|
HC COLONOSCOPY W ENDOS US EXAM
|
Facility
OP
|
$4,156.00
|
|
|
Service Code
|
CPT 45391
|
| Hospital Charge Code |
906745391
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$831.20 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,474.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,493.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$1,870.20
|
| Rate for Payer: Cash Price |
$1,870.20
|
| Rate for Payer: Central Health Plan Commercial |
$3,324.80
|
| Rate for Payer: Cigna of CA PPO |
$3,075.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Galaxy Health WC |
$3,532.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,493.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,740.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,117.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,418.05
|
| Rate for Payer: IEHP medi-cal |
$2,432.79
|
| Rate for Payer: IEHP Medicare Advantage |
$1,474.42
|
| Rate for Payer: Innovage PACE Commercial |
$2,211.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,772.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$831.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,975.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Multiplan Commercial |
$3,117.00
|
| Rate for Payer: Networks By Design Commercial |
$2,701.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,532.60
|
| Rate for Payer: Prime Health Services Medicare |
$1,562.89
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,621.86
|
| Rate for Payer: Riverside University Health MISP |
$1,621.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,493.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,769.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC COLONOSCOPY W ENDOS US EXAM
|
Facility
IP
|
$6,544.00
|
|
|
Service Code
|
CPT 45391
|
| Hospital Charge Code |
906745391
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,308.80 |
| Max. Negotiated Rate |
$5,889.60 |
| Rate for Payer: Cash Price |
$2,944.80
|
| Rate for Payer: Central Health Plan Commercial |
$5,235.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,617.60
|
| Rate for Payer: Galaxy Health WC |
$5,562.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,926.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,889.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,364.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,308.80
|
| Rate for Payer: Multiplan Commercial |
$4,908.00
|
| Rate for Payer: Networks By Design Commercial |
$4,253.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,562.40
|
|
|
HC COLONOSCOPY W FB REMOVAL
|
Facility
IP
|
$6,871.00
|
|
|
Service Code
|
CPT 45379
|
| Hospital Charge Code |
906745379
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,374.20 |
| Max. Negotiated Rate |
$6,183.90 |
| Rate for Payer: Cash Price |
$3,091.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,496.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,748.40
|
| Rate for Payer: Galaxy Health WC |
$5,840.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,122.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,183.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,582.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,374.20
|
| Rate for Payer: Multiplan Commercial |
$5,153.25
|
| Rate for Payer: Networks By Design Commercial |
$4,466.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,840.35
|
|
|
HC COLONOSCOPY W FB REMOVAL
|
Facility
OP
|
$4,156.00
|
|
|
Service Code
|
CPT 45379
|
| Hospital Charge Code |
906745379
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$831.20 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,474.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,493.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$1,870.20
|
| Rate for Payer: Cash Price |
$1,870.20
|
| Rate for Payer: Cash Price |
$1,870.20
|
| Rate for Payer: Central Health Plan Commercial |
$3,324.80
|
| Rate for Payer: Cigna of CA PPO |
$3,075.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Galaxy Health WC |
$3,532.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,493.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,740.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,117.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,418.05
|
| Rate for Payer: IEHP medi-cal |
$2,432.79
|
| Rate for Payer: IEHP Medicare Advantage |
$1,474.42
|
| Rate for Payer: Innovage PACE Commercial |
$2,211.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,772.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$831.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,975.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Multiplan Commercial |
$3,117.00
|
| Rate for Payer: Networks By Design Commercial |
$2,701.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,532.60
|
| Rate for Payer: Prime Health Services Medicare |
$1,562.89
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,621.86
|
| Rate for Payer: Riverside University Health MISP |
$1,621.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,493.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,769.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC COLONOSCOPY W POLYPECTOMY
|
Facility
IP
|
$5,263.00
|
|
|
Service Code
|
CPT 45384
|
| Hospital Charge Code |
906745384
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,052.60 |
| Max. Negotiated Rate |
$4,736.70 |
| Rate for Payer: Cash Price |
$2,368.35
|
| Rate for Payer: Central Health Plan Commercial |
$4,210.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,105.20
|
| Rate for Payer: Galaxy Health WC |
$4,473.55
|
| Rate for Payer: Global Benefits Group Commercial |
