|
HC ENDO SM INT ILEUM W CNTRL BLEEDING
|
Facility
|
IP
|
$3,088.00
|
|
|
Service Code
|
CPT 44378
|
| Hospital Charge Code |
906744378
|
|
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 INT ILEUM W CNTRL BLEEDING
|
Facility
|
OP
|
$3,088.00
|
|
|
Service Code
|
CPT 44378
|
| Hospital Charge Code |
906744378
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$598.73 |
| 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 |
$598.73
|
| 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 |
$661.39
|
| 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 STNT PLCMNT
|
Facility
|
OP
|
$8,470.00
|
|
|
Service Code
|
CPT 44379
|
| Hospital Charge Code |
906744379
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$553.27 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$1,694.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,563.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,345.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,320.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,563.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,320.00
|
| Rate for Payer: Blue Shield of California Commercial |
$12,745.22
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$4,658.50
|
| Rate for Payer: Cash Price |
$4,658.50
|
| Rate for Payer: Cash Price |
$4,658.50
|
| Rate for Payer: Central Health Plan Commercial |
$6,776.00
|
| Rate for Payer: Cigna of CA HMO |
$5,420.80
|
| Rate for Payer: Cigna of CA PPO |
$6,267.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,345.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,320.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,563.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,210.91
|
| Rate for Payer: EPIC Health Plan Senior |
$7,563.64
|
| Rate for Payer: Galaxy Health WC |
$7,199.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,082.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,623.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,404.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$553.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,563.64
|
| Rate for Payer: InnovAge PACE Commercial |
$11,345.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,649.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$611.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,563.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,694.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,135.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,135.28
|
| Rate for Payer: Multiplan Commercial |
$6,352.50
|
| Rate for Payer: Networks By Design Commercial |
$5,505.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,563.64
|
| Rate for Payer: Prime Health Services Commercial |
$7,199.50
|
| Rate for Payer: Prime Health Services Medicare |
$8,017.46
|
| Rate for Payer: Riverside University Health System MISP |
$8,320.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,082.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,076.37
|
| 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 |
$7,563.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,345.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,320.00
|
| Rate for Payer: Vantage Medical Group Senior |
$7,563.64
|
|
|
HC ENDO SM INT ILEUM W STNT PLCMNT
|
Facility
|
IP
|
$8,470.00
|
|
|
Service Code
|
CPT 44379
|
| Hospital Charge Code |
906744379
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,694.00 |
| Max. Negotiated Rate |
$7,623.00 |
| Rate for Payer: Adventist Health Commercial |
$1,694.00
|
| Rate for Payer: Cash Price |
$4,658.50
|
| Rate for Payer: Central Health Plan Commercial |
$6,776.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,388.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,388.00
|
| Rate for Payer: Galaxy Health WC |
$7,199.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,082.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,623.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,649.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,227.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,242.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,694.00
|
| Rate for Payer: Multiplan Commercial |
$6,352.50
|
| Rate for Payer: Networks By Design Commercial |
$5,505.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,199.50
|
|
|
HC ENDO SM INT W/ABLATION
|
Facility
|
OP
|
$3,088.00
|
|
|
Service Code
|
CPT 44369
|
| Hospital Charge Code |
906744369
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$453.37 |
| 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 |
$453.37
|
| 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 |
$500.82
|
| 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 W/ABLATION
|
Facility
|
IP
|
$3,088.00
|
|
|
Service Code
|
CPT 44369
|
| Hospital Charge Code |
906744369
|
|
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 INT W/ CONVERSION
|
Facility
|
IP
|
$5,360.00
|
|
|
Service Code
|
CPT 44373
|
| Hospital Charge Code |
906744373
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,072.00 |
| Max. Negotiated Rate |
$4,824.00 |
| Rate for Payer: Adventist Health Commercial |
$1,072.00
|
| Rate for Payer: Cash Price |
$2,948.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,288.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,144.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,144.00
|
| Rate for Payer: Galaxy Health WC |
$4,556.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,216.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,824.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,575.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,042.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,317.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,072.00
