|
HC ENDOMYCARDIAL BIOPSY
|
Facility
|
IP
|
$5,573.00
|
|
|
Service Code
|
CPT 93505
|
| Hospital Charge Code |
906820039
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,114.60 |
| Max. Negotiated Rate |
$5,015.70 |
| Rate for Payer: Adventist Health Commercial |
$1,114.60
|
| Rate for Payer: Cash Price |
$3,065.15
|
| Rate for Payer: Central Health Plan Commercial |
$4,458.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,229.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,229.20
|
| 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: Kaiser Permanente of CA Commercial/Self Funded |
$3,717.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,123.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,449.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,114.60
|
| Rate for Payer: Multiplan Commercial |
$4,179.75
|
| Rate for Payer: Networks By Design Commercial |
$3,622.45
|
| Rate for Payer: Prime Health Services Commercial |
$4,737.05
|
|
|
HC ENDO POLY HIP, PNEU/HYD/ROT
|
Facility
|
OP
|
$13,267.75
|
|
|
Service Code
|
CPT L5961
|
| Hospital Charge Code |
915355961
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$4,345.19 |
| Max. Negotiated Rate |
$11,940.98 |
| Rate for Payer: Adventist Health Commercial |
$5,439.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,277.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,297.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,950.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,792.15
|
| Rate for Payer: Blue Shield of California Commercial |
$10,255.97
|
| Rate for Payer: Blue Shield of California EPN |
$6,686.95
|
| Rate for Payer: Cash Price |
$7,297.26
|
| Rate for Payer: Central Health Plan Commercial |
$10,614.20
|
| Rate for Payer: Cigna of CA HMO |
$9,287.42
|
| Rate for Payer: Cigna of CA PPO |
$9,287.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,277.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,277.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11,277.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,307.10
|
| Rate for Payer: EPIC Health Plan Senior |
$5,307.10
|
| Rate for Payer: Galaxy Health WC |
$11,277.59
|
| Rate for Payer: Global Benefits Group Commercial |
$7,960.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,940.98
|
| Rate for Payer: InnovAge PACE Commercial |
$6,633.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,849.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,212.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,439.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,287.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,287.42
|
| Rate for Payer: Multiplan Commercial |
$9,950.81
|
| Rate for Payer: Networks By Design Commercial |
$6,633.88
|
| Rate for Payer: Prime Health Services Commercial |
$11,277.59
|
| Rate for Payer: Riverside University Health System MISP |
$5,307.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,960.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,960.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,979.39
|
| Rate for Payer: United Healthcare All Other HMO |
$4,846.71
|
| Rate for Payer: United Healthcare HMO Rider |
$4,741.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,345.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,277.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,277.59
|
| Rate for Payer: Vantage Medical Group Senior |
$11,277.59
|
|
|
HC ENDO POLY HIP, PNEU/HYD/ROT
|
Facility
|
OP
|
$13,267.75
|
|
|
Service Code
|
CPT L5961
|
| Hospital Charge Code |
905355961
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$4,345.19 |
| Max. Negotiated Rate |
$11,940.98 |
| Rate for Payer: Adventist Health Commercial |
$5,439.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,277.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,297.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,950.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,792.15
|
| Rate for Payer: Blue Shield of California Commercial |
$10,255.97
|
| Rate for Payer: Blue Shield of California EPN |
$6,686.95
|
| Rate for Payer: Cash Price |
$7,297.26
|
| Rate for Payer: Central Health Plan Commercial |
$10,614.20
|
| Rate for Payer: Cigna of CA HMO |
$9,287.42
|
| Rate for Payer: Cigna of CA PPO |
$9,287.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,277.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,277.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11,277.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,307.10
|
| Rate for Payer: EPIC Health Plan Senior |
$5,307.10
|
| Rate for Payer: Galaxy Health WC |
$11,277.59
|
| Rate for Payer: Global Benefits Group Commercial |
$7,960.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,940.98
|
| Rate for Payer: InnovAge PACE Commercial |
$6,633.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,849.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,212.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,439.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,287.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,287.42
|
| Rate for Payer: Multiplan Commercial |
$9,950.81
|
| Rate for Payer: Networks By Design Commercial |
$6,633.88
|
| Rate for Payer: Prime Health Services Commercial |
$11,277.59
|
| Rate for Payer: Riverside University Health System MISP |
