|
HC EMBOLIZATION LCBEADS
|
Facility
|
OP
|
$4,397.50
|
|
| Hospital Charge Code |
909020052
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$879.50 |
| Max. Negotiated Rate |
$3,957.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,670.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,737.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,418.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,418.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,129.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,598.04
|
| Rate for Payer: Blue Distinction Transplant |
$2,638.50
|
| Rate for Payer: Blue Shield of California Commercial |
$2,766.03
|
| Rate for Payer: Blue Shield of California EPN |
$2,150.38
|
| Rate for Payer: Cash Price |
$1,978.88
|
| Rate for Payer: Central Health Plan Commercial |
$3,518.00
|
| Rate for Payer: Cigna of CA HMO |
$2,814.40
|
| Rate for Payer: Cigna of CA PPO |
$3,254.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,737.88
|
| Rate for Payer: Dignity Health Media |
$3,737.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,737.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,759.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,759.00
|
| Rate for Payer: Galaxy Health WC |
$3,737.88
|
| Rate for Payer: Global Benefits Group Commercial |
$2,638.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,957.75
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,298.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,539.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,933.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,675.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$879.50
|
| Rate for Payer: Multiplan Commercial |
$3,298.12
|
| Rate for Payer: Networks By Design Commercial |
$2,858.38
|
| Rate for Payer: Prime Health Services Commercial |
$3,737.88
|
| Rate for Payer: Riverside University Health System MISP |
$1,759.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,638.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,638.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,198.75
|
| Rate for Payer: United Healthcare All Other HMO |
$2,198.75
|
| Rate for Payer: United Healthcare HMO Rider |
$2,198.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,198.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,737.88
|
| Rate for Payer: Vantage Medical Group Senior |
$3,737.88
|
|
|
HC EMBOLIZATION LCBEADS
|
Facility
|
IP
|
$4,397.50
|
|
| Hospital Charge Code |
909020052
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$879.50 |
| Max. Negotiated Rate |
$3,957.75 |
| Rate for Payer: Cash Price |
$1,978.88
|
| Rate for Payer: Central Health Plan Commercial |
$3,518.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,759.00
|
| Rate for Payer: Galaxy Health WC |
$3,737.88
|
| Rate for Payer: Global Benefits Group Commercial |
$2,638.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,957.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,933.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,675.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$879.50
|
| Rate for Payer: Multiplan Commercial |
$3,298.12
|
| Rate for Payer: Networks By Design Commercial |
$2,858.38
|
| Rate for Payer: Prime Health Services Commercial |
$3,737.88
|
|
|
HC EMBOLIZATION PARTICLE
|
Facility
|
OP
|
$1,122.40
|
|
| Hospital Charge Code |
909081256
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$224.48 |
| Max. Negotiated Rate |
$1,010.16 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$954.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$617.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$617.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$512.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$625.18
|
| Rate for Payer: Blue Distinction Transplant |
$673.44
|
| Rate for Payer: Blue Shield of California Commercial |
$841.80
|
| Rate for Payer: Blue Shield of California EPN |
$610.59
|
| Rate for Payer: Cash Price |
$505.08
|
| Rate for Payer: Central Health Plan Commercial |
$897.92
|
| Rate for Payer: Cigna of CA HMO |
$785.68
|
| Rate for Payer: Cigna of CA PPO |
$785.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$954.04
|
| Rate for Payer: Dignity Health Media |
$954.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$954.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$448.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$448.96
|
| Rate for Payer: Galaxy Health WC |
$954.04
|
| Rate for Payer: Global Benefits Group Commercial |
$673.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,010.16
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$841.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$392.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$748.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$427.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$224.48
|
| Rate for Payer: Multiplan Commercial |
$841.80
|
| Rate for Payer: Networks By Design Commercial |
$561.20
|
| Rate for Payer: Prime Health Services Commercial |
$954.04
|
| Rate for Payer: Riverside University Health System MISP |
$448.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$673.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$673.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$561.20
|
| Rate for Payer: United Healthcare All Other HMO |
$561.20
|
| Rate for Payer: United Healthcare HMO Rider |
$561.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$561.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$954.04
|
| Rate for Payer: Vantage Medical Group Senior |
$954.04
|
|
|
HC EMBOLIZATION PARTICLE
|
Facility
|
IP
|
$1,122.40
|
|
| Hospital Charge Code |
909081256
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$224.48 |
| Max. Negotiated Rate |
$1,010.16 |
| Rate for Payer: Blue Shield of California EPN |
$599.36
|
| Rate for Payer: Cash Price |
$505.08
|
| Rate for Payer: Central Health Plan Commercial |
$897.92
|
| Rate for Payer: Cigna of CA HMO |
$785.68
|
| Rate for Payer: Cigna of CA PPO |
$785.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$448.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$448.96
|
| Rate for Payer: Galaxy Health WC |
$954.04
|
| Rate for Payer: Global Benefits Group Commercial |
$673.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,010.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$748.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$427.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$224.48
|
| Rate for Payer: Multiplan Commercial |
$841.80
|
| Rate for Payer: Prime Health Services Commercial |
$954.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$423.82
|
| Rate for Payer: United Healthcare All Other HMO |
$413.94
|
| Rate for Payer: United Healthcare HMO Rider |
$404.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$370.39
|
|
|
HC EMBOLIZ, INTRACRAN/SP.CRD.