|
| Rate for Payer: Multiplan Commercial |
$4,020.00
|
| Rate for Payer: Networks By Design Commercial |
$3,484.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,556.00
|
|
|
HC ENDO SM INT W/ CONVERSION
|
Facility
|
OP
|
$5,360.00
|
|
|
Service Code
|
CPT 44373
|
| Hospital Charge Code |
906744373
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$364.36 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$1,072.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,410.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,410.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$2,948.00
|
| Rate for Payer: Cash Price |
$2,948.00
|
| Rate for Payer: Cash Price |
$2,948.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,288.00
|
| Rate for Payer: Cigna of CA HMO |
$3,430.40
|
| Rate for Payer: Cigna of CA PPO |
$3,966.40
|
| 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 |
$4,556.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,216.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,824.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,952.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$364.36
|
| 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 |
$3,575.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$402.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,410.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,072.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,229.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,229.83
|
| Rate for Payer: Multiplan Commercial |
$4,020.00
|
| Rate for Payer: Networks By Design Commercial |
$3,484.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Prime Health Services Commercial |
$4,556.00
|
| 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 |
$3,216.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,892.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,410.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,410.32
|
|
|
HC ENDO SM INT W/FORCEPS
|
Facility
|
OP
|
$3,088.00
|
|
|
Service Code
|
CPT 44365
|
| Hospital Charge Code |
906744365
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$446.98 |
| 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 |
$446.98
|
| 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 |
$493.75
|
| 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 W/FORCEPS
|
Facility
|
IP
|
$3,088.00
|
|
|
Service Code
|
CPT 44365
|
| Hospital Charge Code |
906744365
|
|
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 INT W/PLCMNT PERCUT
|
Facility
|
OP
|
$5,368.00
|
|
|
Service Code
|
CPT 44372
|
| Hospital Charge Code |
906744372
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$412.39 |
| 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 |
$412.39
|
| 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 |
$455.54
|
| 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 W/PLCMNT PERCUT
|
Facility
|
IP
|
$5,368.00
|
|
|
Service Code
|
CPT 44372
|
| Hospital Charge Code |
906744372
|
|
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 INT W/RMVL FB
|
Facility
|
IP
|
$3,088.00
|
|
|
Service Code
|
CPT 44363
|
| Hospital Charge Code |
906744363
|
|
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 INT W/RMVL FB
|
Facility
|
OP
|
$3,088.00
|
|
|
Service Code
|
CPT 44363
|
| Hospital Charge Code |
906744363
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$290.71 |
| 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 |
$290.71
|
| 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 |
$321.14
|
| 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 W/SNARE
|
Facility
|
IP
|
$3,088.00
|
|
|
Service Code
|
CPT 44364
|
| Hospital Charge Code |
906744364
|
|
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 INT W/SNARE
|
Facility
|
OP
|
$3,088.00
|
|
|
Service Code
|
CPT 44364
|
| Hospital Charge Code |
906744364
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$348.99 |
| 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 |
$348.99
|
| 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 |
$385.51
|
| 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 W STENT PLCMNT
|
Facility
|
OP
|
$8,470.00
|
|
|
Service Code
|
CPT 44370
|
| Hospital Charge Code |
906744370
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$339.39 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$1,694.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,563.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,345.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,320.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,563.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,320.00
|
| Rate for Payer: Blue Shield of California Commercial |
$12,745.22
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$4,658.50
|
| Rate for Payer: Cash Price |
$4,658.50
|
| Rate for Payer: Cash Price |
$4,658.50
|
| Rate for Payer: Central Health Plan Commercial |
$6,776.00
|
| Rate for Payer: Cigna of CA HMO |
$5,420.80
|
| Rate for Payer: Cigna of CA PPO |
$6,267.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,345.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,320.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,563.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,210.91
|
| Rate for Payer: EPIC Health Plan Senior |
$7,563.64
|
| Rate for Payer: Galaxy Health WC |
$7,199.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,082.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,623.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,404.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$339.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,563.64
