|
HC DEVELOP TEST W INTERP & RPT MCAL
|
Facility
|
OP
|
$1,234.00
|
|
|
Service Code
|
CPT 96110
|
| Hospital Charge Code |
901300035
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$12.10 |
| Max. Negotiated Rate |
$1,110.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,048.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$678.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$678.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$349.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$740.40
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$555.30
|
| Rate for Payer: Cash Price |
$555.30
|
| Rate for Payer: Cash Price |
$555.30
|
| Rate for Payer: Cash Price |
$555.30
|
| Rate for Payer: Central Health Plan Commercial |
$987.20
|
| Rate for Payer: Cigna of CA HMO |
$789.76
|
| Rate for Payer: Cigna of CA PPO |
$913.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,048.90
|
| Rate for Payer: Dignity Health Media |
$1,048.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,048.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$493.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$493.60
|
| Rate for Payer: Galaxy Health WC |
$1,048.90
|
| Rate for Payer: Global Benefits Group Commercial |
$740.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,110.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$925.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$431.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$823.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$505.94
|
| Rate for Payer: Multiplan Commercial |
$925.50
|
| Rate for Payer: Networks By Design Commercial |
$802.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,048.90
|
| Rate for Payer: Riverside University Health System MISP |
$493.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$740.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$740.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,048.90
|
| Rate for Payer: Vantage Medical Group Senior |
$1,048.90
|
|
|
HC D EXT PWR MECH ELBW SWITCH CON
|
Facility
|
IP
|
$38,383.00
|
|
|
Service Code
|
CPT L6960
|
| Hospital Charge Code |
905356960
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$7,676.60 |
| Max. Negotiated Rate |
$34,544.70 |
| Rate for Payer: Blue Shield of California EPN |
$20,496.52
|
| Rate for Payer: Cash Price |
$17,272.35
|
| Rate for Payer: Central Health Plan Commercial |
$30,706.40
|
| Rate for Payer: Cigna of CA HMO |
$26,868.10
|
| Rate for Payer: Cigna of CA PPO |
$26,868.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,353.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$15,353.20
|
| Rate for Payer: Galaxy Health WC |
$32,625.55
|
| Rate for Payer: Global Benefits Group Commercial |
$23,029.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,544.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,601.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,623.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,676.60
|
| Rate for Payer: Multiplan Commercial |
$28,787.25
|
| Rate for Payer: Networks By Design Commercial |
$19,191.50
|
| Rate for Payer: Prime Health Services Commercial |
$32,625.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,493.42
|
| Rate for Payer: United Healthcare All Other HMO |
$14,155.65
|
| Rate for Payer: United Healthcare HMO Rider |
$13,848.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12,666.39
|
|
|
HC D EXT PWR MECH ELBW SWITCH CON
|
Facility
|
OP
|
$38,383.00
|
|
|
Service Code
|
CPT L6960
|
| Hospital Charge Code |
905356960
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$10,906.00 |
| Max. Negotiated Rate |
$34,544.70 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32,625.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21,110.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21,110.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18,585.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,676.68
|
| Rate for Payer: Blue Distinction Transplant |
$23,029.80
|
| Rate for Payer: Blue Shield of California Commercial |
$28,787.25
|
| Rate for Payer: Blue Shield of California EPN |
$20,880.35
|
| Rate for Payer: Cash Price |
$17,272.35
|
| Rate for Payer: Cash Price |
$17,272.35
|
| Rate for Payer: Central Health Plan Commercial |
$30,706.40
|
| Rate for Payer: Cigna of CA HMO |
$26,868.10
|
| Rate for Payer: Cigna of CA PPO |
$26,868.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32,625.55
|
| Rate for Payer: Dignity Health Media |
$32,625.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$32,625.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,353.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$15,353.20
|
| Rate for Payer: Galaxy Health WC |
$32,625.55
|
| Rate for Payer: Global Benefits Group Commercial |
$23,029.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,544.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$28,787.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13,434.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,601.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,906.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,737.03
|
| Rate for Payer: Multiplan Commercial |
$28,787.25
|
| Rate for Payer: Networks By Design Commercial |
$19,191.50
|
| Rate for Payer: Prime Health Services Commercial |
$32,625.55
|
| Rate for Payer: Riverside University Health System MISP |
$15,353.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23,029.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23,029.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$19,191.50
|
| Rate for Payer: United Healthcare All Other HMO |
$19,191.50
|
| Rate for Payer: United Healthcare HMO Rider |
$19,191.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19,191.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32,625.55
|
| Rate for Payer: Vantage Medical Group Senior |
$32,625.55
|
|
|
HC DHEA-S
|
Facility
|
IP
|
$406.00
|
|
|
Service Code
|