|
Facility
|
IP
|
$10,366.00
|
|
|
Service Code
|
CPT 61624
|
| Hospital Charge Code |
909081337
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,073.20 |
| Max. Negotiated Rate |
$9,329.40 |
| Rate for Payer: Cash Price |
$4,664.70
|
| Rate for Payer: Central Health Plan Commercial |
$8,292.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,146.40
|
| Rate for Payer: Galaxy Health WC |
$8,811.10
|
| Rate for Payer: Global Benefits Group Commercial |
$6,219.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,329.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,914.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,949.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,073.20
|
| Rate for Payer: Multiplan Commercial |
$7,774.50
|
| Rate for Payer: Networks By Design Commercial |
$6,737.90
|
| Rate for Payer: Prime Health Services Commercial |
$8,811.10
|
|
|
HC EMBOLIZ, INTRACRAN/SP.CRD.
|
Facility
|
OP
|
$10,366.00
|
|
|
Service Code
|
CPT 61624
|
| Hospital Charge Code |
909081337
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,585.93 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,811.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,701.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,701.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,219.60
|
| 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: Cash Price |
$4,664.70
|
| Rate for Payer: Cash Price |
$4,664.70
|
| Rate for Payer: Central Health Plan Commercial |
$8,292.80
|
| Rate for Payer: Cigna of CA PPO |
$7,670.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,811.10
|
| Rate for Payer: Dignity Health Media |
$8,811.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,811.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,146.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,146.40
|
| Rate for Payer: Galaxy Health WC |
$8,811.10
|
| Rate for Payer: Global Benefits Group Commercial |
$6,219.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,329.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,774.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,628.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,914.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,585.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,073.20
|
| Rate for Payer: Multiplan Commercial |
$7,774.50
|
| Rate for Payer: Networks By Design Commercial |
$6,737.90
|
| Rate for Payer: Prime Health Services Commercial |
$8,811.10
|
| Rate for Payer: Riverside University Health System MISP |
$4,146.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,219.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,811.10
|
| Rate for Payer: Vantage Medical Group Senior |
$8,811.10
|
|
|
HC EM EMBED ONLY
|
Facility
|
IP
|
$610.00
|
|
|
Service Code
|
CPT 88399
|
| Hospital Charge Code |
903800053
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$122.00 |
| Max. Negotiated Rate |
$549.00 |
| Rate for Payer: Cash Price |
$274.50
|
| Rate for Payer: Central Health Plan Commercial |
$488.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$244.00
|
| Rate for Payer: Galaxy Health WC |
$518.50
|
| Rate for Payer: Global Benefits Group Commercial |
$366.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$549.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$406.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$232.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.00
|
| Rate for Payer: Multiplan Commercial |
$457.50
|
| Rate for Payer: Networks By Design Commercial |
$396.50
|
| Rate for Payer: Prime Health Services Commercial |
$518.50
|
|
|
HC EM EMBED ONLY
|
Facility
|
OP
|
$336.00
|
|
|
Service Code
|
CPT 88399
|
| Hospital Charge Code |
903800053
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$41.11 |
| Max. Negotiated Rate |
$302.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$67.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$204.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$101.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$74.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$162.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$198.51
|
| Rate for Payer: Blue Distinction Transplant |
$201.60
|
| Rate for Payer: Blue Shield of California Commercial |
$207.65
|
| Rate for Payer: Blue Shield of California EPN |
$163.30
|
| Rate for Payer: Caremore Medicare Advantage |
$67.70
|
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: Central Health Plan Commercial |
$268.80
|
| Rate for Payer: Cigna of CA HMO |
$215.04
|
| Rate for Payer: Cigna of CA PPO |
$248.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$101.55
|
| Rate for Payer: Dignity Health Media |
$67.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$74.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$67.70
|
| Rate for Payer: EPIC Health Plan Transplant |
$67.70
|
| Rate for Payer: Galaxy Health WC |
$285.60
|
| Rate for Payer: Global Benefits Group Commercial |
$201.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$302.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$252.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$111.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$111.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67.70
|
| Rate for Payer: InnovAge PACE Commercial |
$101.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$224.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$67.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$67.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$90.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$90.72
|
| Rate for Payer: Multiplan Commercial |
$252.00
|
| Rate for Payer: Networks By Design Commercial |
$218.40
|
| Rate for Payer: Prime Health Services Commercial |
$285.60
|
| Rate for Payer: Prime Health Services Medicare |
$71.76
|
| Rate for Payer: Riverside University Health System MISP |
$74.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$201.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$201.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.11
|
| Rate for Payer: United Healthcare All Other HMO |
$41.11
|
| Rate for Payer: United Healthcare HMO Rider |
$41.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$101.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$74.47