$3,157.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,736.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,510.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,052.60
|
| Rate for Payer: Multiplan Commercial |
$3,947.25
|
| Rate for Payer: Networks By Design Commercial |
$3,420.95
|
| Rate for Payer: Prime Health Services Commercial |
$4,473.55
|
|
|
HC COLONOSCOPY W POLYPECTOMY
|
Facility
OP
|
$3,037.00
|
|
|
Service Code
|
CPT 45384
|
| Hospital Charge Code |
906745384
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$607.40 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,474.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,822.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$1,366.65
|
| Rate for Payer: Cash Price |
$1,366.65
|
| Rate for Payer: Cash Price |
$1,366.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,429.60
|
| Rate for Payer: Cigna of CA PPO |
$2,247.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Galaxy Health WC |
$2,581.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,822.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,733.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,277.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,418.05
|
| Rate for Payer: IEHP medi-cal |
$2,432.79
|
| Rate for Payer: IEHP Medicare Advantage |
$1,474.42
|
| Rate for Payer: Innovage PACE Commercial |
$2,211.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,025.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$607.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,975.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Multiplan Commercial |
$2,277.75
|
| Rate for Payer: Networks By Design Commercial |
$1,974.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,581.45
|
| Rate for Payer: Prime Health Services Medicare |
$1,562.89
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,621.86
|
| Rate for Payer: Riverside University Health MISP |
$1,621.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,822.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,769.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC COLONOSCOPY W RESECTION
|
Facility
OP
|
$2,817.00
|
|
|
Service Code
|
CPT 44403
|
| Hospital Charge Code |
906744403
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$563.40 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,474.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,690.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$1,267.65
|
| Rate for Payer: Cash Price |
$1,267.65
|
| Rate for Payer: Cash Price |
$1,267.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,253.60
|
| Rate for Payer: Cigna of CA PPO |
$2,084.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Galaxy Health WC |
$2,394.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,690.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,535.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,112.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,418.05
|
| Rate for Payer: IEHP medi-cal |
$2,432.79
|
| Rate for Payer: IEHP Medicare Advantage |
$1,474.42
|
| Rate for Payer: Innovage PACE Commercial |
$2,211.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,878.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$563.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,975.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Multiplan Commercial |
$2,112.75
|
| Rate for Payer: Networks By Design Commercial |
$1,831.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,394.45
|
| Rate for Payer: Prime Health Services Medicare |
$1,562.89
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,621.86
|
| Rate for Payer: Riverside University Health MISP |
$1,621.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,690.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,769.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC COLONOSCOPY W RESECTION
|
Facility
IP
|
$2,817.00
|
|
|
Service Code
|
CPT 44403
|
| Hospital Charge Code |
906744403
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$563.40 |
| Max. Negotiated Rate |
$2,535.30 |
| Rate for Payer: Cash Price |
$1,267.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,253.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,126.80
|
| Rate for Payer: Galaxy Health WC |
$2,394.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,690.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,535.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,878.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$563.40
|
| Rate for Payer: Multiplan Commercial |
$2,112.75
|
| Rate for Payer: Networks By Design Commercial |
$1,831.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,394.45
|
|
|
HC COLONOSCOPY W STENT PLCMNT
|
Facility
OP
|
$5,066.00
|
|
|
Service Code
|
CPT 45389
|
| Hospital Charge Code |
906745389
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,013.20 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,120.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,681.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,832.91
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,120.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,039.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$7,120.83
|
| Rate for Payer: Cash Price |
$2,279.70
|
| Rate for Payer: Cash Price |
$2,279.70
|
| Rate for Payer: Cash Price |
$2,279.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,052.80
|
| Rate for Payer: Cigna of CA PPO |
$3,748.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,681.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,613.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,120.83
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,120.83
|
| Rate for Payer: Galaxy Health WC |