CPT 82627
|
| Hospital Charge Code |
900912126
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$81.20 |
| Max. Negotiated Rate |
$365.40 |
| Rate for Payer: Cash Price |
$182.70
|
| Rate for Payer: Central Health Plan Commercial |
$324.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$162.40
|
| Rate for Payer: Galaxy Health WC |
$345.10
|
| Rate for Payer: Global Benefits Group Commercial |
$243.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$365.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$270.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$154.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.20
|
| Rate for Payer: Multiplan Commercial |
$304.50
|
| Rate for Payer: Networks By Design Commercial |
$263.90
|
| Rate for Payer: Prime Health Services Commercial |
$345.10
|
|
|
HC DHEA-S
|
Facility
|
OP
|
$67.00
|
|
|
Service Code
|
CPT 82627
|
| Hospital Charge Code |
900912126
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.40 |
| Max. Negotiated Rate |
$197.26 |
| Rate for Payer: Adventist Health Medi-Cal |
$22.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$163.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$161.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$197.26
|
| Rate for Payer: Blue Distinction Transplant |
$40.20
|
| Rate for Payer: Blue Shield of California Commercial |
$41.41
|
| Rate for Payer: Blue Shield of California EPN |
$32.56
|
| Rate for Payer: Caremore Medicare Advantage |
$22.23
|
| Rate for Payer: Cash Price |
$30.15
|
| Rate for Payer: Cash Price |
$30.15
|
| Rate for Payer: Central Health Plan Commercial |
$53.60
|
| Rate for Payer: Cigna of CA HMO |
$42.88
|
| Rate for Payer: Cigna of CA PPO |
$49.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.34
|
| Rate for Payer: Dignity Health Media |
$22.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22.23
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.23
|
| Rate for Payer: Galaxy Health WC |
$56.95
|
| Rate for Payer: Global Benefits Group Commercial |
$40.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$60.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$50.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$36.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$36.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22.23
|
| Rate for Payer: InnovAge PACE Commercial |
$33.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29.79
|
| Rate for Payer: Multiplan Commercial |
$50.25
|
| Rate for Payer: Networks By Design Commercial |
$43.55
|
| Rate for Payer: Prime Health Services Commercial |
$56.95
|
| Rate for Payer: Prime Health Services Medicare |
$23.56
|
| Rate for Payer: Riverside University Health System MISP |
$24.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$40.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$40.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.01
|
| Rate for Payer: United Healthcare All Other HMO |
$18.01
|
| Rate for Payer: United Healthcare HMO Rider |
$18.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.45
|
| Rate for Payer: Vantage Medical Group Senior |
$22.23
|
|
|
HC DIAB OP SELF MGMT-GRP 30 MIN
|
Facility
|
IP
|
$136.00
|
|
|
Service Code
|
CPT G0109
|
| Hospital Charge Code |
902501101
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$122.40 |
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Central Health Plan Commercial |
$108.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.40
|
| Rate for Payer: Galaxy Health WC |
$115.60
|
| Rate for Payer: Global Benefits Group Commercial |
$81.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$122.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$90.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$51.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.20
|
| Rate for Payer: Multiplan Commercial |
$102.00
|
| Rate for Payer: Networks By Design Commercial |
$88.40
|
| Rate for Payer: Prime Health Services Commercial |
$115.60
|
|
|
HC DIAB OP SELF MGMT-GRP 30 MIN
|
Facility
|
OP
|
$136.00
|
|
|
Service Code
|
CPT G0109
|
| Hospital Charge Code |
902501101
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$26.87 |
| Max. Negotiated Rate |
$785.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$97.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$115.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$74.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$74.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$65.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$80.35
|
| Rate for Payer: Blue Distinction Transplant |
$81.60
|
| Rate for Payer: Blue Shield of California Commercial |
$85.54
|
| Rate for Payer: Blue Shield of California EPN |
$66.50
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Central Health Plan Commercial |
$108.80
|
| Rate for Payer: Cigna of CA HMO |
$87.04
|
| Rate for Payer: Cigna of CA PPO |
$100.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$115.60
|
| Rate for Payer: Dignity Health Media |
$115.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$115.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$54.40
|
| Rate for Payer: Galaxy Health WC |
$115.60
|
| Rate for Payer: Global Benefits Group Commercial |
$81.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$122.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$102.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$47.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$90.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.20
|
| Rate for Payer: Multiplan Commercial |
$102.00
|
| Rate for Payer: Networks By Design Commercial |
$88.40
|
| Rate for Payer: Prime Health Services Commercial |
$115.60
|
| Rate for Payer: Riverside University Health System MISP |
$54.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$81.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$81.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$602.00
|