|
| Rate for Payer: Vantage Medical Group Senior |
$67.70
|
|
|
HC END ABL THY INC VEIN 1ST VEIN
|
Facility
|
IP
|
$17,160.00
|
|
|
Service Code
|
CPT 36482
|
| Hospital Charge Code |
909026482
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,432.00 |
| Max. Negotiated Rate |
$15,444.00 |
| Rate for Payer: Cash Price |
$7,722.00
|
| Rate for Payer: Central Health Plan Commercial |
$13,728.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,864.00
|
| Rate for Payer: Galaxy Health WC |
$14,586.00
|
| Rate for Payer: Global Benefits Group Commercial |
$10,296.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,444.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,445.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,537.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,432.00
|
| Rate for Payer: Multiplan Commercial |
$12,870.00
|
| Rate for Payer: Networks By Design Commercial |
$11,154.00
|
| Rate for Payer: Prime Health Services Commercial |
$14,586.00
|
|
|
HC END ABL THY INC VEIN 1ST VEIN
|
Facility
|
OP
|
$17,160.00
|
|
|
Service Code
|
CPT 36482
|
| Hospital Charge Code |
909026482
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,432.00 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$6,866.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,866.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$10,296.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Caremore Medicare Advantage |
$6,866.07
|
| Rate for Payer: Cash Price |
$7,722.00
|
| Rate for Payer: Cash Price |
$7,722.00
|
| Rate for Payer: Central Health Plan Commercial |
$13,728.00
|
| Rate for Payer: Cigna of CA PPO |
$12,698.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Dignity Health Media |
$6,866.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,552.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,269.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6,866.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,866.07
|
| Rate for Payer: Galaxy Health WC |
$14,586.00
|
| Rate for Payer: Global Benefits Group Commercial |
$10,296.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,444.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$12,870.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,260.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11,329.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,866.07
|
| Rate for Payer: InnovAge PACE Commercial |
$10,299.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,445.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,740.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,866.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,432.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,200.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,200.53
|
| Rate for Payer: Multiplan Commercial |
$12,870.00
|
| Rate for Payer: Networks By Design Commercial |
$11,154.00
|
| Rate for Payer: Prime Health Services Commercial |
$14,586.00
|
| Rate for Payer: Prime Health Services Medicare |
$7,278.03
|
| Rate for Payer: Riverside University Health System MISP |
$7,552.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,296.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: Vantage Medical Group Senior |
$6,866.07
|
|
|
HC ENDLMNL BX RNL PLVS AND OR URE
|
Facility
|
OP
|
$4,886.00
|
|
|
Service Code
|
CPT 50606
|
| Hospital Charge Code |
909050606
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$913.22 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,153.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,687.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,687.30
|
| 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 |
$2,931.60
|
| 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: Cash Price |
$2,198.70
|
| Rate for Payer: Cash Price |
$2,198.70
|
| Rate for Payer: Cash Price |
$2,198.70
|
| Rate for Payer: Central Health Plan Commercial |
$3,908.80
|
| Rate for Payer: Cigna of CA PPO |
$3,615.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,153.10
|
| Rate for Payer: Dignity Health Media |
$4,153.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,153.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,954.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,954.40
|
| Rate for Payer: Galaxy Health WC |
$4,153.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,931.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,397.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,664.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,710.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,258.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$913.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$977.20
|
| Rate for Payer: Multiplan Commercial |
$3,664.50
|
| Rate for Payer: Networks By Design Commercial |
$3,175.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,153.10
|
| Rate for Payer: Riverside University Health System MISP |
$1,954.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,931.60
|
| 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 |
$4,153.10
|
| Rate for Payer: Vantage Medical Group Senior |
$4,153.10
|
|
|
HC ENDLMNL BX RNL PLVS AND OR URE
|
Facility
|
IP
|
$4,886.00
|
|
|
Service Code
|
CPT 50606
|
| Hospital Charge Code |
909050606
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$977.20 |
| Max. Negotiated Rate |
$4,397.40 |
| Rate for Payer: Cash Price |
$2,198.70
|
| Rate for Payer: Central Health Plan Commercial |
$3,908.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,954.40
|
| Rate for Payer: Galaxy Health WC |
$4,153.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,931.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,397.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,258.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,861.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$977.20
|
| Rate for Payer: Multiplan Commercial |
$3,664.50
|
| Rate for Payer: Networks By Design Commercial |
$3,175.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,153.10
|
|
|
HC ENDOCERVICAL CURETTAGE
|
Facility
|
IP
|
$2,489.00
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
900501170
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$497.80 |
| Max. Negotiated Rate |
$2,240.10 |
| Rate for Payer: Cash Price |