$5,307.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,960.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,960.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,979.39
|
| Rate for Payer: United Healthcare All Other HMO |
$4,846.71
|
| Rate for Payer: United Healthcare HMO Rider |
$4,741.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,345.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,277.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,277.59
|
| Rate for Payer: Vantage Medical Group Senior |
$11,277.59
|
|
|
HC ENDO POLY HIP, PNEU/HYD/ROT
|
Facility
|
IP
|
$13,267.75
|
|
|
Service Code
|
CPT L5961
|
| Hospital Charge Code |
905355961
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$2,653.55 |
| Max. Negotiated Rate |
$11,940.98 |
| Rate for Payer: Adventist Health Commercial |
$2,653.55
|
| Rate for Payer: Blue Shield of California Commercial |
$10,255.97
|
| Rate for Payer: Blue Shield of California EPN |
$6,686.95
|
| Rate for Payer: Cash Price |
$7,297.26
|
| Rate for Payer: Central Health Plan Commercial |
$10,614.20
|
| Rate for Payer: Cigna of CA HMO |
$9,287.42
|
| Rate for Payer: Cigna of CA PPO |
$9,287.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,307.10
|
| Rate for Payer: EPIC Health Plan Senior |
$5,307.10
|
| Rate for Payer: Galaxy Health WC |
$11,277.59
|
| Rate for Payer: Global Benefits Group Commercial |
$7,960.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,940.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,849.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,055.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,212.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,653.55
|
| Rate for Payer: Multiplan Commercial |
$9,950.81
|
| Rate for Payer: Networks By Design Commercial |
$8,624.04
|
| Rate for Payer: Prime Health Services Commercial |
$11,277.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,979.39
|
| Rate for Payer: United Healthcare All Other HMO |
$4,846.71
|
| Rate for Payer: United Healthcare HMO Rider |
$4,741.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,345.19
|
|
|
HC ENDO POLY HIP, PNEU/HYD/ROT
|
Facility
|
IP
|
$13,267.75
|
|
|
Service Code
|
CPT L5961
|
| Hospital Charge Code |
915355961
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$2,653.55 |
| Max. Negotiated Rate |
$11,940.98 |
| Rate for Payer: Adventist Health Commercial |
$2,653.55
|
| Rate for Payer: Blue Shield of California Commercial |
$10,255.97
|
| Rate for Payer: Blue Shield of California EPN |
$6,686.95
|
| Rate for Payer: Cash Price |
$7,297.26
|
| Rate for Payer: Central Health Plan Commercial |
$10,614.20
|
| Rate for Payer: Cigna of CA HMO |
$9,287.42
|
| Rate for Payer: Cigna of CA PPO |
$9,287.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,307.10
|
| Rate for Payer: EPIC Health Plan Senior |
$5,307.10
|
| Rate for Payer: Galaxy Health WC |
$11,277.59
|
| Rate for Payer: Global Benefits Group Commercial |
$7,960.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,940.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,849.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,055.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,212.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,653.55
|
| Rate for Payer: Multiplan Commercial |
$9,950.81
|
| Rate for Payer: Networks By Design Commercial |
$8,624.04
|
| Rate for Payer: Prime Health Services Commercial |
$11,277.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,979.39
|
| Rate for Payer: United Healthcare All Other HMO |
$4,846.71
|
| Rate for Payer: United Healthcare HMO Rider |
$4,741.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,345.19
|
|
|
HC ENDO RESTORE2 W CLLCTN ADPTR 7.0-8.5MM
|
Facility
|
IP
|
$230.00
|
|
| Hospital Charge Code |
900800921
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.00 |
| Max. Negotiated Rate |
$207.00 |
| Rate for Payer: Adventist Health Commercial |
$46.00
|
| Rate for Payer: Cash Price |
$126.50
|
| Rate for Payer: Central Health Plan Commercial |
$184.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$92.00
|
| Rate for Payer: EPIC Health Plan Senior |
$92.00
|
| Rate for Payer: Galaxy Health WC |
$195.50
|
| Rate for Payer: Global Benefits Group Commercial |
$138.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$207.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$153.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$87.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$142.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.00
|
| Rate for Payer: Multiplan Commercial |
$172.50
|
| Rate for Payer: Networks By Design Commercial |
$149.50
|
| Rate for Payer: Prime Health Services Commercial |
$195.50
|
|
|
HC ENDO RESTORE2 W CLLCTN ADPTR 7.0-8.5MM
|
Facility
|
OP
|
$230.00
|
|
| Hospital Charge Code |
900800921
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.00 |
| Max. Negotiated Rate |
$207.00 |
| Rate for Payer: Adventist Health Commercial |
$46.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$139.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$195.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$126.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$172.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$111.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$135.08
|
| Rate for Payer: Blue Shield of California Commercial |
$140.53
|
| Rate for Payer: Blue Shield of California EPN |
