|
HC I & D THYROGLOSSAL DUCT CYST
|
Facility
|
IP
|
$4,689.00
|
|
|
Service Code
|
CPT 60000
|
| Hospital Charge Code |
900501674
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$937.80 |
| Max. Negotiated Rate |
$4,220.10 |
| Rate for Payer: Adventist Health Commercial |
$937.80
|
| Rate for Payer: Cash Price |
$2,578.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,751.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,875.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,875.60
|
| Rate for Payer: Galaxy Health WC |
$3,985.65
|
| Rate for Payer: Global Benefits Group Commercial |
$2,813.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,220.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,127.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,786.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,902.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$937.80
|
| Rate for Payer: Multiplan Commercial |
$3,516.75
|
| Rate for Payer: Networks By Design Commercial |
$3,047.85
|
| Rate for Payer: Prime Health Services Commercial |
$3,985.65
|
|
|
HC I & D VAGINAL HEMATOMA
|
Facility
|
IP
|
$6,832.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
902400747
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,366.40 |
| Max. Negotiated Rate |
$6,148.80 |
| Rate for Payer: Adventist Health Commercial |
$1,366.40
|
| Rate for Payer: Cash Price |
$3,757.60
|
| Rate for Payer: Central Health Plan Commercial |
$5,465.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,732.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,732.80
|
| Rate for Payer: Galaxy Health WC |
$5,807.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,099.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,148.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,556.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,602.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,229.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,366.40
|
| Rate for Payer: Multiplan Commercial |
$5,124.00
|
| Rate for Payer: Networks By Design Commercial |
$4,440.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,807.20
|
|
|
HC I & D VAGINAL HEMATOMA
|
Facility
|
IP
|
$6,832.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
902400747
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,366.40 |
| Max. Negotiated Rate |
$6,148.80 |
| Rate for Payer: Adventist Health Commercial |
$1,366.40
|
| Rate for Payer: Cash Price |
$3,757.60
|
| Rate for Payer: Central Health Plan Commercial |
$5,465.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,732.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,732.80
|
| Rate for Payer: Galaxy Health WC |
$5,807.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,099.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,148.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,556.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,602.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,229.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,366.40
|
| Rate for Payer: Multiplan Commercial |
$5,124.00
|
| Rate for Payer: Networks By Design Commercial |
$4,440.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,807.20
|
|
|
HC I & D VAGINAL HEMATOMA
|
Facility
|
OP
|
$6,832.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
902400747
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$581.00 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Commercial |
$1,366.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,636.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,636.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,174.35
|
| Rate for Payer: Blue Shield of California EPN |
$2,725.97
|
| Rate for Payer: Cash Price |
$3,757.60
|
| Rate for Payer: Cash Price |
$3,757.60
|
| Rate for Payer: Cash Price |
$3,757.60
|
| Rate for Payer: Central Health Plan Commercial |
$5,465.60
|
| Rate for Payer: Cigna of CA HMO |
$4,372.48
|
| Rate for Payer: Cigna of CA PPO |
$5,055.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,000.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,636.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,909.30
|
| Rate for Payer: EPIC Health Plan Senior |
$3,636.52
|
| Rate for Payer: Galaxy Health WC |
$5,807.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,099.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,148.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,963.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,636.52
|
| Rate for Payer: InnovAge PACE Commercial |
$5,454.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,556.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,602.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,636.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,366.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,872.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,872.94
|
| Rate for Payer: Multiplan Commercial |
$5,124.00
|
| Rate for Payer: Networks By Design Commercial |
$4,440.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,636.52
|
| Rate for Payer: Prime Health Services Commercial |
$5,807.20
|
| Rate for Payer: Prime Health Services Medicare |
$3,854.71
|
| Rate for Payer: Riverside University Health System MISP |
$4,000.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,099.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,099.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,091.00
|
| Rate for Payer: United Healthcare All Other HMO |
$839.00
|
| Rate for Payer: United Healthcare HMO Rider |
$635.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$581.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,636.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Vantage Medical Group Senior |
$3,636.52
|
|
|
HC I & D VAGINAL HEMATOMA
|
Facility
|
OP
|
$6,832.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
902400747
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Commercial |
$1,366.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,636.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$5,794.14
|
| Rate for Payer: Cash Price |
