|
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
|
|
|
HC DIAGNOSTIC LARYNGOSCOPY W/MICR
|
Facility
|
OP
|
$11,671.00
|
|
|
Service Code
|
CPT 31526
|
| Hospital Charge Code |
900501508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$262.43 |
| Max. Negotiated Rate |
$10,503.90 |
| 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 |
$7,002.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$2,120.62
|
| 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 |
$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 |
$7,784.56
|
| 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 |
$5,893.00
|
| 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 DIALYSIS ACCESS DOPPLER
|
Facility
|
IP
|
$1,140.00
|
|
|
Service Code
|
CPT 93990
|
| Hospital Charge Code |
906601660
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$228.00 |
| Max. Negotiated Rate |
$1,026.00 |
| Rate for Payer: Cash Price |
$513.00
|
| Rate for Payer: Central Health Plan Commercial |
$912.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$456.00
|
| Rate for Payer: Galaxy Health WC |
$969.00
|
| Rate for Payer: Global Benefits Group Commercial |
$684.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,026.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$760.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$434.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$228.00
|
| Rate for Payer: Multiplan Commercial |
$855.00
|
| Rate for Payer: Networks By Design Commercial |
$741.00
|
| Rate for Payer: Prime Health Services Commercial |
$969.00
|
|
|
HC DIALYSIS ACCESS DOPPLER
|
Facility
|
OP
|
$1,140.00
|
|
|
Service Code
|
CPT 93990
|
| Hospital Charge Code |
906601660
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$136.32 |
| Max. Negotiated Rate |
$1,507.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$137.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$585.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$761.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$673.51
|
| Rate for Payer: Blue Distinction Transplant |
$684.00
|
| Rate for Payer: Blue Shield of California Commercial |
$704.52
|
| Rate for Payer: Blue Shield of California EPN |
$554.04
|
| Rate for Payer: Caremore Medicare Advantage |
$137.36
|
| Rate for Payer: Cash Price |
$513.00
|
| Rate for Payer: Cash Price |
$513.00
|
| Rate for Payer: Cash Price |
$513.00
|
| Rate for Payer: Central Health Plan Commercial |
$912.00
|
| Rate for Payer: Cigna of CA HMO |
$729.60
|
| Rate for Payer: Cigna of CA PPO |
$843.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Media |
$137.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
| Rate for Payer: Galaxy Health WC |
$969.00
|
| Rate for Payer: Global Benefits Group Commercial |
$684.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,026.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$855.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$225.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$226.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$137.36
|
| Rate for Payer: InnovAge PACE Commercial |
$206.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$760.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$136.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$228.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$184.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
| Rate for Payer: Multiplan Commercial |
$855.00
|
| Rate for Payer: Networks By Design Commercial |
$741.00
|
| Rate for Payer: Prime Health Services Commercial |
$969.00
|
| Rate for Payer: Prime Health Services Medicare |
$145.60
|
| Rate for Payer: Riverside University Health System MISP |
$151.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$684.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$684.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,507.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,228.00
|
| Rate for Payer: United Healthcare HMO Rider |
$931.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$851.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC DIALYSIS CRCT VASC EMBO OR OCC
|
Facility
|
IP
|
$8,527.00
|
|
|
Service Code
|
CPT 36909
|
| Hospital Charge Code |
909036909
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,705.40 |
| Max. Negotiated Rate |
$7,674.30 |
| Rate for Payer: Cash Price |
$3,837.15
|
| Rate for Payer: Central Health Plan Commercial |
$6,821.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,410.80
|
| Rate for Payer: Galaxy Health WC |
$7,247.95
|
| Rate for Payer: Global Benefits Group Commercial |
$5,116.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,674.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,687.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,248.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,705.40
|
| Rate for Payer: Multiplan Commercial |
$6,395.25
|
| Rate for Payer: Networks By Design Commercial |
$5,542.55
|
| Rate for Payer: Prime Health Services Commercial |
$7,247.95
|
|
|
HC DIALYSIS CRCT VASC EMBO OR OCC
|
Facility
|
OP
|
$8,527.00
|
|
|
Service Code
|
CPT 36909
|
| Hospital Charge Code |
909036909
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$951.00 |
| Max. Negotiated Rate |
$7,674.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,247.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,689.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,689.85
|
| 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 |
$5,116.20
|
| Rate for Payer: Blue Shield of California Commercial |
$5,824.53
|
| Rate for Payer: Blue Shield of California EPN |
$4,183.44
|
| Rate for Payer: Cash Price |
$3,837.15
|
| Rate for Payer: Cash Price |
$3,837.15
|
| Rate for Payer: Central Health Plan Commercial |
$6,821.60
|
| Rate for Payer: Cigna of CA PPO |
$6,309.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,247.95
|
| Rate for Payer: Dignity Health Media |
$7,247.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,247.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,410.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,410.80