| Rate for Payer: United Healthcare All Other HMO |
$785.00
|
| Rate for Payer: United Healthcare HMO Rider |
$593.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$542.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$115.60
|
| Rate for Payer: Vantage Medical Group Senior |
$115.60
|
|
|
HC DIAB OP SELF MGMT-INDIV 30 MIN
|
Facility
|
OP
|
$311.00
|
|
|
Service Code
|
CPT G0108
|
| Hospital Charge Code |
902501100
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$62.20 |
| Max. Negotiated Rate |
$785.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$282.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$264.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$171.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$150.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$183.74
|
| Rate for Payer: Blue Distinction Transplant |
$186.60
|
| Rate for Payer: Blue Shield of California Commercial |
$195.62
|
| Rate for Payer: Blue Shield of California EPN |
$152.08
|
| Rate for Payer: Cash Price |
$139.95
|
| Rate for Payer: Cash Price |
$139.95
|
| Rate for Payer: Cash Price |
$139.95
|
| Rate for Payer: Central Health Plan Commercial |
$248.80
|
| Rate for Payer: Cigna of CA HMO |
$199.04
|
| Rate for Payer: Cigna of CA PPO |
$230.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$264.35
|
| Rate for Payer: Dignity Health Media |
$264.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$264.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$124.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$124.40
|
| Rate for Payer: Galaxy Health WC |
$264.35
|
| Rate for Payer: Global Benefits Group Commercial |
$186.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$279.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$233.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$108.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$207.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$86.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.20
|
| Rate for Payer: Multiplan Commercial |
$233.25
|
| Rate for Payer: Networks By Design Commercial |
$202.15
|
| Rate for Payer: Prime Health Services Commercial |
$264.35
|
| Rate for Payer: Riverside University Health System MISP |
$124.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$186.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$186.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$602.00
|
| Rate for Payer: United Healthcare All Other HMO |
$785.00
|
| Rate for Payer: United Healthcare HMO Rider |
$593.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$542.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$264.35
|
| Rate for Payer: Vantage Medical Group Senior |
$264.35
|
|
|
HC DIAB OP SELF MGMT-INDIV 30 MIN
|
Facility
|
IP
|
$311.00
|
|
|
Service Code
|
CPT G0108
|
| Hospital Charge Code |
902501100
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$62.20 |
| Max. Negotiated Rate |
$279.90 |
| Rate for Payer: Cash Price |
$139.95
|
| Rate for Payer: Central Health Plan Commercial |
$248.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$124.40
|
| Rate for Payer: Galaxy Health WC |
$264.35
|
| Rate for Payer: Global Benefits Group Commercial |
$186.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$279.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$207.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$118.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.20
|
| Rate for Payer: Multiplan Commercial |
$233.25
|
| Rate for Payer: Networks By Design Commercial |
$202.15
|
| Rate for Payer: Prime Health Services Commercial |
$264.35
|
|
|
HC DIAG GASTRO INTUB W ASP SPECS
|
Facility
|
OP
|
$476.00
|
|
|
Service Code
|
CPT 43755
|
| Hospital Charge Code |
906743755
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$93.99 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$195.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$195.17
|
| 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 |
$285.60
|
| 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 |
$195.17
|
| Rate for Payer: Cash Price |
$214.20
|
| Rate for Payer: Cash Price |
$214.20
|
| Rate for Payer: Central Health Plan Commercial |
$380.80
|
| Rate for Payer: Cigna of CA PPO |
$352.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| Rate for Payer: Dignity Health Media |
$195.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$263.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$195.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$195.17
|
| Rate for Payer: Galaxy Health WC |
$404.60
|
| Rate for Payer: Global Benefits Group Commercial |
$285.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$428.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$357.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$320.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$322.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$195.17
|
| Rate for Payer: InnovAge PACE Commercial |
$292.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$317.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$93.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$195.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$261.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$261.53
|
| Rate for Payer: Multiplan Commercial |
$357.00
|
| Rate for Payer: Networks By Design Commercial |
$309.40
|
| Rate for Payer: Prime Health Services Commercial |
$404.60
|
| Rate for Payer: Prime Health Services Medicare |
$206.88
|
| Rate for Payer: Riverside University Health System MISP |
$214.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$285.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$234.20
|
| 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 |
$292.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Vantage Medical Group Senior |
$195.17
|
|
|
HC DIAG GASTRO INTUB W ASP SPECS
|
Facility
|
IP
|
$476.00
|
|
|
Service Code
|
CPT 43755
|
| Hospital Charge Code |
906743755