$3,757.60
|
| Rate for Payer: Cash Price |
$3,757.60
|
| Rate for Payer: Cash Price |
$3,757.60
|
| Rate for Payer: Cash Price |
$3,757.60
|
| Rate for Payer: Central Health Plan Commercial |
$5,465.60
|
| Rate for Payer: Cigna of CA HMO |
$4,372.48
|
| Rate for Payer: Cigna of CA PPO |
$5,055.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,000.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,636.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,909.30
|
| Rate for Payer: EPIC Health Plan Senior |
$3,636.52
|
| Rate for Payer: Galaxy Health WC |
$5,807.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,099.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,148.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,963.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,636.52
|
| Rate for Payer: InnovAge PACE Commercial |
$5,454.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,556.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,602.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,636.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,366.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,872.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,872.94
|
| Rate for Payer: Multiplan Commercial |
$5,124.00
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: Networks By Design Commercial |
$4,440.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,636.52
|
| Rate for Payer: Preferred Health Network WC |
$5,912.39
|
| Rate for Payer: Prime Health Services Commercial |
$5,807.20
|
| Rate for Payer: Prime Health Services Medicare |
$3,854.71
|
| Rate for Payer: Prime Health Services WC |
$5,735.02
|
| Rate for Payer: Riverside University Health System MISP |
$4,000.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,099.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,416.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,416.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,416.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,416.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,636.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Vantage Medical Group Senior |
$3,636.52
|
|
|
HC IHC EACH ADDL SINGLE MULTI PER SPEC MEDI
|
Facility
|
OP
|
$660.00
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
903800243
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$110.32 |
| Max. Negotiated Rate |
$749.58 |
| Rate for Payer: Adventist Health Commercial |
$132.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$457.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$400.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$685.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$502.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$457.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$543.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.32
|
| Rate for Payer: Blue Shield of California Commercial |
$400.62
|
| Rate for Payer: Blue Shield of California EPN |
$262.02
|
| Rate for Payer: Cash Price |
$363.00
|
| Rate for Payer: Cash Price |
$363.00
|
| Rate for Payer: Central Health Plan Commercial |
$528.00
|
| Rate for Payer: Cigna of CA HMO |
$422.40
|
| Rate for Payer: Cigna of CA PPO |
$488.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$685.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$502.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$457.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$617.03
|
| Rate for Payer: EPIC Health Plan Senior |
$457.06
|
| Rate for Payer: Galaxy Health WC |
$561.00
|
| Rate for Payer: Global Benefits Group Commercial |
$396.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$594.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$749.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$180.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$457.06
|
| Rate for Payer: InnovAge PACE Commercial |
$685.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$440.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$199.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$457.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$612.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$612.46
|
| Rate for Payer: Multiplan Commercial |
$495.00
|
| Rate for Payer: Networks By Design Commercial |
$429.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$457.06
|
| Rate for Payer: Prime Health Services Commercial |
$561.00
|
| Rate for Payer: Prime Health Services Medicare |
$484.48
|
| Rate for Payer: Riverside University Health System MISP |
$502.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$396.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$396.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.94
|
| Rate for Payer: United Healthcare All Other HMO |
$240.94
|
| Rate for Payer: United Healthcare HMO Rider |
$240.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.94
|
| Rate for Payer: Upland Medical Group Pediatric |
$457.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$685.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$502.77
|
| Rate for Payer: Vantage Medical Group Senior |
$457.06
|
|
|
HC IHC EACH ADDL SINGLE MULTI PER SPEC MEDI
|
Facility
|
IP
|
$660.00
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
903800243
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$132.00 |
| Max. Negotiated Rate |
$594.00 |
| Rate for Payer: Adventist Health Commercial |
$132.00
|
| Rate for Payer: Cash Price |
$363.00
|
| Rate for Payer: Central Health Plan Commercial |
$528.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$264.00
|
| Rate for Payer: EPIC Health Plan Senior |
$264.00
|
| Rate for Payer: Galaxy Health WC |
$561.00
|
| Rate for Payer: Global Benefits Group Commercial |
$396.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$594.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$440.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$251.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$408.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.00
|
| Rate for Payer: Multiplan Commercial |
$495.00
|
| Rate for Payer: Networks By Design Commercial |
