|
HC CYLINDER CAST-THIGH TO ANKLE
|
Facility
OP
|
$699.00
|
|
|
Service Code
|
CPT 29365
|
| Hospital Charge Code |
950510041
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$139.80 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$503.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$369.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$335.55
|
| 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: BCBS Transplant Transplant |
$419.40
|
| Rate for Payer: Caremore Medicare Advantage |
$335.55
|
| Rate for Payer: Cash Price |
$314.55
|
| Rate for Payer: Cash Price |
$314.55
|
| Rate for Payer: Cash Price |
$314.55
|
| Rate for Payer: Cash Price |
$314.55
|
| Rate for Payer: Central Health Plan Commercial |
$559.20
|
| Rate for Payer: Cigna of CA PPO |
$517.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$503.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$452.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$335.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$335.55
|
| Rate for Payer: Galaxy Health WC |
$594.15
|
| Rate for Payer: Global Benefits Group Commercial |
$419.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$629.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$524.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$550.30
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$335.55
|
| Rate for Payer: Innovage PACE Commercial |
$503.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$466.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$335.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$449.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$449.64
|
| Rate for Payer: Multiplan Commercial |
$524.25
|
| Rate for Payer: Networks By Design Commercial |
$454.35
|
| Rate for Payer: Prime Health Services Commercial |
$594.15
|
| Rate for Payer: Prime Health Services Medicare |
$355.68
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$419.40
|
| Rate for Payer: Riverside University Health MISP |
$369.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$419.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$349.50
|
| Rate for Payer: United Healthcare All Other HMO |
$349.50
|
| Rate for Payer: United Healthcare HMO Rider |
$349.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$349.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$503.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$369.10
|
| Rate for Payer: Vantage Medical Group Senior |
$335.55
|
|
|
HC CYSTOGRAM, INJECTION
|
Facility
OP
|
$875.00
|
|
|
Service Code
|
CPT 51600
|
| Hospital Charge Code |
909000171
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$175.00 |
| Max. Negotiated Rate |
$5,779.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$264.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$743.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$481.25
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$481.25
|
| 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 |
$525.00
|
| Rate for Payer: Blue Shield of California Commercial |
$540.75
|
| Rate for Payer: Blue Shield of California EPN |
$425.25
|
| Rate for Payer: Cash Price |
$393.75
|
| Rate for Payer: Cash Price |
$393.75
|
| Rate for Payer: Central Health Plan Commercial |
$700.00
|
| Rate for Payer: Cigna of CA HMO |
$560.00
|
| Rate for Payer: Cigna of CA PPO |
$647.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$743.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$350.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$350.00
|
| Rate for Payer: Galaxy Health WC |
$743.75
|
| Rate for Payer: Global Benefits Group Commercial |
$525.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$787.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$656.25
|
| Rate for Payer: IEHP medi-cal |
$306.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$583.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$175.00
|
| Rate for Payer: Multiplan Commercial |
$656.25
|
| Rate for Payer: Networks By Design Commercial |
$568.75
|
| Rate for Payer: Prime Health Services Commercial |
$743.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$525.00
|
| Rate for Payer: Riverside University Health MISP |
$350.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$525.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$525.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$437.50
|
| Rate for Payer: United Healthcare All Other HMO |
$437.50
|
| Rate for Payer: United Healthcare HMO Rider |
$437.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$437.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$743.75
|
| Rate for Payer: Vantage Medical Group Senior |
$743.75
|
|
|
HC CYSTOGRAM, INJECTION
|
Facility
IP
|
$875.00
|
|
|
Service Code
|
CPT 51600
|
| Hospital Charge Code |
909000171
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$175.00 |
| Max. Negotiated Rate |
$787.50 |
| Rate for Payer: Cash Price |
$393.75
|
| Rate for Payer: Central Health Plan Commercial |
$700.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$350.00
|
| Rate for Payer: Galaxy Health WC |
$743.75
|
| Rate for Payer: Global Benefits Group Commercial |
$525.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$787.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$583.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$175.00