$91.77
|
| Rate for Payer: Cash Price |
$126.50
|
| Rate for Payer: Central Health Plan Commercial |
$184.00
|
| Rate for Payer: Cigna of CA HMO |
$147.20
|
| Rate for Payer: Cigna of CA PPO |
$170.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$195.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$195.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$195.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$92.00
|
| Rate for Payer: EPIC Health Plan Senior |
$92.00
|
| Rate for Payer: Galaxy Health WC |
$195.50
|
| Rate for Payer: Global Benefits Group Commercial |
$138.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$207.00
|
| Rate for Payer: InnovAge PACE Commercial |
$115.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$153.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$87.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$142.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$161.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$161.00
|
| Rate for Payer: Multiplan Commercial |
$172.50
|
| Rate for Payer: Networks By Design Commercial |
$149.50
|
| Rate for Payer: Prime Health Services Commercial |
$195.50
|
| Rate for Payer: Riverside University Health System MISP |
$92.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$138.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$138.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$115.00
|
| Rate for Payer: United Healthcare All Other HMO |
$115.00
|
| Rate for Payer: United Healthcare HMO Rider |
$115.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$115.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$195.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$195.50
|
| Rate for Payer: Vantage Medical Group Senior |
$195.50
|
|
|
HC ENDOSCOPIC PANCREATOSCOPY
|
Facility
|
OP
|
$6,389.00
|
|
|
Service Code
|
CPT 43273
|
| Hospital Charge Code |
906743273
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$160.73 |
| Max. Negotiated Rate |
$6,333.00 |
| Rate for Payer: Adventist Health Commercial |
$1,277.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,430.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,513.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,791.75
|
| 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 |
$3,513.95
|
| Rate for Payer: Cash Price |
$3,513.95
|
| Rate for Payer: Cash Price |
$3,513.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,111.20
|
| Rate for Payer: Cigna of CA HMO |
$4,088.96
|
| Rate for Payer: Cigna of CA PPO |
$4,727.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,430.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,430.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,430.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,555.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,555.60
|
| Rate for Payer: Galaxy Health WC |
$5,430.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,833.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,750.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$160.73
|
| Rate for Payer: InnovAge PACE Commercial |
$3,194.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,261.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$177.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,954.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,277.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,472.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,472.30
|
| Rate for Payer: Multiplan Commercial |
$4,791.75
|
| Rate for Payer: Networks By Design Commercial |
$4,152.85
|
| Rate for Payer: Prime Health Services Commercial |
$5,430.65
|
| Rate for Payer: Riverside University Health System MISP |
$2,555.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,833.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,833.40
|
| 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 |
$5,430.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,430.65
|
| Rate for Payer: Vantage Medical Group Senior |
$5,430.65
|
|
|
HC ENDOSCOPIC PANCREATOSCOPY
|
Facility
|
IP
|
$6,389.00
|
|
|
Service Code
|
CPT 43273
|
| Hospital Charge Code |
906743273
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,277.80 |
| Max. Negotiated Rate |
$5,750.10 |
| Rate for Payer: Adventist Health Commercial |
$1,277.80
|
| Rate for Payer: Cash Price |
$3,513.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,111.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,555.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,555.60
|
| Rate for Payer: Galaxy Health WC |
$5,430.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,833.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,750.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,261.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,434.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,954.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,277.80
|
| Rate for Payer: Multiplan Commercial |
$4,791.75
|
| Rate for Payer: Networks By Design Commercial |
$4,152.85
|
| Rate for Payer: Prime Health Services Commercial |
$5,430.65
|
|
|
HC ENDOSCOPIC STUDY SWALLOW FUNCT
|
Facility
|
OP
|
$1,177.00
|
|
|
Service Code
|
CPT 92612
|
| Hospital Charge Code |
905601751
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$197.66 |
| Max. Negotiated Rate |
$1,059.30 |
| Rate for Payer: Adventist Health Commercial |