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$95.20 |
| Max. Negotiated Rate |
$428.40 |
| Rate for Payer: Cash Price |
$214.20
|
| Rate for Payer: Central Health Plan Commercial |
$380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$190.40
|
| Rate for Payer: Galaxy Health WC |
$404.60
|
| Rate for Payer: Global Benefits Group Commercial |
$285.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$428.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$317.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$181.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.20
|
| Rate for Payer: Multiplan Commercial |
$357.00
|
| Rate for Payer: Networks By Design Commercial |
$309.40
|
| Rate for Payer: Prime Health Services Commercial |
$404.60
|
|
|
HC DIAGNOSTIC BRONCH
|
Facility
|
IP
|
$7,121.00
|
|
|
Service Code
|
CPT 31622
|
| Hospital Charge Code |
900501418
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,424.20 |
| Max. Negotiated Rate |
$6,408.90 |
| Rate for Payer: Cash Price |
$3,204.45
|
| Rate for Payer: Central Health Plan Commercial |
$5,696.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,848.40
|
| Rate for Payer: Galaxy Health WC |
$6,052.85
|
| Rate for Payer: Global Benefits Group Commercial |
$4,272.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,408.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,749.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,713.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,424.20
|
| Rate for Payer: Multiplan Commercial |
$5,340.75
|
| Rate for Payer: Networks By Design Commercial |
$4,628.65
|
| Rate for Payer: Prime Health Services Commercial |
$6,052.85
|
|
|
HC DIAGNOSTIC BRONCH
|
Facility
|
IP
|
$7,121.00
|
|
|
Service Code
|
CPT 31622
|
| Hospital Charge Code |
900501418
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,424.20 |
| Max. Negotiated Rate |
$6,408.90 |
| Rate for Payer: Cash Price |
$3,204.45
|
| Rate for Payer: Central Health Plan Commercial |
$5,696.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,848.40
|
| Rate for Payer: Galaxy Health WC |
$6,052.85
|
| Rate for Payer: Global Benefits Group Commercial |
$4,272.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,408.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,749.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,713.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,424.20
|
| Rate for Payer: Multiplan Commercial |
$5,340.75
|
| Rate for Payer: Networks By Design Commercial |
$4,628.65
|
| Rate for Payer: Prime Health Services Commercial |
$6,052.85
|
|
|
HC DIAGNOSTIC BRONCH
|
Facility
|
OP
|
$7,121.00
|
|
|
Service Code
|
CPT 31622
|
| Hospital Charge Code |
900501418
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$313.37 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,120.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| 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 |
$4,272.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$2,120.62
|
| Rate for Payer: Cash Price |
$3,204.45
|
| Rate for Payer: Cash Price |
$3,204.45
|
| Rate for Payer: Central Health Plan Commercial |
$5,696.80
|
| Rate for Payer: Cigna of CA PPO |
$5,269.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Dignity Health Media |
$2,120.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,332.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,862.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,120.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,120.62
|
| Rate for Payer: Galaxy Health WC |
$6,052.85
|
| Rate for Payer: Global Benefits Group Commercial |
$4,272.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,408.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,340.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,477.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,499.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,120.62
|
| Rate for Payer: InnovAge PACE Commercial |
$3,180.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,749.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$313.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,120.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,424.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,841.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,841.63
|
| Rate for Payer: Multiplan Commercial |
$5,340.75
|
| Rate for Payer: Networks By Design Commercial |
$4,628.65
|
| Rate for Payer: Prime Health Services Commercial |
$6,052.85
|
| Rate for Payer: Prime Health Services Medicare |
$2,247.86
|
| Rate for Payer: Riverside University Health System MISP |
$2,332.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,272.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,120.62
|
|
|
HC DIAGNOSTIC BRONCH
|
Facility
|
OP
|
$7,121.00
|
|
|
Service Code
|
CPT 31622
|
| Hospital Charge Code |
900501418
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$313.37 |
| Max. Negotiated Rate |
$6,408.90 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| 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 |
$4,272.60
|
| Rate for Payer: Caremore Medicare Advantage |
$2,120.62
|
| Rate for Payer: Cash Price |
$3,204.45
|
| Rate for Payer: Cash Price |
$3,204.45
|
| Rate for Payer: Cash Price |
$3,204.45
|
| Rate for Payer: Cash Price |
$3,204.45
|
| Rate for Payer: Central Health Plan Commercial |
$5,696.80
|
| Rate for Payer: Cigna of CA PPO |
$5,269.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Dignity Health Media |
$2,120.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,332.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,862.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,120.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,120.62
|
| Rate for Payer: Galaxy Health WC |
$6,052.85
|
| Rate for Payer: Global Benefits Group Commercial |
$4,272.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,408.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,340.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,477.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,120.62