$429.00
|
| Rate for Payer: Prime Health Services Commercial |
$561.00
|
|
|
HC IHC FIRST SINGLE MULTI PER SPEC MEDI
|
Facility
|
IP
|
$534.00
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
903800242
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$106.80 |
| Max. Negotiated Rate |
$480.60 |
| Rate for Payer: Adventist Health Commercial |
$106.80
|
| Rate for Payer: Cash Price |
$293.70
|
| Rate for Payer: Central Health Plan Commercial |
$427.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$213.60
|
| Rate for Payer: EPIC Health Plan Senior |
$213.60
|
| Rate for Payer: Galaxy Health WC |
$453.90
|
| Rate for Payer: Global Benefits Group Commercial |
$320.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$480.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$356.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$203.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$330.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$106.80
|
| Rate for Payer: Multiplan Commercial |
$400.50
|
| Rate for Payer: Networks By Design Commercial |
$347.10
|
| Rate for Payer: Prime Health Services Commercial |
$453.90
|
|
|
HC IHC FIRST SINGLE MULTI PER SPEC MEDI
|
Facility
|
OP
|
$534.00
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
903800242
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$14.08 |
| Max. Negotiated Rate |
$480.60 |
| Rate for Payer: Adventist Health Commercial |
$106.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$217.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$324.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$217.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$69.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.08
|
| Rate for Payer: Blue Shield of California Commercial |
$324.14
|
| Rate for Payer: Blue Shield of California EPN |
$212.00
|
| Rate for Payer: Cash Price |
$293.70
|
| Rate for Payer: Cash Price |
$293.70
|
| Rate for Payer: Central Health Plan Commercial |
$427.20
|
| Rate for Payer: Cigna of CA HMO |
$341.76
|
| Rate for Payer: Cigna of CA PPO |
$395.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$326.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$239.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$217.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$293.94
|
| Rate for Payer: EPIC Health Plan Senior |
$217.73
|
| Rate for Payer: Galaxy Health WC |
$453.90
|
| Rate for Payer: Global Benefits Group Commercial |
$320.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$480.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$357.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$92.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$217.73
|
| Rate for Payer: InnovAge PACE Commercial |
$326.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$356.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$217.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$106.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$291.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$291.76
|
| Rate for Payer: Multiplan Commercial |
$400.50
|
| Rate for Payer: Networks By Design Commercial |
$347.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$217.73
|
| Rate for Payer: Prime Health Services Commercial |
$453.90
|
| Rate for Payer: Prime Health Services Medicare |
$230.79
|
| Rate for Payer: Riverside University Health System MISP |
$239.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$320.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$320.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Upland Medical Group Pediatric |
$217.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Vantage Medical Group Senior |
$217.73
|
|
|
HC ILAC ART ANGIO CARDIAC CATH
|
Facility
|
OP
|
$2,788.00
|
|
|
Service Code
|
CPT G0278
|
| Hospital Charge Code |
906811387
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$13.89 |
| Max. Negotiated Rate |
$2,509.20 |
| Rate for Payer: Adventist Health Commercial |
$557.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,693.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,369.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,533.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,091.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$68.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.89
|
| Rate for Payer: Blue Shield of California Commercial |
$1,692.32
|
| Rate for Payer: Blue Shield of California EPN |
$1,106.84
|
| Rate for Payer: Cash Price |
$1,533.40
|
| Rate for Payer: Cash Price |
$1,533.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,230.40
|
| Rate for Payer: Cigna of CA HMO |
$1,784.32
|
| Rate for Payer: Cigna of CA PPO |
$2,063.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,369.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,369.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,369.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,115.20
|
| Rate for Payer: Galaxy Health WC |
$2,369.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,672.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,509.20
|
| Rate for Payer: InnovAge PACE Commercial |
$1,394.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,859.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,062.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,725.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,951.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,951.60
|
| Rate for Payer: Multiplan Commercial |
$2,091.00
|
| Rate for Payer: Networks By Design Commercial |
$1,812.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,369.80
|
| Rate for Payer: Riverside University Health System MISP |
$1,115.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,672.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,672.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,394.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,394.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,394.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,394.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,369.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,369.80