|
| Rate for Payer: Galaxy Health WC |
$7,247.95
|
| Rate for Payer: Global Benefits Group Commercial |
$5,116.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,674.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,395.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,984.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,687.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,431.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,705.40
|
| Rate for Payer: Multiplan Commercial |
$6,395.25
|
| Rate for Payer: Networks By Design Commercial |
$5,542.55
|
| Rate for Payer: Prime Health Services Commercial |
$7,247.95
|
| Rate for Payer: Riverside University Health System MISP |
$3,410.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,116.20
|
| 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 Medi-Cal |
$7,247.95
|
| Rate for Payer: Vantage Medical Group Senior |
$7,247.95
|
|
|
HC DIALYSIS ONLY IV PUSH EA ADD NEW DRUG
|
Facility
|
IP
|
$638.00
|
|
|
Service Code
|
CPT 96375
|
| Hospital Charge Code |
946100112
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.60 |
| Max. Negotiated Rate |
$574.20 |
| Rate for Payer: Cash Price |
$287.10
|
| Rate for Payer: Central Health Plan Commercial |
$510.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$255.20
|
| Rate for Payer: Galaxy Health WC |
$542.30
|
| Rate for Payer: Global Benefits Group Commercial |
$382.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$574.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$425.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$243.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.60
|
| Rate for Payer: Multiplan Commercial |
$478.50
|
| Rate for Payer: Networks By Design Commercial |
$414.70
|
| Rate for Payer: Prime Health Services Commercial |
$542.30
|
|
|
HC DIALYSIS ONLY IV PUSH EA ADD NEW DRUG
|
Facility
|
OP
|
$638.00
|
|
|
Service Code
|
CPT 96375
|
| Hospital Charge Code |
946100112
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$40.45 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Adventist Health Medi-Cal |
$59.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$136.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$89.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$65.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$59.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$903.00
|
| Rate for Payer: Blue Distinction Transplant |
$382.80
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$59.35
|
| Rate for Payer: Cash Price |
$287.10
|
| Rate for Payer: Cash Price |
$287.10
|
| Rate for Payer: Cash Price |
$287.10
|
| Rate for Payer: Central Health Plan Commercial |
$510.40
|
| Rate for Payer: Cigna of CA PPO |
$472.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$89.02
|
| Rate for Payer: Dignity Health Media |
$59.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$65.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$59.35
|
| Rate for Payer: EPIC Health Plan Transplant |
$59.35
|
| Rate for Payer: Galaxy Health WC |
$542.30
|
| Rate for Payer: Global Benefits Group Commercial |
$382.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$574.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$478.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$97.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$97.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$59.35
|
| Rate for Payer: InnovAge PACE Commercial |
$89.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$425.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$79.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79.53
|
| Rate for Payer: Multiplan Commercial |
$478.50
|
| Rate for Payer: Networks By Design Commercial |
$414.70
|
| Rate for Payer: Prime Health Services Commercial |
$542.30
|
| Rate for Payer: Prime Health Services Medicare |
$62.91
|
| Rate for Payer: Riverside University Health System MISP |
$65.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$382.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$319.00
|
| Rate for Payer: United Healthcare All Other HMO |
$319.00
|
| Rate for Payer: United Healthcare HMO Rider |
$319.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$319.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$89.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$65.28
|
| Rate for Payer: Vantage Medical Group Senior |
$59.35
|
|
|
HC DIALYSIS PERITONEAL/CCPD
|
Facility
|
OP
|
$1,288.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
944000100
|
|
Hospital Revenue Code
|
804
|
| Min. Negotiated Rate |
$137.10 |
| Max. Negotiated Rate |
$1,159.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$553.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$475.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$830.08
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$608.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$553.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$623.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$760.95
|
| Rate for Payer: Blue Distinction Transplant |
$772.80
|
| Rate for Payer: Blue Shield of California Commercial |
$810.15
|
| Rate for Payer: Blue Shield of California EPN |
$629.83
|
| Rate for Payer: Caremore Medicare Advantage |
$553.39
|
| Rate for Payer: Cash Price |
$579.60
|
| Rate for Payer: Cash Price |
$579.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,030.40
|
| Rate for Payer: Cigna of CA HMO |
$824.32
|
| Rate for Payer: Cigna of CA PPO |
$953.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$830.08
|
| Rate for Payer: Dignity Health Media |
$553.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$608.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$747.08
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$553.39
|
| Rate for Payer: EPIC Health Plan Transplant |
$553.39
|
| Rate for Payer: Galaxy Health WC |
$1,094.80
|