|
| Rate for Payer: InnovAge PACE Commercial |
$3,180.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,749.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$313.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,120.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,424.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,841.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,841.63
|
| Rate for Payer: Multiplan Commercial |
$5,340.75
|
| Rate for Payer: Networks By Design Commercial |
$4,628.65
|
| Rate for Payer: Prime Health Services Commercial |
$6,052.85
|
| Rate for Payer: Prime Health Services Medicare |
$2,247.86
|
| Rate for Payer: Riverside University Health System MISP |
$2,332.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,272.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,560.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,560.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,560.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,560.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,120.62
|
|
|
HC DIAGNOSTIC BRONCH W BIOPSY
|
Facility
|
OP
|
$6,856.00
|
|
|
Service Code
|
CPT 31625
|
| Hospital Charge Code |
900803503
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$382.68 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,120.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| 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 |
$4,113.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4,312.42
|
| Rate for Payer: Blue Shield of California EPN |
$3,352.58
|
| Rate for Payer: Caremore Medicare Advantage |
$2,120.62
|
| Rate for Payer: Cash Price |
$3,085.20
|
| Rate for Payer: Cash Price |
$3,085.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,484.80
|
| Rate for Payer: Cigna of CA HMO |
$4,387.84
|
| Rate for Payer: Cigna of CA PPO |
$5,073.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Dignity Health Media |
$2,120.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,332.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,862.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,120.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,120.62
|
| Rate for Payer: Galaxy Health WC |
$5,827.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,113.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,170.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,142.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,477.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,499.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,120.62
|
| Rate for Payer: InnovAge PACE Commercial |
$3,180.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,572.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$382.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,120.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,371.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,841.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,841.63
|
| Rate for Payer: Multiplan Commercial |
$5,142.00
|
| Rate for Payer: Networks By Design Commercial |
$4,456.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,827.60
|
| Rate for Payer: Prime Health Services Medicare |
$2,247.86
|
| Rate for Payer: Riverside University Health System MISP |
$2,332.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,113.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,113.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,428.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,428.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,428.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,120.62
|
|
|
HC DIAGNOSTIC BRONCH W BIOPSY
|
Facility
|
IP
|
$6,856.00
|
|
|
Service Code
|
CPT 31625
|
| Hospital Charge Code |
900803503
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,371.20 |
| Max. Negotiated Rate |
$6,170.40 |
| Rate for Payer: Cash Price |
$3,085.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,484.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,742.40
|
| Rate for Payer: Galaxy Health WC |
$5,827.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,113.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,170.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,572.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,612.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,371.20
|
| Rate for Payer: Multiplan Commercial |
$5,142.00
|
| Rate for Payer: Networks By Design Commercial |
$4,456.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,827.60
|
|
|
HC DIAGNOSTIC BRONCH W/BRUSHING
|
Facility
|
IP
|
$5,414.00
|
|
|
Service Code
|
CPT 31623
|
| Hospital Charge Code |
900803501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,082.80 |
| Max. Negotiated Rate |
$4,872.60 |
| Rate for Payer: Cash Price |
$2,436.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,331.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,165.60
|
| Rate for Payer: Galaxy Health WC |
$4,601.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,248.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,872.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,611.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,062.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,082.80
|
| Rate for Payer: Multiplan Commercial |
$4,060.50
|
| Rate for Payer: Networks By Design Commercial |
$3,519.10
|
| Rate for Payer: Prime Health Services Commercial |
$4,601.90
|
|
|
HC DIAGNOSTIC BRONCH W/BRUSHING
|
Facility
|
OP
|
$5,414.00
|
|
|
Service Code
|
CPT 31623
|
| Hospital Charge Code |
900803501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$401.79 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,120.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| 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 |
$3,248.40
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$2,120.62