$4,306.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,039.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,559.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,799.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,678.16
|
| Rate for Payer: IEHP medi-cal |
$11,749.37
|
| Rate for Payer: IEHP Medicare Advantage |
$7,120.83
|
| Rate for Payer: Innovage PACE Commercial |
$10,681.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,379.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,120.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,013.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,541.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,541.91
|
| Rate for Payer: Multiplan Commercial |
$3,799.50
|
| Rate for Payer: Networks By Design Commercial |
$3,292.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,306.10
|
| Rate for Payer: Prime Health Services Medicare |
$7,548.08
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7,832.91
|
| Rate for Payer: Riverside University Health MISP |
$7,832.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,039.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,545.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,681.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,832.91
|
| Rate for Payer: Vantage Medical Group Senior |
$7,120.83
|
|
|
HC COLONOSCOPY W STENT PLCMNT
|
Facility
IP
|
$7,978.00
|
|
|
Service Code
|
CPT 45389
|
| Hospital Charge Code |
906745389
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,595.60 |
| Max. Negotiated Rate |
$7,180.20 |
| Rate for Payer: Cash Price |
$3,590.10
|
| Rate for Payer: Central Health Plan Commercial |
$6,382.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,191.20
|
| Rate for Payer: Galaxy Health WC |
$6,781.30
|
| Rate for Payer: Global Benefits Group Commercial |
$4,786.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,180.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,321.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,595.60
|
| Rate for Payer: Multiplan Commercial |
$5,983.50
|
| Rate for Payer: Networks By Design Commercial |
$5,185.70
|
| Rate for Payer: Prime Health Services Commercial |
$6,781.30
|
|
|
HC COLONOSCOPY W SUBMUCOSAL INJ
|
Facility
OP
|
$4,567.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
906745381
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$913.40 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,474.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,740.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$2,055.15
|
| Rate for Payer: Cash Price |
$2,055.15
|
| Rate for Payer: Cash Price |
$2,055.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,653.60
|
| Rate for Payer: Cigna of CA PPO |
$3,379.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Galaxy Health WC |
$3,881.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,740.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,110.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,425.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,418.05
|
| Rate for Payer: IEHP medi-cal |
$2,432.79
|
| Rate for Payer: IEHP Medicare Advantage |
$1,474.42
|
| Rate for Payer: Innovage PACE Commercial |
$2,211.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,046.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$913.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,975.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Multiplan Commercial |
$3,425.25
|
| Rate for Payer: Networks By Design Commercial |
$2,968.55
|
| Rate for Payer: Prime Health Services Commercial |
$3,881.95
|
| Rate for Payer: Prime Health Services Medicare |
$1,562.89
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,621.86
|
| Rate for Payer: Riverside University Health MISP |
$1,621.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,740.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,769.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC COLONOSCOPY W SUBMUCOSAL INJ
|
Facility
IP
|
$7,191.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
906745381
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,438.20 |
| Max. Negotiated Rate |
$6,471.90 |
| Rate for Payer: Cash Price |
$3,235.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,752.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,876.40
|
| Rate for Payer: Galaxy Health WC |
$6,112.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,314.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,471.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,796.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,438.20
|
| Rate for Payer: Multiplan Commercial |
$5,393.25
|
| Rate for Payer: Networks By Design Commercial |
$4,674.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,112.35
|
|
|
HC COLONOSCOPY W/TUMOR SNARE RMVL
|
Facility
OP
|
$4,567.00
|
|
|
Service Code
|
CPT 45385
|
| Hospital Charge Code |
906745385
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$913.40 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,474.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,740.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$2,055.15
|
| Rate for Payer: Cash Price |
$2,055.15
|
| Rate for Payer: Cash Price |
$2,055.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,653.60
|
| Rate for Payer: Cigna of CA PPO |
$3,379.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Galaxy Health WC |
$3,881.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,740.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,110.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,425.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,418.05
|
| Rate for Payer: IEHP medi-cal |
$2,432.79
|
| Rate for Payer: IEHP Medicare Advantage |
$1,474.42
|
