|
HC COLORECTAL CANCER SCRN HIGH RISK
|
Facility
|
IP
|
$2,589.00
|
|
|
Service Code
|
CPT G0105
|
| Hospital Charge Code |
900100675
|
|
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: Kaiser Permanente of CA Medi-Cal |
$986.41
|
| 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 COLPORRHAPHY
|
Facility
|
OP
|
$6,632.00
|
|
|
Service Code
|
CPT 57200
|
| Hospital Charge Code |
900501301
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,406.14 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,859.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,296.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,906.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,979.20
|
| Rate for Payer: Caremore Medicare Advantage |
$3,906.18
|
| Rate for Payer: Cash Price |
$2,984.40
|
| Rate for Payer: Cash Price |
$2,984.40
|
| Rate for Payer: Cash Price |
$2,984.40
|
| Rate for Payer: Cash Price |
$2,984.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,305.60
|
| Rate for Payer: Cigna of CA PPO |
$4,907.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,859.27
|
| Rate for Payer: Dignity Health Media |
$3,906.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,296.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,273.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,906.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,906.18
|
| Rate for Payer: Galaxy Health WC |
$5,637.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,979.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,968.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,974.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,406.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,906.18
|
| Rate for Payer: InnovAge PACE Commercial |
$5,859.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,423.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$571.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,906.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,326.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,234.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,234.28
|
| Rate for Payer: Multiplan Commercial |
$4,974.00
|
| Rate for Payer: Networks By Design Commercial |
$4,310.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,637.20
|
| Rate for Payer: Prime Health Services Medicare |
$4,140.55
|
| Rate for Payer: Riverside University Health System MISP |
$4,296.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,979.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,316.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,316.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,316.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,316.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,859.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,296.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,906.18
|
|
|
HC COLPORRHAPHY
|
Facility
|
IP
|
$6,632.00
|
|
|
Service Code
|
CPT 57200
|
| Hospital Charge Code |
900501301
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,326.40 |
| Max. Negotiated Rate |
$5,968.80 |
| Rate for Payer: Cash Price |
$2,984.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,305.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,652.80
|
| Rate for Payer: Galaxy Health WC |
$5,637.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,979.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,968.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,423.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,526.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,326.40
|
| Rate for Payer: Multiplan Commercial |
$4,974.00
|
| Rate for Payer: Networks By Design Commercial |
$4,310.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,637.20
|
|
|
HC COLPOSCOPY BX OF VAG/CERVIX
|
Facility
|
IP
|
$2,114.00
|
|
|
Service Code
|
CPT 57421
|
| Hospital Charge Code |
904057421
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$422.80 |
| Max. Negotiated Rate |
$1,902.60 |
| Rate for Payer: Cash Price |
$951.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,691.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$845.60
|
| Rate for Payer: Galaxy Health WC |
$1,796.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,268.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,902.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,410.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$805.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$422.80
|
| Rate for Payer: Multiplan Commercial |
$1,585.50
|
| Rate for Payer: Networks By Design Commercial |
$1,374.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,796.90
|
|
|
HC COLPOSCOPY BX OF VAG/CERVIX
|
Facility
|
OP
|
$2,114.00
|
|
|
Service Code
|
CPT 57421
|
| Hospital Charge Code |
904057421
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$307.29 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,004.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,506.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,104.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,004.43
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,268.40
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$1,004.43
|
| Rate for Payer: Cash Price |
$951.30
|
| Rate for Payer: Cash Price |
$951.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,691.20
|
| Rate for Payer: Cigna of CA PPO |
$1,564.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,506.64
|
| Rate for Payer: Dignity Health Media |
$1,004.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,104.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,355.98
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,004.43
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,004.43
|
| Rate for Payer: Galaxy Health WC |
$1,796.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,268.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,902.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,585.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,647.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,657.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,004.43
|
| Rate for Payer: InnovAge PACE Commercial |
$1,506.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,410.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$307.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,004.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$422.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,345.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,345.94
