for Payer: Cash Price |
$497.75
|
| Rate for Payer: Central Health Plan Commercial |
$724.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$362.00
|
| Rate for Payer: EPIC Health Plan Senior |
$362.00
|
| Rate for Payer: Galaxy Health WC |
$769.25
|
| Rate for Payer: Global Benefits Group Commercial |
$543.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$814.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$603.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$344.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$560.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$181.00
|
| Rate for Payer: Multiplan Commercial |
$678.75
|
| Rate for Payer: Networks By Design Commercial |
$588.25
|
| Rate for Payer: Prime Health Services Commercial |
$769.25
|
|
|
HC ENDOMETRIAL BIOPSY
|
Facility
|
OP
|
$905.00
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
900501615
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$77.98 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$181.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$383.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$281.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$255.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$407.27
|
| Rate for Payer: Cash Price |
$497.75
|
| Rate for Payer: Cash Price |
$497.75
|
| Rate for Payer: Cash Price |
$497.75
|
| Rate for Payer: Cash Price |
$497.75
|
| Rate for Payer: Central Health Plan Commercial |
$724.00
|
| Rate for Payer: Cigna of CA HMO |
$579.20
|
| Rate for Payer: Cigna of CA PPO |
$669.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$383.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$281.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$255.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$345.07
|
| Rate for Payer: EPIC Health Plan Senior |
$255.61
|
| Rate for Payer: Galaxy Health WC |
$769.25
|
| Rate for Payer: Global Benefits Group Commercial |
$543.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$814.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$419.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$255.61
|
| Rate for Payer: InnovAge PACE Commercial |
$383.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$603.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$255.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$181.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$342.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$342.52
|
| Rate for Payer: Multiplan Commercial |
$678.75
|
| Rate for Payer: Multiplan WC |
$407.27
|
| Rate for Payer: Networks By Design Commercial |
$588.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$255.61
|
| Rate for Payer: Preferred Health Network WC |
$415.58
|
| Rate for Payer: Prime Health Services Commercial |
$769.25
|
| Rate for Payer: Prime Health Services Medicare |
$270.95
|
| Rate for Payer: Prime Health Services WC |
$403.11
|
| Rate for Payer: Riverside University Health System MISP |
$281.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$543.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$452.50
|
| Rate for Payer: United Healthcare All Other HMO |
$452.50
|
| Rate for Payer: United Healthcare HMO Rider |
$452.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$452.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$255.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$383.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$281.17
|
| Rate for Payer: Vantage Medical Group Senior |
$255.61
|
|
|
HC ENDOMETRIAL BIOPSY
|
Facility
|
OP
|
$905.00
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
900501615
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$70.59 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$181.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$255.61
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$383.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$281.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$255.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$438.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$531.51
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$407.27
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$497.75
|
| Rate for Payer: Cash Price |
$497.75
|
| Rate for Payer: Cash Price |
$497.75
|
| Rate for Payer: Central Health Plan Commercial |
$724.00
|
| Rate for Payer: Cigna of CA HMO |
$579.20
|
| Rate for Payer: Cigna of CA PPO |
$669.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$383.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$281.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$255.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$345.07
|
| Rate for Payer: EPIC Health Plan Senior |
$255.61
|
| Rate for Payer: Galaxy Health WC |
$769.25
|
| Rate for Payer: Global Benefits Group Commercial |
$543.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$814.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$419.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$70.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$255.61
|
| Rate for Payer: InnovAge PACE Commercial |
$383.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$603.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$255.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$181.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$342.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$342.52
|
| Rate for Payer: Multiplan Commercial |
$678.75
|
| Rate for Payer: Multiplan WC |
$407.27
|
| Rate for Payer: Networks By Design Commercial |
$588.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$255.61
|
| Rate for Payer: Preferred Health Network WC |
$415.58
|
| Rate for Payer: Prime Health Services Commercial |
$769.25
|
| Rate for Payer: Prime Health Services Medicare |
$270.95
|
| Rate for Payer: Prime Health Services WC |
$403.11
|
| Rate for Payer: Riverside University Health System MISP |
$281.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$543.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$255.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$383.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$281.17
|
| Rate for Payer: Vantage Medical Group Senior |
$255.61
|
|
|
HC ENDOMETRIAL BX CONJUNCT W COLPOSCOPY
|
Facility
|
OP
|
$325.00
|
|
|
Service Code
|
CPT 58110
|
| Hospital Charge Code |
904000019
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$65.00 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$65.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$276.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$178.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$243.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$157.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.87
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$178.75