| Rate for Payer: Innovage PACE Commercial |
$2,211.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,046.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$913.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,975.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Multiplan Commercial |
$3,425.25
|
| Rate for Payer: Networks By Design Commercial |
$2,968.55
|
| Rate for Payer: Prime Health Services Commercial |
$3,881.95
|
| Rate for Payer: Prime Health Services Medicare |
$1,562.89
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,621.86
|
| Rate for Payer: Riverside University Health MISP |
$1,621.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,740.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,769.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC COLONOSCOPY W/TUMOR SNARE RMVL
|
Facility
IP
|
$7,191.00
|
|
|
Service Code
|
CPT 45385
|
| Hospital Charge Code |
906745385
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,438.20 |
| Max. Negotiated Rate |
$6,471.90 |
| Rate for Payer: Cash Price |
$3,235.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,752.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,876.40
|
| Rate for Payer: Galaxy Health WC |
$6,112.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,314.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,471.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,796.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,438.20
|
| Rate for Payer: Multiplan Commercial |
$5,393.25
|
| Rate for Payer: Networks By Design Commercial |
$4,674.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,112.35
|
|
|
HC COLONSCOPY STOMA W RMVL
|
Facility
OP
|
$3,793.00
|
|
|
Service Code
|
CPT 44394
|
| Hospital Charge Code |
906744394
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$758.60 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,474.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,275.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$1,706.85
|
| Rate for Payer: Cash Price |
$1,706.85
|
| Rate for Payer: Cash Price |
$1,706.85
|
| Rate for Payer: Central Health Plan Commercial |
$3,034.40
|
| Rate for Payer: Cigna of CA PPO |
$2,806.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Galaxy Health WC |
$3,224.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,275.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,413.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,844.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,418.05
|
| Rate for Payer: IEHP medi-cal |
$2,432.79
|
| Rate for Payer: IEHP Medicare Advantage |
$1,474.42
|
| Rate for Payer: Innovage PACE Commercial |
$2,211.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,529.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$758.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,975.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Multiplan Commercial |
$2,844.75
|
| Rate for Payer: Networks By Design Commercial |
$2,465.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,224.05
|
| Rate for Payer: Prime Health Services Medicare |
$1,562.89
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,621.86
|
| Rate for Payer: Riverside University Health MISP |
$1,621.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,275.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,769.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC COLONSCOPY STOMA W RMVL
|
Facility
IP
|
$5,972.00
|
|
|
Service Code
|
CPT 44394
|
| Hospital Charge Code |
906744394
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,194.40 |
| Max. Negotiated Rate |
$5,374.80 |
| Rate for Payer: Cash Price |
$2,687.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,777.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,388.80
|
| Rate for Payer: Galaxy Health WC |
$5,076.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,583.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,374.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,983.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,194.40
|
| Rate for Payer: Multiplan Commercial |
$4,479.00
|
| Rate for Payer: Networks By Design Commercial |
$3,881.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,076.20
|
|
|
HC COLON VIA STOMA W FB REMOVAL
|
Facility
IP
|
$2,222.00
|
|
|
Service Code
|
CPT 44390
|
| Hospital Charge Code |
906744390
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$444.40 |
| Max. Negotiated Rate |
$1,999.80 |
| Rate for Payer: Cash Price |
$999.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,777.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$888.80
|
| Rate for Payer: Galaxy Health WC |
$1,888.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,333.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,999.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,482.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$444.40
|
| Rate for Payer: Multiplan Commercial |
$1,666.50
|
| Rate for Payer: Networks By Design Commercial |
$1,444.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,888.70
|
|
|
HC COLON VIA STOMA W FB REMOVAL
|
Facility
OP
|
$2,222.00
|
|
|
Service Code
|
CPT 44390
|
| Hospital Charge Code |
906744390
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$444.40 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,141.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,333.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,141.93
|
| Rate for Payer: Cash Price |
$999.90
|
| Rate for Payer: Cash Price |
$999.90
|
| Rate for Payer: Cash Price |
$999.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,777.60
|
| Rate for Payer: Cigna of CA PPO |