$1,120.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,991.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$995.60
|
| Rate for Payer: Galaxy Health WC |
$2,115.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,493.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,240.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,660.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$948.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$497.80
|
| Rate for Payer: Multiplan Commercial |
$1,866.75
|
| Rate for Payer: Networks By Design Commercial |
$1,617.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,115.65
|
|
|
HC ENDOCERVICAL CURETTAGE
|
Facility
|
OP
|
$2,489.00
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
900501170
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$275.86 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,004.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,506.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,104.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,004.43
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,493.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,565.58
|
| Rate for Payer: Blue Shield of California EPN |
$1,217.12
|
| Rate for Payer: Caremore Medicare Advantage |
$1,004.43
|
| Rate for Payer: Cash Price |
$1,120.05
|
| Rate for Payer: Cash Price |
$1,120.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,991.20
|
| Rate for Payer: Cigna of CA HMO |
$1,592.96
|
| Rate for Payer: Cigna of CA PPO |
$1,841.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,506.64
|
| Rate for Payer: Dignity Health Media |
$1,004.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,104.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,355.98
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,004.43
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,004.43
|
| Rate for Payer: Galaxy Health WC |
$2,115.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,493.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,240.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,866.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,647.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,657.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,004.43
|
| Rate for Payer: InnovAge PACE Commercial |
$1,506.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,660.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$275.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,004.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$497.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,345.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,345.94
|
| Rate for Payer: Multiplan Commercial |
$1,866.75
|
| Rate for Payer: Networks By Design Commercial |
$1,617.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,115.65
|
| Rate for Payer: Prime Health Services Medicare |
$1,064.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,104.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,493.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,493.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,244.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,244.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,244.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,244.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,506.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.87
|
| Rate for Payer: Vantage Medical Group Senior |
$1,004.43
|
|
|
HC ENDOCERVICAL CURETTAGE
|
Facility
|
IP
|
$2,489.00
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
900501170
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$497.80 |
| Max. Negotiated Rate |
$2,240.10 |
| Rate for Payer: Cash Price |
$1,120.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,991.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$995.60
|
| Rate for Payer: Galaxy Health WC |
$2,115.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,493.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,240.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,660.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$948.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$497.80
|
| Rate for Payer: Multiplan Commercial |
$1,866.75
|
| Rate for Payer: Networks By Design Commercial |
$1,617.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,115.65
|
|
|
HC ENDOCERVICAL CURETTAGE
|
Facility
|
OP
|
$2,489.00
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
900501170
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$275.86 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,506.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,104.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,004.43
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,493.40
|
| Rate for Payer: Caremore Medicare Advantage |
$1,004.43
|
| Rate for Payer: Cash Price |
$1,120.05
|
| Rate for Payer: Cash Price |
$1,120.05
|
| Rate for Payer: Cash Price |
$1,120.05
|
| Rate for Payer: Cash Price |
$1,120.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,991.20
|
| Rate for Payer: Cigna of CA PPO |
$1,841.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,506.64
|
| Rate for Payer: Dignity Health Media |
$1,004.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,104.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,355.98
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,004.43
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,004.43
|
| Rate for Payer: Galaxy Health WC |
$2,115.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,493.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,240.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,866.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,647.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,004.43
|
| Rate for Payer: InnovAge PACE Commercial |
$1,506.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,660.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$275.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,004.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$497.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,345.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,345.94
|
| Rate for Payer: Multiplan Commercial |
$1,866.75