|
| Rate for Payer: Multiplan Commercial |
$656.25
|
| Rate for Payer: Networks By Design Commercial |
$568.75
|
| Rate for Payer: Prime Health Services Commercial |
$743.75
|
|
|
HC CYSTOGRAPH MIN 3 VIEWS
|
Facility
OP
|
$1,261.00
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
909001901
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$218.49 |
| Max. Negotiated Rate |
$1,134.90 |
| Rate for Payer: Adventist Health Medi-Cal |
$480.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$255.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$720.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$528.55
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$480.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$218.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$266.50
|
| Rate for Payer: BCBS Transplant Transplant |
$756.60
|
| Rate for Payer: Blue Shield of California Commercial |
$779.30
|
| Rate for Payer: Blue Shield of California EPN |
$612.85
|
| Rate for Payer: Caremore Medicare Advantage |
$480.50
|
| Rate for Payer: Cash Price |
$567.45
|
| Rate for Payer: Cash Price |
$567.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,008.80
|
| Rate for Payer: Cigna of CA HMO |
$807.04
|
| Rate for Payer: Cigna of CA PPO |
$933.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$720.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$648.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$480.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$480.50
|
| Rate for Payer: Galaxy Health WC |
$1,071.85
|
| Rate for Payer: Global Benefits Group Commercial |
$756.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,134.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$945.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$788.02
|
| Rate for Payer: IEHP medi-cal |
$792.82
|
| Rate for Payer: IEHP Medicare Advantage |
$480.50
|
| Rate for Payer: Innovage PACE Commercial |
$720.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$841.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$480.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$643.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$643.87
|
| Rate for Payer: Multiplan Commercial |
$945.75
|
| Rate for Payer: Networks By Design Commercial |
$819.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,071.85
|
| Rate for Payer: Prime Health Services Medicare |
$509.33
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$756.60
|
| Rate for Payer: Riverside University Health MISP |
$528.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$756.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$756.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$470.69
|
| Rate for Payer: United Healthcare All Other HMO |
$470.69
|
| Rate for Payer: United Healthcare HMO Rider |
$470.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$470.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$720.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$528.55
|
| Rate for Payer: Vantage Medical Group Senior |
$480.50
|
|
|
HC CYSTOGRAPH MIN 3 VIEWS
|
Facility
IP
|
$1,261.00
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
909001901
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$252.20 |
| Max. Negotiated Rate |
$1,134.90 |
| Rate for Payer: Cash Price |
$567.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,008.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$504.40
|
| Rate for Payer: Galaxy Health WC |
$1,071.85
|
| Rate for Payer: Global Benefits Group Commercial |
$756.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,134.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$841.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.20
|
| Rate for Payer: Multiplan Commercial |
$945.75
|
| Rate for Payer: Networks By Design Commercial |
$819.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,071.85
|
|
|
HC CYSTOSTOMY TUBE CHG SIMPLE
|
Facility
OP
|
$1,558.00
|
|
|
Service Code
|
CPT 51705
|
| Hospital Charge Code |
900501165
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$308.79 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$308.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$463.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$339.67
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$308.79
|
| 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: BCBS Transplant Transplant |
$934.80
|
| Rate for Payer: Blue Shield of California Commercial |
$979.98
|
| Rate for Payer: Blue Shield of California EPN |
$761.86
|
| Rate for Payer: Caremore Medicare Advantage |
$308.79
|
| Rate for Payer: Cash Price |
$701.10
|
| Rate for Payer: Cash Price |
$701.10
|
| Rate for Payer: Cash Price |
$701.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,246.40
|
| Rate for Payer: Cigna of CA HMO |
$997.12
|
| Rate for Payer: Cigna of CA PPO |
$1,152.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$463.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$416.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$308.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$308.79
|
| Rate for Payer: Galaxy Health WC |
$1,324.30
|
| Rate for Payer: Global Benefits Group Commercial |
$934.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,402.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,168.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$506.42