|
| Rate for Payer: Vantage Medical Group Senior |
$2,369.80
|
|
|
HC ILAC ART ANGIO CARDIAC CATH
|
Facility
|
IP
|
$3,280.00
|
|
|
Service Code
|
CPT G0278
|
| Hospital Charge Code |
906820131
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$656.00 |
| Max. Negotiated Rate |
$2,952.00 |
| Rate for Payer: Adventist Health Commercial |
$656.00
|
| Rate for Payer: Cash Price |
$1,804.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,624.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,312.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,312.00
|
| Rate for Payer: Galaxy Health WC |
$2,788.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,968.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,952.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,187.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,249.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,030.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$656.00
|
| Rate for Payer: Multiplan Commercial |
$2,460.00
|
| Rate for Payer: Networks By Design Commercial |
$2,132.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,788.00
|
|
|
HC ILAC ART ANGIO CARDIAC CATH
|
Facility
|
IP
|
$2,788.00
|
|
|
Service Code
|
CPT G0278
|
| Hospital Charge Code |
906811387
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$557.60 |
| Max. Negotiated Rate |
$2,509.20 |
| Rate for Payer: Adventist Health Commercial |
$557.60
|
| Rate for Payer: Cash Price |
$1,533.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,230.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,115.20
|
| Rate for Payer: Galaxy Health WC |
$2,369.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,672.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,509.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,859.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,062.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,725.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.60
|
| Rate for Payer: Multiplan Commercial |
$2,091.00
|
| Rate for Payer: Networks By Design Commercial |
$1,812.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,369.80
|
|
|
HC ILAC ART ANGIO CARDIAC CATH
|
Facility
|
OP
|
$3,280.00
|
|
|
Service Code
|
CPT G0278
|
| Hospital Charge Code |
906820131
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$13.89 |
| Max. Negotiated Rate |
$2,952.00 |
| Rate for Payer: Adventist Health Commercial |
$656.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,991.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,788.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,804.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,460.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$68.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.89
|
| Rate for Payer: Blue Shield of California Commercial |
$1,990.96
|
| Rate for Payer: Blue Shield of California EPN |
$1,302.16
|
| Rate for Payer: Cash Price |
$1,804.00
|
| Rate for Payer: Cash Price |
$1,804.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,624.00
|
| Rate for Payer: Cigna of CA HMO |
$2,099.20
|
| Rate for Payer: Cigna of CA PPO |
$2,427.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,788.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,788.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,788.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,312.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,312.00
|
| Rate for Payer: Galaxy Health WC |
$2,788.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,968.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,952.00
|
| Rate for Payer: InnovAge PACE Commercial |
$1,640.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,187.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,249.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,030.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$656.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,296.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,296.00
|
| Rate for Payer: Multiplan Commercial |
$2,460.00
|
| Rate for Payer: Networks By Design Commercial |
$2,132.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,788.00
|
| Rate for Payer: Riverside University Health System MISP |
$1,312.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,968.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,968.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,640.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,640.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,640.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,640.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,788.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,788.00
|
| Rate for Payer: Vantage Medical Group Senior |
$2,788.00
|
|
|
HC ILEOSCOPY STOMA W/BALLOON DILATION
|
Facility
|
OP
|
$6,574.00
|
|
|
Service Code
|
CPT 44381
|
| Hospital Charge Code |
950442410
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,314.80 |
| Max. Negotiated Rate |
$7,764.00 |
| Rate for Payer: Adventist Health Commercial |
$1,314.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,410.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,410.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,764.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,851.77
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$3,615.70
|
| Rate for Payer: Cash Price |
$3,615.70
|
| Rate for Payer: Cash Price |
$3,615.70
|
| Rate for Payer: Central Health Plan Commercial |
$5,259.20
|
| Rate for Payer: Cigna of CA HMO |
$4,207.36
|
| Rate for Payer: Cigna of CA PPO |
$4,864.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,651.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,410.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,253.93
|
| Rate for Payer: EPIC Health Plan Senior |
$2,410.32
|
| Rate for Payer: Galaxy Health WC |
$5,587.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,944.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,916.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,952.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,410.32