|
| Rate for Payer: InnovAge PACE Commercial |
$11,345.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,649.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$374.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,563.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,694.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,135.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,135.28
|
| Rate for Payer: Multiplan Commercial |
$6,352.50
|
| Rate for Payer: Networks By Design Commercial |
$5,505.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,563.64
|
| Rate for Payer: Prime Health Services Commercial |
$7,199.50
|
| Rate for Payer: Prime Health Services Medicare |
$8,017.46
|
| Rate for Payer: Riverside University Health System MISP |
$8,320.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,082.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,076.37
|
| 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 |
$7,563.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,345.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,320.00
|
| Rate for Payer: Vantage Medical Group Senior |
$7,563.64
|
|
|
HC ENDO SM INT W STENT PLCMNT
|
Facility
|
IP
|
$8,470.00
|
|
|
Service Code
|
CPT 44370
|
| Hospital Charge Code |
906744370
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,694.00 |
| Max. Negotiated Rate |
$7,623.00 |
| Rate for Payer: Adventist Health Commercial |
$1,694.00
|
| Rate for Payer: Cash Price |
$4,658.50
|
| Rate for Payer: Central Health Plan Commercial |
$6,776.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,388.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,388.00
|
| Rate for Payer: Galaxy Health WC |
$7,199.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,082.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,623.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,649.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,227.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,242.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,694.00
|
| Rate for Payer: Multiplan Commercial |
$6,352.50
|
| Rate for Payer: Networks By Design Commercial |
$5,505.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,199.50
|
|
|
HC ENDOTRACH 5.0MM W/CUFF PEDS
|
Facility
|
OP
|
$45.26
|
|
| Hospital Charge Code |
901698775
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.05 |
| Max. Negotiated Rate |
$40.73 |
| Rate for Payer: Adventist Health Commercial |
$9.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$38.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$33.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$21.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26.58
|
| Rate for Payer: Blue Shield of California Commercial |
$27.65
|
| Rate for Payer: Blue Shield of California EPN |
$18.06
|
| Rate for Payer: Cash Price |
$24.89
|
| Rate for Payer: Central Health Plan Commercial |
$36.21
|
| Rate for Payer: Cigna of CA HMO |
$28.97
|
| Rate for Payer: Cigna of CA PPO |
$33.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$38.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.10
|
| Rate for Payer: EPIC Health Plan Senior |
$18.10
|
| Rate for Payer: Galaxy Health WC |
$38.47
|
| Rate for Payer: Global Benefits Group Commercial |
$27.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.73
|
| Rate for Payer: InnovAge PACE Commercial |
$22.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31.68
|
| Rate for Payer: Multiplan Commercial |
$33.95
|
| Rate for Payer: Networks By Design Commercial |
$29.42
|
| Rate for Payer: Prime Health Services Commercial |
$38.47
|
| Rate for Payer: Riverside University Health System MISP |
$18.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$22.63
|
| Rate for Payer: United Healthcare All Other HMO |
$22.63
|
| Rate for Payer: United Healthcare HMO Rider |
$22.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$38.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.47
|
| Rate for Payer: Vantage Medical Group Senior |
$38.47
|
|
|
HC ENDOTRACH 5.0MM W/CUFF PEDS
|
Facility
|
IP
|
$45.26
|
|
| Hospital Charge Code |
901698775
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.05 |
| Max. Negotiated Rate |
$40.73 |
| Rate for Payer: Adventist Health Commercial |
$9.05
|
| Rate for Payer: Cash Price |
$24.89
|
| Rate for Payer: Central Health Plan Commercial |
$36.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.10
|
| Rate for Payer: EPIC Health Plan Senior |
$18.10
|
| Rate for Payer: Galaxy Health WC |
$38.47
|
| Rate for Payer: Global Benefits Group Commercial |
$27.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.05
|
| Rate for Payer: Multiplan Commercial |
$33.95
|
| Rate for Payer: Networks By Design Commercial |
$29.42
|
| Rate for Payer: Prime Health Services Commercial |
$38.47
|
|
|
HC ENDOTRACH 5.5MM W/CUFF PEDS
|
Facility
|
IP
|
$45.26
|
|
| Hospital Charge Code |
901698774
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.05 |
| Max. Negotiated Rate |
$40.73 |
| Rate for Payer: Adventist Health Commercial |
$9.05
|
| Rate for Payer: Cash Price |
$24.89
|
| Rate for Payer: Central Health Plan Commercial |
$36.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.10
|
| Rate for Payer: EPIC Health Plan Senior |
$18.10
|
| Rate for Payer: Galaxy Health WC |
$38.47
|
| Rate for Payer: Global Benefits Group Commercial |
$27.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.05
|
| Rate for Payer: Multiplan Commercial |
$33.95
|
| Rate for Payer: Networks By Design Commercial |
$29.42
|
| Rate for Payer: Prime Health Services Commercial |