|
| Rate for Payer: IEHP medi-cal |
$509.50
|
| Rate for Payer: IEHP Medicare Advantage |
$308.79
|
| Rate for Payer: Innovage PACE Commercial |
$463.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,039.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$308.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$311.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$413.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$413.78
|
| Rate for Payer: Multiplan Commercial |
$1,168.50
|
| Rate for Payer: Networks By Design Commercial |
$1,012.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,324.30
|
| Rate for Payer: Prime Health Services Medicare |
$327.32
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$934.80
|
| Rate for Payer: Riverside University Health MISP |
$339.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$934.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$934.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$779.00
|
| Rate for Payer: United Healthcare All Other HMO |
$779.00
|
| Rate for Payer: United Healthcare HMO Rider |
$779.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$779.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$463.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$339.67
|
| Rate for Payer: Vantage Medical Group Senior |
$308.79
|
|
|
HC CYSTOSTOMY TUBE CHG SIMPLE
|
Facility
IP
|
$1,558.00
|
|
|
Service Code
|
CPT 51705
|
| Hospital Charge Code |
900501165
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$311.60 |
| Max. Negotiated Rate |
$1,402.20 |
| Rate for Payer: Cash Price |
$701.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,246.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$623.20
|
| Rate for Payer: Galaxy Health WC |
$1,324.30
|
| Rate for Payer: Global Benefits Group Commercial |
$934.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,402.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,039.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$311.60
|
| Rate for Payer: Multiplan Commercial |
$1,168.50
|
| Rate for Payer: Networks By Design Commercial |
$1,012.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,324.30
|
|
|
HC CYSTOSTOMY TUBE CHG SIMPLE
|
Facility
IP
|
$1,558.00
|
|
|
Service Code
|
CPT 51705
|
| Hospital Charge Code |
900501165
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$311.60 |
| Max. Negotiated Rate |
$1,402.20 |
| Rate for Payer: Cash Price |
$701.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,246.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$623.20
|
| Rate for Payer: Galaxy Health WC |
$1,324.30
|
| Rate for Payer: Global Benefits Group Commercial |
$934.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,402.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,039.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$311.60
|
| Rate for Payer: Multiplan Commercial |
$1,168.50
|
| Rate for Payer: Networks By Design Commercial |
$1,012.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,324.30
|
|
|
HC CYSTOSTOMY TUBE CHG SIMPLE
|
Facility
OP
|
$1,558.00
|
|
|
Service Code
|
CPT 51705
|
| Hospital Charge Code |
900501165
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$308.79 |
| 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: AlphaCare Medical Group Commercial/Exchange |
$463.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$339.67
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$308.79
|
| 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: BCBS Transplant Transplant |
$934.80
|
| Rate for Payer: Caremore Medicare Advantage |
$308.79
|
| Rate for Payer: Cash Price |
$701.10
|
| Rate for Payer: Cash Price |
$701.10
|
| Rate for Payer: Cash Price |
$701.10
|
| Rate for Payer: Cash Price |
$701.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,246.40
|
| Rate for Payer: Cigna of CA PPO |
$1,152.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$463.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$416.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$308.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$308.79
|
| Rate for Payer: Galaxy Health WC |
$1,324.30
|
| Rate for Payer: Global Benefits Group Commercial |
$934.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,402.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,168.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$506.42
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$308.79
|
| Rate for Payer: Innovage PACE Commercial |
$463.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,039.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$308.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$311.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$413.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$413.78
|
| Rate for Payer: Multiplan Commercial |
$1,168.50
|
| Rate for Payer: Networks By Design Commercial |
$1,012.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,324.30
|
| Rate for Payer: Prime Health Services Medicare |
$327.32
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$934.80
|
| Rate for Payer: Riverside University Health MISP |
$339.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$934.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$779.00
|