|
| Rate for Payer: Multiplan Commercial |
$1,585.50
|
| Rate for Payer: Networks By Design Commercial |
$1,374.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,796.90
|
| Rate for Payer: Prime Health Services Medicare |
$1,064.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,104.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,268.40
|
| 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 |
$1,506.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.87
|
| Rate for Payer: Vantage Medical Group Senior |
$1,004.43
|
|
|
HC COLPOSCOPY CERV INCL UP/ADJ VAGINA W BX CERVIX
|
Facility
|
OP
|
$1,027.00
|
|
|
Service Code
|
CPT 57455
|
| Hospital Charge Code |
904000021
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$205.40 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$400.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$616.20
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$400.82
|
| Rate for Payer: Cash Price |
$462.15
|
| Rate for Payer: Cash Price |
$462.15
|
| Rate for Payer: Central Health Plan Commercial |
$821.60
|
| Rate for Payer: Cigna of CA PPO |
$759.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$601.23
|
| Rate for Payer: Dignity Health Media |
$400.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$440.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$541.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$400.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$400.82
|
| Rate for Payer: Galaxy Health WC |
$872.95
|
| Rate for Payer: Global Benefits Group Commercial |
$616.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$924.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$770.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$657.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$661.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$400.82
|
| Rate for Payer: InnovAge PACE Commercial |
$601.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$685.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$279.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$400.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$205.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$537.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$537.10
|
| Rate for Payer: Multiplan Commercial |
$770.25
|
| Rate for Payer: Networks By Design Commercial |
$667.55
|
| Rate for Payer: Prime Health Services Commercial |
$872.95
|
| Rate for Payer: Prime Health Services Medicare |
$424.87
|
| Rate for Payer: Riverside University Health System MISP |
$440.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$616.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Vantage Medical Group Senior |
$400.82
|
|
|
HC COLPOSCOPY CERV INCL UP/ADJ VAGINA W BX CERVIX
|
Facility
|
IP
|
$1,027.00
|
|
|
Service Code
|
CPT 57455
|
| Hospital Charge Code |
904000021
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$205.40 |
| Max. Negotiated Rate |
$924.30 |
| Rate for Payer: Cash Price |
$462.15
|
| Rate for Payer: Central Health Plan Commercial |
$821.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$410.80
|
| Rate for Payer: Galaxy Health WC |
$872.95
|
| Rate for Payer: Global Benefits Group Commercial |
$616.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$924.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$685.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$391.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$205.40
|
| Rate for Payer: Multiplan Commercial |
$770.25
|
| Rate for Payer: Networks By Design Commercial |
$667.55
|
| Rate for Payer: Prime Health Services Commercial |
$872.95
|
|
|
HC COLPOSCOPY/ECC
|
Facility
|
OP
|
$1,027.00
|
|
|
Service Code
|
CPT 57456
|
| Hospital Charge Code |
904000024
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$142.48 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$400.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$616.20
|
| 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 |
$400.82
|
| Rate for Payer: Cash Price |
$462.15
|
| Rate for Payer: Cash Price |
$462.15
|
| Rate for Payer: Central Health Plan Commercial |
$821.60
|
| Rate for Payer: Cigna of CA PPO |
$759.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$601.23
|
| Rate for Payer: Dignity Health Media |
$400.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$440.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$541.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$400.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$400.82
|
| Rate for Payer: Galaxy Health WC |
$872.95
|
| Rate for Payer: Global Benefits Group Commercial |
$616.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$924.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$770.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$657.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$661.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$400.82
|
| Rate for Payer: InnovAge PACE Commercial |
$601.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$685.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$400.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$205.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$537.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$537.10
|
| Rate for Payer: Multiplan Commercial |
$770.25
|
| Rate for Payer: Networks By Design Commercial |
$667.55
|
| Rate for Payer: Prime Health Services Commercial |
$872.95
|
| Rate for Payer: Prime Health Services Medicare |
$424.87
|
| Rate for Payer: Riverside University Health System MISP |
$440.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$616.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Vantage Medical Group Senior |
$400.82
|
|
|
HC COLPOSCOPY/ECC
|
Facility
|
IP
|
$1,027.00
|
|
|
Service Code
|
CPT 57456
|
| Hospital Charge Code |
904000024
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$205.40 |
| Max. Negotiated Rate |
$924.30 |
| Rate for Payer: Cash Price |
$462.15
|
| Rate for Payer: Central Health Plan Commercial |
$821.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$410.80
|
| Rate for Payer: Galaxy Health WC |
$872.95
|
| Rate for Payer: Global Benefits Group Commercial |
$616.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$924.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$685.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$391.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$205.40