$38.47
|
|
|
HC ENDOTRACH 5.5MM W/CUFF PEDS
|
Facility
|
OP
|
$45.26
|
|
| Hospital Charge Code |
901698774
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.05 |
| Max. Negotiated Rate |
$40.73 |
| Rate for Payer: Adventist Health Commercial |
$9.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$38.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$33.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$21.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26.58
|
| Rate for Payer: Blue Shield of California Commercial |
$27.65
|
| Rate for Payer: Blue Shield of California EPN |
$18.06
|
| Rate for Payer: Cash Price |
$24.89
|
| Rate for Payer: Central Health Plan Commercial |
$36.21
|
| Rate for Payer: Cigna of CA HMO |
$28.97
|
| Rate for Payer: Cigna of CA PPO |
$33.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$38.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.10
|
| Rate for Payer: EPIC Health Plan Senior |
$18.10
|
| Rate for Payer: Galaxy Health WC |
$38.47
|
| Rate for Payer: Global Benefits Group Commercial |
$27.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.73
|
| Rate for Payer: InnovAge PACE Commercial |
$22.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31.68
|
| Rate for Payer: Multiplan Commercial |
$33.95
|
| Rate for Payer: Networks By Design Commercial |
$29.42
|
| Rate for Payer: Prime Health Services Commercial |
$38.47
|
| Rate for Payer: Riverside University Health System MISP |
$18.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$22.63
|
| Rate for Payer: United Healthcare All Other HMO |
$22.63
|
| Rate for Payer: United Healthcare HMO Rider |
$22.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$38.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.47
|
| Rate for Payer: Vantage Medical Group Senior |
$38.47
|
|
|
HC ENDOTRACH 6.5MM W/CUFF ADULT
|
Facility
|
IP
|
$61.66
|
|
| Hospital Charge Code |
901698776
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.33 |
| Max. Negotiated Rate |
$55.49 |
| Rate for Payer: Adventist Health Commercial |
$12.33
|
| Rate for Payer: Cash Price |
$33.91
|
| Rate for Payer: Central Health Plan Commercial |
$49.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.66
|
| Rate for Payer: EPIC Health Plan Senior |
$24.66
|
| Rate for Payer: Galaxy Health WC |
$52.41
|
| Rate for Payer: Global Benefits Group Commercial |
$37.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$55.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$41.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.33
|
| Rate for Payer: Multiplan Commercial |
$46.24
|
| Rate for Payer: Networks By Design Commercial |
$40.08
|
| Rate for Payer: Prime Health Services Commercial |
$52.41
|
|
|
HC ENDOTRACH 6.5MM W/CUFF ADULT
|
Facility
|
OP
|
$61.66
|
|
| Hospital Charge Code |
901698776
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.33 |
| Max. Negotiated Rate |
$55.49 |
| Rate for Payer: Adventist Health Commercial |
$12.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$46.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$29.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36.21
|
| Rate for Payer: Blue Shield of California Commercial |
$37.67
|
| Rate for Payer: Blue Shield of California EPN |
$24.60
|
| Rate for Payer: Cash Price |
$33.91
|
| Rate for Payer: Central Health Plan Commercial |
$49.33
|
| Rate for Payer: Cigna of CA HMO |
$39.46
|
| Rate for Payer: Cigna of CA PPO |
$45.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$52.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.66
|
| Rate for Payer: EPIC Health Plan Senior |
$24.66
|
| Rate for Payer: Galaxy Health WC |
$52.41
|
| Rate for Payer: Global Benefits Group Commercial |
$37.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$55.49
|
| Rate for Payer: InnovAge PACE Commercial |
$30.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$41.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43.16
|
| Rate for Payer: Multiplan Commercial |
$46.24
|
| Rate for Payer: Networks By Design Commercial |
$40.08
|
| Rate for Payer: Prime Health Services Commercial |
$52.41
|
| Rate for Payer: Riverside University Health System MISP |
$24.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$37.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$37.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.83
|
| Rate for Payer: United Healthcare All Other HMO |
$30.83
|
| Rate for Payer: United Healthcare HMO Rider |
$30.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.41
|
| Rate for Payer: Vantage Medical Group Senior |
$52.41
|
|
|
HC ENDOTRACHEAL INTUBATION
|
Facility
|
IP
|
$3,873.00
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
900800115
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$774.60 |
| Max. Negotiated Rate |
$3,485.70 |
| Rate for Payer: Adventist Health Commercial |
$774.60
|
| Rate for Payer: Cash Price |
$2,130.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,098.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,549.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,549.20
|
| Rate for Payer: Galaxy Health WC |
$3,292.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,323.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,485.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,583.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,475.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,397.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$774.60
|
| Rate for Payer: Multiplan Commercial |
$2,904.75
|
| Rate for Payer: Networks By Design Commercial |
$2,517.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,292.05
|
|