| Rate for Payer: United Healthcare All Other HMO |
$779.00
|
| Rate for Payer: United Healthcare HMO Rider |
$779.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$779.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$463.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$339.67
|
| Rate for Payer: Vantage Medical Group Senior |
$308.79
|
|
|
HC CYSTOSTOMY W DRAINAGE
|
Facility
IP
|
$11,497.00
|
|
|
Service Code
|
CPT 51040
|
| Hospital Charge Code |
900551040
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$2,299.40 |
| Max. Negotiated Rate |
$10,347.30 |
| Rate for Payer: Cash Price |
$5,173.65
|
| Rate for Payer: Central Health Plan Commercial |
$9,197.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,598.80
|
| Rate for Payer: Galaxy Health WC |
$9,772.45
|
| Rate for Payer: Global Benefits Group Commercial |
$6,898.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,347.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,668.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,299.40
|
| Rate for Payer: Multiplan Commercial |
$8,622.75
|
| Rate for Payer: Networks By Design Commercial |
$7,473.05
|
| Rate for Payer: Prime Health Services Commercial |
$9,772.45
|
|
|
HC CYSTOSTOMY W DRAINAGE
|
Facility
OP
|
$11,497.00
|
|
|
Service Code
|
CPT 51040
|
| Hospital Charge Code |
900551040
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$10,567.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,544.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: BCBS Transplant Transplant |
$6,898.20
|
| Rate for Payer: Caremore Medicare Advantage |
$2,544.87
|
| Rate for Payer: Cash Price |
$5,173.65
|
| Rate for Payer: Cash Price |
$5,173.65
|
| Rate for Payer: Cash Price |
$5,173.65
|
| Rate for Payer: Cash Price |
$5,173.65
|
| Rate for Payer: Central Health Plan Commercial |
$9,197.60
|
| Rate for Payer: Cigna of CA PPO |
$8,507.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,817.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,435.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,544.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,544.87
|
| Rate for Payer: Galaxy Health WC |
$9,772.45
|
| Rate for Payer: Global Benefits Group Commercial |
$6,898.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,347.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8,622.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,173.59
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$2,544.87
|
| Rate for Payer: Innovage PACE Commercial |
$3,817.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,668.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,544.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,299.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,410.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,410.13
|
| Rate for Payer: Multiplan Commercial |
$8,622.75
|
| Rate for Payer: Networks By Design Commercial |
$7,473.05
|
| Rate for Payer: Prime Health Services Commercial |
$9,772.45
|
| Rate for Payer: Prime Health Services Medicare |
$2,697.56
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6,898.20
|
| Rate for Payer: Riverside University Health MISP |
$2,799.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,898.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,748.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,748.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,748.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,748.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: Vantage Medical Group Senior |
$2,544.87
|
|
|
HC CYSTOSTOMY W DRAINAGE
|
Facility
IP
|
$11,497.00
|
|
|
Service Code
|
CPT 51040
|
| Hospital Charge Code |
900551040
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,299.40 |
| Max. Negotiated Rate |
$10,347.30 |
| Rate for Payer: Cash Price |
$5,173.65
|
| Rate for Payer: Central Health Plan Commercial |
$9,197.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,598.80
|
| Rate for Payer: Galaxy Health WC |
$9,772.45
|
| Rate for Payer: Global Benefits Group Commercial |
$6,898.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,347.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,668.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,299.40
|
| Rate for Payer: Multiplan Commercial |
$8,622.75
|
| Rate for Payer: Networks By Design Commercial |
$7,473.05
|
| Rate for Payer: Prime Health Services Commercial |
$9,772.45
|
|
|
HC CYSTOSTOMY W DRAINAGE
|
Facility
OP
|
$11,497.00
|
|
|
Service Code
|
CPT 51040
|
| Hospital Charge Code |
900551040
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$2,299.40 |
| Max. Negotiated Rate |
$10,567.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,544.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,544.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: BCBS Transplant Transplant |
$6,898.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,231.61
|
| Rate for Payer: Blue Shield of California EPN |
$5,622.03
|
| Rate for Payer: Caremore Medicare Advantage |
$2,544.87
|
| Rate for Payer: Cash Price |
$5,173.65
|
| Rate for Payer: Cash Price |
$5,173.65
|
| Rate for Payer: Central Health Plan Commercial |
$9,197.60
|
| Rate for Payer: Cigna of CA HMO |
$7,358.08
|
| Rate for Payer: Cigna of CA PPO |