| Rate for Payer: Global Benefits Group Commercial |
$772.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,159.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$966.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$907.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$913.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$553.39
|
| Rate for Payer: InnovAge PACE Commercial |
$830.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$859.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$553.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$741.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$741.54
|
| Rate for Payer: Multiplan Commercial |
$966.00
|
| Rate for Payer: Networks By Design Commercial |
$837.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,094.80
|
| Rate for Payer: Prime Health Services Medicare |
$586.59
|
| Rate for Payer: Riverside University Health System MISP |
$608.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$772.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$772.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$644.00
|
| Rate for Payer: United Healthcare All Other HMO |
$644.00
|
| Rate for Payer: United Healthcare HMO Rider |
$644.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$644.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$830.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$608.73
|
| Rate for Payer: Vantage Medical Group Senior |
$553.39
|
|
|
HC DIALYSIS PERITONEAL/CCPD
|
Facility
|
IP
|
$1,288.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
944000100
|
|
Hospital Revenue Code
|
804
|
| Min. Negotiated Rate |
$257.60 |
| Max. Negotiated Rate |
$1,159.20 |
| Rate for Payer: Cash Price |
$579.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,030.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$515.20
|
| Rate for Payer: Galaxy Health WC |
$1,094.80
|
| Rate for Payer: Global Benefits Group Commercial |
$772.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,159.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$859.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$490.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.60
|
| Rate for Payer: Multiplan Commercial |
$966.00
|
| Rate for Payer: Networks By Design Commercial |
$837.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,094.80
|
|
|
HC DIALYSIS PERITONEAL REPEAT
|
Facility
|
OP
|
$406.00
|
|
|
Service Code
|
CPT 90947
|
| Hospital Charge Code |
988190947
|
|
Hospital Revenue Code
|
804
|
| Min. Negotiated Rate |
$81.20 |
| Max. Negotiated Rate |
$715.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$715.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$345.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$223.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$223.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$196.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$239.86
|
| Rate for Payer: Blue Distinction Transplant |
$243.60
|
| Rate for Payer: Blue Shield of California Commercial |
$255.37
|
| Rate for Payer: Blue Shield of California EPN |
$198.53
|
| Rate for Payer: Cash Price |
$182.70
|
| Rate for Payer: Cash Price |
$182.70
|
| Rate for Payer: Central Health Plan Commercial |
$324.80
|
| Rate for Payer: Cigna of CA HMO |
$259.84
|
| Rate for Payer: Cigna of CA PPO |
$300.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$345.10
|
| Rate for Payer: Dignity Health Media |
$345.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$345.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$162.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada (Sierra) Other |
$304.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$142.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$270.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$205.66
|
| 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
|
| Rate for Payer: Riverside University Health System MISP |
$162.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$243.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$243.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$203.00
|
| Rate for Payer: United Healthcare All Other HMO |
$203.00
|
| Rate for Payer: United Healthcare HMO Rider |
$203.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$203.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$345.10
|
| Rate for Payer: Vantage Medical Group Senior |
$345.10
|
|
|
HC DIALYSIS PERITONEAL REPEAT
|
Facility
|
IP
|
$406.00
|
|
|
Service Code
|
CPT 90947
|
| Hospital Charge Code |
988190947
|
|
Hospital Revenue Code
|
804
|
| 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 DIFFERENTIAL LUNG SCAN
|
Facility
|
IP
|
$3,586.00
|
|
|
Service Code
|
CPT 78597
|
| Hospital Charge Code |
909301404
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$717.20 |
| Max. Negotiated Rate |
$3,227.40 |
| Rate for Payer: Cash Price |
$1,613.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,868.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,434.40
|
| Rate for Payer: Galaxy Health WC |
$3,048.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,151.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,227.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,391.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,366.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$717.20
|
| Rate for Payer: Multiplan Commercial |
$2,689.50
|
| Rate for Payer: Networks By Design Commercial |
$2,330.90
|
| Rate for Payer: Prime Health Services Commercial |
$3,048.10
|
|
|
HC DIFFERENTIAL LUNG SCAN
|
Facility
|
OP
|
$3,586.00
|
|
|
Service Code
|
CPT 78597
|
| Hospital Charge Code |
909301404
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$337.42 |
| Max. Negotiated Rate |
$3,227.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$515.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$916.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$772.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$566.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$515.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$977.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,191.87