|
| Rate for Payer: Networks By Design Commercial |
$1,617.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,115.65
|
| Rate for Payer: Prime Health Services Medicare |
$1,064.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,104.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,493.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,244.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,244.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,244.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,244.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,506.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.87
|
| Rate for Payer: Vantage Medical Group Senior |
$1,004.43
|
|
|
HC ENDO EVAL SM INTESTINE W BX
|
Facility
|
OP
|
$2,428.00
|
|
|
Service Code
|
CPT 44386
|
| Hospital Charge Code |
906744386
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$231.31 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,141.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,456.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,141.93
|
| Rate for Payer: Cash Price |
$1,092.60
|
| Rate for Payer: Cash Price |
$1,092.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,942.40
|
| Rate for Payer: Cigna of CA PPO |
$1,796.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Dignity Health Media |
$1,141.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,256.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$2,063.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,456.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,185.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,821.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,872.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,884.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,141.93
|
| Rate for Payer: InnovAge PACE Commercial |
$1,712.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,619.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$231.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$485.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$1,821.00
|
| Rate for Payer: Networks By Design Commercial |
$1,578.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,063.80
|
| Rate for Payer: Prime Health Services Medicare |
$1,210.45
|
| Rate for Payer: Riverside University Health System MISP |
$1,256.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,456.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,370.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC ENDO EVAL SM INTESTINE W BX
|
Facility
|
IP
|
$5,499.00
|
|
|
Service Code
|
CPT 44386
|
| Hospital Charge Code |
906744386
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,099.80 |
| Max. Negotiated Rate |
$4,949.10 |
| Rate for Payer: Cash Price |
$2,474.55
|
| Rate for Payer: Central Health Plan Commercial |
$4,399.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,199.60
|
| Rate for Payer: Galaxy Health WC |
$4,674.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,299.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,949.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,667.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,095.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,099.80
|
| Rate for Payer: Multiplan Commercial |
$4,124.25
|
| Rate for Payer: Networks By Design Commercial |
$3,574.35
|
| Rate for Payer: Prime Health Services Commercial |
$4,674.15
|
|
|
HC ENDO EVAL SM INTESTINE W WO COLLECT
|
Facility
|
IP
|
$4,400.00
|
|
|
Service Code
|
CPT 44385
|
| Hospital Charge Code |
906744385
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$880.00 |
| Max. Negotiated Rate |
$3,960.00 |
| Rate for Payer: Cash Price |
$1,980.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,520.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,760.00
|
| Rate for Payer: Galaxy Health WC |
$3,740.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,640.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,960.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,934.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,676.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$880.00
|
| Rate for Payer: Multiplan Commercial |
$3,300.00
|
| Rate for Payer: Networks By Design Commercial |
$2,860.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,740.00
|
|
|
HC ENDO EVAL SM INTESTINE W WO COLLECT
|
Facility
|
OP
|
$2,428.00
|
|
|
Service Code
|
CPT 44385
|
| Hospital Charge Code |
906744385
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$228.48 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,141.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,456.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,141.93
|
| Rate for Payer: Cash Price |
$1,092.60
|
| Rate for Payer: Cash Price |
$1,092.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,942.40
|
| Rate for Payer: Cigna of CA PPO |
$1,796.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Dignity Health Media |
$1,141.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,256.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$2,063.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,456.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,185.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,821.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,872.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,884.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,141.93
|
| Rate for Payer: InnovAge PACE Commercial |
$1,712.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,619.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$228.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$485.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$1,821.00
|
| Rate for Payer: Networks By Design Commercial |
$1,578.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,063.80
|
| Rate for Payer: Prime Health Services Medicare |
$1,210.45
|
| Rate for Payer: Riverside University Health System MISP |
$1,256.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,456.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,370.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC ENDOLUMINAL BRUSHING
|
Facility
|
IP
|
$1,128.00
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
909081376