$8,507.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,817.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,435.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,544.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,544.87
|
| Rate for Payer: Galaxy Health WC |
$9,772.45
|
| Rate for Payer: Global Benefits Group Commercial |
$6,898.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,347.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8,622.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,173.59
|
| Rate for Payer: IEHP medi-cal |
$4,199.04
|
| Rate for Payer: IEHP Medicare Advantage |
$2,544.87
|
| Rate for Payer: Innovage PACE Commercial |
$3,817.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,668.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,544.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,299.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,410.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,410.13
|
| Rate for Payer: Multiplan Commercial |
$8,622.75
|
| Rate for Payer: Networks By Design Commercial |
$7,473.05
|
| Rate for Payer: Prime Health Services Commercial |
$9,772.45
|
| Rate for Payer: Prime Health Services Medicare |
$2,697.56
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6,898.20
|
| Rate for Payer: Riverside University Health MISP |
$2,799.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,898.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,898.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,748.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,748.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,748.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,748.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: Vantage Medical Group Senior |
$2,544.87
|
|
|
HC CYSTOSTOMY W INSERTION CATH OR STNT
|
Facility
OP
|
$2,470.00
|
|
|
Service Code
|
CPT 51045
|
| Hospital Charge Code |
900551045
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$494.00 |
| Max. Negotiated Rate |
$10,567.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,544.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,544.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,482.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,553.63
|
| Rate for Payer: Blue Shield of California EPN |
$1,207.83
|
| Rate for Payer: Caremore Medicare Advantage |
$2,544.87
|
| Rate for Payer: Cash Price |
$1,111.50
|
| Rate for Payer: Cash Price |
$1,111.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,976.00
|
| Rate for Payer: Cigna of CA HMO |
$1,580.80
|
| Rate for Payer: Cigna of CA PPO |
$1,827.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,817.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,435.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,544.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,544.87
|
| Rate for Payer: Galaxy Health WC |
$2,099.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,482.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,223.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,852.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,173.59
|
| Rate for Payer: IEHP medi-cal |
$4,199.04
|
| Rate for Payer: IEHP Medicare Advantage |
$2,544.87
|
| Rate for Payer: Innovage PACE Commercial |
$3,817.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,647.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,544.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$494.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,410.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,410.13
|
| Rate for Payer: Multiplan Commercial |
$1,852.50
|
| Rate for Payer: Networks By Design Commercial |
$1,605.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,099.50
|
| Rate for Payer: Prime Health Services Medicare |
$2,697.56
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,482.00
|
| Rate for Payer: Riverside University Health MISP |
$2,799.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,482.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,482.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,235.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,235.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,235.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,235.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: Vantage Medical Group Senior |
$2,544.87
|
|
|
HC CYSTOSTOMY W INSERTION CATH OR STNT
|
Facility
IP
|
$2,470.00
|
|
|
Service Code
|
CPT 51045
|
| Hospital Charge Code |
900551045
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$494.00 |
| Max. Negotiated Rate |
$2,223.00 |
| Rate for Payer: Cash Price |
$1,111.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,976.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$988.00
|
| Rate for Payer: Galaxy Health WC |
$2,099.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,482.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,223.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,647.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$494.00
|
| Rate for Payer: Multiplan Commercial |
$1,852.50
|
| Rate for Payer: Networks By Design Commercial |
$1,605.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,099.50
|
|
|
HC CYSTOSTOMY W INSERTION CATH OR STNT
|
Facility
IP
|
$2,470.00
|
|
|
Service Code
|
CPT 51045
|
| Hospital Charge Code |
900551045