|
| Rate for Payer: Blue Distinction Transplant |
$2,151.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,216.15
|
| Rate for Payer: Blue Shield of California EPN |
$1,742.80
|
| Rate for Payer: Caremore Medicare Advantage |
$515.32
|
| Rate for Payer: Cash Price |
$1,613.70
|
| Rate for Payer: Cash Price |
$1,613.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,868.80
|
| Rate for Payer: Cigna of CA HMO |
$2,295.04
|
| Rate for Payer: Cigna of CA PPO |
$2,653.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$772.98
|
| Rate for Payer: Dignity Health Media |
$515.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$566.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$695.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$515.32
|
| Rate for Payer: EPIC Health Plan Transplant |
$515.32
|
| Rate for Payer: Galaxy Health WC |
$3,048.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,151.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,227.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,689.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$845.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$850.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$515.32
|
| Rate for Payer: InnovAge PACE Commercial |
$772.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,391.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$337.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$515.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$717.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$690.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$690.53
|
| Rate for Payer: Multiplan Commercial |
$2,689.50
|
| Rate for Payer: Networks By Design Commercial |
$2,330.90
|
| Rate for Payer: Prime Health Services Commercial |
$3,048.10
|
| Rate for Payer: Prime Health Services Medicare |
$546.24
|
| Rate for Payer: Riverside University Health System MISP |
$566.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,151.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,151.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$518.19
|
| Rate for Payer: United Healthcare All Other HMO |
$518.19
|
| Rate for Payer: United Healthcare HMO Rider |
$518.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$518.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$772.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$566.85
|
| Rate for Payer: Vantage Medical Group Senior |
$515.32
|
|
|
HC DIGITAL-SCREENING MAMMO, BILAT
|
Facility
|
IP
|
$759.00
|
|
|
Service Code
|
CPT 77067
|
| Hospital Charge Code |
909002010
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$151.80 |
| Max. Negotiated Rate |
$683.10 |
| Rate for Payer: Cash Price |
$341.55
|
| Rate for Payer: Central Health Plan Commercial |
$607.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$303.60
|
| Rate for Payer: Galaxy Health WC |
$645.15
|
| Rate for Payer: Global Benefits Group Commercial |
$455.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$683.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$506.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$289.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.80
|
| Rate for Payer: Multiplan Commercial |
$569.25
|
| Rate for Payer: Networks By Design Commercial |
$493.35
|
| Rate for Payer: Prime Health Services Commercial |
$645.15
|
|
|
HC DIGITAL-SCREENING MAMMO, BILAT
|
Facility
|
OP
|
$759.00
|
|
|
Service Code
|
CPT 77067
|
| Hospital Charge Code |
909002010
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$151.80 |
| Max. Negotiated Rate |
$683.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$564.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$645.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$417.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$417.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$590.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$448.42
|
| Rate for Payer: Blue Distinction Transplant |
$455.40
|
| Rate for Payer: Blue Shield of California Commercial |
$469.06
|
| Rate for Payer: Blue Shield of California EPN |
$368.87
|
| Rate for Payer: Cash Price |
$341.55
|
| Rate for Payer: Cash Price |
$341.55
|
| Rate for Payer: Central Health Plan Commercial |
$607.20
|
| Rate for Payer: Cigna of CA HMO |
$485.76
|
| Rate for Payer: Cigna of CA PPO |
$561.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$645.15
|
| Rate for Payer: Dignity Health Media |
$645.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$645.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$303.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$303.60
|
| Rate for Payer: Galaxy Health WC |
$645.15
|
| Rate for Payer: Global Benefits Group Commercial |
$455.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$683.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$569.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$265.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$506.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$226.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.80
|
| Rate for Payer: Multiplan Commercial |
$569.25
|
| Rate for Payer: Networks By Design Commercial |
$493.35
|
| Rate for Payer: Prime Health Services Commercial |
$645.15
|
| Rate for Payer: Riverside University Health System MISP |
$303.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$455.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$455.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$269.26
|
| Rate for Payer: United Healthcare All Other HMO |
$269.26
|
| Rate for Payer: United Healthcare HMO Rider |
$269.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$269.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$645.15
|
| Rate for Payer: Vantage Medical Group Senior |
$645.15
|
|
|
HC DIGOXIN
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