|
| Rate for Payer: InnovAge PACE Commercial |
$3,615.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,384.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,410.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,314.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,229.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,229.83
|
| Rate for Payer: Multiplan Commercial |
$4,930.50
|
| Rate for Payer: Networks By Design Commercial |
$4,273.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Prime Health Services Commercial |
$5,587.90
|
| Rate for Payer: Prime Health Services Medicare |
$2,554.94
|
| Rate for Payer: Riverside University Health System MISP |
$2,651.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,944.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,892.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,410.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,410.32
|
|
|
HC ILEOSCOPY STOMA W/BALLOON DILATION
|
Facility
|
IP
|
$6,574.00
|
|
|
Service Code
|
CPT 44381
|
| Hospital Charge Code |
950442410
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,314.80 |
| Max. Negotiated Rate |
$5,916.60 |
| Rate for Payer: Adventist Health Commercial |
$1,314.80
|
| Rate for Payer: Cash Price |
$3,615.70
|
| Rate for Payer: Central Health Plan Commercial |
$5,259.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,629.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,629.60
|
| Rate for Payer: Galaxy Health WC |
$5,587.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,944.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,916.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,384.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,504.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,069.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,314.80
|
| Rate for Payer: Multiplan Commercial |
$4,930.50
|
| Rate for Payer: Networks By Design Commercial |
$4,273.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,587.90
|
|
|
HC ILEOSCOPY STOMA W BX
|
Facility
|
OP
|
$5,368.00
|
|
|
Service Code
|
CPT 44382
|
| Hospital Charge Code |
906744382
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$187.62 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$1,073.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,191.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$2,952.40
|
| Rate for Payer: Cash Price |
$2,952.40
|
| Rate for Payer: Cash Price |
$2,952.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,294.40
|
| Rate for Payer: Cigna of CA HMO |
$3,435.52
|
| Rate for Payer: Cigna of CA PPO |
$3,972.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,608.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,191.26
|
| Rate for Payer: Galaxy Health WC |
$4,562.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,220.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,831.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,953.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$187.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: InnovAge PACE Commercial |
$1,786.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,580.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$207.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,191.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,073.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,596.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,596.29
|
| Rate for Payer: Multiplan Commercial |
$4,026.00
|
| Rate for Payer: Networks By Design Commercial |
$3,489.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,191.26
|
| Rate for Payer: Prime Health Services Commercial |
$4,562.80
|
| Rate for Payer: Prime Health Services Medicare |
$1,262.74
|
| Rate for Payer: Riverside University Health System MISP |
$1,310.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,220.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,429.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,191.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
HC ILEOSCOPY STOMA W BX
|
Facility
|
IP
|
$5,368.00
|
|
|
Service Code
|
CPT 44382
|
| Hospital Charge Code |
906744382
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,073.60 |
| Max. Negotiated Rate |
$4,831.20 |
| Rate for Payer: Adventist Health Commercial |
$1,073.60
|
| Rate for Payer: Cash Price |
$2,952.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,294.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,147.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,147.20
|
| Rate for Payer: Galaxy Health WC |
$4,562.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,220.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,831.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,580.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,045.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,322.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,073.60
|
| Rate for Payer: Multiplan Commercial |
$4,026.00
|
| Rate for Payer: Networks By Design Commercial |
$3,489.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,562.80
|
|
|
HC ILEOSCOPY STOMA W WO COLLECT
|
Facility
|
OP
|
$5,368.00
|
|
|
Service Code
|
CPT 44380
|
| Hospital Charge Code |
906744380
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$159.87 |
| Max. Negotiated Rate |
$4,831.20 |
| Rate for Payer: Adventist Health Commercial |
$1,073.60
|
| 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 |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,898.06
|
| Rate for Payer: Cash Price |
$2,952.40
|
| Rate for Payer: Cash Price |
$2,952.40
|
| Rate for Payer: Cash Price |
$2,952.40
|
| Rate for Payer: Cash Price |
$2,952.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,294.40
|
| Rate for Payer: Cigna of CA HMO |
$3,435.52
|
| Rate for Payer: Cigna of CA PPO |
$3,972.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,608.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,191.26
|
| Rate for Payer: Galaxy Health WC |