$1,644.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$1,888.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,333.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,999.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,666.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,872.77
|
| Rate for Payer: IEHP medi-cal |
$1,884.18
|
| Rate for Payer: IEHP Medicare Advantage |
$1,141.93
|
| Rate for Payer: Innovage PACE Commercial |
$1,712.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,482.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$444.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$1,666.50
|
| Rate for Payer: Networks By Design Commercial |
$1,444.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,888.70
|
| Rate for Payer: Prime Health Services Medicare |
$1,210.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,256.12
|
| Rate for Payer: Riverside University Health MISP |
$1,256.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,333.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,370.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC COLON W SNGL CONTRAST ENEMA
|
Facility
OP
|
$1,436.00
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
909001806
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$219.73 |
| Max. Negotiated Rate |
$1,292.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$229.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$488.09
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$344.34
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$252.52
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$229.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$344.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$420.63
|
| Rate for Payer: BCBS Transplant Transplant |
$861.60
|
| Rate for Payer: Blue Shield of California Commercial |
$887.45
|
| Rate for Payer: Blue Shield of California EPN |
$697.90
|
| Rate for Payer: Caremore Medicare Advantage |
$229.56
|
| Rate for Payer: Cash Price |
$646.20
|
| Rate for Payer: Cash Price |
$646.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,148.80
|
| Rate for Payer: Cigna of CA HMO |
$919.04
|
| Rate for Payer: Cigna of CA PPO |
$1,062.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$344.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$229.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$229.56
|
| Rate for Payer: Galaxy Health WC |
$1,220.60
|
| Rate for Payer: Global Benefits Group Commercial |
$861.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,292.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,077.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$376.48
|
| Rate for Payer: IEHP medi-cal |
$378.77
|
| Rate for Payer: IEHP Medicare Advantage |
$229.56
|
| Rate for Payer: Innovage PACE Commercial |
$344.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$957.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$229.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$287.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$307.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$307.61
|
| Rate for Payer: Multiplan Commercial |
$1,077.00
|
| Rate for Payer: Networks By Design Commercial |
$933.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,220.60
|
| Rate for Payer: Prime Health Services Medicare |
$243.33
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$861.60
|
| Rate for Payer: Riverside University Health MISP |
$252.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$861.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$861.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$219.73
|
| Rate for Payer: United Healthcare All Other HMO |
$219.73
|
| Rate for Payer: United Healthcare HMO Rider |
$219.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$219.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$344.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$252.52
|
| Rate for Payer: Vantage Medical Group Senior |
$229.56
|
|
|
HC COLON W SNGL CONTRAST ENEMA
|
Facility
IP
|
$1,436.00
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
909001806
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$287.20 |
| Max. Negotiated Rate |
$1,292.40 |
| Rate for Payer: Cash Price |
$646.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,148.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$574.40
|
| Rate for Payer: Galaxy Health WC |
$1,220.60
|
| Rate for Payer: Global Benefits Group Commercial |
$861.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,292.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$957.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$287.20
|
| Rate for Payer: Multiplan Commercial |
$1,077.00
|
| Rate for Payer: Networks By Design Commercial |
$933.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,220.60
|
|
|
HC COLORCTL CNCR SCRN NON HGH RSK
|
Facility
OP
|
$2,589.00
|
|
|
Service Code
|
CPT G0121
|
| Hospital Charge Code |
900100676
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$517.80 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,141.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,553.40
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$1,141.93
|
| Rate for Payer: Cash Price |
$1,165.05
|
| Rate for Payer: Cash Price |
$1,165.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,071.20
|
| Rate for Payer: Cigna of CA PPO |
$1,915.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$2,200.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,553.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,330.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,941.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,872.77
|
| Rate for Payer: IEHP medi-cal |
$1,884.18
|
| Rate for Payer: IEHP Medicare Advantage |
$1,141.93
|
| Rate for Payer: Innovage PACE Commercial |