$482.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$714.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,000.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$647.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$882.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$647.35
|
| Rate for Payer: Cash Price |
$647.35
|
| Rate for Payer: Cash Price |
$647.35
|
| Rate for Payer: Cash Price |
$647.35
|
| Rate for Payer: Central Health Plan Commercial |
$941.60
|
| Rate for Payer: Cigna of CA HMO |
$753.28
|
| Rate for Payer: Cigna of CA PPO |
$870.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,000.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,000.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,000.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$470.80
|
| Rate for Payer: EPIC Health Plan Senior |
$470.80
|
| Rate for Payer: Galaxy Health WC |
$1,000.45
|
| Rate for Payer: Global Benefits Group Commercial |
$706.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,059.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$197.66
|
| Rate for Payer: InnovAge PACE Commercial |
$588.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$785.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$728.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$482.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$823.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$823.90
|
| Rate for Payer: Multiplan Commercial |
$882.75
|
| Rate for Payer: Networks By Design Commercial |
$765.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,000.45
|
| Rate for Payer: Riverside University Health System MISP |
$470.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$706.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$706.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,000.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,000.45
|
| Rate for Payer: Vantage Medical Group Senior |
$1,000.45
|
|
|
HC ENDOSCOPIC STUDY SWALLOW FUNCT
|
Facility
|
IP
|
$1,177.00
|
|
|
Service Code
|
CPT 92612
|
| Hospital Charge Code |
905601751
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$235.40 |
| Max. Negotiated Rate |
$1,059.30 |
| Rate for Payer: Adventist Health Commercial |
$235.40
|
| Rate for Payer: Cash Price |
$647.35
|
| Rate for Payer: Central Health Plan Commercial |
$941.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$470.80
|
| Rate for Payer: EPIC Health Plan Senior |
$470.80
|
| Rate for Payer: Galaxy Health WC |
$1,000.45
|
| Rate for Payer: Global Benefits Group Commercial |
$706.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,059.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$785.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$448.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$728.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$235.40
|
| Rate for Payer: Multiplan Commercial |
$882.75
|
| Rate for Payer: Networks By Design Commercial |
$765.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,000.45
|
|
|
HC ENDOSCOPIC STUDY SWALLOW FUNCT MCAL
|
Facility
|
OP
|
$1,177.00
|
|
|
Service Code
|
CPT 92612
|
| Hospital Charge Code |
907000015
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$197.66 |
| Max. Negotiated Rate |
$1,059.30 |
| Rate for Payer: Adventist Health Commercial |
$482.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$714.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,000.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$647.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$882.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$647.35
|
| Rate for Payer: Cash Price |
$647.35
|
| Rate for Payer: Cash Price |
$647.35
|
| Rate for Payer: Cash Price |
$647.35
|
| Rate for Payer: Central Health Plan Commercial |
$941.60
|
| Rate for Payer: Cigna of CA HMO |
$753.28
|
| Rate for Payer: Cigna of CA PPO |
$870.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,000.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,000.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,000.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$470.80
|
| Rate for Payer: EPIC Health Plan Senior |
$470.80
|
| Rate for Payer: Galaxy Health WC |
$1,000.45
|
| Rate for Payer: Global Benefits Group Commercial |
$706.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,059.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$197.66
|
| Rate for Payer: InnovAge PACE Commercial |
$588.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$785.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$728.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$482.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$823.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$823.90
|
| Rate for Payer: Multiplan Commercial |
$882.75
|
| Rate for Payer: Networks By Design Commercial |
$765.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,000.45
|
| Rate for Payer: Riverside University Health System MISP |
$470.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$706.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$706.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,000.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,000.45
|
| Rate for Payer: Vantage Medical Group Senior |
$1,000.45
|
|
|
HC ENDOSCOPIC STUDY SWALLOW FUNCT MCAL
|
Facility
|
IP
|
$1,177.00
|
|
|
Service Code
|
CPT 92612
|
| Hospital Charge Code |