CPT 80162
|
| Hospital Charge Code |
900910816
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$117.81 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$97.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$96.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$117.81
|
| Rate for Payer: Blue Distinction Transplant |
$30.00
|
| Rate for Payer: Blue Shield of California Commercial |
$30.90
|
| Rate for Payer: Blue Shield of California EPN |
$24.30
|
| Rate for Payer: Caremore Medicare Advantage |
$13.28
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Central Health Plan Commercial |
$40.00
|
| Rate for Payer: Cigna of CA HMO |
$32.00
|
| Rate for Payer: Cigna of CA PPO |
$37.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.92
|
| Rate for Payer: Dignity Health Media |
$13.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.93
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.28
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$37.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$21.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.28
|
| Rate for Payer: InnovAge PACE Commercial |
$19.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.80
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
| Rate for Payer: Prime Health Services Medicare |
$14.08
|
| Rate for Payer: Riverside University Health System MISP |
$14.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.76
|
| Rate for Payer: United Healthcare All Other HMO |
$10.76
|
| Rate for Payer: United Healthcare HMO Rider |
$10.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.61
|
| Rate for Payer: Vantage Medical Group Senior |
$13.28
|
|
|
HC DIGOXIN
|
Facility
|
IP
|
$196.00
|
|
|
Service Code
|
CPT 80162
|
| Hospital Charge Code |
900910816
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$176.40 |
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Central Health Plan Commercial |
$156.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$130.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$74.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.20
|
| Rate for Payer: Multiplan Commercial |
$147.00
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
|
|
HC DILAT ANAL SPHINC UNDER ANES
|
Facility
|
IP
|
$13,288.00
|
|
|
Service Code
|
CPT 45905
|
| Hospital Charge Code |
906745905
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,657.60 |
| Max. Negotiated Rate |
$11,959.20 |
| Rate for Payer: Cash Price |
$5,979.60
|
| Rate for Payer: Central Health Plan Commercial |
$10,630.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,315.20
|
| Rate for Payer: Galaxy Health WC |
$11,294.80
|
| Rate for Payer: Global Benefits Group Commercial |
$7,972.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,959.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,863.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,062.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,657.60
|
| Rate for Payer: Multiplan Commercial |
$9,966.00
|
| Rate for Payer: Networks By Design Commercial |
$8,637.20
|
| Rate for Payer: Prime Health Services Commercial |
$11,294.80
|
|
|
HC DILAT ANAL SPHINC UNDER ANES
|
Facility
|
OP
|
$7,336.00
|
|
|
Service Code
|
CPT 45905
|
| Hospital Charge Code |
906745905
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$286.48 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,474.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| 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 |
$4,401.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$3,301.20
|
| Rate for Payer: Cash Price |
$3,301.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,868.80
|
| Rate for Payer: Cigna of CA PPO |
$5,428.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Dignity Health Media |
$1,474.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,621.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Galaxy Health WC |
$6,235.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,401.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,602.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,502.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,418.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,432.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,474.42
|
| Rate for Payer: InnovAge PACE Commercial |
$2,211.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,893.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$286.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,467.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,975.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Multiplan Commercial |
$5,502.00
|
| Rate for Payer: Networks By Design Commercial |
$4,768.40
|
| Rate for Payer: Prime Health Services Commercial |
$6,235.60
|
| Rate for Payer: Prime Health Services Medicare |
$1,562.89
|
| Rate for Payer: Riverside University Health System MISP |
$1,621.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,401.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,769.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC DILAT ANAL SPHINC UNDER ANES
|
Facility
|
OP
|
$7,336.00
|
|
|
Service Code
|
CPT 45905
|
| Hospital Charge Code |
906745905
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$286.48 |
| Max. Negotiated Rate |
$6,602.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,474.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| 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 |
$4,401.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4,614.34
|
| Rate for Payer: Blue Shield of California EPN |
$3,587.30
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$3,301.20
|
| Rate for Payer: Cash Price |
$3,301.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,868.80
|
| Rate for Payer: Cigna of CA HMO |
$4,695.04
|
| Rate for Payer: Cigna of CA PPO |
$5,428.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Dignity Health Media |
$1,474.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,621.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Galaxy Health WC |