|
| Rate for Payer: Multiplan Commercial |
$770.25
|
| Rate for Payer: Networks By Design Commercial |
$667.55
|
| Rate for Payer: Prime Health Services Commercial |
$872.95
|
|
|
HC COLPOSCOPY VAG W CRVIX
|
Facility
|
OP
|
$727.00
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
906757420
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$145.40 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$400.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$436.20
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$400.82
|
| Rate for Payer: Cash Price |
$327.15
|
| Rate for Payer: Cash Price |
$327.15
|
| Rate for Payer: Central Health Plan Commercial |
$581.60
|
| Rate for Payer: Cigna of CA PPO |
$537.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$601.23
|
| Rate for Payer: Dignity Health Media |
$400.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$440.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$541.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$400.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$400.82
|
| Rate for Payer: Galaxy Health WC |
$617.95
|
| Rate for Payer: Global Benefits Group Commercial |
$436.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$654.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$545.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$657.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$661.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$400.82
|
| Rate for Payer: InnovAge PACE Commercial |
$601.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$484.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$258.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$400.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$145.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$537.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$537.10
|
| Rate for Payer: Multiplan Commercial |
$545.25
|
| Rate for Payer: Networks By Design Commercial |
$472.55
|
| Rate for Payer: Prime Health Services Commercial |
$617.95
|
| Rate for Payer: Prime Health Services Medicare |
$424.87
|
| Rate for Payer: Riverside University Health System MISP |
$440.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$436.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$480.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Vantage Medical Group Senior |
$400.82
|
|
|
HC COLPOSCOPY VAG W CRVIX
|
Facility
|
OP
|
$727.00
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
906757420
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$145.40 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$400.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$436.20
|
| Rate for Payer: Caremore Medicare Advantage |
$400.82
|
| Rate for Payer: Cash Price |
$327.15
|
| Rate for Payer: Cash Price |
$327.15
|
| Rate for Payer: Cash Price |
$327.15
|
| Rate for Payer: Cash Price |
$327.15
|
| Rate for Payer: Central Health Plan Commercial |
$581.60
|
| Rate for Payer: Cigna of CA PPO |
$537.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$601.23
|
| Rate for Payer: Dignity Health Media |
$400.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$440.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$541.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$400.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$400.82
|
| Rate for Payer: Galaxy Health WC |
$617.95
|
| Rate for Payer: Global Benefits Group Commercial |
$436.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$654.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$545.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$657.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$400.82
|
| Rate for Payer: InnovAge PACE Commercial |
$601.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$484.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$258.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$400.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$145.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$537.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$537.10
|
| Rate for Payer: Multiplan Commercial |
$545.25
|
| Rate for Payer: Networks By Design Commercial |
$472.55
|
| Rate for Payer: Prime Health Services Commercial |
$617.95
|
| Rate for Payer: Prime Health Services Medicare |
$424.87
|
| Rate for Payer: Riverside University Health System MISP |
$440.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$436.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$363.50
|
| Rate for Payer: United Healthcare All Other HMO |
$363.50
|
| Rate for Payer: United Healthcare HMO Rider |
$363.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$363.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Vantage Medical Group Senior |
$400.82
|
|
|
HC COLPOSCOPY VAG W CRVIX
|
Facility
|
IP
|
$1,372.00
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
906757420
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$274.40 |
| Max. Negotiated Rate |
$1,234.80 |
| Rate for Payer: Cash Price |
$617.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,097.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$548.80
|
| Rate for Payer: Galaxy Health WC |
$1,166.20
|
| Rate for Payer: Global Benefits Group Commercial |
$823.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,234.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$915.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$522.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$274.40
|
| Rate for Payer: Multiplan Commercial |
$1,029.00
|
| Rate for Payer: Networks By Design Commercial |
$891.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,166.20
|
|
|
HC COLPOSCOPY VAG W CRVIX
|
Facility
|
OP
|
$727.00
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
906757420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$145.40 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$400.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$436.20
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$400.82
|
| Rate for Payer: Cash Price |
$327.15
|
| Rate for Payer: Cash Price |
$327.15
|
| Rate for Payer: Central Health Plan Commercial |
$581.60
|
| Rate for Payer: Cigna of CA PPO |
$537.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$601.23
|
| Rate for Payer: Dignity Health Media |
$400.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$440.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$541.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$400.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$400.82