907000015
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$235.40 |
| Max. Negotiated Rate |
$1,059.30 |
| Rate for Payer: Adventist Health Commercial |
$235.40
|
| Rate for Payer: Cash Price |
$647.35
|
| Rate for Payer: Central Health Plan Commercial |
$941.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$470.80
|
| Rate for Payer: EPIC Health Plan Senior |
$470.80
|
| Rate for Payer: Galaxy Health WC |
$1,000.45
|
| Rate for Payer: Global Benefits Group Commercial |
$706.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,059.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$785.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$448.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$728.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$235.40
|
| Rate for Payer: Multiplan Commercial |
$882.75
|
| Rate for Payer: Networks By Design Commercial |
$765.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,000.45
|
|
|
HC ENDOSCOPIC US EXAM
|
Facility
|
OP
|
$1,512.00
|
|
|
Service Code
|
CPT 43237
|
| Hospital Charge Code |
906743237
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$215.15 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$302.40
|
| 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 |
$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 |
$831.60
|
| Rate for Payer: Cash Price |
$831.60
|
| Rate for Payer: Cash Price |
$831.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,209.60
|
| Rate for Payer: Cigna of CA HMO |
$967.68
|
| Rate for Payer: Cigna of CA PPO |
$1,118.88
|
| 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 |
$1,285.20
|
| Rate for Payer: Global Benefits Group Commercial |
$907.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,360.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,952.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$215.15
|
| 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 |
$1,008.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$237.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,410.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.40
|
| 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 |
$1,134.00
|
| Rate for Payer: Networks By Design Commercial |
$982.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Prime Health Services Commercial |
$1,285.20
|
| 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 |
$907.20
|
| 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 ENDOSCOPIC US EXAM
|
Facility
|
IP
|
$1,512.00
|
|
|
Service Code
|
CPT 43237
|
| Hospital Charge Code |
906743237
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$302.40 |
| Max. Negotiated Rate |
$1,360.80 |
| Rate for Payer: Adventist Health Commercial |
$302.40
|
| Rate for Payer: Cash Price |
$831.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,209.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$604.80
|
| Rate for Payer: EPIC Health Plan Senior |
$604.80
|
| Rate for Payer: Galaxy Health WC |
$1,285.20
|
| Rate for Payer: Global Benefits Group Commercial |
$907.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,360.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,008.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$576.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$935.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.40
|
| Rate for Payer: Multiplan Commercial |
$1,134.00
|
| Rate for Payer: Networks By Design Commercial |
$982.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,285.20
|
|
|
HC ENDO SM INT CNTRL BLEEDING
|
Facility
|
OP
|
$3,088.00
|
|
|
Service Code
|
CPT 44366
|
| Hospital Charge Code |
906744366
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$404.06 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$617.60
|
| 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 |
$1,698.40
|
| Rate for Payer: Cash Price |
$1,698.40
|
| Rate for Payer: Cash Price |
$1,698.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,470.40
|
| Rate for Payer: Cigna of CA HMO |
$1,976.32
|
| Rate for Payer: Cigna of CA PPO |
$2,285.12
|
| 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 |
$2,624.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,852.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,779.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,952.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$404.06
|
| 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 |
$2,059.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$446.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,410.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$617.60
|
| 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 |
$2,316.00
|
| Rate for Payer: Networks By Design Commercial |
$2,007.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Prime Health Services Commercial |
$2,624.80
|
| 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 |
$1,852.80
|
| 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 ENDO SM INT CNTRL BLEEDING
|
Facility
|
IP
|
$3,088.00
|
|
|
Service Code
|
CPT 44366
|
| Hospital Charge Code |
906744366
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$617.60 |
| Max. Negotiated Rate |
$2,779.20 |
| Rate for Payer: Adventist Health Commercial |
$617.60
|
| Rate for Payer: Cash Price |
$1,698.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,470.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,235.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,235.20