$6,235.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,401.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,602.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,502.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,418.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,432.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,474.42
|
| Rate for Payer: InnovAge PACE Commercial |
$2,211.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,893.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$286.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,467.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,975.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Multiplan Commercial |
$5,502.00
|
| Rate for Payer: Networks By Design Commercial |
$4,768.40
|
| Rate for Payer: Prime Health Services Commercial |
$6,235.60
|
| Rate for Payer: Prime Health Services Medicare |
$1,562.89
|
| Rate for Payer: Riverside University Health System MISP |
$1,621.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,401.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,401.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,668.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,668.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,668.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,668.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC DILAT ANAL SPHINC UNDER ANES
|
Facility
|
IP
|
$13,288.00
|
|
|
Service Code
|
CPT 45905
|
| Hospital Charge Code |
906745905
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$2,657.60 |
| Max. Negotiated Rate |
$11,959.20 |
| Rate for Payer: Cash Price |
$5,979.60
|
| Rate for Payer: Central Health Plan Commercial |
$10,630.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,315.20
|
| Rate for Payer: Galaxy Health WC |
$11,294.80
|
| Rate for Payer: Global Benefits Group Commercial |
$7,972.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,959.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,863.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,062.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,657.60
|
| Rate for Payer: Multiplan Commercial |
$9,966.00
|
| Rate for Payer: Networks By Design Commercial |
$8,637.20
|
| Rate for Payer: Prime Health Services Commercial |
$11,294.80
|
|
|
HC DILATE BILIARY OR AMPULLA PERC
|
Facility
|
IP
|
$1,489.00
|
|
|
Service Code
|
CPT 47542
|
| Hospital Charge Code |
909047542
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$297.80 |
| Max. Negotiated Rate |
$1,340.10 |
| Rate for Payer: Cash Price |
$670.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,191.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$595.60
|
| Rate for Payer: Galaxy Health WC |
$1,265.65
|
| Rate for Payer: Global Benefits Group Commercial |
$893.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,340.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$993.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$567.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$297.80
|
| Rate for Payer: Multiplan Commercial |
$1,116.75
|
| Rate for Payer: Networks By Design Commercial |
$967.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,265.65
|
|
|
HC DILATE BILIARY OR AMPULLA PERC
|
Facility
|
OP
|
$1,489.00
|
|
|
Service Code
|
CPT 47542
|
| Hospital Charge Code |
909047542
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$297.80 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,265.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$818.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$818.95
|
| 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 |
$893.40
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Cash Price |
$670.05
|
| Rate for Payer: Cash Price |
$670.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,191.20
|
| Rate for Payer: Cigna of CA PPO |
$1,101.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,265.65
|
| Rate for Payer: Dignity Health Media |
$1,265.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,265.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$595.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$595.60
|
| Rate for Payer: Galaxy Health WC |
$1,265.65
|
| Rate for Payer: Global Benefits Group Commercial |
$893.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,340.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,116.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$521.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$993.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$891.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$297.80
|
| Rate for Payer: Multiplan Commercial |
$1,116.75
|
| Rate for Payer: Networks By Design Commercial |
$967.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,265.65
|
| Rate for Payer: Riverside University Health System MISP |
$595.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$893.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,265.65
|
| Rate for Payer: Vantage Medical Group Senior |
$1,265.65
|
|
|
HC DILAT ESOPH BOUGIE/SNGL OR MUL
|
Facility
|
IP
|
$6,678.00
|
|
|
Service Code
|
CPT 43450
|
| Hospital Charge Code |
906743450
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,335.60 |
| Max. Negotiated Rate |
$6,010.20 |
| Rate for Payer: Cash Price |
$3,005.10
|
| Rate for Payer: Central Health Plan Commercial |
$5,342.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,671.20
|
| Rate for Payer: Galaxy Health WC |
$5,676.30
|
| Rate for Payer: Global Benefits Group Commercial |
$4,006.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,010.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,454.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,544.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,335.60
|
| Rate for Payer: Multiplan Commercial |
$5,008.50
|
| Rate for Payer: Networks By Design Commercial |
$4,340.70
|
| Rate for Payer: Prime Health Services Commercial |
$5,676.30
|
|