|
| Rate for Payer: Galaxy Health WC |
$617.95
|
| Rate for Payer: Global Benefits Group Commercial |
$436.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$654.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$545.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$657.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$661.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$400.82
|
| Rate for Payer: InnovAge PACE Commercial |
$601.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$484.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$258.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$400.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$145.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$537.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$537.10
|
| Rate for Payer: Multiplan Commercial |
$545.25
|
| Rate for Payer: Networks By Design Commercial |
$472.55
|
| Rate for Payer: Prime Health Services Commercial |
$617.95
|
| Rate for Payer: Prime Health Services Medicare |
$424.87
|
| Rate for Payer: Riverside University Health System MISP |
$440.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$436.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Vantage Medical Group Senior |
$400.82
|
|
|
HC COLPOSCOPY VAG W CRVIX
|
Facility
|
IP
|
$1,372.00
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
906757420
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$274.40 |
| Max. Negotiated Rate |
$1,234.80 |
| Rate for Payer: Cash Price |
$617.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,097.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$548.80
|
| Rate for Payer: Galaxy Health WC |
$1,166.20
|
| Rate for Payer: Global Benefits Group Commercial |
$823.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,234.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$915.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$522.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$274.40
|
| Rate for Payer: Multiplan Commercial |
$1,029.00
|
| Rate for Payer: Networks By Design Commercial |
$891.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,166.20
|
|
|
HC COLPOSCOPY VAG W CRVIX
|
Facility
|
IP
|
$1,372.00
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
906757420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$274.40 |
| Max. Negotiated Rate |
$1,234.80 |
| Rate for Payer: Cash Price |
$617.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,097.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$548.80
|
| Rate for Payer: Galaxy Health WC |
$1,166.20
|
| Rate for Payer: Global Benefits Group Commercial |
$823.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,234.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$915.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$522.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$274.40
|
| Rate for Payer: Multiplan Commercial |
$1,029.00
|
| Rate for Payer: Networks By Design Commercial |
$891.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,166.20
|
|
|
HC COLPOSCOPY VULVA W BIOPSY
|
Facility
|
IP
|
$484.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
904000023
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$96.80 |
| Max. Negotiated Rate |
$435.60 |
| Rate for Payer: Cash Price |
$217.80
|
| Rate for Payer: Central Health Plan Commercial |
$387.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$193.60
|
| Rate for Payer: Galaxy Health WC |
$411.40
|
| Rate for Payer: Global Benefits Group Commercial |
$290.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$435.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$322.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$184.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.80
|
| Rate for Payer: Multiplan Commercial |
$363.00
|
| Rate for Payer: Networks By Design Commercial |
$314.60
|
| Rate for Payer: Prime Health Services Commercial |
$411.40
|
|
|
HC COLPOSCOPY VULVA W BIOPSY
|
Facility
|
OP
|
$484.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
904000023
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$96.80 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$400.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$290.40
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$400.82
|
| Rate for Payer: Cash Price |
$217.80
|
| Rate for Payer: Cash Price |
$217.80
|
| Rate for Payer: Central Health Plan Commercial |
$387.20
|
| Rate for Payer: Cigna of CA PPO |
$358.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$601.23
|
| Rate for Payer: Dignity Health Media |
$400.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$440.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$541.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$400.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$400.82
|
| Rate for Payer: Galaxy Health WC |
$411.40
|
| Rate for Payer: Global Benefits Group Commercial |
$290.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$435.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$363.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$657.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$661.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$400.82
|
| Rate for Payer: InnovAge PACE Commercial |
$601.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$322.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$308.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$400.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$537.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$537.10
|
| Rate for Payer: Multiplan Commercial |
$363.00
|
| Rate for Payer: Networks By Design Commercial |
$314.60
|
| Rate for Payer: Prime Health Services Commercial |
$411.40
|
| Rate for Payer: Prime Health Services Medicare |
$424.87
|
| Rate for Payer: Riverside University Health System MISP |
$440.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$290.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Vantage Medical Group Senior |
$400.82
|
|
|
HC COLPOSCOPY W/BIOPSY CERVIX
|
Facility
|
OP
|
$1,364.00
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
902890150
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$163.67 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$400.82
|
| 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: Blue Distinction Transplant |
$818.40
|