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$494.00 |
| Max. Negotiated Rate |
$2,223.00 |
| Rate for Payer: Cash Price |
$1,111.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,976.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$988.00
|
| Rate for Payer: Galaxy Health WC |
$2,099.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,482.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,223.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,647.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$494.00
|
| Rate for Payer: Multiplan Commercial |
$1,852.50
|
| Rate for Payer: Networks By Design Commercial |
$1,605.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,099.50
|
|
|
HC CYSTOSTOMY W INSERTION CATH OR STNT
|
Facility
OP
|
$2,470.00
|
|
|
Service Code
|
CPT 51045
|
| Hospital Charge Code |
900551045
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$10,567.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,544.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,482.00
|
| Rate for Payer: Caremore Medicare Advantage |
$2,544.87
|
| Rate for Payer: Cash Price |
$1,111.50
|
| Rate for Payer: Cash Price |
$1,111.50
|
| Rate for Payer: Cash Price |
$1,111.50
|
| Rate for Payer: Cash Price |
$1,111.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,976.00
|
| Rate for Payer: Cigna of CA PPO |
$1,827.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,817.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,435.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,544.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,544.87
|
| Rate for Payer: Galaxy Health WC |
$2,099.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,482.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,223.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,852.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,173.59
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$2,544.87
|
| Rate for Payer: Innovage PACE Commercial |
$3,817.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,647.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,544.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$494.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,410.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,410.13
|
| Rate for Payer: Multiplan Commercial |
$1,852.50
|
| Rate for Payer: Networks By Design Commercial |
$1,605.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,099.50
|
| Rate for Payer: Prime Health Services Medicare |
$2,697.56
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,482.00
|
| Rate for Payer: Riverside University Health MISP |
$2,799.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,482.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,235.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,235.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,235.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,235.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: Vantage Medical Group Senior |
$2,544.87
|
|
|
HC CYSTOURETHROSCOPY
|
Facility
IP
|
$4,210.00
|
|
|
Service Code
|
CPT 52000
|
| Hospital Charge Code |
900501353
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$842.00 |
| Max. Negotiated Rate |
$3,789.00 |
| Rate for Payer: Cash Price |
$1,894.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,368.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,684.00
|
| Rate for Payer: Galaxy Health WC |
$3,578.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,526.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,789.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,808.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$842.00
|
| Rate for Payer: Multiplan Commercial |
$3,157.50
|
| Rate for Payer: Networks By Design Commercial |
$2,736.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,578.50
|
|
|
HC CYSTOURETHROSCOPY
|
Facility
OP
|
$4,210.00
|
|
|
Service Code
|
CPT 52000
|
| Hospital Charge Code |
900501353
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$5,779.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,280.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$938.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$853.50
|
| 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 |
$2,526.00
|
| Rate for Payer: Caremore Medicare Advantage |
$853.50
|
| Rate for Payer: Cash Price |
$1,894.50
|
| Rate for Payer: Cash Price |
$1,894.50
|
| Rate for Payer: Cash Price |
$1,894.50
|
| Rate for Payer: Cash Price |
$1,894.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,368.00
|
| Rate for Payer: Cigna of CA PPO |
$3,115.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,280.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,152.22
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$853.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$853.50
|
| Rate for Payer: Galaxy Health WC |
$3,578.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,526.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,789.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,157.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,399.74
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$853.50
|
| Rate for Payer: Innovage PACE Commercial |