$4,562.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,220.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,831.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,953.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: InnovAge PACE Commercial |
$1,786.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,580.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$159.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,191.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,073.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,596.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,596.29
|
| Rate for Payer: Multiplan Commercial |
$4,026.00
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: Networks By Design Commercial |
$3,489.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,191.26
|
| Rate for Payer: Preferred Health Network WC |
$1,936.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,562.80
|
| Rate for Payer: Prime Health Services Medicare |
$1,262.74
|
| Rate for Payer: Prime Health Services WC |
$1,878.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,310.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,220.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,684.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,684.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,684.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,684.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,191.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
HC ILEOSCOPY STOMA W WO COLLECT
|
Facility
|
IP
|
$5,368.00
|
|
|
Service Code
|
CPT 44380
|
| Hospital Charge Code |
906744380
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,073.60 |
| Max. Negotiated Rate |
$4,831.20 |
| Rate for Payer: Adventist Health Commercial |
$1,073.60
|
| Rate for Payer: Cash Price |
$2,952.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,294.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,147.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,147.20
|
| Rate for Payer: Galaxy Health WC |
$4,562.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,220.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,831.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,580.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,045.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,322.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,073.60
|
| Rate for Payer: Multiplan Commercial |
$4,026.00
|
| Rate for Payer: Networks By Design Commercial |
$3,489.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,562.80
|
|
|
HC ILEOSCOPY STOMA W WO COLLECT
|
Facility
|
IP
|
$5,368.00
|
|
|
Service Code
|
CPT 44380
|
| Hospital Charge Code |
906744380
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,073.60 |
| Max. Negotiated Rate |
$4,831.20 |
| Rate for Payer: Adventist Health Commercial |
$1,073.60
|
| Rate for Payer: Cash Price |
$2,952.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,294.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,147.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,147.20
|
| Rate for Payer: Galaxy Health WC |
$4,562.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,220.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,831.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,580.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,045.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,322.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,073.60
|
| Rate for Payer: Multiplan Commercial |
$4,026.00
|
| Rate for Payer: Networks By Design Commercial |
$3,489.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,562.80
|
|
|
HC ILEOSCOPY STOMA W WO COLLECT
|
Facility
|
OP
|
$5,368.00
|
|
|
Service Code
|
CPT 44380
|
| Hospital Charge Code |
906744380
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$144.72 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$1,073.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,191.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$2,952.40
|
| Rate for Payer: Cash Price |
$2,952.40
|
| Rate for Payer: Cash Price |
$2,952.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,294.40
|
| Rate for Payer: Cigna of CA HMO |
$3,435.52
|
| Rate for Payer: Cigna of CA PPO |
$3,972.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,608.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,191.26
|
| Rate for Payer: Galaxy Health WC |
$4,562.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,220.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,831.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,953.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$144.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: InnovAge PACE Commercial |
$1,786.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,580.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$159.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,191.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,073.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,596.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,596.29
|
| Rate for Payer: Multiplan Commercial |
$4,026.00
|
| Rate for Payer: Networks By Design Commercial |
$3,489.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,191.26
|
| Rate for Payer: Prime Health Services Commercial |
$4,562.80
|
| Rate for Payer: Prime Health Services Medicare |
$1,262.74
|
| Rate for Payer: Riverside University Health System MISP |
$1,310.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,220.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,429.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,191.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
HC ILEOSCOPY W/STNT PLCMNT
|
Facility
|
IP
|
$6,416.00
|
|
|
Service Code
|
CPT 44383
|
| Hospital Charge Code |
906744383
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,283.20 |
| Max. Negotiated Rate |
$5,774.40 |
| Rate for Payer: Adventist Health Commercial |
$1,283.20
|
| Rate for Payer: Cash Price |
$3,528.80
|
| Rate for Payer: Central Health Plan Commercial |
$5,132.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,566.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,566.40
|
| Rate for Payer: Galaxy Health WC |