|
| Rate for Payer: Cash Price |
$178.75
|
| Rate for Payer: Cash Price |
$178.75
|
| Rate for Payer: Central Health Plan Commercial |
$260.00
|
| Rate for Payer: Cigna of CA HMO |
$208.00
|
| Rate for Payer: Cigna of CA PPO |
$240.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$276.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$276.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$276.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.00
|
| Rate for Payer: EPIC Health Plan Senior |
$130.00
|
| Rate for Payer: Galaxy Health WC |
$276.25
|
| Rate for Payer: Global Benefits Group Commercial |
$195.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$292.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$76.66
|
| Rate for Payer: InnovAge PACE Commercial |
$162.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$216.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$84.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$201.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$227.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$227.50
|
| Rate for Payer: Multiplan Commercial |
$243.75
|
| Rate for Payer: Networks By Design Commercial |
$211.25
|
| Rate for Payer: Prime Health Services Commercial |
$276.25
|
| Rate for Payer: Riverside University Health System MISP |
$130.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$195.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$276.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$276.25
|
| Rate for Payer: Vantage Medical Group Senior |
$276.25
|
|
|
HC ENDOMETRIAL BX CONJUNCT W COLPOSCOPY
|
Facility
|
IP
|
$325.00
|
|
|
Service Code
|
CPT 58110
|
| Hospital Charge Code |
904000019
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$65.00 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Adventist Health Commercial |
$65.00
|
| Rate for Payer: Cash Price |
$178.75
|
| Rate for Payer: Central Health Plan Commercial |
$260.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.00
|
| Rate for Payer: EPIC Health Plan Senior |
$130.00
|
| Rate for Payer: Galaxy Health WC |
$276.25
|
| Rate for Payer: Global Benefits Group Commercial |
$195.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$292.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$216.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$123.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$201.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.00
|
| Rate for Payer: Multiplan Commercial |
$243.75
|
| Rate for Payer: Networks By Design Commercial |
$211.25
|
| Rate for Payer: Prime Health Services Commercial |
$276.25
|
|
|
HC ENDOMYCARDIAL BIOPSY
|
Facility
|
IP
|
$4,737.00
|
|
|
Service Code
|
CPT 93505
|
| Hospital Charge Code |
906811308
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$947.40 |
| Max. Negotiated Rate |
$4,263.30 |
| Rate for Payer: Adventist Health Commercial |
$947.40
|
| Rate for Payer: Cash Price |
$2,605.35
|
| Rate for Payer: Central Health Plan Commercial |
$3,789.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,894.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,894.80
|
| Rate for Payer: Galaxy Health WC |
$4,026.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,842.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,263.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,159.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,804.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,932.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$947.40
|
| Rate for Payer: Multiplan Commercial |
$3,552.75
|
| Rate for Payer: Networks By Design Commercial |
$3,079.05
|
| Rate for Payer: Prime Health Services Commercial |
$4,026.45
|
|
|
HC ENDOMYCARDIAL BIOPSY
|
Facility
|
OP
|
$4,737.00
|
|
|
Service Code
|
CPT 93505
|
| Hospital Charge Code |
906811308
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$408.95 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$947.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| 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 |
$2,605.35
|
| Rate for Payer: Cash Price |
$2,605.35
|
| Rate for Payer: Cash Price |
$2,605.35
|
| Rate for Payer: Central Health Plan Commercial |
$3,789.60
|
| Rate for Payer: Cigna of CA HMO |
$3,079.05
|
| Rate for Payer: Cigna of CA PPO |
$3,505.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$4,026.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,842.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,263.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$408.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: InnovAge PACE Commercial |
$5,998.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,159.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$451.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$947.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$3,552.75
|
| Rate for Payer: Networks By Design Commercial |
$3,079.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Prime Health Services Commercial |
$4,026.45
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,842.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,000.00
|
| 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 |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC ENDOMYCARDIAL BIOPSY
|
Facility
|
OP
|
$5,573.00
|
|
|
Service Code
|
CPT 93505
|
| Hospital Charge Code |
906820039
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$408.95 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$1,114.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| 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 |
$3,065.15
|
| Rate for Payer: Cash Price |
$3,065.15
|
| Rate for Payer: Cash Price |
$3,065.15
|
| Rate for Payer: Central Health Plan Commercial |
$4,458.40
|
| Rate for Payer: Cigna of CA HMO |
$3,622.45
|
| Rate for Payer: Cigna of CA PPO |
$4,124.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$4,737.05
|
| Rate for Payer: Global Benefits Group Commercial |
$3,343.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,015.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$408.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: InnovAge PACE Commercial |
$5,998.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,717.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$451.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,114.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$4,179.75
|
| Rate for Payer: Networks By Design Commercial |
$3,622.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Prime Health Services Commercial |
$4,737.05
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,343.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,000.00
|
| 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 |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