$1,280.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,808.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$853.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$842.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,143.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,143.69
|
| Rate for Payer: Multiplan Commercial |
$3,157.50
|
| Rate for Payer: Networks By Design Commercial |
$2,736.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,578.50
|
| Rate for Payer: Prime Health Services Medicare |
$904.71
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,526.00
|
| Rate for Payer: Riverside University Health MISP |
$938.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,526.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,105.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,105.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,105.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,105.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,280.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$938.85
|
| Rate for Payer: Vantage Medical Group Senior |
$853.50
|
|
|
HC CYSTOURETHROSCOPY, W/DILATION
|
Facility
OP
|
$9,635.00
|
|
|
Service Code
|
CPT 52281
|
| Hospital Charge Code |
900501303
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$8,671.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,544.87
|
| 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 |
$5,781.00
|
| Rate for Payer: Caremore Medicare Advantage |
$2,544.87
|
| Rate for Payer: Cash Price |
$4,335.75
|
| Rate for Payer: Cash Price |
$4,335.75
|
| Rate for Payer: Cash Price |
$4,335.75
|
| Rate for Payer: Cash Price |
$4,335.75
|
| Rate for Payer: Central Health Plan Commercial |
$7,708.00
|
| Rate for Payer: Cigna of CA PPO |
$7,129.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,817.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,435.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,544.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,544.87
|
| Rate for Payer: Galaxy Health WC |
$8,189.75
|
| Rate for Payer: Global Benefits Group Commercial |
$5,781.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,671.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7,226.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,173.59
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$2,544.87
|
| Rate for Payer: Innovage PACE Commercial |
$3,817.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,426.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,544.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,927.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,410.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,410.13
|
| Rate for Payer: Multiplan Commercial |
$7,226.25
|
| Rate for Payer: Networks By Design Commercial |
$6,262.75
|
| Rate for Payer: Prime Health Services Commercial |
$8,189.75
|
| Rate for Payer: Prime Health Services Medicare |
$2,697.56
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,781.00
|
| Rate for Payer: Riverside University Health MISP |
$2,799.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,781.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,817.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,817.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,817.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,817.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: Vantage Medical Group Senior |
$2,544.87
|
|
|
HC CYSTOURETHROSCOPY, W/DILATION
|
Facility
IP
|
$9,635.00
|
|
|
Service Code
|
CPT 52281
|
| Hospital Charge Code |
900501303
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,927.00 |
| Max. Negotiated Rate |
$8,671.50 |
| Rate for Payer: Cash Price |
$4,335.75
|
| Rate for Payer: Central Health Plan Commercial |
$7,708.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,854.00
|
| Rate for Payer: Galaxy Health WC |
$8,189.75
|
| Rate for Payer: Global Benefits Group Commercial |
$5,781.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,671.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,426.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,927.00
|
| Rate for Payer: Multiplan Commercial |
$7,226.25
|
| Rate for Payer: Networks By Design Commercial |
$6,262.75
|
| Rate for Payer: Prime Health Services Commercial |
$8,189.75
|
|
|
HC CYSTOURETHROSCOPY W/RMVL F B
|
Facility
OP
|
$10,519.00
|
|
|
Service Code
|
CPT 52310
|
| Hospital Charge Code |
900501293
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$9,467.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,544.87
|
| 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 |
$6,311.40
|
| Rate for Payer: Caremore Medicare Advantage |
$2,544.87
|
| Rate for Payer: Cash Price |
$4,733.55
|
| Rate for Payer: Cash Price |
$4,733.55
|
| Rate for Payer: Cash Price |
$4,733.55
|
| Rate for Payer: Cash Price |
$4,733.55
|
| Rate for Payer: Central Health Plan Commercial |
$8,415.20
|
| Rate for Payer: Cigna of CA PPO |
$7,784.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,817.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,435.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,544.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,544.87
|
| Rate for Payer: Galaxy Health WC |
$8,941.15
|
| Rate for Payer: Global Benefits Group Commercial |
$6,311.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,467.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7,889.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,173.59