|
| Rate for Payer: Cash Price |
$2,436.30
|
| Rate for Payer: Cash Price |
$2,436.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,331.20
|
| Rate for Payer: Cigna of CA PPO |
$4,006.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Dignity Health Media |
$2,120.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,332.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,862.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,120.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,120.62
|
| Rate for Payer: Galaxy Health WC |
$4,601.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,248.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,872.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,060.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,477.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,499.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,120.62
|
| Rate for Payer: InnovAge PACE Commercial |
$3,180.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,611.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$401.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,120.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,082.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,841.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,841.63
|
| Rate for Payer: Multiplan Commercial |
$4,060.50
|
| Rate for Payer: Networks By Design Commercial |
$3,519.10
|
| Rate for Payer: Prime Health Services Commercial |
$4,601.90
|
| Rate for Payer: Prime Health Services Medicare |
$2,247.86
|
| Rate for Payer: Riverside University Health System MISP |
$2,332.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,248.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,120.62
|
|
|
HC DIAGNOSTIC LARYNGOSCOPY
|
Facility
|
OP
|
$11,766.00
|
|
|
Service Code
|
CPT 31525
|
| Hospital Charge Code |
900803512
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$287.00 |
| Max. Negotiated Rate |
$10,589.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,120.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| 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 |
$7,059.60
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Caremore Medicare Advantage |
$2,120.62
|
| Rate for Payer: Cash Price |
$5,294.70
|
| Rate for Payer: Cash Price |
$5,294.70
|
| Rate for Payer: Cash Price |
$5,294.70
|
| Rate for Payer: Central Health Plan Commercial |
$9,412.80
|
| Rate for Payer: Cigna of CA HMO |
$7,530.24
|
| Rate for Payer: Cigna of CA PPO |
$8,706.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Dignity Health Media |
$2,120.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,332.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,862.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,120.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,120.62
|
| Rate for Payer: Galaxy Health WC |
$10,001.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,059.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,589.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,824.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,477.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,499.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,120.62
|
| Rate for Payer: InnovAge PACE Commercial |
$3,180.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,847.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$320.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,120.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,353.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,841.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,841.63
|
| Rate for Payer: Multiplan Commercial |
$8,824.50
|
| Rate for Payer: Networks By Design Commercial |
$7,647.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,001.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,247.86
|
| Rate for Payer: Riverside University Health System MISP |
$2,332.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,059.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,059.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$509.00
|
| Rate for Payer: United Healthcare All Other HMO |
$478.00
|
| Rate for Payer: United Healthcare HMO Rider |
$428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$391.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,120.62
|
|
|
HC DIAGNOSTIC LARYNGOSCOPY
|
Facility
|
IP
|
$11,766.00
|
|
|
Service Code
|
CPT 31525
|
| Hospital Charge Code |
900803512
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,353.20 |
| Max. Negotiated Rate |
$10,589.40 |
| Rate for Payer: Cash Price |
$5,294.70
|
| Rate for Payer: Central Health Plan Commercial |
$9,412.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,706.40
|
| Rate for Payer: Galaxy Health WC |
$10,001.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,059.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,589.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,847.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,482.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,353.20
|
| Rate for Payer: Multiplan Commercial |
$8,824.50
|
| Rate for Payer: Networks By Design Commercial |
$7,647.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,001.10
|
|
|
HC DIAGNOSTIC LARYNGOSCOPY
|
Facility
|
OP
|
$11,766.00
|
|
|
Service Code
|
CPT 31525
|
| Hospital Charge Code |
900803512
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$320.44 |
| Max. Negotiated Rate |
$10,589.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| 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 |
$7,059.60
|
| Rate for Payer: Caremore Medicare Advantage |
$2,120.62
|
| Rate for Payer: Cash Price |
$5,294.70
|
| Rate for Payer: Cash Price |
$5,294.70
|
| Rate for Payer: Cash Price |
$5,294.70
|
| Rate for Payer: Cash Price |
$5,294.70
|
| Rate for Payer: Central Health Plan Commercial |
$9,412.80
|
| Rate for Payer: Cigna of CA PPO |