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$225.60 |
| Max. Negotiated Rate |
$1,015.20 |
| Rate for Payer: Cash Price |
$507.60
|
| Rate for Payer: Central Health Plan Commercial |
$902.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$451.20
|
| Rate for Payer: Galaxy Health WC |
$958.80
|
| Rate for Payer: Global Benefits Group Commercial |
$676.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,015.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$752.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$429.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.60
|
| Rate for Payer: Multiplan Commercial |
$846.00
|
| Rate for Payer: Networks By Design Commercial |
$733.20
|
| Rate for Payer: Prime Health Services Commercial |
$958.80
|
|
|
HC ENDOLUMINAL BRUSHING
|
Facility
|
OP
|
$1,128.00
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
909081376
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$160.57 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$958.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$620.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$620.40
|
| 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 |
$676.80
|
| 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: Cash Price |
$507.60
|
| Rate for Payer: Cash Price |
$507.60
|
| Rate for Payer: Cash Price |
$507.60
|
| Rate for Payer: Central Health Plan Commercial |
$902.40
|
| Rate for Payer: Cigna of CA PPO |
$834.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$958.80
|
| Rate for Payer: Dignity Health Media |
$958.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$958.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$451.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$451.20
|
| Rate for Payer: Galaxy Health WC |
$958.80
|
| Rate for Payer: Global Benefits Group Commercial |
$676.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,015.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$846.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$394.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$752.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.60
|
| Rate for Payer: Multiplan Commercial |
$846.00
|
| Rate for Payer: Networks By Design Commercial |
$733.20
|
| Rate for Payer: Prime Health Services Commercial |
$958.80
|
| Rate for Payer: Riverside University Health System MISP |
$451.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$676.80
|
| 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 |
$958.80
|
| Rate for Payer: Vantage Medical Group Senior |
$958.80
|
|
|
HC ENDOLUMINAL BRUSHING
|
Facility
|
OP
|
$1,128.00
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
909081376
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$160.57 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$958.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$620.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$620.40
|
| 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 |
$676.80
|
| Rate for Payer: Cash Price |
$507.60
|
| Rate for Payer: Cash Price |
$507.60
|
| Rate for Payer: Cash Price |
$507.60
|
| Rate for Payer: Cash Price |
$507.60
|
| Rate for Payer: Central Health Plan Commercial |
$902.40
|
| Rate for Payer: Cigna of CA PPO |
$834.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$958.80
|
| Rate for Payer: Dignity Health Media |
$958.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$958.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$451.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$451.20
|
| Rate for Payer: Galaxy Health WC |
$958.80
|
| Rate for Payer: Global Benefits Group Commercial |
$676.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,015.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$846.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$752.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.60
|
| Rate for Payer: Multiplan Commercial |
$846.00
|
| Rate for Payer: Networks By Design Commercial |
$733.20
|
| Rate for Payer: Prime Health Services Commercial |
$958.80
|
| Rate for Payer: Riverside University Health System MISP |
$451.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$676.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$564.00
|
| Rate for Payer: United Healthcare All Other HMO |
$564.00
|
| Rate for Payer: United Healthcare HMO Rider |
$564.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$564.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$958.80
|
| Rate for Payer: Vantage Medical Group Senior |
$958.80
|
|
|
HC ENDOLUMINAL BRUSHING
|
Facility
|
IP
|
$1,128.00
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
909081376
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$225.60 |
| Max. Negotiated Rate |
$1,015.20 |
| Rate for Payer: Cash Price |
$507.60
|
| Rate for Payer: Central Health Plan Commercial |
$902.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$451.20
|
| Rate for Payer: Galaxy Health WC |
$958.80
|
| Rate for Payer: Global Benefits Group Commercial |
$676.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,015.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$752.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$429.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.60
|
| Rate for Payer: Multiplan Commercial |
$846.00
|
| Rate for Payer: Networks By Design Commercial |
$733.20
|
| Rate for Payer: Prime Health Services Commercial |
$958.80
|
|
|
HC ENDOLUMINAL BX BILIARY TREE
|
Facility
|
IP
|
$1,263.00
|
|
|
Service Code
|
CPT 47543
|
| Hospital Charge Code |
909047543
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$252.60 |
| Max. Negotiated Rate |
$1,136.70 |
| Rate for Payer: Cash Price |
$568.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,010.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$505.20
|
| Rate for Payer: Galaxy Health WC |
$1,073.55
|
| Rate for Payer: Global Benefits Group Commercial |
$757.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,136.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$842.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$481.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.60
|
| Rate for Payer: Multiplan Commercial |
$947.25
|
| Rate for Payer: Networks By Design Commercial |
$820.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,073.55
|
|