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$2,544.87
|
| Rate for Payer: Innovage PACE Commercial |
$3,817.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,016.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,544.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,103.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,410.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,410.13
|
| Rate for Payer: Multiplan Commercial |
$7,889.25
|
| Rate for Payer: Networks By Design Commercial |
$6,837.35
|
| Rate for Payer: Prime Health Services Commercial |
$8,941.15
|
| Rate for Payer: Prime Health Services Medicare |
$2,697.56
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6,311.40
|
| Rate for Payer: Riverside University Health MISP |
$2,799.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,311.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,259.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,259.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,259.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,259.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: Vantage Medical Group Senior |
$2,544.87
|
|
|
HC CYSTOURETHROSCOPY W/RMVL F B
|
Facility
IP
|
$10,519.00
|
|
|
Service Code
|
CPT 52310
|
| Hospital Charge Code |
900501293
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,103.80 |
| Max. Negotiated Rate |
$9,467.10 |
| Rate for Payer: Cash Price |
$4,733.55
|
| Rate for Payer: Central Health Plan Commercial |
$8,415.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,207.60
|
| Rate for Payer: Galaxy Health WC |
$8,941.15
|
| Rate for Payer: Global Benefits Group Commercial |
$6,311.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,467.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,016.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,103.80
|
| Rate for Payer: Multiplan Commercial |
$7,889.25
|
| Rate for Payer: Networks By Design Commercial |
$6,837.35
|
| Rate for Payer: Prime Health Services Commercial |
$8,941.15
|
|
|
HC CYSTOURETHROSCOPY,W/UTERAL CAT
|
Facility
IP
|
$12,044.00
|
|
|
Service Code
|
CPT 52005
|
| Hospital Charge Code |
900501312
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,408.80 |
| Max. Negotiated Rate |
$10,839.60 |
| Rate for Payer: Cash Price |
$5,419.80
|
| Rate for Payer: Central Health Plan Commercial |
$9,635.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,817.60
|
| Rate for Payer: Galaxy Health WC |
$10,237.40
|
| Rate for Payer: Global Benefits Group Commercial |
$7,226.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,839.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,033.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,408.80
|
| Rate for Payer: Multiplan Commercial |
$9,033.00
|
| Rate for Payer: Networks By Design Commercial |
$7,828.60
|
| Rate for Payer: Prime Health Services Commercial |
$10,237.40
|
|
|
HC CYSTOURETHROSCOPY,W/UTERAL CAT
|
Facility
OP
|
$12,044.00
|
|
|
Service Code
|
CPT 52005
|
| Hospital Charge Code |
900501312
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$10,839.60 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,544.87
|
| 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 |
$7,226.40
|
| Rate for Payer: Caremore Medicare Advantage |
$2,544.87
|
| Rate for Payer: Cash Price |
$5,419.80
|
| Rate for Payer: Cash Price |
$5,419.80
|
| Rate for Payer: Cash Price |
$5,419.80
|
| Rate for Payer: Cash Price |
$5,419.80
|
| Rate for Payer: Central Health Plan Commercial |
$9,635.20
|
| Rate for Payer: Cigna of CA PPO |
$8,912.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,817.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,435.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,544.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,544.87
|
| Rate for Payer: Galaxy Health WC |
$10,237.40
|
| Rate for Payer: Global Benefits Group Commercial |
$7,226.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,839.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9,033.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,173.59
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$2,544.87
|
| Rate for Payer: Innovage PACE Commercial |
$3,817.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,033.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,544.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,408.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,410.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,410.13
|
| Rate for Payer: Multiplan Commercial |
$9,033.00
|
| Rate for Payer: Networks By Design Commercial |
$7,828.60
|
| Rate for Payer: Prime Health Services Commercial |
$10,237.40
|
| Rate for Payer: Prime Health Services Medicare |
$2,697.56
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7,226.40
|
| Rate for Payer: Riverside University Health MISP |
$2,799.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,226.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,022.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6,022.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6,022.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,022.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: Vantage Medical Group Senior |
$2,544.87
|
|