$1,712.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,726.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$517.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$1,941.75
|
| Rate for Payer: Networks By Design Commercial |
$1,682.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,200.65
|
| Rate for Payer: Prime Health Services Medicare |
$1,210.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,256.12
|
| Rate for Payer: Riverside University Health MISP |
$1,256.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,553.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,370.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC COLORCTL CNCR SCRN NON HGH RSK
|
Facility
IP
|
$2,589.00
|
|
|
Service Code
|
CPT G0121
|
| Hospital Charge Code |
900100676
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$517.80 |
| Max. Negotiated Rate |
$2,330.10 |
| Rate for Payer: Cash Price |
$1,165.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,071.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,035.60
|
| Rate for Payer: Galaxy Health WC |
$2,200.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,553.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,330.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,726.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$517.80
|
| Rate for Payer: Multiplan Commercial |
$1,941.75
|
| Rate for Payer: Networks By Design Commercial |
$1,682.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,200.65
|
|
|
HC COLORECTAL CANCER SCRN FLXBL SGMDSCPY
|
Facility
OP
|
$2,423.00
|
|
|
Service Code
|
CPT G0104
|
| Hospital Charge Code |
900100230
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$484.60 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,141.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,453.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,141.93
|
| Rate for Payer: Cash Price |
$1,090.35
|
| Rate for Payer: Cash Price |
$1,090.35
|
| Rate for Payer: Cash Price |
$1,090.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,938.40
|
| Rate for Payer: Cigna of CA PPO |
$1,793.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$2,059.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,453.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,180.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,817.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,872.77
|
| Rate for Payer: IEHP medi-cal |
$1,884.18
|
| Rate for Payer: IEHP Medicare Advantage |
$1,141.93
|
| Rate for Payer: Innovage PACE Commercial |
$1,712.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,616.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$484.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$1,817.25
|
| Rate for Payer: Networks By Design Commercial |
$1,574.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,059.55
|
| Rate for Payer: Prime Health Services Medicare |
$1,210.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,256.12
|
| Rate for Payer: Riverside University Health MISP |
$1,256.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,453.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,370.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC COLORECTAL CANCER SCRN FLXBL SGMDSCPY
|
Facility
IP
|
$2,423.00
|
|
|
Service Code
|
CPT G0104
|
| Hospital Charge Code |
900100230
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$484.60 |
| Max. Negotiated Rate |
$2,180.70 |
| Rate for Payer: Cash Price |
$1,090.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,938.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$969.20
|
| Rate for Payer: Galaxy Health WC |
$2,059.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,453.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,180.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,616.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$484.60
|
| Rate for Payer: Multiplan Commercial |
$1,817.25
|
| Rate for Payer: Networks By Design Commercial |
$1,574.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,059.55
|
|
|
HC COLORECTAL CANCER SCRN HIGH RISK
|
Facility
OP
|
$2,589.00
|
|
|
Service Code
|
CPT G0105
|
| Hospital Charge Code |
900100675
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$517.80 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,141.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,553.40
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$1,141.93
|
| Rate for Payer: Cash Price |
$1,165.05
|
| Rate for Payer: Cash Price |
$1,165.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,071.20
|
| Rate for Payer: Cigna of CA PPO |
$1,915.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$2,200.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,553.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,330.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,941.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,872.77
|
| Rate for Payer: IEHP medi-cal |
$1,884.18
|
| Rate for Payer: IEHP Medicare Advantage |
$1,141.93
|
| Rate for Payer: Innovage PACE Commercial |
$1,712.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,726.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$517.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$1,941.75
|
| Rate for Payer: Networks By Design Commercial |
$1,682.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,200.65
|
| Rate for Payer: Prime Health Services Medicare |
$1,210.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,256.12
|
| Rate for Payer: Riverside University Health MISP |
$1,256.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,553.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,370.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