$5,453.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,849.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,774.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,279.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,444.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,971.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,283.20
|
| Rate for Payer: Multiplan Commercial |
$4,812.00
|
| Rate for Payer: Networks By Design Commercial |
$4,170.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,453.60
|
|
|
HC ILEOSCOPY W/STNT PLCMNT
|
Facility
|
OP
|
$8,470.00
|
|
|
Service Code
|
CPT 44384
|
| Hospital Charge Code |
906744384
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,694.00 |
| Max. Negotiated Rate |
$7,623.00 |
| Rate for Payer: Adventist Health Commercial |
$1,694.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,410.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,410.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$4,658.50
|
| Rate for Payer: Cash Price |
$4,658.50
|
| Rate for Payer: Cash Price |
$4,658.50
|
| Rate for Payer: Central Health Plan Commercial |
$6,776.00
|
| Rate for Payer: Cigna of CA HMO |
$5,420.80
|
| Rate for Payer: Cigna of CA PPO |
$6,267.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,651.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,410.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,253.93
|
| Rate for Payer: EPIC Health Plan Senior |
$2,410.32
|
| Rate for Payer: Galaxy Health WC |
$7,199.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,082.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,623.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,952.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,410.32
|
| Rate for Payer: InnovAge PACE Commercial |
$3,615.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,649.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,410.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,694.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,229.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,229.83
|
| Rate for Payer: Multiplan Commercial |
$6,352.50
|
| Rate for Payer: Networks By Design Commercial |
$5,505.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Prime Health Services Commercial |
$7,199.50
|
| Rate for Payer: Prime Health Services Medicare |
$2,554.94
|
| Rate for Payer: Riverside University Health System MISP |
$2,651.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,082.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,892.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,410.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,410.32
|
|
|
HC ILEOSCOPY W/STNT PLCMNT
|
Facility
|
IP
|
$8,470.00
|
|
|
Service Code
|
CPT 44384
|
| Hospital Charge Code |
906744384
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,694.00 |
| Max. Negotiated Rate |
$7,623.00 |
| Rate for Payer: Adventist Health Commercial |
$1,694.00
|
| Rate for Payer: Cash Price |
$4,658.50
|
| Rate for Payer: Central Health Plan Commercial |
$6,776.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,388.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,388.00
|
| Rate for Payer: Galaxy Health WC |
$7,199.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,082.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,623.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,649.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,227.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,242.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,694.00
|
| Rate for Payer: Multiplan Commercial |
$6,352.50
|
| Rate for Payer: Networks By Design Commercial |
$5,505.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,199.50
|
|
|
HC ILEOSCOPY W/STNT PLCMNT
|
Facility
|
OP
|
$6,416.00
|
|
|
Service Code
|
CPT 44383
|
| Hospital Charge Code |
906744383
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,283.20 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,283.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,453.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,528.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,812.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,106.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,768.12
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,528.80
|
| Rate for Payer: Cash Price |
$3,528.80
|
| Rate for Payer: Central Health Plan Commercial |
$5,132.80
|
| Rate for Payer: Cigna of CA HMO |
$4,106.24
|
| Rate for Payer: Cigna of CA PPO |
$4,747.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,453.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,453.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,453.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,566.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,566.40
|
| Rate for Payer: Galaxy Health WC |
$5,453.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,849.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,774.40
|
| Rate for Payer: InnovAge PACE Commercial |
$3,208.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,279.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,444.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,971.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,283.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,491.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,491.20
|
| Rate for Payer: Multiplan Commercial |
$4,812.00
|
| Rate for Payer: Networks By Design Commercial |
$4,170.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,453.60
|
| Rate for Payer: Riverside University Health System MISP |
$2,566.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,849.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,849.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,208.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,208.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,208.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,453.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,453.60
|
| Rate for Payer: Vantage Medical Group Senior |
$5,453.60
|
|