| Rate for Payer: Blue Shield of California Commercial |
$857.96
|
| Rate for Payer: Blue Shield of California EPN |
$667.00
|
| Rate for Payer: Caremore Medicare Advantage |
$400.82
|
| Rate for Payer: Cash Price |
$613.80
|
| Rate for Payer: Cash Price |
$613.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,091.20
|
| Rate for Payer: Cigna of CA HMO |
$872.96
|
| Rate for Payer: Cigna of CA PPO |
$1,009.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$601.23
|
| Rate for Payer: Dignity Health Media |
$400.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$440.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$541.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$400.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$400.82
|
| Rate for Payer: Galaxy Health WC |
$1,159.40
|
| Rate for Payer: Global Benefits Group Commercial |
$818.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,227.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,023.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$657.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$661.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$400.82
|
| Rate for Payer: InnovAge PACE Commercial |
$601.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$909.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$163.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$400.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$272.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$537.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$537.10
|
| Rate for Payer: Multiplan Commercial |
$1,023.00
|
| Rate for Payer: Networks By Design Commercial |
$886.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,159.40
|
| Rate for Payer: Prime Health Services Medicare |
$424.87
|
| Rate for Payer: Riverside University Health System MISP |
$440.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$818.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$818.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$682.00
|
| Rate for Payer: United Healthcare All Other HMO |
$682.00
|
| Rate for Payer: United Healthcare HMO Rider |
$682.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$682.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Vantage Medical Group Senior |
$400.82
|
|
|
HC COLPOSCOPY W/BIOPSY CERVIX
|
Facility
|
IP
|
$1,364.00
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
902890150
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$272.80 |
| Max. Negotiated Rate |
$1,227.60 |
| Rate for Payer: Cash Price |
$613.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,091.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$545.60
|
| Rate for Payer: Galaxy Health WC |
$1,159.40
|
| Rate for Payer: Global Benefits Group Commercial |
$818.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,227.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$909.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$519.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$272.80
|
| Rate for Payer: Multiplan Commercial |
$1,023.00
|
| Rate for Payer: Networks By Design Commercial |
$886.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,159.40
|
|
|
HC COLPOSCOPY W/BIOPSY CERVIX
|
Facility
|
IP
|
$1,364.00
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
902890150
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$272.80 |
| Max. Negotiated Rate |
$1,227.60 |
| Rate for Payer: Cash Price |
$613.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,091.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$545.60
|
| Rate for Payer: Galaxy Health WC |
$1,159.40
|
| Rate for Payer: Global Benefits Group Commercial |
$818.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,227.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$909.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$519.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$272.80
|
| Rate for Payer: Multiplan Commercial |
$1,023.00
|
| Rate for Payer: Networks By Design Commercial |
$886.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,159.40
|
|
|
HC COLPOSCOPY W/BIOPSY CERVIX
|
Facility
|
OP
|
$1,364.00
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
902890150
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$163.67 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$400.82
|
| 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: Blue Distinction Transplant |
$818.40
|
| Rate for Payer: Blue Shield of California Commercial |
$857.96
|
| Rate for Payer: Blue Shield of California EPN |
$667.00
|
| Rate for Payer: Caremore Medicare Advantage |
$400.82
|
| Rate for Payer: Cash Price |
$613.80
|
| Rate for Payer: Cash Price |
$613.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,091.20
|
| Rate for Payer: Cigna of CA HMO |
$872.96
|
| Rate for Payer: Cigna of CA PPO |
$1,009.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$601.23
|
| Rate for Payer: Dignity Health Media |
$400.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$440.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$541.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$400.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$400.82
|
| Rate for Payer: Galaxy Health WC |
$1,159.40
|
| Rate for Payer: Global Benefits Group Commercial |
$818.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,227.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,023.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$657.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$661.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$400.82
|
| Rate for Payer: InnovAge PACE Commercial |
$601.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$909.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$163.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$400.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$272.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$537.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$537.10
|
| Rate for Payer: Multiplan Commercial |
$1,023.00
|
| Rate for Payer: Networks By Design Commercial |
$886.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,159.40
|
| Rate for Payer: Prime Health Services Medicare |
$424.87
|
| Rate for Payer: Riverside University Health System MISP |
$440.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$818.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$818.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$682.00
|