|
| Rate for Payer: Galaxy Health WC |
$2,624.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,852.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,779.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,059.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,176.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,911.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$617.60
|
| Rate for Payer: Multiplan Commercial |
$2,316.00
|
| Rate for Payer: Networks By Design Commercial |
$2,007.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,624.80
|
|
|
HC ENDO SM INTEST ENDO W/BX SNGL OR MUL
|
Facility
|
IP
|
$5,368.00
|
|
|
Service Code
|
CPT 44361
|
| Hospital Charge Code |
906744361
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,073.60 |
| Max. Negotiated Rate |
$4,831.20 |
| Rate for Payer: Adventist Health Commercial |
$1,073.60
|
| Rate for Payer: Cash Price |
$2,952.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,294.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,147.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,147.20
|
| Rate for Payer: Galaxy Health WC |
$4,562.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,220.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,831.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,580.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,045.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,322.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,073.60
|
| Rate for Payer: Multiplan Commercial |
$4,026.00
|
| Rate for Payer: Networks By Design Commercial |
$3,489.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,562.80
|
|
|
HC ENDO SM INTEST ENDO W/BX SNGL OR MUL
|
Facility
|
OP
|
$5,368.00
|
|
|
Service Code
|
CPT 44361
|
| Hospital Charge Code |
906744361
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$307.36 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$1,073.60
|
| 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 |
$2,952.40
|
| Rate for Payer: Cash Price |
$2,952.40
|
| Rate for Payer: Cash Price |
$2,952.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,294.40
|
| Rate for Payer: Cigna of CA HMO |
$3,435.52
|
| Rate for Payer: Cigna of CA PPO |
$3,972.32
|
| 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 |
$4,562.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,220.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,831.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,952.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$307.36
|
| 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 |
$3,580.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$339.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,410.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,073.60
|
| 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 |
$4,026.00
|
| Rate for Payer: Networks By Design Commercial |
$3,489.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Prime Health Services Commercial |
$4,562.80
|
| 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 |
$3,220.80
|
| 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 ENDO SM INTEST W WO CO
|
Facility
|
IP
|
$5,368.00
|
|
|
Service Code
|
CPT 44360
|
| Hospital Charge Code |
906744360
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,073.60 |
| Max. Negotiated Rate |
$4,831.20 |
| Rate for Payer: Adventist Health Commercial |
$1,073.60
|
| Rate for Payer: Cash Price |
$2,952.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,294.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,147.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,147.20
|
| Rate for Payer: Galaxy Health WC |
$4,562.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,220.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,831.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,580.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,045.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,322.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,073.60
|
| Rate for Payer: Multiplan Commercial |
$4,026.00
|
| Rate for Payer: Networks By Design Commercial |
$3,489.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,562.80
|
|
|
HC ENDO SM INTEST W WO CO
|
Facility
|
OP
|
$5,368.00
|
|
|
Service Code
|
CPT 44360
|
| Hospital Charge Code |
906744360
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$261.90 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$1,073.60
|
| 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 |
$2,952.40
|
| Rate for Payer: Cash Price |
$2,952.40
|
| Rate for Payer: Cash Price |
$2,952.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,294.40
|
| Rate for Payer: Cigna of CA HMO |
$3,435.52
|
| Rate for Payer: Cigna of CA PPO |
$3,972.32
|
| 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 |
$4,562.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,220.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,831.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,952.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$261.90
|
| 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 |
$3,580.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$289.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,410.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,073.60
|