$8,706.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Dignity Health Media |
$2,120.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,332.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,862.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,120.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,120.62
|
| Rate for Payer: Galaxy Health WC |
$10,001.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,059.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,589.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,824.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,477.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,120.62
|
| Rate for Payer: InnovAge PACE Commercial |
$3,180.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,847.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$320.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,120.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,353.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,841.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,841.63
|
| Rate for Payer: Multiplan Commercial |
$8,824.50
|
| Rate for Payer: Networks By Design Commercial |
$7,647.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,001.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,247.86
|
| Rate for Payer: Riverside University Health System MISP |
$2,332.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,059.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,883.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,883.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,883.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,883.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,120.62
|
|
|
HC DIAGNOSTIC LARYNGOSCOPY
|
Facility
|
IP
|
$11,766.00
|
|
|
Service Code
|
CPT 31525
|
| Hospital Charge Code |
900803512
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$2,353.20 |
| Max. Negotiated Rate |
$10,589.40 |
| Rate for Payer: Cash Price |
$5,294.70
|
| Rate for Payer: Central Health Plan Commercial |
$9,412.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,706.40
|
| Rate for Payer: Galaxy Health WC |
$10,001.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,059.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,589.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,847.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,482.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,353.20
|
| Rate for Payer: Multiplan Commercial |
$8,824.50
|
| Rate for Payer: Networks By Design Commercial |
$7,647.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,001.10
|
|
|
HC DIAGNOSTIC LARYNGOSCOPY W/MICR
|
Facility
|
OP
|
$11,671.00
|
|
|
Service Code
|
CPT 31526
|
| Hospital Charge Code |
900501508
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$262.43 |
| Max. Negotiated Rate |
$10,503.90 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| 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 |
$7,002.60
|
| Rate for Payer: Caremore Medicare Advantage |
$2,120.62
|
| Rate for Payer: Cash Price |
$5,251.95
|
| Rate for Payer: Cash Price |
$5,251.95
|
| Rate for Payer: Cash Price |
$5,251.95
|
| Rate for Payer: Cash Price |
$5,251.95
|
| Rate for Payer: Central Health Plan Commercial |
$9,336.80
|
| Rate for Payer: Cigna of CA PPO |
$8,636.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Dignity Health Media |
$2,120.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,332.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,862.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,120.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,120.62
|
| Rate for Payer: Galaxy Health WC |
$9,920.35
|
| Rate for Payer: Global Benefits Group Commercial |
$7,002.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,503.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,753.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,477.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,120.62
|
| Rate for Payer: InnovAge PACE Commercial |
$3,180.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,784.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$262.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,120.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,334.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,841.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,841.63
|
| Rate for Payer: Multiplan Commercial |
$8,753.25
|
| Rate for Payer: Networks By Design Commercial |
$7,586.15
|
| Rate for Payer: Prime Health Services Commercial |
$9,920.35
|
| Rate for Payer: Prime Health Services Medicare |
$2,247.86
|
| Rate for Payer: Riverside University Health System MISP |
$2,332.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,002.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,835.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,835.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,835.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,835.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,120.62
|
|
|
HC DIAGNOSTIC LARYNGOSCOPY W/MICR
|
Facility
|
IP
|
$11,671.00
|
|
|
Service Code
|
CPT 31526
|
| Hospital Charge Code |
900501508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,334.20 |
| Max. Negotiated Rate |
$10,503.90 |
| Rate for Payer: Cash Price |
$5,251.95
|
| Rate for Payer: Central Health Plan Commercial |
$9,336.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,668.40
|
| Rate for Payer: Galaxy Health WC |
$9,920.35
|
| Rate for Payer: Global Benefits Group Commercial |
$7,002.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,503.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,784.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,446.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,334.20
|
| Rate for Payer: Multiplan Commercial |
$8,753.25
|
| Rate for Payer: Networks By Design Commercial |
$7,586.15
|
| Rate for Payer: Prime Health Services Commercial |
$9,920.35
|
|