| Rate for Payer: United Healthcare All Other HMO |
$682.00
|
| Rate for Payer: United Healthcare HMO Rider |
$682.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$682.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Vantage Medical Group Senior |
$400.82
|
|
|
HC COMMON CAROTID HEAD UNI
|
Facility
|
IP
|
$10,387.00
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
909020146
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,077.40 |
| Max. Negotiated Rate |
$9,348.30 |
| Rate for Payer: Cash Price |
$4,674.15
|
| Rate for Payer: Central Health Plan Commercial |
$8,309.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,154.80
|
| Rate for Payer: Galaxy Health WC |
$8,828.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,232.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,348.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,928.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,957.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,077.40
|
| Rate for Payer: Multiplan Commercial |
$7,790.25
|
| Rate for Payer: Networks By Design Commercial |
$6,751.55
|
| Rate for Payer: Prime Health Services Commercial |
$8,828.95
|
|
|
HC COMMON CAROTID HEAD UNI
|
Facility
|
OP
|
$10,387.00
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
906820221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$488.09 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$6,866.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,866.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,232.20
|
| 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 |
$6,866.07
|
| Rate for Payer: Cash Price |
$4,674.15
|
| Rate for Payer: Cash Price |
$4,674.15
|
| Rate for Payer: Central Health Plan Commercial |
$8,309.60
|
| Rate for Payer: Cigna of CA PPO |
$7,686.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Dignity Health Media |
$6,866.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,552.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,269.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6,866.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,866.07
|
| Rate for Payer: Galaxy Health WC |
$8,828.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,232.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,348.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,790.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,260.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11,329.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,866.07
|
| Rate for Payer: InnovAge PACE Commercial |
$10,299.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,928.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$488.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,866.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,077.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,200.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,200.53
|
| Rate for Payer: Multiplan Commercial |
$7,790.25
|
| Rate for Payer: Networks By Design Commercial |
$6,751.55
|
| Rate for Payer: Prime Health Services Commercial |
$8,828.95
|
| Rate for Payer: Prime Health Services Medicare |
$7,278.03
|
| Rate for Payer: Riverside University Health System MISP |
$7,552.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,232.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: Vantage Medical Group Senior |
$6,866.07
|
|
|
HC COMMON CAROTID HEAD UNI
|
Facility
|
IP
|
$10,387.00
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
906820221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,077.40 |
| Max. Negotiated Rate |
$9,348.30 |
| Rate for Payer: Cash Price |
$4,674.15
|
| Rate for Payer: Central Health Plan Commercial |
$8,309.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,154.80
|
| Rate for Payer: Galaxy Health WC |
$8,828.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,232.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,348.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,928.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,957.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,077.40
|
| Rate for Payer: Multiplan Commercial |
$7,790.25
|
| Rate for Payer: Networks By Design Commercial |
$6,751.55
|
| Rate for Payer: Prime Health Services Commercial |
$8,828.95
|
|
|
HC COMMON CAROTID HEAD UNI
|
Facility
|
OP
|
$10,387.00
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
909020146
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$488.09 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$6,866.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,866.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,232.20
|
| 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 |
$6,866.07
|
| Rate for Payer: Cash Price |
$4,674.15
|
| Rate for Payer: Cash Price |
$4,674.15
|
| Rate for Payer: Central Health Plan Commercial |
$8,309.60
|
| Rate for Payer: Cigna of CA PPO |
$7,686.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Dignity Health Media |
$6,866.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,552.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,269.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6,866.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,866.07
|
| Rate for Payer: Galaxy Health WC |
$8,828.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,232.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,348.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,790.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,260.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11,329.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,866.07
|
| Rate for Payer: InnovAge PACE Commercial |
$10,299.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,928.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$488.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,866.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,077.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,200.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,200.53
|
| Rate for Payer: Multiplan Commercial |
$7,790.25
|
| Rate for Payer: Networks By Design Commercial |
$6,751.55
|
| Rate for Payer: Prime Health Services Commercial |
$8,828.95
|
| Rate for Payer: Prime Health Services Medicare |
$7,278.03
|
| Rate for Payer: Riverside University Health System MISP |
$7,552.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,232.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: Vantage Medical Group Senior |
$6,866.07
|
|