| 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 |
$4,026.00
|
| Rate for Payer: Networks By Design Commercial |
$3,489.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Prime Health Services Commercial |
$4,562.80
|
| 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 |
$3,220.80
|
| 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 ENDO SM INT ILEUM DIAG
|
Facility
|
OP
|
$5,589.00
|
|
|
Service Code
|
CPT 44376
|
| Hospital Charge Code |
906744376
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$434.16 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$1,117.80
|
| 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 |
$3,073.95
|
| Rate for Payer: Cash Price |
$3,073.95
|
| Rate for Payer: Cash Price |
$3,073.95
|
| Rate for Payer: Central Health Plan Commercial |
$4,471.20
|
| Rate for Payer: Cigna of CA HMO |
$3,576.96
|
| Rate for Payer: Cigna of CA PPO |
$4,135.86
|
| 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 |
$4,750.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,353.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,030.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,952.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$434.16
|
| 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 |
$3,727.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$479.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,410.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,117.80
|
| 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 |
$4,191.75
|
| Rate for Payer: Networks By Design Commercial |
$3,632.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Prime Health Services Commercial |
$4,750.65
|
| 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 |
$3,353.40
|
| 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 ENDO SM INT ILEUM DIAG
|
Facility
|
IP
|
$5,589.00
|
|
|
Service Code
|
CPT 44376
|
| Hospital Charge Code |
906744376
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,117.80 |
| Max. Negotiated Rate |
$5,030.10 |
| Rate for Payer: Adventist Health Commercial |
$1,117.80
|
| Rate for Payer: Cash Price |
$3,073.95
|
| Rate for Payer: Central Health Plan Commercial |
$4,471.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,235.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,235.60
|
| Rate for Payer: Galaxy Health WC |
$4,750.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,353.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,030.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,727.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,129.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,459.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,117.80
|
| Rate for Payer: Multiplan Commercial |
$4,191.75
|
| Rate for Payer: Networks By Design Commercial |
$3,632.85
|
| Rate for Payer: Prime Health Services Commercial |
$4,750.65
|
|
|
HC ENDO SM INT ILEUM W BX
|
Facility
|
OP
|
$3,088.00
|
|
|
Service Code
|
CPT 44377
|
| Hospital Charge Code |
906744377
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$459.14 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$617.60
|
| 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 |
$1,698.40
|
| Rate for Payer: Cash Price |
$1,698.40
|
| Rate for Payer: Cash Price |
$1,698.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,470.40
|
| Rate for Payer: Cigna of CA HMO |
$1,976.32
|
| Rate for Payer: Cigna of CA PPO |
$2,285.12
|
| 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 |
$2,624.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,852.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,779.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,952.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$459.14
|
| 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 |
$2,059.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$507.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,410.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$617.60
|
| 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 |
$2,316.00
|
| Rate for Payer: Networks By Design Commercial |
$2,007.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Prime Health Services Commercial |
$2,624.80
|
| 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 |
$1,852.80
|
| 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 ENDO SM INT ILEUM W BX
|
Facility
|
IP
|
$3,088.00
|
|
|
Service Code
|
CPT 44377
|
| Hospital Charge Code |
906744377
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$617.60 |
| Max. Negotiated Rate |
$2,779.20 |
| Rate for Payer: Adventist Health Commercial |
$617.60
|
| Rate for Payer: Cash Price |
$1,698.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,470.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,235.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,235.20
|
| Rate for Payer: Galaxy Health WC |
$2,624.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,852.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,779.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,059.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,176.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,911.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$617.60
|
| Rate for Payer: Multiplan Commercial |
$2,316.00
|
| Rate for Payer: Networks By Design Commercial |
$2,007.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,624.80
|
|
